Minding the Mind-Body in Medicine
A Reflection on Integrating Ancient and Conventional Medicine and the Importance of ‘Physician Heal Thyself’
There’s an Overwhelming Theme of Hope and May 2016 Top Holistic and Integrative Health News
Recently, America celebrated a day of remembrance. It was entwined with the bitter-sweet reflections of what makes our country so great and the sacrifices endured to get where we are. No one can argue that there also is an underlying unrest in the political, health, and societal landscape of U.S. citizens. For many, the smell of change is in the air, but it’s not all bad.
The fact is, we may be on the verge of a healthcare revolution, not based on a revolt, but based on the need for a refocus on reformation. Although it’s important to educate people about the problem, in order to provide the basis for a resolution, there’s also a time to look ahead and find solutions. I know the past few months I’ve been expressing my passion for this change, and laying this foundation. I’ve written all about the various aspects of our current health system and where we are falling short in our country. This is made evident by:
- the inefficacy of the current model, which is based on poor diagnostics
- our pathetic global rankings in health outcomes
- excessive medical errors
- our narrow focus on disease mitigation verses promotion of health
Now, it’s time for that refocus on solutions which are based within a changing landscape of the fragmentation of healers to unification of all practitioners. Many may argue we have a long way to go. However, this integration of natural methods and mind-based practices in our current model, as well as the honoring of these techniques for their innate healing powers as stand-alone practices, is not only becoming more frequent but also more evidence-based. (Even if it within the confines of some of the pitfalls of the evidence-based model and biases of science applications to the real world).
My hope is that this blog and BreakFree Medicine will also help guide those who are looking for a proactive and empowered approach to health care and wellness. Although no book or writing can replace therapeutic guidance when someone is stuck, it can lay a foundation for support and prevention by the promotion of healthy habits. For example, one study this month found that exercise was linked to lowering the risk for 13 types of cancer.
This month especially, perhaps because I was looking for it, I noticed this transformation in the focus on new solutions and the revival of acceptance of ancient practices.
One of the most amazing references I came across was this VERY LONG link for abstracts from The International Congress on Integrative Medicine and Health (ICIMH). It reported on various integrative, natural, holistic, and ancient therapeutics, including essential oils! Wow!
Now just a warning, it took me about 45 minutes just to skim and read through the most interesting ones! Still, if you click on it, you’ll get an idea of what I mean about half-way through scrolling down. You can use the link for your non-believing friends who think there is no “science of the weird stuff you do.”
For the essential oil enthusiasts, like me, here are some excerpts from some of the abstracts on our favorite secondary metabolites (I took my usual liberty of bolding):
- PO5.33 An Exploration into Essential Oil Preferences Among Children and Adolescents with Chronic Pain. Rae Kingsley, Janet Rose, Mark Connelly
Results: Seventy-five subjects (57 female) ages 8–17 (M?=?14.1 SD?=?2.4) completed study procedures. The majority self-reported widespread (50.7%) or localized (40%) pain. Sweet orange was preferred among male subjects (44.4%) and was tied with lemon as the most preferred among females (26.3%). Age and sex were not significantly associated with favorite oil, ?2 (10, N?=?75)?=?8.01, p?=?.63 and ?2 (5, N?=?75)?=?2.78, p?=?.74, respectively, or with willingness to use any of the essential oils at home. Most subjects would use lemon (66.2%), sweet orange (63.5%), and peppermint (59.7%) at home to help them feel better. Lavender resulted in a significant order effect with subjects feeling more energized the later lavender was introduced and calmer the earlier lavender was introduced, r (73)?=??.40, p?<?.01. There were no adverse effects.
Conclusion: Excluding chamomile, children would use these scents at home, finding them pleasing and helpful. This study supports that children have specific essential oil preferences and preliminarily suggests essential oils can be offered as a safe and pleasing adjunct to allopathic pediatric pain management.
