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The Biological Underpinnings of MindBody Medicine

In this post I want to set the stage for the basis of all the MindBody Medicine Skills I will be teaching in my 8 week small groups as created by James S. Gorden, MD, the founder of The Center for Mind-Body Medicine.



At its core, Mind-Body Medicine is a form of self-care. It focuses on utilizing the conscious mind to influence positive change in the body and mental/emotional states via the Autonomic Nervous System and the powerful ways in which we can help heal and care for ourselves. It also utilizes the latest science in neurogenesis and neuroplasticity, meaning we can grow new neural pathways and can consciously choose which ones we want to strengthen. It gives each one of us a sense of agency, that we have some control over our health and wellbeing. It teaches that the mind and body are deeply interconnected as a unified whole in which one aspect can have a profoundly dramatic effect on the other. Thoughts, feelings, beliefs, and attitudes can have a profoundly impactful effect on every aspect of our biological functioning. And conversely, how we care for our bodies can affect our minds and spirit. In essence, our beliefs, thoughts, and emotions have the power to stimulate health or disease. 


Learning to use various Mind-Body Medicine Skills, such as meditation, guided imagery, and conscious breathing will help affect our own health and wellbeing for the better. It helps us claim a sense of agency in the midst of stress, upheaval, or illness and keeps us grounded in the knowledge that there are specific activities we can do for ourselves that can help effect the outcome of our daily lives and potentially traumatic or difficult life events. Having these tools in your back pocket in times of need will help you self-regulate your own nervous system so you can remain calm and connected to your inner resources and intuitive capabilities.


Topics Covered in This Post


 

The Autonomic Nervous System


The Autonomic Nervous System, or ANS, is a complex network of neural pathways that regulates unconscious body processes such as breath, sweating, blood pressure, and digestion. It is comprised of two main complementary branches called the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). We could think of the SNS as the gas pedal and the PNS as the brake, both providing the necessary antagonistic actions to keep our bodies in a state of internal balance. They support each other when they are in a healthy state. The 19th century French scientist Claude Bernard described this as, "the body's capacity to maintain homeostasis-or a stable environment-in the midst of a continually changing external world."


Harvard professor Walter Cannon coined the term, "fight or flight repsonse" in describing our bodies immediate physiological responses to a perceived threat in our environment that allows us to prepare for combat or to run away as fast as we can. He noted that all vertebrates have this built-in adaptive response system- from fish to dogs to humans. We have all had the experience in one way or another of feeling in danger. Our senses become more acutely aware. Our pupils dilate so we can see the potential threat better. Our heart rates quicken as does our blood pressure. Digestion slows down because it in not a priority and our hands and feet can get cold because blood is shunted away from our skin and extremities to our large muscles groups to prepare us to fight off and attacker or flee to the best of our ability.


Once the emergency has passed, our bodies then begin to return to normal. The internal stable environment called homeostasis. Our heart rate and blood pressure returns to normal. Breathing naturally deepens a little more, digestion resumes, hands and feet become warmer as blood flow is permitted back to the extremities. This is the natural, self-regulating equilibrium of our adaptive, wholistic, autonomic nervous system. The interactive play and balance-back and forth-from the sympathetic to parasympathetic nervous systems, moment to moment as needed.


The autonomic nervous system was so named because it was thought to operated automatically and outside of any conscious control. In the last 50 years we have learned that this is not entirely true. While, thankfully, we don't have to think to keep our hearts beating or to digest the food we just ate, we do have the ability to use our conscious mind to affect the workings of our autonomic nervous system. According to Dr. James S. Gorden, the founder of the Center for Mind-Body Medicine, "This possibility for exerting conscious control over the autonomic nervous system is central to all our work with mind-body medicine. many of the techniques we use, including soft belly [our beginning meditation in group 1], are designed to give us conscious control of the autonomic nervous system."


Back to the sympathetic and parasympathetic branches, the sympathetic NS helps the body mobilize a response to threat or danger, real or perceived, (fight/flight) and the parasympathetic NS helps the body calm down and restore a sense of relaxation and renewal. It is aptly called the "rest and digest" system. It slows the heart rate, lowers blood pressure, and increases digestion among many other beneficial processes. Ideally, both work in harmony and balance as we move through our day incountering various life events that require more gas/speed/action, or more brake/slowdown/reflection. If fighting or fleeing is not an option to real or perceived danger, the unconscious mind may slam on the brakes to illict the the "freeze" response. It is also called "collapsed" or "feigning death". When we think of the opposum that "plays" dead, it does so outside of its conscious will because its built-in adaptive protective freeze response takes over. This is also called tonic immobility and in humans, sometimes the psychological state of dissociation is common during the freeze state.



