Category Archives: Health

New classes: on transforming stress, and dealing with pain

Two new classes this Fall quarter at Whatcom Community College, one on the new science of stress, and another on dealing with pain. 

Want to transform your relationship with stress? The new science on stress validates the power of our minds over the way we experience stressful events. On Thursday October 12th, I’ll present some of the myths and the new science about stress, and we’ll discuss the ways we typically react when we experience stress. We’ll also learn some simple ways to mitigate the harmful effects and boost the positives—and contrary to what we’ve been told, there are many positives that come out of stressful times.

Occasional or chronic pain is a reality for most of us at one time or another, and yet most pain medicines are problematic when used regularly—in fact, there is no cure for chronic pain. Typical common causes for pain include headaches, low back pain, nerve damage, recovery from surgery or other medical treatment, and other disabilities. Any of these can affect quality of life, including things like getting the sleep or activity we need to stay positive and healthy.

Hypnosis is a proven method for mitigating or reducing pain, and hypnosis has no side effects other than relaxation. In this class on October 26th, you’ll learn how, by practicing at home, you can use hypnosis to get more control over pain and its effects.

Register for either class at Whatcom Community College, by email, or by phone at 360-383-3200.

And by all means contact me with any questions about either of these new classes.

A brand new study about inflammation, heart disease, and cancer

I just this morning read an article in the Guardian about a major study of inflammation and heart disease–a four year study from Brigham and Women’s Hospital of 10,000 heart attack survivors. The results showed a 15% reduction in complications for participants who took the anti-inflammatory drug canakinumab–a breakthrough confirming the theory that inflammation contributes to heart disease.

This is great news in itself, but there’s more: what was unusual about this study is that, knowing the inflammation pathway the drug targeted was also known to be involved in cancer risk, the researchers ensured that patients with risk factors for cancer were evenly distributed among the study groups.

The results are in: for patients taking a low dose of the anti-inflammatory drug, lung cancer rates were reduced 26%. In patients with a medium dose, the rate dropped 39%. Patients with the highest dose showed a 67% drop, and their overall cancer death rate was about half that of the placebo group.

It’s early days, of course. There will be lots more research to come before this translates to new cancer treatments. But how great to be able to see the beginnings of a promising line of research. Go science!

Learning patience and persistence from a large pile of heavy rocks

Last week I mentioned the adventures with heavy rocks that resulted in me spending too much sedentary time contemplating the effects of inflammation. (I’m doing well now, and I’m learning good stuff from a wonderful PT, so the outlook is much much brighter.)

Now I have a routine for strengthening my back and getting more flexible, so that I can get back to the yard project I wanted to do this summer—which leads me to the subject of motivation.

I’m the kind who does the exercises until I don’t hurt anymore, which has always seemed like a reasonable way to deal with aches and pains. But now I’m seeing that it really isn’t that simple—or at least not so simple as it seemed when I was much younger.

The reality is that if I want to do the yard project, I need a greater level of fitness than I’ve enjoyed in a long time. I won’t be able to finish it unless I get stronger, and getting stronger before the summer’s gone means I need to raise the priority—the exercises  and stretches need to happen every day. I know myself well enough to admit that won’t happen unless I make a routine, linking the physical therapy exercises with something I’m already reliably doing.

Although I say “every day,” and mean it, I also know it’s not a realistic expectation. Life regularly gets in the way of my plans, so I have to recognize and prepare for interruptions—that way I’m more likely to relax and enjoy the distractions, knowing I’ll be able to get back to the routine next day. In this case, my plan is, if I can’t do all the exercises, I will at least do the stretches—and it doesn’t matter when during the day I do them. And since I know life will interfere, I’m more focused on getting the work done on the days it’s easy to keep to the schedule. 

Here’s an outline of the basic idea:

  • Have a goal:  Get fit for yard project
  • Have a plan for daily work: Right now that’s about 25 minutes of exercises and stretches
  • Have a plan for when I can’t (or choose not to) do the work: Do the stretches and skip the harder stuff
  • Have a plan for getting back into the work after a day off: Raise it in the priorities for the day, and/or Enlist helpers to remind me, and/or Use a calendar to mark each day’s effort for a visual reminder 

This last one is more detailed, I think because at this stage I’m still fighting my tendency to see yesterday’s decision not to do the hard stuff as a failure on my part. Even though I know this tendency isn’t helpful, it’s a hard thought-habit to break. So I don’t want to feed it; instead I want the alternative of a reasonable response to those normal days when Plan A doesn’t work.

Another effect of this approach is that by recognizing the obstacles (including the emotional one of feeling shame when I miss a day), and making a plan for dealing with them, it’s easier to follow through. As a result, I become more patient with myself, and thereby more confident that I can make good progress toward my goal.

When I do my early morning routine self-hypnosis, my plan for the day includes doing the PT exercises, too. It all helps.

Fighting inflammation

In the aftermath of a overly ambitious attempt to move a large quantity of heavy rocks in a short amount of time, I’ve spent much of the last week thinking about inflammation, while being careful not to move very much, or very quickly.

Fortunately, the June 17 issue of New Scientist arrived with an article about inflammation:  what it is, why it’s a problem, and why nothing we usually try can fix it. Fascinating.

The article gives an overview of how inflammation works, as our natural response to injury or infection, or stress. The short version is that the symptoms of inflammation are the product of our immune system at work. But the system isn’t working as well as it should for more and more people, especially anyone who carries around more body fat, has type 2 diabetes, eats a lot of sugar, or has an autoimmune disease. What happens is that the system ramps up, but the natural process is designed to ramp down after its work is done, and for many, this step doesn’t happen.

However, inflammation that occurs as part of the body’s response to exercise—a good run, for example—does still seem to work just fine. The molecule that summons the immune response also summons the next wave of chemicals, called resolvins, that trigger the liver to clean up, reducing inflammation in turn. 

The amount of fat we carry affects inflammation levels because cytokines—the signaling cells that are released by stress, injury, or infection—are stored in body fat; the more fat we have, the more extreme our inflammation response. Also, when there’s a lot of body fat, the cytokines are more likely to leak into surrounding tissue, triggering the inflammation response.

Why is it a big deal that the inflammation response is active when it’s not needed? Cold symptoms are produced by the body’s attempts to deal with the virus. If the inflammation persists, the symptoms persist. That’s the simplest effect. Longterm, chronic inflammation has been linked with more serious effects: persistent infections, depression, and cardiovascular disease.

This is a very incomplete picture of what is doubtless a much more complicated issue—as new research comes along, there will likely be more and more theories about how and why inflammation acts as it does. But for now, this new knowledge doesn’t answer the question of “how do I deal with the aches and pains, the fatigue, or the high blood sugars related to chronic inflammation?”

But the article does give us a place to start. We can make sure our bodies get what they need to support a healthy inflammation cycle. (Of course, the first step should include talking to your doctor about this information and how it may affect you.)

We might as well start with the easiest thing first, and then find ways to add in the rest of the list, one step at a time:

  • Take a daily low-dose aspirin, if your doctor agrees it’s a good fit for you. It could protect your cardiovascular system, and aspirin is the one over-the-counter anti-inflammatory that doesn’t inhibit the production of resolvins.
  • Stretch—this doesn’t have to be hard. By all means, take a yoga class. But if you’re not a budding yogi or yogini, why not just stretch whenever you get up from a chair during the day?
  • Eat foods with omega-3 fats. There’s some discussion about what kinds we metabolize most effectively, but let’s just do the best we can with what’s available to us.
  • Get some physical activity—it stimulates production of anti-inflammatory chemicals, and cues the liver to metabolize fat. As little as 20 minutes has a beneficial effect.
  • Get motivated to keep fat below about 25-30% of body weight—a certain amount is protective, but more than about 25-30% body weight provides a lot of storage for the cytokines that fire up inflammation.

What’s really significant about this research is not that it reveals the workings of inflammation—this is just the beginning. It’s that it tells us what we can do about inflammation with the choices we make on a daily basis—it’s the usual suspects, the things we already know support all-round better health.  And it’s motivation to keep on that path. 

If you are fighting your own personal battle against inflammation, a step you might find helpful is to use this list as a focus for a morning self-hypnosis session, just to affirm your intention to be good to your body each day.  Also, since the immune system generally responds really well to hypnosis, why not include suggestions to calm the inflammation response?

Positivity skills worth learning

Science Daily is a great resource if you’re interested in what’s happening in the world of science. I just read about a study at Northwestern University, part of a larger study by Judith Moskowitz on teaching positivity skills to enhance the experience of people dealing with illness or other high stressors. This study compared the benefits of teaching these kinds of skills versus prescribing (or increasing) anti-depressants for 159 patients recently diagnosed with HIV. About 17% of these patients were already on antidepressants.

Half the participants took 5 weekly classes focusing on eight positivity skills. After 15 months, the rate of antidepressant use had not changed in the group learning to cultivate feeling calm, happy, and satisfied, and 91% of them showed a reduction of the virus in their blood, compared with 76% in the control group, more of whom were then using antidepressants (35%).

Here’s the report’s description of the 8 skills they learned to practice:

  • Recognizing a positive event each day
  • Savoring that positive event and logging it in a journal or telling someone about it
  • Starting a daily gratitude journal
  • Noting a recent use of a personal strength
  • Setting an attainable goal each day and noting progress
  • Reporting a relatively minor stressor each day, then listing possible ways to reframe the event positively
  • Practicing a small act of kindness each day
  • Practicing mindfulness with a daily 10-minute breathing exercise, concentrating on the breath

Reading this, I’m reminded, once again, that there is a direct connection between active positivity and immune system function, and that we can support our own wellbeing—even when dealing with illness or other difficult stressors—with small daily actions.

Update: I have been doing a brief (10 minutes at most) self-hypnosis session in the mornings to remind myself of what I need to focus on–it helps with motivation, I find. Since I read about this study last week, I’ve been including using this list with a daily journal. It’s been great, although full of unexpected challenges, like focusing on when I’ve used personal strengths. One that I particularly appreciated is the reminder to be thoughtful about stressors; it feels really good when something difficult comes up to be able to view it in a positive way, instead of just trying to forget it as soon as possible.

Judith Moskowitz, the study’s author, is also doing the same work with diabetes patients, women with breast cancer, and caregivers of dementia patients. I imagine aspects of this could be helpful for people living with dementia as well.

An additional resource is a book I often recommend in my classes: Hardwiring Happiness by Rick Hanson. He’s a well-known psychologist and long-time meditator, and the author of Buddha’s Brain, about the neuroscience behind the effects of meditation on the brain. Hardwiring Happiness helped me make a breakthrough in realizing that I can move beyond my innate “negativity bias,” and giving me practical tools for developing and strengthening a more positive frame of mind.

Dementia rates falling

Aging is not for wimps. I can say that with confidence, from the vantage point of my sixth decade. That said, I’m fortunate to know people who exemplify aging well, and I’m doing my best to follow their example.

I just read an article in the New Scientist about dementia: “Defying dementia; it’s not inevitable” giving an overview about the types of dementia and what the current research has to tell us about the diseases and treatments. First the bad news: there isn’t a cure, although a number of promising drugs have been tested and found wanting. The good news is that we can fight back.

Aging is inevitable, and normal aging does involve slower but otherwise normal cognitive processing, but that is not the same as dementia, which affects memory, language ability, sensory perception, and executive function (focus, planning, etc.).

I’d read that there are fewer people with dementia in each age group than there were, and this article confirms that. Between the 1980’s and 2011 in England and Wales, the rate of people aged 65 and over with dementia dropped by 20%, and in the US, between 2000 and 2012, the rate dropped by 24%. The decrease is attributed to the populations’ increase in education level and in control of cardiovascular health.

It’s a great article; I recommend it, and I appreciated the clarity it brought to my lurking fears of impairment with aging. I really appreciated reading that there are so many ways to keep symptoms at bay: keeping to a healthy diet, getting enough physical activity, staying connected with others, sleeping well, keeping an active mental life. One of the experts put it this way: “walk, talk, and read.”

Another article, this one from Psyblog, looked at 3 groups of women who’d been sleep-deprived—one group drank coffee or cola, one group took a placebo, and the third walked the stairs for 10 minutes (this was a low-intensity effort—they weren’t running or even hurrying). Neither the caffeine group nor the placebo group reported any benefit in terms of energy and motivation for work, but the group on the stairs did.

It’s a bonus, isn’t it, to think that one small thing we can do to claim a little more motivation and energy in the moment is also something that serves us so well in the long run.

A prescription for yoga

I’m constantly looking for new ways to help people who want to make the transition from a sedentary to a more active life. I’ve finally realized that the simplest thing I can do in my classes, for example, is add a couple of stretches for every hour of class. Maybe feeling the difference a couple of stretches can make will inspire us all to do a little more.

I’m like a broken record when it comes to the benefits of walking, especially outdoors (green exercise, it’s called). Mostly I talk about it because I love it, and I feel the benefits—it’s the best stress relief I’ve ever found, and I think it does more to support my health than any other activity I do.

Here’s what Psychology Today has to say about green exercise:

Outdoor exercise makes people happier, less fatigued and angry, more tranquil and relaxed, and bestows a more lasting energy boost compared to indoor exercise. Even five minutes of green exercise (like walking across a park or campus) is likely to boost self-esteem and mood. Green exercise is experienced as more restorative and is more likely to increase a person’s frequency of exercise compared to indoor exercise, and all these effects are enhanced with both duration and intensity of outdoor exercise.

Improved self-esteem and mood in 5 minutes? Who doesn’t need more of this?

However, a 2010 study from Boston University Medical Center compared the effects of Iyengar yoga classes against the benefits of walking on 34 healthy people.  The results showed that compared with walking, “yoga appears to be accompanied by greater improvement in mood and decrease in anxiety and a boost in the brain chemical associated with these benefits.”

The brain chemical referred to is the neurotransmitter GABA, low levels of which are associated with depressed mood and anxiety. The participants in the yoga groups showed higher GABA levels as well as reporting better mood compared to the walkers in the control group, who walked for an hour three times per week. In spite of the higher level of exercise in the control group, the yoga groups showed more improvement in mood.

Now, a new study from Boston University Medical Center looks at the effects of Iyengar yoga classes and deep breathing practice on 30 people with major depression. The study put participants in two groups; one attended yoga classes two times per week and practiced at home, and the other attended three classes per week as well as practicing at home. After twelve weeks, there was no difference between the affects on the two groups: all the participants experienced a reduction in their depressive symptoms. Good news, indeed.

Whether or not depression is an issue, any enjoyable way to reduce anxiety and improve mood is very welcome. We need those in our self-care toolkit.

A link between sugar and dementia?

A few years ago, if we’d looked at a graph comparing the rise of both diabetes and Alzheimer’s Disease, we’d have been looking at the same curve. In fact, a theory began to emerge that Alzheimer’s was another form, or stage, of diabetes.

Here’s a page from a 2007 brochure about Alzheimer’s Disease:

Doctors don’t know yet what causes Alzheimer’s disease or exactly how Alzheimer’s and diabetes are connected. But they do know that high blood sugar or insulin can harm the brain in several ways:

  • Diabetes raises the risk of heart disease and stroke, which hurt the heart and blood vessels. Damaged blood vessels in the brain may contribute to Alzheimer’s disease.
  • The brain depends on many different chemicals, which may be unbalanced by too much insulin. Some of these changes may help trigger Alzheimer’s Disease.
  • High blood sugar causes inflammation. This may damage brain cells and help Alzheimer’s to develop.

So, ten years later, the picture has changed, in that dementia rates in the US are decreasing, and the age of onset is later—good news. From a NY Times article: “The new study found that the dementia rate in Americans 65 and older fell by 24 percent over 12 years . . . . In 2000, people received a diagnosis of dementia at an average age of 80.7; in 2012, the average age was 82.4.”

But although the data is pretty convincing, no one yet knows what caused the changes. One theory is that the difference may be due to better management of diabetes. A brand new study has found a possible link between diabetes and Alzheimer’s: glucose in the blood binds to and inhibits an enzyme called macrophage migration inhibitory factor (MIF), which is part of a normal immune response to a buildup of abnormal proteins in the brain.

In other words, sugar in the blood inhibits a normal immune system response to abnormal proteins that could be involved with developing Alzheimer’s Disease.

Although I have strong opinions about the importance of eating real food and avoiding processed food, I also recognize that many people lead healthy and happy lives without being anywhere near so strict about what they eat, or perhaps more to the point, what foods they avoid. But to me this development reaffirms the need to be careful about sugar.

The placebo effect–an update

I’m fascinated by the placebo effect, and hypnosis as a way of activating it, so I was particularly interested in reading about some of the current research in Cure, A Journey Into the Science of Mind Over Body, by British science writer Jo Marchant.

But first I should clarify what a placebo is. Here’s a very mainstream definition from Dictionary.com: “an inactive substance or other sham form of therapy administered to a patient usually to compare its effects with those of a real drug or treatment, but sometimes for the psychological benefit to the patient through his believing he is receiving treatment.”

Here it is in black and white, the prevailing assumption that physical ailments require dosing with a “real” medical treatment, and that “psychological” benefits from “sham” treatments affect the mind but not the body.

To me, the word “placebo” instead refers to the mind’s ability to activate the body’s natural healing abilities, including, for example, the immune system. This explanation makes so much more sense when I think about the way we experience everything in this life through the dual lens of our bodies’ experiences and our minds’ interpretations of those experiences.

Cure is a fascinating look at some of the cutting edge research into the interaction between our thoughts and our physical experience. In particular, the meaning, or value, we find in the experience or the treatment makes the treatment more powerful, and more likely to result in either a cure or a lessening of symptoms.

In some cases, the mind-body connection changes both our experience of our physical state and changes the underlying condition, as in IBS, for example, which responds well to hypnosis. In other cases, although the symptoms get better, the underlying condition stays the same. For example, the pain we experience from a slipped disk becomes less severe when we use hypnosis, although the damage from the disc injury is unchanged.

I loved the book—available at the Bellingham Public Library—and its thorough discussion of the current research that’s challenging the old model of a separate, mechanical physical experience and a separate psychological experience of the mind. I recommend it.

A little activity can take us a long way

People love to talk about how much exercise we “should” get. I wonder how helpful it is to approach the notion of exercise from that perspective: how much should I get? I suppose for the folks who are into doing everything right, it might be helpful. Or the folks who are seriously into exploring and quantifying every aspect of their lives—and they at least will be evaluating the recommendations against their experience.

But lots of people suffer from a learned aversion to exercise, and I know this kind of direction is not helpful. So if this is you, take heart. It turns out that when it comes to the health benefits of moving around—a little goes a long way.

This news is from a British study of 63,591 middle-aged people, over 8 years. It didn’t matter whether they followed the recommended guidelines for a certain number of hours of exercise per day, or simply went for a long walk on a weekend day—a lesser amount of exercise was still effective in preventing disease.

In terms of physical health, although there are studies supporting specific benefits of many different kinds of strenuous exercise—weight training, running, yoga, etc.—all those recommendations about how much of each kind of exercise we need don’t matter as much as making sure we get any exercise at all. A little bit of activity still conveys real health benefits.

I suspect it also has similar benefits in the other areas that regular, more frequent exercise is known to provide. I’m thinking about one of my favorite passages from Kelly McGonigal’s The Willpower Instinct, in which she lists the surprise effects of a study on enhancing self control (also known as willpower). The participants, who had all been sedentary before the study, were given a gym membership for two months. Typically they used it once a week at first, but most were up to 3 times per week by the end of the study. The results? Improvements in attention (less distractible), a reduction in smoking, drinking, caffeine use, eating junk food, and watching TV. They also made more healthy food choices, and spent more time studying. They spent less money on impulse purchases, and saved more money. They felt more in control of their emotions.

Truly, moving around makes everything work better. And it doesn’t matter how small the initial effort is—you’ll feel the benefits. By the way, here’s a list of things to try, in case you don’t have a favorite activity already.