Saturday, August 23, 2008
Friday, July 11, 2008
Attendees included all kinds of people in service professions: doctors, medical students, nurses, pastors, therapists, dentists, social workers, and teachers. It is no surprise that many of us value human connections in our lives and work. But what might be surprising is that many of us overlook the sheer power of telling stories about our lives -- and listening to those of others.
Medicine in particular seems to force us to adhere to interview protocols, with little time for veering outside those informatic lines into more personal, soulful areas. Yet these are often the very areas where healing is most needed. We also forget that what touches people (including us) is not data, but stories to which we can relate. Numbers can be important, but context and relatedness allow us both to feel and be moved.
One of the workshop exercises was to think of a disappointment in our lives, and to describe our emotional response to this with written adjectives. Then, we divided into pairs. We were to tell the story of this disappointment to our partner, with the partner attending carefully but not speaking or intervening.
What happened for me was profound.
I looked in the eyes of my partner, knowing only that she agreed to confidentiality about my story. I chose to tell about a loss that was nearly 20 years old -- it simply popped into my mind when Dr. Remen told shared the exercise. I did not realize the depth of my own emotion about this.
Within minutes my story flowed, and so did my tears. My partner said nothing, but her caring expression remained throughout. At the actual time of my loss, I had not been able to grieve this well -- mostly because of little support, feelings of shame, and need to keep working. Here, now, was opportunity -- but I had no idea where this would go. I had thought I was "done" with that. After all, it was nearly 20 years ago!
I wasn't. But, in the space of 15 minutes of being allowed to simply "be" as I was, my feelings shifted from anguish and pain to forgiveness and relief. The loss was still there, but somehow this could be part of my life rather than something walled-off from it. It became warm and gentle rather than cold and severe. Amazing process, this listening, telling, and being heard.
Of course I went into medicine to do this -- to attend quietly to the true selves of my patients. But having this done for me? It doesn't happen so often -- and I am very grateful. In a world where most managed care insurance limits time with physicians, the healing power of our listening is devalued. I appreciated re-experiencing how healing, how essential, and how powerful the act of simply listening can be.
Saturday, February 23, 2008
Although Miller closed this brewery in 2003, I recently remembered the slogan while taking a course called "Leadership in Green Health Care", through Teleosis Institute in Berkeley, CA. It educates physicians about the link between our environment, medicine, and human health. The whole idea of "Sustainable Medicine" is to provide better health care while also protecting our limited environmental and medical resources. It's an up-and-coming trend, I hope.
Part of the course involved learning about all the medicines in our water supplies . . . including Prozac, Zoloft, and Lipitor. Did you know your personal metabolic by-products can survive waste-treatment plants and end up in rivers, lakes, and oceans?
An even larger culprit is the practice of flushing unused medicines down the toilet. Did your doctor or pharmacist ever tell you to do this?
There must be some un-depressed fish with low cholesterol swimming in our streams, rivers, and oceans these days. Maybe they're having their endocrine and neurological systems rearranged in other ways too. And then we eat them. hmmm . . . . could there be a problem here?
There's a brief podcast on Marketplace about this issue, also mentioning medicine take-back programs being set up in various cities so that this kind of pollution won't happen. The medicines can be incinerated so they don't impact marine life. Of course, drug companies feel this is much ado about nothing -- could it be because they might have to pay for ways to avoid polluting water supplies with their products? hmmmm . . .
Personally, I like clean water. And, I vote for staying as healthy as we can so we need less medicine in the first place.
Wednesday, February 06, 2008
It's a question that troubles our society (including Psychiatry).
Coached by pharmaceutical companies, some might believe immediate intervention is needed for any 'down' emotions whatsoever. Lose your boyfriend? Get fired from a job? Here: take a Prozac, it'll be all better.
As a psychiatrist I know there's a difference between life-numbing depression and basic everyday suffering. Not to discount the painfulness of the latter, this difference matters even if it's not always clear.
A patient come in the other day telling me about his first visit with another psychiatrist. "Within the first 15 minutes," he said, "that doctor started writing prescriptions and explaining how they would help me 'feel better.' But I wanted to know what I was feeling better from."
He tried the medicines (antidepressants and antianxiety agents) for awhile, but wanted a second opinion and possibly different approach.
I thought about how pressured we often are to feel "good" these days, as if there is no room for regular human discomfort -- even suffering. But, short of life-sapping depression that engulfs us in apathy, can't sadness and discontent alert us to things needing change? Can they even result in growth? This has often been true in my own life . . . and probably in both Barack Obama's and Hillary Clinton's campaigns. :-)
This week Newsweek (Feb 11, 2008) published a story entitled: "Happiness: enough already" ; it is a kind of backlash against being flooded with demands for constant joy. We've been flooded by ads for well-being, as if normal ebb and flow of emotional responses cannot be a part of this.
