Tag Archives: stress

Remembered Wellness

I have just completed reading Timeless Healing – The Power and Biology of Belief by Herbert Benson, the founder of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. This is the third book by Benson that I have read in the past month, and definitely the most compelling. About two-thirds through the book I took a break to read the Relaxation Response (also by him) and found that book and this one to be excellent complements to one another with each illuminating the other. If you opt to read one, I heartily recommend reading the other and within a short time period of one another.

REMEMBERED WELLNESS – What it is

What drew me to this book was wanting to understand “remembered wellness”, which many of us might know as the “placebo effect.” The placebo effect is the belief a person has to heal based upon projecting “our intense desire for wellness onto the medicine we take” even if the medicine is just a sugar pill with no medicinal chemical ingredients. In addition, as Benson states “…all of us have the ability to “remember” the calm and confidence associated with health and happiness, but not just in an emotional or psychologically soothing way. This memory is also physical.” Hence, Dr Benson’s conclusion that the placebo effect should be renamed and thought of as “remembered wellness.” To me, the simple act of conjuring remembered wellness is more powerful than the thought of taking a pill called a placebo. As marketers know, there’s much to be said for how something is labeled!

In the late 1990s I was diagnosed with a Stage 1 breast cancer. I vividly recall the conversation with Dr Josephson, the breast surgeon who would operate on my left breast.

Me: Will I die.
Dr J: No.
Me: Will I lose my hair?
Dr J: No.
Me: Okay then, let’s do it!

It is important to know that up till that time I was generally a hard core optimist about most things in life, that I had a head of long, curly, thick red hair, and – most important -– I was the mother of 7 and 14 year old sons.

I didn’t give the conversation much thought again till recently, upon reading this book. Early in the book Dr Benson states what is necessary for remembered wellness:

THREE COMPONENTS OF REMEMBERED WELLNESS

  1. Belief and expectancy on the part of the patient
  2. Belief and expectancy on the part of the caregiver
  3. Belief and expectancies generated by a relationship between the patient and the caregiver

As per my conversation with Dr Josephson each of those items would have a big checkmark next to them. And number 3 was surely impacted by my knowing Dr Josephson as the warm, funny, kind mother of one of my older son’s soccer teammates. (Heck, I knew she went to circus camp as an adult!)

None of this was a placebo – I did have surgery, I did have treatment in the form of radiation, and I did take medicine for five years. However, the surgery and my recovery went smoothly and, after reading Benson’s book, I am convinced that my desire for “remembered wellness” played a major positive part in the process. As the book title suggests, Dr Benson spends a large portion of the book discussing the importance of and science behind the impact of belief.

REMEMBERED WELLNESS – It’s opposite

Turns out there is the opposite side of remembered wellness, the “nocebo” effect. If the placebo effect results in a person believing the best about their treatment, the nocebo effect results in a person believing the worst about their treatment. And what the mind believes, the body does; the body responds to the beliefs we have.

Benson refers to Dr Arthur Barsky, Professor of Psychiatry at Harvard Medical School, who “reminds us that paying attention to a symptom or problem amplifies it while distractions lessen our experience of it.” Barsky is quoted as stating “the mandate for self-discipline and self-control becomes so burdensome and so arduous that it begins to erode our sense of well-being and makes us feel increasingly insecure about [our] health.”

THE BIOLOGY

Regardless of whether a person believes in the placebo or the nocebo effect, in times of perceived stress the brain will cause specific hormones to be released. The hormones, in turn, cause physical responses within the body. The severity of those responses and how they are dealt with, using one or any combination of what Dr Benson refers to as the three-legged stool of medicine (Health and Well-Being is the seat supported by the three legs of Self-Care, Surgery and Procedures, and Pharmaceuticals) is influenced by the belief held by the individual. I found an interesting and information-packed TED Talk by Lissa Rankin from 2012, Is there scientific proof we can heal ourselves? that pulled together much of what I’ve been mulling over in Benson’s books.

Your thoughts and feelings about the daily experiences of your life both originate from and transmit signals to your body, neurologically and biochemically instructing and changing your health. [p 245]

RELAXATION RESPONSE and REMEMBERED WELLNESS

They seem to go hand-in-hand, these two, with the relaxation response preparing the mind – and hence, the body – for positive receptivity for remembered wellness.

We know that mental focusing techniques that elicit the relaxation response quiet the mind and the body to a more substantial degree and with greater speed than any other means. We know that the experience seems to clean the slate of the mind, making it more receptive and creative. And we know that the experience feels very spiritual to some people, and that spirituality agrees with them, producing better health. [p 213]

Spirituality is a highly personal feeling. People experience and seek out spirituality in their own way, in their own time, and to varying degrees. Spirituality is separate from  religious belief, though it can definitely be a major component of religious belief. It is not so much religious belief that impacts the magnitude of the impact of remembered wellness as it is simply a belief in something, in other words, some sort of spiritual belief.  For more about spirituality and health, visit the University of Minnesota’s Earl E. Bakken Center for Spirituality & Healing Taking Charge of your Health & Wellbeing website, which I found when doing a search for What Is Spirituality.

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The Relaxation Response – part 2

My previous post introduced Dr. Herbert Benson and his work on the Relaxation Response. In particular, I wrote about the opposite of the Relaxation Response, the “fight or flight” response and its relationship to stress and how stress impacts the human body. Benson’s research illuminated what he termed the Relaxation Response, the body’s natural capacity to counter the stress response.

While both responses are inherent in our nervous system, the “fight or flight” response is involuntary, meaning it is automatically set into action by the brain, and the Relaxation Response needs to be consciously called upon.  RelaxationResponse.org lists the Steps to Elicit the Relaxation Response. and you can also hear Dr Benson explain the steps in the video below.

What interests me about the Relaxation Response is how it relates to the practice of yoga. I have been practicing yoga since 2005 and teaching it since 2016, and have experienced as a yogi and a teacher how yoga can help calm the body, calm the mind, and set the circumstances for invoking the Relaxation Response. The reading I have been doing over the past two weeks (yippee for vacation!) has been to help me understand the underpinnings of why yoga can be a powerful entry to eliciting the Relaxation Response, and to guide my thinking as I plan and cue yoga practice for others.

Dr Benson begins by describing the ancient yogis and their meditation practices. As a scientist, Benson was not content to merely accept what history told him. He studied, measured and monitored monks practicing yoga in Asia (Hemis and Rumtek monasteries) as well as practitioners of Transcendental Meditation who came to Harvard asking to be studied because “they felt they could lower their blood pressure through” TM.

Benson’s research found that Yoga caused physiologic changes that elicited the Relaxation Response: decreased oxygen consumption, deceased respiratory rate, decreased heart rate, increased alpha waves, and decreased blood pressure in those with elevated blood pressure. [the Relaxation Response by Herbert Benson, pgs 74-75.] In his book the Relaxation Response, Benson explains

Yoga meditation is concentration on a single point – for example, a physical object or a thought. By dwelling upon an object one may cancel out all distractions that are associated with one’s everyday life and thus achieve a passive attitude.

In my years of practicing yoga it has not been the meditation, per se, that appealed to me. Rather, it has been the physical practice of yoga – the flowing through the asanas, or poses, while moving with my breath. This breath-guided movement has calmed my body and, with it, calmed my mind, and has likely and unknowingly caused me to invoke the Relaxation Response. For the majority of my early years of practicing yoga I was not tuned in to doing any form of conscious meditation, focusing instead on absorbing the asanas into muscle memory and refining them thru subsequent yoga explorations. Still, I did practice forms of silent sitting as my various teachers each guided breath explorations during silent sitting or lying down.

Now that I am a bit more seasoned as a practitioner and as I learn to be a teacher, I believe an initial benefit of yoga is to calm the body. This is akin to Step 3 of how to elicit the Relaxation Response:

Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed. 

A good yoga practice is grounded in stretching, strengthening, and relieving tension in the body, the end result of which is often relaxed muscles. With that physical relaxation present, sitting to invoke the Relaxation Response becomes a natural next step, one that is often guided by yoga teachers as they cue breath explorations, and quiet or guided meditations toward the end of a practice. It is where I find the therapeutic benefits of yoga to truly kick in, and why yoga provided such solace for me when I initially began practicing and continues to nourish my psyche and, I hope, that of my students.

The Relaxation Response – part 1

I have concurrently been reading two books by Dr Herbert Benson: Timeless Healing – The Power and Biology of Belief, and the Relaxation Response. Dr Benson is the founder of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital.

Dr Benson came into my viewfinder as a result of ongoing yoga studies with Jillian Pransky, and participation in last Fall’s online class Being Well in a Digital Age – The Science and Practice of Yoga. I’ve written numerous posts here about the course, including a piece here about the human nervous system that concludes with information about the Relaxation Response and a video of Dr Benson guiding the response.

In doing the above searching it turns out I also wrote about the Relaxation Response in October 2011 after assisting in a workshop entitled Preventing Burnout. (I keep thinking perhaps that blog and this should be merged; it would be so much easier to track related posts!) In that post I included a link to the web site RelaxationResponse.org as well Steps to Elicit the Relaxation Response.

You have perhaps heard of the “fight or flight” response. I have also seen “faint” added to the combo. “Fight or flight” is the body’s natural response when it senses a stressful situation. Back in the day, this likely meant a predator was present, and the human had to very quickly figure out what to do as a matter of self-preservation.

In that instance, when faced with a threatening situation, the beating of the human’s heart sped up, their blood pressure increased, they started breathing faster, and their metabolism sped up. To prepare for movement for running or fighting more blood flowed to the muscles in the arms and legs, and muscle tension increased. The signals for these bodily changes were brought about by the release of the hormones adrenalin (epinephrine) and noradrenalin (norepinephrine), which triggered the human’s brain and muscles into action. In perceiving a stressful situation the human automatically released these stress hormones, which in turn caused bodily changes in the human making it possible to react (hopefully with success!) to the perceived stress.

This is all well and good when a life threatening stimulus presents itself to a human. However, in this day and age many of the stimuli that we face are not life-threatening, yet our bodies respond to the stimuli as if it was life-threatening. This presents a problem for the individual because those same stress hormones are released whenever the brain perceives a stressful situation. Dr Benson provides a definition of stress in The Wellness Book: The Comprehensive Guide to Maintaining Health and Treating Stress-Related Illness (another book I recently read).

Stress is the perception of a threat to one’s physical or psychological well-being and the perception that one is unable to cope with that threat.

In The Wellness Book Benson distinguishes between good stress, which can have a positive impact, and distress, which is chronic or excessive stress. Positive stress will dissipate and leave minimal side effects behind; chronic stress does not dissipate and causes actual harm to the body. In particular, chronic stress causes high blood pressure, which is medically known as hypertension, and is considered a precursor to heart attacks and strokes.

There are many ways to respond to the sensation of stress, some that alleviate it in a more beneficial manner, and some, such as overeating or bingeing on unhealthy delectables, excessive drinking of alcohol, or reliance on  drugs that provide temporary respite while causing detrimental side effects. In Benson’s research he found that the Relaxation Response is a built-in, natural response that can be evoked to counteract the effects of the body’s automatic stress response. For more about this, please see The Relaxation Response – part 2.

 

Our Nervous System, explained

I am taking the online course Being Well in a Digital Age – The Science and Practice of Yoga, which partially explains why it has been two years since my last post on this blog. During the first half of 2016 I was studying for my 200-hour yoga teacher certification and blogging at my other web home, Yoga ~ Dance ~ Music ~ Movement. And for large portions of 2015, 2016, and the summer of 2017, my son, daughter-in-law and grandchildren were living with us. Spend time blogging here or with my family; easy decision!

My yoga blog has been the recipient of all yoga-related writing and below is a cross-post of my most recent post, written earlier today. It deals exclusively with the nervous system and how stress impacts and is dealt with by the nervous system. The post is reprinted below.


The lectures by Catherine Spann and Stacy Dockins from Being Well in a Digital Age – The Science and Practice of Yoga have explained the basics of what happens when stress manifests in the human body. A little bit of stress is manageable; a lot of stress begins to break down our capacity to effectively deal with the stress, and that in turn can manifest in the malfunctioning of other body systems.

Our nervous system consists of two parts, the central nervous system and the peripheral nervous system. I use the word “central” to help remember what the central nervous system consists of – it consists of our brain and spinal cord, the part of our nervous system that runs center or central in our body from our head to the bottom of the spine and is housed in our axial skeleton.

The peripheral nervous system is the communications conduit between the central nervous system and the rest of the body. The word “peripheral” means outlying items or those not centrally located. Again, this helps me remember what the peripheral nervous system deals with – the parts of our nervous system peripheral to the brain and spinal cord, the parts of our nervous system that run through our appendicular skeleton.

The peripheral nervous system consists of the somatic nervous system, which are our voluntary actions, and the autonomic nervous system, which are our unconscious actions such as our heart beating (though we can control that to some extent), and the regulation of digestion, respiration, to name a few of the systems.

Finally, the autonomic nervous system is further composed of the sympathetic nervous system and the parasympathetic nervous system. These two have alliterative words to quickly and easily describe their functions. The sympathetic nervous system triggers the fight, flight or freeze response, which Catherine likens to putting a lead foot on a gas pedal.  The parasympathetic nervous system invokes the rest and digest response, which Catherine equates to putting on the brakes. All of these systems interact with the hypothalamus in the brain, which along with the pituitary gland and the thalamus are part of the endocrine system.

The last piece of this puzzle is the vagus nerve, the longest nerve of the autonomic nervous system. Its role as part of the parasympathetic nervous system involves regulating the heart, lungs and digestive tract. You can read more about this intriguing nerve in 9 Nervy Facts About the Vagus Nerve.

Now we come to stress and how it impacts our nervous system. Stress can be of a short duration, known as acute stress, or it can be chronic stress meaning it is ongoing over a long period of time or simply recurring over and over and over. Our nervous system has a “set point” where it is relatively in balance; this is called homeostasis. Each time our body undergoes some form of stress, our nervous system makes adjustments to return to homeostasis. This adjustment process is known as allostasis. If we are frequently engaged in allostasis it leads to allostatic load, which is the wear and tear on our body systems that often leads to an autonomic imbalance, meaning our sympathetic and parasympathetic nervous systems are out of whack.

Eventually allostatic load causes a cycle that over time makes it difficult to reset our nervous system and find our way back to homeostasis. This is where yoga comes in! Yoga can calm the nervous system and strengthen the ability to self-regulate. A calm nervous system can begin the process of allostasis and correcting for the growing internal imbalances.

One way of calming the nervous system is by stimulating the relaxation response as described by Dr Herbert Benson. Deep, slow breathing stimulates the vagus nerve, which then positively triggers the parasympathetic nervous system. As noted in a prior post, the combination of movement (the physical part of yoga), breath, mindful attention, and relaxation lead to improved mental health. This combination makes for a powerful self-regulation tool that lets you consciously partner with allostasis to reset your body in homeostasis.

Commuting.

For this school year, I am commuting 62 miles each way to where I teach. That translates to an hour’s drive in the morning, and on the days of after school meetings, anywhere from 70 to 90 minutes for the drive home.

After 14 years of teaching just four miles from my home, and several times a year walking home from school, you can perhaps begin to imagine the impact this change of time spent sitting in a car has had on me – less time available for walking, poor air quality (though I recirculate the interior air while driving on I-95 so as to minimize the trucking fumes), muscle strain from sitting in one position, and stress from intense concentration so as to keep my drive safe.

The Hidden Toll of Traffic Jams, in the November 2011 Health & Wellness section of The Wall Street Journal, discusses the impact of traffic emissions on commuters, including this tidbit:

And older men and women long exposed to higher levels of traffic-related particles and ozone had memory and reasoning problems that effectively added five years to their mental age, other university researchers in Boston reported this year. The emissions may also heighten the risk of Alzheimer’s disease and speed the effects of Parkinson’s disease.

That last sentence is fascinating to me because my Dad commuted daily from New Hyde Park, NY to Hasbrouck Heights, NJ for upwards of 20 years. While his distance was half of my current commute, the time spent in the car was about equal due to the enormous volume of traffic crossing the George Washington Bridge.

And why is this fascinating? My Dad developed Alzheimer’s and Parkinson’s in his later years. To be sure, some of that was likely hard-wired into his DNA, but “heighten the risk” and “speed the effects” make me wonder about the commute’s impact. 

Bruce McEwen, in a March 2011 Dana Foundation article Effects of Stress on the Developing Brain, talks about the effects of stress on the brain and body. “Besides major life events, abuse and neglect, it is the ordinary day-to-day experiences in family, neighborhood, commuting and work, and school that affect brain and body function and promote those health damaging behaviors.

A recent acquaintance, who crafts infographics, sent me this infographic describing The Killer Commute. The graphic is provided by CollegeAtHome.com and it speaks volumes! She asked for my feedback, and this is what I had to say: 

The graphic is a killer! Okay, what I mean is, it depicts my experience – all the “yuck” parts of commuting. I had already determined to leave my job (and gave notice in January that I did not want another contract), but if I hadn’t already done that, the graphic would have convinced me to do so.
 
The parts covering health detriments are intense, (perhaps I can use them to drum up business for a “Yoga for Commuters” class….)
 
I only have two issues with an otherwise highly effective and convincing graphic – it is demoralizing! And the sources at the bottom were difficult for me to read.

Cortisol

Think about something you remember well. Most likely that something produced an emotional response in you. Be it positive or negative, the more intense your emotional response, the stronger your memory of that particular event. It turns out that memories encoded through emotions are the strongest of all our memories.

Cortisol gets released from the adrenal glands (located above the kidneys) in response to strong stimuli, especially if the stimuli causes you some stress, again either positive or negative. Research has shown that cortisol plays a role in memory and learning, although too much of it causes the opposite effect of not thinking or remembering clearly. When the brain perceives strong stress, cortisol partners with adrenaline to deal with fight or flight. A little bit of cortisol is helpful but too much of it can be detrimental.The Human Brain and Stress page at The Franklin Institute Science Museum contains informative explanations of the effects of noise on creating stress within the brain, and the impact of stress on memory and gender. About three-quarters along on the page you will find information about the role of Cortisol.