Complementary Approaches to Health

As I mentioned in a recent post, the outer ring of the Wheel of Health focuses on Professional Care, which may include both conventional and complementary approaches to healthcare. A primary goal of integrative medicine is to erase the distinction between conventional and complementary approaches and instead encourage the use of the most effective, evidence-based modalities across the continuum.

 As a public health professional, I absolutely believe in the importance of prevention and primary care services that are typically obtained through more traditional or “Western medicine” practices. However, I also believe in, and have experienced firsthand, the benefits of more complementary approaches, many of which are grounded in more “Eastern medicine” traditions. I have had conversations with many individuals who are skeptical about the effectiveness of complementary approaches. My belief is that if you are open to these approaches and believe they can help you, they will. Whereas if you are skeptical and doubtful of their effectiveness, they likely won’t work for you. I feel fortunate that we all have a choice when it comes to deciding what treatments we seek to help us achieve and maintain our health and wellbeing.

Firsthand experience

I’d like to share my experience with some complementary approaches I have used to help manage anxiety. I have dealt with anxiety since I was a young child. One of the ways my anxiety manifested itself was through a nervous habit of biting the inside of my cheeks. I would chew away as I ruminated on my many worries about school, family, fitting in and all the other concerns of an adolescent trying to find her place in the world. I didn’t think much of it as a kid, but I became more self-conscious about it as I matured. I imagine I looked pretty silly with my mouth contorted to one side or the other. When my husband gently inquired about this habit, it made me realize it was noticeable to others and not something I could keep hidden.

I knew I wanted to break this habit but felt powerless to do so. As anyone who has tried to stop a long-standing habit knows, it can be incredibly difficult to change the behavior. I tried chewing gum to keep my mouth occupied. I tried that bitter tasting chemical that is supposed to help you stop biting your finger nails. I decided to try therapy, to address the underlying issue of anxiety. It helped manage the anxiety to some degree but didn’t break the habit. I eventually decided to see a psychiatrist and try anti-anxiety medication, which to me was a last resort. I try to avoid prescription medications unless absolutely necessary. I started taking a relatively low dose of an SSRI (selective serotonin reuptake inhibitor, a class of drugs commonly used to treat depression and generalized anxiety disorder). I would say it took the edge off a little, but it wasn’t solving the problem I wanted to fix which was the cheek biting. I weaned off the medication after about two years, as it wasn’t doing enough, and I did not feel like trying different medications.

At that point, I felt stuck and resigned myself to living with this habit. Then one day my husband came back from a weekend of camping with some friends and shared some interesting news. A couple of the guys had shared that they were working with a local shaman to help resolve some physical and mental health issues – and that this shaman was essentially a miracle worker, curing their ills. I was somewhat taken aback as these gentlemen are well-educated, highly respected professionals…and the first image conjured up in my mind when I heard the word shaman was “witch doctor.” My curiosity was piqued. My husband gently suggested that perhaps this shaman could help with my cheek biting. I was skeptical at first but willing to try anything to get some relief.

I went for my first visit with the shaman and left feeling like a new person. I had not really experienced energy work before, but I felt like he literally wiped away all negative energy that had been present in my body. It took about three or four sessions to kick the habit, but I did stop biting my cheeks. It felt like a huge weight had been lifted from my shoulders. I did experience an occasional relapse, but I would go in for a booster session and be good as new. The only downside to the experience was the cost – it was several hundred dollars per session and not covered by insurance. For me, it was worth every penny, but I realize I was fortunate that I could afford to seek his services.

I stayed free from my nervous habit for a couple of years but then started to experience more relapses. At this point, our financial situation had changed and we did not have as much disposable income to spend on these services. I sought some less expensive opportunities involving energy work, but they were not as effective at stopping the cheek biting. I felt resigned again to just live with it but knowing that it was possible to break the habit made me continue to seek other options. One day I was doing some internet research about cheek biting and stumbled upon individuals who had success with hypnosis. I was intrigued but skeptical again, as all I knew about hypnosis was the Vegas-style shows where some volunteer from the audience gets hypnotized and does silly things on stage to entertain the crowd. As I read more, I realized that hypnosis was different than that and many people have used it to help stop smoking or to lose weight.

I was hesitant to take the leap until I found a local practitioner who also happened to be a fellow graduate of the Duke health coaching program I attended. This connection gave me the courage to reach out and make an appointment. Once again, it took a few appointments to completely kick the habit. However, in the past year or so since I first underwent hypnosis, I have only had a couple of minor relapses that were easily fixed with a one-time booster session. The cost of hypnosis is much more reasonable and since I sought the services to help address a health issue (anxiety), I have been able to use our Health Savings Account to cover the cost.

I will readily admit that I don’t know exactly how the energy work and the hypnosis helped me break this habit. When I questioned the shaman about how his therapy works, he really couldn’t explain it. His response was basically “if it fixed your problem, does it really matter how it works?” He’s got a point. From what I have read about hypnosis, it is a way to access a person’s subconscious mind to help implement the desired change. The hypnotist serves as a guide, using suggestions that can help you modify your behavior and achieve your goals. Regardless of how these approaches work, I am grateful that they have helped me when conventional healthcare couldn’t. I encourage you to consider exploring complementary approaches if you are not achieving the results you desire through more traditional means.

Prevention and Intervention – Focus on the Flu Vaccine

The outer ring of the Wheel of Health focuses on Professional Care, which is just as important as the areas of self-care I have discussed in previous posts. Maintaining optimal health includes seeking routine preventive medical care such as annual physical exams, recommended cancer screenings (e.g., mammogram, colonoscopy) and vaccinations.

You can find the latest recommendations for adult preventive care on the US Preventive Services Task Force website.  I highly encourage you to review the recommendations for your age and sex and discuss them with your healthcare provider. However, there is one recommendation I want to focus on for this post and that is the annual influenza vaccination, better known as the flu shot.

As a public health professional, I am often befuddled by the level of disagreement over getting vaccinated against the flu. I see friends debating it on Facebook. Some get the shot every year, others have never gotten it and never will. I have had friendly debates within my own family about the importance of annual vaccination. I agree with the Centers for Disease Control and Prevention (CDC)’s recommendation which is routine annual influenza vaccination for all persons aged ≥6 months who do not have contraindications. That last part is important – there are some individuals who cannot and should not receive the vaccination. But for most of us, there is no reason not to take this simple step to protect yourself from a potentially serious and sometimes fatal illness.

If you have any access to mainstream media, you are likely very aware of the toll that the flu has taken on communities across the country this year. This flu season is the worst in nearly a decade and we are not out of the woods yet.  Children and adults alike are getting sick, being hospitalized and dying – yes, dying – from the flu and its complications. I know several people who have had the flu and developed pneumonia, requiring hospital stays and heavy-duty antibiotics in order to recover.

I know there are some myths and incorrect beliefs circulating about the flu shot. Some people think they will get the flu if they are vaccinated (they won’t – if they get sick, they were likely exposed before they received the vaccine). Others argue that it is not worth getting vaccinated if the vaccine is not a good match to the virus strains that are circulating. It is difficult to get an exact match of the virus strain each season, as vaccine production must begin months before the flu virus presents itself. However, even if the vaccine is not an exact or even a good match, getting vaccinated will help reduce the risk of flu-associated complications that often require hospitalization. It can also make your illness milder if you do get sick.

Some people claim that they have never gotten the flu shot and have never gotten the flu, thus, they believe they are not susceptible. The flaw in that argument is that the flu virus strain changes every year so it’s likely they will eventually be exposed to a strain that does cause them to fall ill – especially if they decline to be vaccinated. That is why annual vaccination against the flu is so important. The flu is not simply a “bad cold” that someone can weather through. It is a serious illness that should not be taken lightly.

If you’re still not convinced to get vaccinated for your own protection, please consider doing so to protect the people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions. If you haven’t yet been vaccinated and are now willing to do so, it’s not too late. I encourage you to act fast though as flu shots are running low due to the heavy flu season.  You can use the Flu Vaccine Finder tool on the CDC website to see where vaccine is still available in your area. The flu vaccine is typically covered by most health insurance plans and many pharmacies offer the flu shot at reduced cost for those who don’t have insurance.

For more information about the flu and how to protect yourself, please visit the CDC website.