- PO7.52 The Effectiveness of Nurse-Delivered Aromatherapy in an Acute Care Setting. Jill Johnson, Rachael Rivard, Kristen Griffin, Alison Kolste, Denise Joswiak, Mary Ellen Kinney, Jeffery Dusek. Allina Health
Results: During the study timeframe, there were 10,262 hospital admissions in which nurse-delivered aromatherapy was part of patient care. The majority of admissions receiving aromatherapy were female (81.71%) and white (87.32%). Over 75% of all aromatherapy sessions were administered via inhalation. Lavender had the highest absolute frequency (49.5%) of use regardless of mode of administration, followed by ginger (21.2%), sweet marjoram (12.3%), mandarin (9.4%), and combination oils (7.6%). Sweet marjoram resulted in the largest single oil average pain change at ?3.31 units (95% CI: ?4.28, ?2.33), while lavender and sweet marjoram had equivalent average anxiety changes at ?2.73 units, and ginger had the largest single oil average change in nausea at ?2.02 units (95% CI: ?2.55, ?1.49).
Conclusion: Essential oils generally resulted in significant clinical improvements based on their intended use, although each oil also showed ancillary benefits for other symptoms. Future research should explore use of additional essential oils, modes of administration, and patient populations. Nurse-delivered aromatherapy is a scalable concept with possible utility for hospitalized patients nationwide.
- PO9.23 Effects of Rosmarinus Officinalis CT 1, 8-cineole Essential Oil on Ryodoraku Values. Shih Wei Yang, Malcolm Koo, Ssu-Min Wang, Yuh-Hai Wang
This was a study done on the effect of Rosemary oil on various Chinese meridians in 40 subjects.
Conclusion: This study was the first to report a significant change of Ryodoraku values with the inhalation of R. officinalis CT 1, 8-cineole essential oil. The physiological effects of this essential oil could be mediated through the lung channel, pericardium channel, gallbladder channel, and urinary bladder channel of the Chinese medicine meridian system.
- PO9.32 A Preliminary Investigation in the Efficacy of Geranium Essential Oil and Hand M Technique in Reducing Workplace Stress in Hospital Workers. Janet Rose, Rae Kingsley, Elizabeth Edmundson, Mark Connelly
Methods: Mean age was 45.4 years, 10% male and 90% female. Ethnicity was 95% White/Caucasian and 5% Black/African American. Visual Analog Scale (VAS) with anchors “0” to “10”. Randomized Latin Square design (3 interventions?×?3 orders) with a 2 day “washout” period between each intervention. Interventions: Aromatherapy Only – Subject seated with eyes closed. Two drops of geranium oil placed on an inhalation patch attached to subject’s clothing. At the end of 5 minutes, inhalation patch removed, repackaged, and stored for subjects use at next intervention. M Technique Only – Subject seated with eyes closed and 5 minute hand M Technique provided. Aromatherapy and M Technique – Subject seated with eyes closed. Combination (using refilled inhalation patch) and 5 minute hand M Technique treatment.
Conclusion: This study supports the use of essential oil aromatherapy and the hand M Technique as an effective intervention for hospital worker stress. Either a single intervention with geranium oil, hand M Technique, or a combination of both result in decreased levels of self-reported stress. The combined treatment seemed to have some additional benefits beyond aromatherapy alone.
There were also many authors who focused on the plausibility, hurdles, and outcomes with the use of integrative techniques in conventional and CAM (Complementary and Alternative Medicine) practice models.
For example, here are a few titles:
- PO6.12 Integrative Health Care: An Exploration of Students Who Choose this Undergraduate Major
- PO5.75 ReMind: Reducing Delirium and Improving Patient Satisfaction with a Perioperative Mindfulness Intervention
- PO5.77 Meditation Group Classes Improve Cancer Patient and Caregiver Symptom Distress
- PO6.01 SMART-R: Feasibility and Effectiveness of a Resident Mind Body Program
- PO6.03 Teaching a Lifestyle Intervention for Reversing Impaired Fasting Glucose, Hyperlipidemia and Obesity/Overweight to a Cohort of Local Physicians
- PO6.06 Understanding the Use and Disclosure of Natural Products by Cancer Patients
- PO6.09 PIE for CAM Educators: A NCCIH-Sponsored Conference on Teaching and Integrating Evidence-Based Practice into Curricula at CAM Academic Institutions
As you can see there were so many vast topics validating the impact of mindfulness, acupuncture, yoga, and almost every other topic just in this one link!
This theme was also very evident in this month’s articles I read:
Topics ranged from the healing aspect of talking, to the impact of arguments, how religion effects immune health, how mental health can impact yeast infections, and more:
- Talk Therapy for Shut-Eye
- How Couples Fight Predict Risk for Physical Ailments
- Yoga, Aquatic Exercise Can Help MS Symptoms
- Tai Chi: Rx for Arthritic Knees
- Placebo Effects in Women Are Boosted by Vasopressin
- Redefining Health, Well-Being in America’s Aging Population- Looking at New Factors
- The Psychology of Expectations and Pain
- Start with Behavior Therapy Over Drugs for ADHD
- Prayer Changes Alcoholics Brains and Reduces Cravings
- Religion Linked to Decrease Morality Rates in Women
- Prejudice Impacts Artery Health in Youths, Along with Exercise, Stressors
- Depression Worsens COPD
- Yeast Infection Linked to Mental Illness
And so much more….but a few abstracts in the above never-ending link of abstracts sparked my attention. These were with the focus on the physicians:
- PO6.15 Trait Mindfulness Predicts Burnout in Internal Medicine Residents
- PO6.19 SPRUCE, Supporting Provider Resilience by Upping Compassion and Empathy
- OA1.03 Mindfulness Program Delivered Virtually in the Workplace Shows Correlation Between Decreased Stress and Increased Productivity
The International Congress on Integrative Medicine and Health (ICIMH), Las Vegas, Nevada, USA May 17–20, 2016. The Journal of Alternative and Complementary Medicine. May 2016, ahead of print. doi:10.1089/acm.2016.29003.abstracts.
In a recent article in Medscape, yes the conventional medicine e-blast that I read bi-weekly, there was a beautiful article regarding addressing one of the root issues of our medical model dysfunction- the training of our physicians and inhumane expectations of them in their patient-care workloads.
See, if we don’t look at the delivery of the healing agents, how can we really expect the healing and health to change? Here’s an excerpt:
The “triple aim” of healthcare—enhancing patient outcomes of care, improving population health, and reducing costs—was first introduced in the literature in 2008 and has become healthcare’s Holy Grail. And, unfortunately, it appears as elusive as its counterpart in mythology. This should be no surprise given that, on the average, more than half of the key players are exhibiting a range of burnout symptoms.
The desired shift from “volume to value” continues to elude us. Are the high rates of physician burnout and distress an overlooked but critical issue? A “fourth aim” to address caregiver burnout has been proposed.[2-4] But, rather than a fourth aim—an afterthought—we believe that this aim is so essential to the triple aim that it is a prerequisite. It should be the first aim.
We will continue to fall short of achieving the triple aim if we do not proactively attend to the health and wellness of physicians and not simply react to extremes of physician distress. In addition, we believe that our success in achieving all of the aims will depend on our ability to provide physician leaders with the core skills and holistic wellness to achieve such transformation.