I admit that Sigmund Freud's idea of successful psychoanalysis sounded pretty dour: "substituting hysterical misery for basic human unhappiness." We focused on pathology for so many years, leaving out what facilitates health and healing. Then there was valuable research on happiness, resulting in an entire field: "Positive Psychology". Nothing wrong with that -- but what about regular okayness, simply being?
Jerome Wakefield, a professor at New York University, tells all about it in his book: The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder.
Making room for this seems realistic to me, but maybe Pfizer and others will disagree.
Sunday, January 20, 2008
Yet there are many studies supporting the adjunctive use of mindfulness-based stress reduction, for instance, in conditions such as chronic pain, heart disease, psoriasis, and hypertension -- not to mention conditions said to be 'emotional', like anxiety disorders.
Enter another area for consideration: Ho'oponopono, a spiritual practice developed and used in Hawaii for centuries.
Ho'oponopono, which means "to make right" or "to correct an error", is a step-by-step problem-solving approach to identify and relieve stress. Though it one learns to care appropriately for the self through a practice of repentance, forgiveness, and transmutation. This process helps one develop a better working relationship between the conscious mind, subconscious, and superconscious (mind, body, and spirit), increasing self-understanding and self-acceptance.
Self-Identity through Ho'oponopono is a modernized version of the process created by a kahuna healer named Morrnah Simeona, and is now taught worldwide through The Foundation of I.
Might this spiritual practice also have physical health effects?
Kikikipa Kretzer PhD et al recently published a pilot study, "Self-Identity through Ho'oponopono as adjunctive therapy for hypertension management," in Ethnicity and Disease. They wondered whether Self-Identity through Ho'oponopono along with standard medical therapy might better control hypertension than standard therapy alone.
Serving as their own controls, 23 adults over age 30 with hypertension or pre-hypertension participated in a half-day class on Self-Identity through Ho'oponopono. They learned how to apply this process in their everyday lives. Systolic blood pressure decreased after the intervention, averaging 11.86 mm Hg below pre-intervention levels. Diastolic blood pressure decreased by 5.44 mm Hg. These findings were both statisically and clinically significant.
Reading the actual research paper shows that blood pressures decreased more over the 1-2 months following the intervention, than on the class day itself. Intriguingly, blood pressures even increased slightly on the class day. Why?
I wondered if class participants might have experienced increased stress with new (and maybe unfamiliar) ideas about themselves and their health. This possible effect, mirrored in the blood pressure readings, does seem to have tapered with ongoing time and practice after the class.
How many of our blood pressures rise when someone or something first challenges our long-held assumptions? What if the world really is drastically different -- and much more complex -- than we'd like to believe? hmmm . . . .
Having such spiritual resources within us can be a great relief, once we get over the shock of having them. :-)
The study included measures of spirituality before and after the classes; these scores increased significantly after the intervention.
Also, 91% of study participants wanted more personal involvement in their healthcare treatments. Providing a simple way to deal with stress, Ho'oponopono could allow such involvement while also improving blood pressures.
In this study, Self-Identity through Ho'oponopono offered a low-cost, low-risk, and readily accessible intervention associated with lower blood pressures and improved feelings of well-being in participants.
Though some will say the study is "small" (only 23 subjects), it carries big implications. I'm hoping the authors will explore further -- and that people like us will stay tuned.
Saturday, January 12, 2008
In it Verghese describes his friendship with a medical resident who plays beautiful tennis, is brilliant at patient care, and who fills a deep need for companionship during Verghese's marital separation. Unfortunately, the friend also turns out to be addicted to cocaine.
The author's ability to honestly share his own feelings is rare in medicine, since many of us try to run from emotions we might think are 'negative'. But Verghese expresses pain, jealousy, anger, and intense grief along with compassion, humor, and authentic love for patients, students, family, and work. Also he details minute, earthy characteristics of his surroundings and those who people his life. Through this kind of writing, we are present: seeing, hearing, feeling, smelling, and almost tasting everything.
I could not put the book down.
Writing a book like this takes courage, and yet it also must be like a rushing rapid at times; the story and experience must come out. The author is a witness to what flows through him or her. Not all are as honest with this as Verghese, though. When your soul writes the book, people can feel it; also, their own pain resonates to the surface to be re-experienced and dealt with. Perhaps healing can come about in this way too.
There is a Healer within each of us, which can awaken when others' harmonics call. Verghese wrote his book with purpose and intent, and it could certainly have served his healing from the loss of an intelligent, talented, yet vulnerable friend. However, it was also no accident that I picked up the book, and reacted to myself and ungrieved prior losses through it. With those, there was more acknowledgement and releasing to do.
I am grateful, Dr. Verghese, for your gift. I am grateful also to the Healer within all of us.
Saturday, January 05, 2008
Thanks to Dr. Dan Benor of Wholistic Healing Research for his email containing the following: