When people are doing everything 'right' when it comes to healthy behaviours-eating their organic veggies, avoiding meat, dairy, gluten and processed foods, exercising daily, sleeping well, avoiding addictions, seeing nutritional-medicine doctors to optimize the biochemistry of the body and so on, we should expect them to live long, prosperous lives and die of old age. So why is it that so many health nuts are sicker than others who pig out on barbecue, guzzle beer, sleep five hours a night and veg out on the sofa in front of the telly?
I have come to believe that the purely physical, biochemical realm of illness-the part you can diagnose from laboratory tests, see on radiological studies and explain in Petri dishes under microscopes, the part that benefits from diet, exercise, avoidance of toxins and functional medicine's positive effects on the body-is only part of the equation.
My experience with patients has led me to believe that whether patients get sick or stay healthy, whether they manage to heal themselves or stay sick, may have even more to do with everything else that's going on in the patient's life than with any 'healthy' things they do.
When I was working in an integrative medicine practice in Marin County in Northern California, my patients were the most health-conscious people I'd ever seen. Many of those who came to the centre drank their daily green juice, ate a vegan diet, worked out with personal trainers, slept eight hours a night, took a handful of vitamins and other health supplements every morning, spent a fortune on alternative-medicine healers and mindfully followed their practitioners' orders religiously. This regimen worked wonders for some. They were pinnacles of health with glowing skin and gorgeous bodies and life force emanating through their pores.
But some of them were sicker than ever. In my attempts to help these patients I ran batteries of tests, including specialized tests conventional doctors don't usually order. In a subset of patients-the ones who led healthy lives but still experienced boatloads of symptoms-more often than not I'd find nothing and wind up shrugging my shoulders. I couldn't find a biochemical explanation for why these patients didn't feel vital. There was still a big missing piece of the healing puzzle.
Instead of focusing exclusively on health behaviours, past medical history and other traditional questions, I started digging deep into the personal lives of my patients. Is anything keeping you from being the most authentic, vital you? If so, what is holding you back? What do you love and celebrate about yourself? What's missing from your life? What do you appreciate about your life? Are you in a romantic relationship? If so, are you happy? If not, do you wish you were? Are you fulfilled at work? Do you feel like you're in touch with your life purpose? Do you feel sexually satisfied either with a partner or by yourself? Do you express yourself creatively? If so, how? If not, do you feel creatively thwarted, like there's something within you dying to come out? Do you feel financially healthy or is money a stressor in your life?
If your fairy godmother could change one thing about your life, what would you wish for? What rules do you follow that you wish you could break?
My patients' answers often gave me more insight into why they might be sick than any lab test, medical-record review or X-ray exam could.
I came to see that these patients were 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.
Most of them answered the question on my intake form 'What's missing from your life?', by writing a long list. And when I asked the same question in person, the majority of these patients wept. Something was going on that had nothing to do with vegetables or exercise or vitamins.
On the flip side, I had other patients who ate poorly, exercised rarely, forgot to take their supplements and enjoyed seemingly perfect health. When I read their intake forms, they revealed that their lives were filled with love, fun, meaningful work, financial abundance, creative expression, sexual pleasure, spiritual connections 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.
That's when I began asking my patients the two most essential questions:
o What do you think might lie at the root of your illness?
o What does your body need in order to heal?
More often than not, in answer to the first question my patients said things like "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 purpose", "I don't feel God anymore", "I hate 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" and "I'm living a lie and I feel like a total fraud".
And when I asked my patients the second essential question, what they need in order to heal, they shocked me with their 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", "I need to hire a nanny", "I'm so lonely I need to make more friends", "I need to meditate every day", "I have to tell my husband I'm having an affair", "I need to forgive myself", "I need to love myself" and "I need to stop being such a pessimist".
My bravest patients listened to the quiet voice within and made radical changes. Some quit their jobs. Others left their marriages. Some moved to new cities. Others finally pursued long-suppressed dreams.