Here are the links to the other topics in this article:
- All Physicians Are Leaders—For Better or Worse
- Ignoring Proven Principles and the Science of Leadership
- The Burn-Out Epidemic
- The Hidden Curriculum
- But Physicians Are Not Victims
- Leading from Within
Here’s one of the biggest reformations of change for me- shifting the paradigm from fear of the body to the focus on healing and working with the body. This has been in my mission and vision since I began my journey in naturopathic medicine. In Medscape again, another article the same week, was released with an interview with Dean Ornish. Here’s what he said on the motivation of fear verses love:
We learned that fear is not a sustainable motivator in any aspect of life. It is a powerful motivator, but only for about 4-6 weeks. If someone has a myocardial infarction, they will pretty much do anything that the doctor or nurse asks them for a month or two. Then they often stop doing it, which is a profound source of frustration for many doctors. It is too scary when patients hear, “Take your medication or you are going to have a heart attack or stroke.” We all know that we are going to die; the mortality rate is 100%. But it is not something we think about because it is too scary. What’s sustainable is fun, freedom, pleasure, and love. Also, if it’s meaningful, it’s sustainable. When we choose not to do something that we otherwise could do, it imbues those choices with meaning. I often ask patients, “Why do you want to live longer?” If they reply, “I feel deprived because I can’t eat everything,” that’s untenable. If they say, “I’m choosing not to eat certain foods so that I can heal and continue working, and live long enough to walk my daughter down the aisle and dance at her wedding,” and so on, that’s sustainable.
theheart.org | Medscape Cardiology: In your ACC talk, you also said it was important for physicians to let their patients know that they care for them and even love them.
Dr Ornish: It doesn’t take a lot of time to tell a patient that you care about them, that you hear them, that you are there for them. That you love them, even. But if you don’t feel comfortable with that, use whatever words are comfortable for you. Patients are much more likely to take their medication and, to change their diet and lifestyle, when they feel that their doctor is concerned about them and has empathy and compassion for them. They’re also much less likely to sue their doctors. There are real tangible benefits for both the doctor and the patient.
(Hey clients, I do really care about you!)
Looking Beyond the Clinic Walls Into the Broader View
How we can we have true health if we destroy the very environment that feeds us, provides our oxygen, and nourishes the plants that heal? Finally, instead of a mere focus on manipulating biochemistry with drugs and synthetics, there is an acknowledgement that physicians have to take into account the effect our climate has on our healing. Here is an excerpt from the article that discusses this:
The American College of Physicians (ACP) recently released a position statement emphasizing that climate change poses a catastrophic risk to human health, including more respiratory and heat-related illness, vector-borne diseases, malnutrition, and behavioral health problems, and stating that physicians have a crucial role to play in fighting it. In support of that position, the College released a toolkit to help physicians both advocate for effective climate change adaptation and mitigation policies and educate their communities. Medscape spoke with Nitin Damle, MD, MS, current ACP president, about the toolkit. Dr Damle is a practicing internist and senior/managing partner at South County Internal Medicine in Wakefield, Rhode Island, and a clinical associate professor of medicine at Alpert Medical School, Brown University. He also spoke about changes that he has initiated in his own practice to address this serious public health issue.
Medscape: Why should the ACP take on climate change? Some physicians have suggested, given how busy they are with a huge array of clinical issues, that this is not an issue that they can or should tackle. Why do physicians need to take this on?
Dr Damle: It’s not really global climate change that we are addressing. We are addressing the health effects of global climate change. At ACP, we consider climate change to be a human health issue. Beyond any political or economic ramifications, it is an important issue for the care of our patients. The effects of global climate change are being felt now. We are seeing a longer season and more severe allergy symptoms. There is also an increase in respiratory illnesses and tick-borne and water-borne infectious diseases. In addition, there are heat wave-related illnesses and food insecurity in some parts of the world. These changes are not in the distant future; they are happening as we speak. It’s important for us to try to educate the public, our patients, and our colleagues about the human health effects of global climate change. (Physicians Must Respond to Climate Change: An Interview With ACP President Damle)
The article above discusses the impact of doctors going back to house calls. Yes, it’s the individualized attention and truly seeing what makes the patient who they are by their environmental surroundings.
How to summarize all the above- Hopeful!
Now, onto the Top Holistic and Integrative Health News for May 2016!
Feel free to skim through and click on the articles as you desire.
Buggy Health News (The Role of the Microbiome)
Lots of news here! Click here to read my summary of this important topic that may have spurred the connection between the different models of medicine. Read ‘The Microbiome Explosion of May 2016’ here.