The Difference Between Acute and Chronic Stress


During acute stress, these built-in adaptive responses of fight, flight, and freeze are natural and good. Humans and other animals need these to survive effectively. After our bodies are flooded with the necessary hormones, such as adrenaline and cortisol, to get us through the intial burst of energy needed to confont or avoid danger the excess energy is naturally released and we can then return to normal activities with relaxed awareness. Different ways of realeasing this energy is through shaking, trembling or running to discharge this excess energy. It is a natural response to promote homeostasis of our nervous system and return to a calm and centered state of being. The pioneering work of Dr. Peter Levine is a wonderful resource for a deep dive into how our bodies are built to shake off and unwind these experiences.


The problem occurs when one side gets stuck on. Too much fight or flight, the sympathetic nervous system, and our body's adrenaline response goes into high gear. Humans are subject to chronic stress beyond the initial need for the healthy response because our fight/flight system gets prolonged due to various reasons, some of which can be various traumas, rumination and our thought patterns, or we stay in situations(of our own accord or not) that continually activate our adrenal overdrive. Eventually, being stuck in this state will begin to do damage to the body. After long exposure to stress, and fight or flight being constantly turned on and unable to discharge the excess energy, our bodies become completely exhausted with measurable changes in different systems of the the body such as the immune system, digestive system, and endocrine systems, to name only a few. This state of chronic stress predisposes us to chronic illness.


Dr. Gorden states:


When there has been trauma and/or when our stress levels are high and sustained over time, there can be phyisiological changes. We can be stuck "on"(too much sympathetic drive) or in some cases, stuck "off" (a prolonged, unhealthy stimulation of the parasympathetic freeze response-which can be considered a maladaptive version of the freeze response). Stuck "on" is considered much more common, and can, for example, cause high blood pressure which contributes to heart disease and stroke. Chronic overactive stress response alos produces high levels of the adrenal hormone cortisol which increaases blood sugar, decreases immune functioning, and may lead to anxiey, depression, weight gain and more. Chronic stress can be a factor in many illnesses.


But don't be dismayed! There are things we can do to reverse the downward sprial of chronic stress and break the cycle that contributes to chronic illness. This is where learning the tools of Mind-Body Medicine Skills comes into play, to give you agency over your stress levels and enter the world of conscious control over your autonomic nervous system. We can't control much in life, that in itself can lead to stress for recovering control freaks like myself, but thankfully this, our nervous system, is one thing we can exert some control over for the benefit of our own wellbeing.


Empower Your Health and WellBeing with MindBody Medicine Skills


Mind-Body Medicine Skills are scientifically proven methods that restore a healthy balance to the sympathetic and parasympathetic nervous systems. They encourage and facilitate homeostasis in a body that may be stuck "on" in one or the other and have the power to help you change the way you deal with life's challenges.


As stated in the New England Journal of Medicine April 9, 2020 op-ed "New Era for Mind Body Medicine", Mind Body Medicine is well researched and proven to be beneficial for many health issues:

                "...randomized, controlled trials have suggested improved health outcomes and quality of life in multiple physical and mental health conditions that are related to or exacerbated by stress, including chronic pain, anxiety, depression, cancer related fatigue, tobacco addiction, inflammatory bowel disease, and cardiovascular disease...we believe the future is promising for mind-body medicine."


One simple technique is called, "Soft Belly", a calming concentrative meditation technique using your breath that invites a relaxed state. It is a meditaiton you can practice anywhere, anytime, and nobody will even know what you are doing. You can do it standing in line when you are feeling rushed, or sitting in traffic with absolutely no way of moving forward. Rather than the endless phone surfing we all can do, try this instead:


You can do this with your eyes open or closed, as is safe for you and the situation you find yourself in. Take a deep breath and begin to breathe in through your nose and out through your mouth. It can help stimulate the parasympathetic nervous system if you actually extend you exhale a little more than the inhale. If you pause for a short beat or two after the exhale and before the next inhale, that helps as well. Sometimes I find it helpful starting off with a count to help my stay focused on my breath. With each inhale notice your belly rise and become full and soften and exhale slowly as your belly compresses softly, like a bellows gently releasing the life giving breath under our conscious control.


Inhale...1,2,3,4,...exhale...1,2,3,4,5,6...pause...1,2....inhale...etc...

Then after a good flow and rhythm is happening for you, you can change from counting numbers on the inhale to internally saying the word "soft" and on the exhale to internally saying the word "belly".


Inhale....soft...exhale...belly...inhale...soft...exhale...belly. You may choose to pause after each exhale slightly, but do not force yourself. This is about your own relaxation and wellbeing. Any stress or strain or desire to do it perfectly can be noticed and just gently put aside as you hold yourself with kindness and ease during this practice. There is enough in the world to stress out about. This isn't one of them.


This is just a little taster of the many skills we will be learning in my upcoming 8 week Mind-Body Medicine Skills group. If you miss any of the classes I will be creating mini technique videos for Instagram and posting on this blog the various methods we covered and how they can be used in your day to day life. I hope you have found this post helpful in someway, and if you did, please comment and let me know!


Thank you for taking the time to read my post!



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