The results these patients achieved were astonishing. Sometimes a laundry list of illnesses would disappear, often very quickly. My patients were healing themselves after years of medical therapies had proven useless.
How your lifestyle affects your body
These health conditions were not cured by a drug, supplement or surgery, but by my patients reducing the stress in their lives, relaxing their minds and bodies, following a dream, finding love and filling their bodies with health-inducing hormones while ridding their bodies of harmful stress hormones. These changes in their lives resulted in measurable physiological changes in their bodies.
Ultimately, I discovered that the lifestyle choices you make can result in physiological changes in the body and that this extended to the people you interact with in your personal and professional lives, 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 that optimizes the relaxation response, counteracts the stress response (see box, page 61) and leads to better health.
We all know stress is bad for us in a vague what-do-you-expect-me to-do-about-it sort of way. But I now understood the clear link between the stress the mind experiences and the way the body breaks down. I observed how emotional stressors like loneliness, frustration at work, anger over past trauma, money worries and fear could result in illness.
To lead a vital life, prevent disease and optimize the chances of disease remission, you need:
o healthy relationships, including a strong network of family, friends, loved ones and colleagues
o a healthy, meaningful way to spend your days, whether you work outside the home or in it
o a healthy, fully expressed creative life that allows your soul to sing its song
o a healthy spiritual life, including a sense of connection to the sacred in life
o a healthy sex life that allows you the freedom to express your erotic self and explore fantasies
o a healthy financial life free of undue financial stress that ensures that the essential needs of your body are met
o a healthy environment free of toxins, natural-disaster hazards, radiation and other unhealthy factors that threaten the health of the body
o a healthy mental and emotional life characterized by optimism, happiness, and freedom from fear, anxiety, depression and other mental-health ailments
o a healthy lifestyle that supports the physical health of the body, including good nutrition, regular exercise, adequate sleep and avoidance of unhealthy addictions.
How the body feels a toxic thought
How exactly does a thought or feeling translate into physical effects all over the body? Start, for example, with a thought or feeling like fear.
Your conscious mind-which resides in the forebrain-knows you're frightened. But your lizard brain-the area near the brain stem that houses the hypothalamus-can't tell the difference between an abstract fearful thought and a real-life survival threat.
Your lizard brain thinks you're about to die and this stimulates the stress response, so setting off the fight-or-flight mechanisms, activating the hypothalamic-pituitary-adrenal (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 are meant to be triggered only rarely. The healthy body is supposed to be in a relaxed state of physiological rest most of the time.
But the stressors of daily life-things like loneliness, unhappy relationships, work stress, financial stress, anxiety and depression-result in forebrain thoughts and feelings that repetitively trigger the hypothalamus to elicit stress responses. The mind knows it's just a feeling, but the lizard brain thinks you're under attack.
Feelings like fear, anxiety, anger, frustration, resentment and other negative emotions trigger the HPA axis. Whether or not your body is actually 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 secrete 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 (adrenaline and noradrenaline), which increase pulse rate and blood pressure and affect other physiological responses too.
Secretion of these hormones leads to a variety of metabolic changes all over the body.
Basically your body ignores sleeping, digesting and reproducing, and instead focuses on running, breathing, thinking, and delivering oxygen and energy 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 is only in your mind, the body doesn't realize there is no bodily threat and over time, when the stress response is repetitively triggered, nature's biological survival response winds up doing more harm than good.
As a result, the body can't relax and repair what inevitably goes awry when not maintained by self-repair mechanisms. Organs become damaged and 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.
But it doesn't have to be this way. The body knows how to relax with the counterbalancing relaxation response described by Dr Herbert Benson, professor of medicine at Harvard Medical School and author of a number of books .
