Mind over medicine
p. 68 Mind over Medicine - Revised Edition. Lissa Rankin, M.D. Scientific Proof that you can heal yourself. june 9, 2020
A radical new kind of Health Questions:
Dig into their personal lives, asking questions most doctors had never thought of.
a. Is anything keeping you from being the most authentic, vital you?
b. If so, what is holding you back?
c. What do you love and celebrate about yourself?
d. What’s missing from your life?
e. What do you appreciate about your life?
f. Are you in a romantic relationship?
g. If so, are you happy?
h. If not, do you wish you were?
i. Are you fulfilled at work?
j. Do you feel like you’re in touch with your life purpose?
k. Do you feel sexually satisfied, either with a partner or by yourself?
l. Do you express yourself creatively? How?
m.If not, do you feel creatively thwarted, like there’s something within you dying to come out?
n. Do you feel financially healthy or is money a stressors in your life?
o. If your fairy godmother could change one thing about your life, what would you wish for?
p. What rules do you follow that you wish you could break?
q. What’s missing from your life?
It provides more insight into why they’re sick than any lab test, medical record, or x-ray exam could. The diagnosis was crystal clear in a way I previously had missed because i wasn’t asking the right questions.
Patients are unhealthy, not because of bad genes or poor health habits or rotten luck, but because they were gut-wrenchingly lonely or miserable in their bad relationships, stressed about work, freaked out about their finances, or profoundly depressed.
Majority of patients wept. Something was going on that had nothing to do with vegetables or exercise or vitamins.
Those patients who ate poorly, exercised rarely, forgot to take their supplements, and enjoyed a seemingly perfect health revealed that their lives were filled with love, fun, meaningful work, financial abundance, creative expression, sexual pleasure, spiritual connection, and other traits that differentiated them from the sick health enthusiasts. They were, in essence, happy. And even though they didn’t take the best care of their bodies, their bodies responded with good health.
Ask two mother-lode questions: What do you think might lie at the root of your illness? What does your body need in order to heal?
When I first started asking these questions, I assumed people would tell me that the root cause of their illness was a hormone imbalance or an unhealthy diet. i thought they might share treatment intuitions with me. Things like “I think I’ll choose craniosacral therapy over physical therapy” or “I’m gonna wait on that cholesterol drug and try changing my diet instead.” Occasionally, they answered with insights into conventional health-related modifications they felt they needed to make - things like, “ I really need an antidepressant or “antibiotics should do the trick, or “I need to lose 20 pounds” or “ I really need to get my hormones balanced.”
More often than not, they said things like these: “I give until I’m depleted.” “I’m miserable in my marriage.” “I absolutely hate my job.” “I need more ‘me’ time.” “I’m so lonely I cry myself to sleep every night.” “I’m out of touch with my life's purpose.” “I don’t feel God anymore.” “I have myself so much I can’t look at myself in the mirror.” “I’m avoiding facing the truth.” “I can’t forgive myself for what I’ve done.” “I’m living a lie and I feel like a total fraud.”
What does your body need in order to heal? Answers: “I have to quit my job.” “It’s time to finally come out of the closet to my parents.” “I must divorce my spouse.” “I have to finish my novel.” “ Need to hire a nanny.” I’m so lonely, I need to make more friends.” “I need to meditate everyday.” “I have to tell my husband I’m having an affair.” “I need to forgive myself.” “I need to love myself.” “I need to stop being such a pessimist.”
While many of them were simply not ready to do that they knew their intuition told them their bodies needed, some of them made radical changes. The results of those who followed their intuition were astonishing. Sometimes, a laundry list of illnesses would disappear, often very quickly. Some were healing themselves after years of medical therapies had proven useless.
Maria was a picture of a health enthusiast. She ate a vegetarian diet, hiked, did meditation, competed in triathlons, took dozens of supplements, avoided alcohol, smoking and using illegal drugs. But, she had a medical chart twenty four inches thick and suffered from four different chronic health conditions. She came to see if I could figure out why she was still sick in spite of all of her efforts to get well. On further questioning, it came out that Maria was miserable. She was in a physically and mentally abusive marriage and hadn’t had sex in two years. She felt creatively thwarted because her husband didn’t support her passion for art and she was so busy at work and training for races, she didn’t make time to paint. Plus, she was exhausted from caring for her aging, sick mother who lived in her home.
I knew that her body would never heal until those aspects of her life are healed. With all those negative emotions filing her mind and all those stress hormones coursing through her body, no vegetable, exercise, supplements or drug was going to be strong enough to counteract the harmful health effects of chronic stress responses on her body.
When asked, “What does your body need in order to heal?” She responded, “I need to move to Jacksonville.” “Why Jacksonville?” “I have a vacation home there and whenever I go there, all of my symptoms disappear.”
Maria went and a year later, she said that she helped her mother get into a wonderful retirement community close to where her vacation home is so she can visit weekly, she also filed for divorce, enrolled in an art school and then met a man that she fell in love with. She is enjoying hiking, biking, and painting. All of her symptoms had disappeared within three months of her move.
The lifestyle choices you make can result in physiological changes in the body - extended to the people you interact with in your personal and professional life, how much creative freedom you experience, how spiritually connected you feel, your relationship with money, and how happy you are. People who make happy, healthy life choices, such as finding a loving, supportive life partner, having close relationships with friends and family, and engaging in work they love lead lives full of positivity, which optimize the relaxation response counteract the stress response and lead to better health.
Stress - ‘what do you expect me to do about it’ sort of way.
In order to live a vital life, prevent disease, or optimize the chance for disease remission, you need:
Healthy relationships, including a strong network of family, friends, loved ones, and colleagues.
A healthy, meaningful way to spend your days, whether you work outside the home or in it.
A healthy, fully expressed creative life that allows your soul to sing its song.
A healthy spiritual life, including a sense of connection to the sacred in life.
A healthy sexual life that allows you the freedom to express your erotic self.
A healthy financial life, free of undue financial stress, which ensures that the essential needs of your body are met.
A healthy environment, free of toxins, natural-disaster hazards, radiation, and other unhealthy factors that threaten the health of the body.
A healthy mental and emotional life, characterized by optimism and happiness and free of fear, anxiety, depression and other mental-health ailments.
A healthy lifestyle that supports the physical health of the body, such as good nutrition, regular exercise, adequate sleep, and avoidance of unhealthy addictions.
Your thoughts are powerful. your conscious mind - which resides in the forebrain - knows you’re frightened. but your lizard brain - the area near your brainstem that houses the hypothalamus - can’t tell the difference between an abstract fear thought and a real live survival threat. Your lizard brain thinks you’re about to die, and this stimulates the stress response, setting off the fight-or-flight mechanisms, activating the HPA axis, flipping on the sympathetic nervous system, shutting down your immune system, and getting you ready to run away from danger.
When your body is in the middle of a stress response, your body’s self-maintenance and self-repair functions come to a screeching halt. these stress responses were meant to be triggered only very rarely. The healthy body is supposed to be in a relaxed state of physiological rest most of the time.
Feelings like fear, anxiety, anger, frustration, resentment, and other negative emotions trigger the HPA axis. Whether or not your body is in danger, your mind believes you are, so your hypothalamus is activated and releases corticotrophin-releasing factor (CRF) into the nervous system. CRF responds by stimulating the pituitary gland, causing it to secret prolactin, growth hormone, and adrenocorticotropic hormone (ACTH) which stimulate the adrenal gland and cause it to release cortisol, which in turn is responsible for helping the body maintain homeostasis when the brain signals a threat.
When the hypothalamus is activated, it also turns on the sympathetic nervous system (the fight-or-flight response), causing the adrenal glands to release epinephrine and norepinephrine, which increase pulse and blood pressure and affect other physiological responses. The secretion of these hormones leads to a variety of metabolic changes all over the body.
Blood vessels traveling to the gastrointestinal tract, hands, and feet constrict, while vessels traveling to the heart, large muscle groups, and brain dilate, preferentially shunting blood to the organs that will help you escape in an emergency. Your pupils dilate so more light can get in. Metabolism speeds up in order to jolt you with a boost of energy by breaking down fat stores and liberating glucose into the bloodstream. Your respiratory rate increases and your bronchi dilate, allowing more oxygen in, and your muscles become tense and ready to sprint away from the perceived threat.
Stomach acid increases and digestive enzymes decrease, often leading to esophageal contractions, diarrhea, or constipation. Cortisol suppresses your immune system to reduce the inflammation that would accompany any wounds the attack might inflict. Reproduction gets shut off - sex is a luxury when there's danger!
Basically, your body ignores sleeping, digesting, and reproducing. Instead it focuses on on running, breathing, thinking, and delivering oxygen and energy in order to keep you safe. When your body is facing a physical threat, these changes help you fight or flee the threat. But when the threat exists only in your mind, the body doesn’t realize that there is no bodily threat. When this stress response is repetitively triggered, nature’s biological response winds up actually doing more harm than good.
As a result, the body can’t relax and repair what inevitably gets ill if not maintained by self-repair mechanisms. Organs get damaged. The cancer cells we naturally make every day, which usually get blasted away by the immune system, are allowed to proliferate. The effects of chronic wear and tear on the human body take their toll, and we wind up sick.
It doesn’t have to be this way. When the conscious forebrain thinks positive thoughts and feels things like love, connection, intimacy, pleasure, and hope, the hypothalamus stops triggering the stress responses. When you feel optimistic and hopeful, loved and supported, in the flow in your professional or creative life, spiritually nourished, or sexually connected to another person, the relaxation response takes the place of the stress response.
The sympathetic nervous system shuts off. Cortisol and adrenaline levels drop. The parasympathetic nervous system takes over. The immune system flips back on. And the body can go about its natural self-repair process, preventing illness and taking its stab at treating disease that already exists. As a result, disease is more likely to be prevented in well people, and disease may even be treated in sick people.
Your thoughts lead to self-healing. The mind has healed the body, and it’s not some New Age metaphysical thing. It’s simply physiology.
Positive belief and nurturing care turn off the stress response, trigger the relaxation response, and return the body to its natural state of physiological rest so it can do what it does best - heal itself.
One of the most profound ways your mind can heal your body is through the relationships in your life. We all know that love heals, but did you know that it heals not just the soul but the body? While loneliness, anger, and resentment are poison for the body, the desire for connection, intimacy, and a sense of belonging with family, lovers, and friends is hardwired in our DNA, and when these desires are fulfilled, our bodies respond with better health. When you find your tribe, feel loved, and surround yourself with the people who know your heart and accept you just the way you are, you optimize the body’s capacity for self-repair and make your body ripe for miracles.
Supportive community as preventive medicine. Healthy relationships are medicine for the mind.
The mind has powerful effects on the physiology of the body.
When was the last time your doctor asked you whether your toxic spouse might be causing your fibromyalgia, or your abusive parent’s tongue-lashing could be predisposing you to heart disease? When was the last time you asked yourself that?
The effect of community of life expectancy. Supportive community impacts health. A study in Alameda County, Ca found that, in every age and sex category, people with the fewest social ties were three times more likely to die over a nine-year period than those who reported the most social ties' even when you account for preexisting health conditions, socioeconomic status, smoking, alcohol consumption, obesity, race, life satisfaction, physical activity and use of preventive health services. Those with more social connections were even found to have lower rates of cancer.
In a New Scientist article about the effects of loneliness on health, Dr.Charles Raison, professor of psychiatry at Emory University School of Medicine, concluded, “People who have rich social lives and warm, open relationships don’t get sick and they live longer.”
Individuals who attend religious services regularly lived seven and a half years longer (almost 14 years for African-Americans) than those who never or rarely attend religious gatherings. People who are part of a spiritual community have also been shown to have lower blood pressure and reduced risk of cardiovascular disease, lower rates of depression and suicide, lower rates of substance abuse, and stronger immune systems. The protective effect on health of weekly attendance at a religious even was so strong that it equaled the effect of no-smoking and regular exercise on health.
Faith in a higher power induce positive emotions, which counteract stress and contribute to the state of physiological rest necessary for the body to repair itself. They also experience better health because they are better able to find meaning in the face of loss or trauma.
Lonely people have been shown to have higher rates of heart disease, breast cancer, AD,and suicidal thoughts. A Swedish study of 1290 patients undergoing heart surgery found that patients who agreed with the statement “I feel lonely” had significantly higher mortality rates post-op.
Brene Brown, professor at the Univ of Houston, and author studies shame, fear and the power of vulnerability to transform shame into intimate connection with other human beings. She teaches that the courage to be vulnerable, the cultivation of compassion for the imperfections of others, and the creation of healthy boundaries set the stage of healthy relationships.
In the Gifts of Imperfection, Brown writes, “If we want to live and love with our whole hearts, and if we want to engage with the world from a place of worthiness, we have to talk about the things that get in the way - especially shame, fear, and vulnerability.”
Have shame resilience - the ability to recognize shame when it rears its ugly head, move through it in a healthy way, hang on to our sense of worthiness and authenticity, and use it to develop more courage, compassion for others who feel their own shame and connection with others as a result.