 

 

Mind-Body Connection

This area of the Wheel of Health relates back to the inner ring of Mindful Awareness. It focuses on mind-body practices that can help you be more present and enhance your physical, mental and emotional health. It includes techniques that activate the body’s relaxation and healing response, such as breathing practices, meditation, yoga, and guided imagery.

History of mind-body connection

Awareness of the mind-body connection is not something new. For centuries, almost every system of medicine throughout the world treated the mind and body as a whole. But during the 1600s, the Western world started to see the mind and body as two distinct things. In this view, the body was considered more of a machine, with no connection to the mind at all.

There were some benefits to this Western viewpoint, including advances in surgery, trauma care, pharmaceuticals, and other areas of mainstream medicine. However, it also reduced scientific inquiry around humans’ emotional and spiritual life, and downplayed their innate ability to heal. Fortunately, this perspective started to change again in the 20th century. There was an increase in research related to the mind-body connection and scientists were able to demonstrate the complex links between the body and mind. In addition, this research confirmed the medical and mental benefits of meditation, mindfulness training, yoga, and other mind-body practices.

How does the mind-body connection work?

The mind-body connection is closely related to stress and how you deal with it. The body’s response to stress begins in the brain and spreads through the autonomic nervous system causing the release of powerful hormones, particularly cortisol and adrenaline. The autonomic nervous system controls involuntary body functions such as breathing, blood pressure, and heartbeat. It has two components: the sympathetic and the parasympathetic nervous systems.  The sympathetic nervous system functions like a gas pedal in a car – it triggers the “fight or flight” response, providing the body with a burst of energy so that it can respond to perceived dangers.  On the other hand, the parasympathetic nervous system acts like a brake – it promotes the “rest and digest” response that calms the body down after the danger has passed. Each of these responses has a different impact on the body.

The hormones released during the “fight or flight” response have an impact on many systems within the body, including the immune system. Research has demonstrated that prolonged exposure to stressful events or situations contributes to serious diseases such as high blood pressure, heart irregularities, anxiety, insomnia, persistent fatigue, digestive disorders, mental health issues, and diabetes. In addition, stress can also impact lifestyle and behaviors that affect one’s health and wellbeing. For example, many people are more likely to eat poorly and neglect healthy activities, such as exercise, when they are under stress. The good news is mind-body therapies and practices can help reduce or even prevent the stress response from occurring in your body.

As mentioned above, mind-body practices involve techniques that activate the body’s relaxation and healing response.  When you are exposed to a stressor (say, rush-hour traffic), your response to the stressor determines how your body reacts. You might normally get tense, angry and honk or yell at other drivers who cut you off. However, you can deliberately change your response, through simple techniques like taking some deep breaths and relaxing the muscles in your neck and shoulders.  This response engages the parasympathetic nervous system, which decreases your heart and breathing rate, blood pressure, and muscle tension.

Examples of mind-body practices

There are many strategies to help reduce stress and promote the relaxation response. Below are some of the more common techniques. At first, it may seem challenging or awkward to engage in these activities, but they are skills that develop over time with practice. It may also take some time before you experience positive changes, so patience is key. Try a few different approaches until you find the one(s) that feel most comfortable to you.

Progressive muscle relaxation: This technique involves slowly tensing and then releasing each muscle group in your body, starting with your toes and finishing with your head (or vice versa).

Meditation: The two most common forms of meditation in the United States are transcendental meditation and mindfulness meditation. In transcendental meditation, students repeat a mantra (a single word or phrase). In mindfulness meditation, students focus their attention on their moment by moment thoughts and sensations.

Paced breathing: When we are stressed, we tend to take shallow breaths. We can change this constricted breath and stress response by changing our breathing pattern. The 4/7/8 pattern is one example of paced breathing. To practice, breathe in through the nose for a count of four. Hold for a count of seven. Exhale through the mouth for a count of eight. Repeat these steps four times.

Guided imagery: This technique is a way of focusing your imagination to create calm, peaceful images in your mind, thereby providing a “mental escape.”  You can use an instructor, tapes, or scripts to help you through this process. You can achieve a relaxed state when you imagine all the details of a safe, comfortable place, such as a beach or a garden.

Sources:

University of Maryland Medical Center Complementary and Alternative Medicine Guide

University of Minnesota Taking Charge of Your Health & Wellbeing

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