The relaxation response
Herbert Benson has created a simple meditative technique that can calm stress responses in any situation.
o Pick a focus word, short phrase or prayer that is firmly rooted in your belief system such as 'one', 'peace', 'The Lord is my shepherd', 'Hail Mary, full of grace', 'Shalom' or 'Om'.
o Sit quietly in a comfortable position and close your eyes.
o Relax your muscles, progressing from your feet to your calves, thighs, abdomen, shoulders, head and neck.
o Breathe slowly and naturally and, as you do, say your focus word, sound, phrase or prayer silently to yourself every time you exhale.
o Assume a passive attitude and don't worry about how well you're doing. When other thoughts come to mind, simply say to yourself 'Oh, well' and gently return to your repetition.
o Continue for 10 to 20 minutes.
o At the end of the meditation, do not stand immediately, but continue sitting quietly for a minute or so, allowing other thoughts to return. Then open your eyes and sit for another minute before rising.
o Practise the technique once or twice a day. Good times to do so are before breakfast and before dinner.
This technique has proved to be highly effective for eliciting the relaxation response and improving health. In his book Timeless Healing: The Power and Biology of Belief (New York: Fireside Book, 1997), Benson provides updated information on how to elicit the relaxation response.
Essentially, this is all you need: repetition of a word, sound, phrase, prayer or muscle activity, while passively disregarding everyday thoughts that inevitably come to mind and returning to your repetition.
This can be done while exercising, making art, cooking, shopping, driving . . . whatever.
Triggering the right response
Each aspect of your life-your relationships, your work, your creative outflow, your spiritual life, your sex life and so on-has the power to either stress you or relax you. A healthy relationship elicits relaxation responses in the body. An unhealthy one flips on the stress response.
A healthy spiritual life elicits positive emotions like joy, hope and a sense of oneness, and the relaxation response is turned on. An unhealthy spiritual life, one in which you feel judged by your spiritual community, fear punishment by a vindictive deity or are threatened with negative outcomes like going to hell, is bound to trigger stress responses.
When the conscious forebrain thinks positive thoughts and feels things like love, connection, intimacy, pleasure and hope, the hypothalamus stops triggering stress responses (see box, right).
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, and the parasympathetic nervous system takes over instead. The immune system flips back on and the body can go about its natural
self-repair business, preventing illness and taking a stab at treating diseases that are already present.
As a result, disease is more likely to be prevented in well people and may even be treated in sick people.Your thoughts lead to self-healing. The mind has healed the body through simple physiology.
One of the most profound ways your mind can heal your body is through relationships in your life. 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 into 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.
Do you know the way to Santa Fe?
Marla was the stereotypical Marin County resident. She followed a vegetarian diet, hiked, practised yoga, competed in triathlons, took dozens of supplements as prescribed by her naturopath, and avoided alcohol, smoking and the use of any illegal drugs. But she also had a medical chart two feet thick and suffered from four different chronic health conditions.
After probing into Marla's personal life, I found out she was miserable. Marla 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 have time to paint. Plus she was exhausted from caring for her ageing, sick mother, who lived in her home.
I knew that Marla's body was never going to get well until she healed those other aspects of her life. With all those negative emotions filling her mind and all those stress hormones coursing through her body, no vegetables, supplements, exercise programmes or drugs were going to be strong enough to counteract the harmful health effects of chronic stress responses on her body."What does your body need in order to heal?" I asked her.
Marla said, "I need to move to Santa Fe."
"Why Santa Fe?" I asked.
Marla said, "I have a vacation home in Santa Fe and whenever I go there, all of my symptoms disappear."
A year later I got a call from Marla telling me she had moved to Santa Fe. To make such a drastic move, she sold her company and helped her mother get established in a wonderful retirement community close to Santa Fe, where she would be able to visit her on weekends. She also filed for divorce from her husband. And once Marla got to Santa Fe, she enrolled in art school.
She has since fallen in love with a new man and met a whole new group of artist friends, and she enjoys hiking, biking and skiing in the mountains outside of Santa Fe.
Most important, she told me, all of her symptoms had disappeared as if by magic within three months of her move.
Dr Lissa Rankin
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