The difference between guilt and shame is that guilt implies “I did something bad,” while shame suggests, “I am bad.” While guilt is often a motivator to live with more integrity, shame is nothing but poison that gets in the way of authentic relationships. Muster up the courage to be vulnerable and authentic, embracing self-compassion, letting go of perfectionism, and cultivating what she calls “wholeheartedness,” the practice of living and loving with a whole heart.
Death by overwork. Happiness is Preventive Medicine. Hope heals.
A Harvard study for ten years of 1300 men showed that heart disease rates among optimists were half the rates in pessimists. Pessimists are more susceptible to depression, more likely to experience barriers to professional success, less likely to experience pleasure, more likely to endure challenges in their relationships and more likely to get sick. Optimists catch fewer infectious diseases than pessimists, have stronger immune system and lower blood pressures, live longer, and are less likely to suffer from cardiac disease. In one study, pessimists had twice as many infections diseases and twice as many doctor visits as optimists.
Story of 4-year old Joe with stage 4 cancer who waited for his father whom he has never seen.
Story of 8year old Maria with toxic leukemia and needing bone marrow transplant. Parents decided to conceive, but the baby was not a good match. Through the hope process, Maria was miraculously healed.
Control as an antidote to helplessness. Cheerfulness predicts longevity.
Happiness. When you feel happy because you’re anticipating something exciting, your brain lights up in the area of the nucleus accumbent, the pleasure center of the brain. Activation of this part of the brain is most likely related to the neurotransmitter dopamine, which mediates the transfer of positive emotions between the left prefrontal cortex and the emotional centers in the nucleus accumbens. people with sensitive dopamine receptors tend to have better moods.
Dopamine may be the primary neurotransmitter associated with the kind of happiness you get hen you’re moving toward a goal and then achieve it, whereas other neurotransmitters may be responsible for other types of happiness, such as feelings of love or the sensations of physical pleasure. For example, oxytocin, the cuddle hormone, which plays a role in pair bonding and is released when you fall in love or snuggle your child, may explain part of how happiness affects your health. Made in the hypothalamus and secreted by the pituitary gland, oxytocin reduces inflammation by decreasing cytokines. It also indirectly inhibits release of ACTH, thereby down-regulating the HPA axis that gets triggered during the stress response. Happy people have been found to have lower levels of cortisol, most likely because happy people feel less stress, fear, anger, and other emotions known to trigger the stress response.
Oxytocin also activates serotonin receptors, lifting mood, and inhibits the amygdala, from which the fear that can trigger the stress response arises. Oxytocin also stimulates the release of endorphins, nature’s morphine, which reduce pain and can lead to euphoric feelings such as the runner’s high, some get while exercising. Endorphins, which are released by the pituitary gland during exercise, love, and excitement, trigger dopamine release, which then stimulates the nucleus accumbent and leads to feelings of pleasure. Feelings of sensory pleasure also stimulate the release of nitric oxide, a potent vasodilator, which increases blood flow and is known to be important in protecting certain organs from ischemic damage, which can occur when an organ doesn’t get enough blood flow.
Most likely, happiness also affects the immune system.
The keys to successfully disputing your negative beliefs include trying to find evidence that your negative belief is false (if it is) considering alternative interpretations of the adverse event other than the pessimistic explanations you’ve imagined, determining what payoff you may be gaining from such a negative belief, and if the belief really is true, thinking through the implications of such a belief.
The How of Happiness, Sonja Lyubomirsky shares her findings that the happiest people were not the richest, most beautiful, or most successful. Instead, the golden ticket to happiness lies not so much in changing our natural tendencies or even our life circumstances, but in adopting certain behaviors that have been scientifically proven to increase happiness.Happy people shared similar traits. They devoted a lot of time to nurturing their relationships with family and friends, were comfortable expressing gratitude for what they had, were the first to lend a helping hand, practiced optimism when imagining their futures, savored life’s pleasures and tried to lie in the moment, exercised frequently, were deeply committed to lifelong goals and ambitions, and showed pose and strength when facing life’s inevitable challenges.
She also found that you can be happier by avoiding overthinking, cutting yourself loose from ruminating thoughts, eliminating social comparisons, taking action to solve problems right when they arise, seeking meaning amid stress, loss or trauma, practicing forgiveness, engaging in activities that get you “in the flow,” smiling more, and making effort to take care of your body.
Radical self-care: Study anything and everything on how to improve/maintain health. Do the 7Doctors I talk about a lot.