Environmental Impact News
- Exercise Is Good for You, Even in Polluted Cities: Study
- FDA Banning E-Cigarette Sales to Minors
- Personal Care Products in Pregnancy Linked to Adverse Effects in Newborns
- Pesticides Linked to ALS
- When are Natural and Urban Environments Restorative? Depends on Your Personality.
- BPA in Pregnancy Linked to Obesity
- Kids on the Frontline- How Pesticides Negatively Impact the Next Generation
- UCSF Presentation Reveals Glyphosate Contamination in People Across America
The Parent-Child-Health Relationship
- Mom and Child Being Physiologically “in Sync” Effected by Maternal Depression
- Children’s Brains ‘Light Up’ at Sound of Mom’s Voice
- Harsh Parenting May Harm a Child’s Physical Health
- Prenatal Weight Gain and Insulin Levels Linked to Obesity in Young Children
- Dad Effects Baby’s Health Outcomes Too!
- German’s Fathers’ Commute to Work and Children’s Social and Emotional Well-Being
- Artificial Sweeteners Sipped By Moms Linked to Babies’ Weight
Brain and Mood News
- Brain Cells That May Aid in Weight Control
- How Poverty Effects the Brain
- Researchers ID New Blood Marker in Autism- Study
- Workaholics and Psychiatric Diseases Linked
- Anemia Effects Brain Healing After Injury
Sleep and Light
- Sunlight- for Better or for Worse- a Review of Studies
- How the World Sleeps- There’s an App for That
- How Light Effects Sleep- Blood Sugar and Blue Light at Night
Interesting Health Views
- Hunger Hormones Effect Decision-Making (Rodent Study)
- Some New Findings in Chronic Fatigue and the Cellular- Immune Response
- A New Fat Hormone on the Block?
- Baby’s Immune System Might Hint at Autism Risk
- Should We Rethink Our Views on Dementia- the Immune Connection
- Decline in Cancer Mortality- Linked to Lifestyle (skim to discussion)
- Cholesterol and the Immune System- A New Implication and Role
Eye Opening News and Views
- Fish Oil Capsules Get Blamed for Unreported Drug Interactions Now THERE’S a Surprise . . .
- The Dirty, Hidden, Factor in the Meat- Cancer Connection
How Food Effects Genes and Health Outcomes
- Mediterranean Diet May Slow Aging and Help Bones
- Persistent Metabolic Adaptation 6 Years After “The Biggest Loser” Competition (AKA- Weight Came Back On)
- Epigenetic Study of Lactose Intolerance May Shed Light on the Origin of Mental Illness
- Epigenetics of Food and Fatty Liver in Rodents
- Immune Dysfunction as a Cause and Consequence of Malnutrition
- Connection Between Fruit Intake and Breast Cancer Risk in Teens
- Healthy Living May Offset Genetic Breast Cancer Risk
- Omega 3’s and Lowering of Childhood Aggression
- FODMAP Found Helpful for IBS in Study
- Dean Ornish in Defense of the Dietary Fat – Heart Disease Link
- New ‘Brain Food’ Scale Flags Best Nutrients for Depression
Food-Mood-and Behavioral Influences
- Serious Video Games May Help Increase Fruit and Vegetable Intake
- Effect of Phone Apps, Microblogs, and Digital Media on Disordered Eating and Compulsive Exercise
- Effect of Stress and Mood on Genes and How Nutrients Modulate This
- Got Unused Meds? Here’s What to Do
- No Statins Before Heart Surgery, Study Suggests
- Widely Used Heart Drug Tied to Dementia Risk
- Testosterone Therapy May Not Raise Prostate Cancer Risk
- Cutting Brand-Name Drug Use Could Save U.S. $73 Billion: Study
- Gut Bug Sparing Antibiotic in the Works?
- Acetaminophen Makes You Less Empathetic, Study Reports
- PPI’s and Vascular Cell Aging
- Maternal Use of Selective Serotonin Reuptake Inhibitors and Lengthening of the Umbilical Cord: Indirect Evidence
- Lyrica May Be Linked to Birth Defects
Thanks for the photos Pixabay!