Mind-Body in Naturopathic Medicine
As naturopathic physicians we study the psychological aspects of illness in school. However in practice, we tend to focus on diets and remedies and less so on discovering and resolving the psychological dimensions of illness and disease. In this article, I would like to share my insights into the mind-body approach to healing as it relates to naturopathic medicine. I will also discuss one case from my practice that has validated the mind-body approach for me.
Mind-Body medicine has benefited greatly from the research findings of Psychoneuroimmunology or PNI. PNI has proven the integrity of the mind-body connection by discovering receptor sites for neurotransmitters in unexpected sites such as the heart, liver, and stomach and on T-lymphocytes. I use Hans Selye’s model of the General Adaptation Syndrome to explain to my patients how any stress, be it a physical or psychological can affect both the mind and body in a continual feedback loop. I also explain to them how emotions and feelings produce neuropeptides, which can directly affect our organs and physiology. I also explain how the reverse is also true where organs such as the stomach and GI tract can produce neuropeptides, which affect how we feel emotionally and can actually produce anxiety or panic attacks.
Dr. Han Selye, working on stress research at McGill University said in 1956: “ a general outline of the stress response will not only have to include brain and nerves, pituitary, adrenal, kidney, blood vessels, connective tissue, thyroid, liver and white blood cells but will also have to indicate the manifold interrelations between them”.
Dr. Candace Pert is a neuroscientist who first discovered opiod receptors in the brain. She has gone on to describe the intimate connection of numerous neuropeptides between the body and emotional states in her 1997 book The Molecules of Emotion: the Scientific Basis behind Mind-Body Medicine. In this book she says: “ In the beginning of my work, I matter-of-factly presumed that emotions were in the head or the brain. Now. I would say that they are in the body as well. They are expressed in the body, and are part of the body. I can no longer make a distinction between the brain and the body.”
From these models we learn that there are at least 3 mind-body messenger systems: the central nervous system, the autonomic nervous system and the neuropeptide system. A fourth system which I believe is just as important to mind-body communication is the meridian system as defined by Traditional Chinese Medicine.
Combining this body of knowledge with my work with patients has led me to conclude that an integrated mind-body approach works best in helping patients heal and resolve most, if not all cases of chronic illness. In working with cases such as cancer, fibromyalgia and chronic fatigue I have come to see that these are conditions of both the mind and body and that an integrated approach to treatment is the most effective option for these patients.
I have had an opportunity to work with thousands of patients in my 22-year career as a naturopathic physician. About 15 years ago, I moved my practice to Vancouver Island from Vancouver in order to offer my patients a residential retreat where they could come for one or several weeks to receive in integrated program of natural healing. In this setting I have been able to offer an integrated program of healing that offers patients help for mind, body and spirit.
In this setting, I have had the opportunity to work with patients on an intensive basis spending significant time with them each day. I have witnessed remarkable recoveries and improvements in a variety a chronic conditions. I have seen that all patients benefit greatly from an approach that integrates both a physical and psychological perspective. The approach I use in mind-body medicine is an eclectic one. I teach all patients relaxation and meditation techniques. I encourage them to find a mind-body relaxation technique that suits them such as Tai Chi, yoga or Chi Kung. If they have a religious faith, I encourage them to use it in the context of their healing program. I refer to outside resources, when appropriate, such as psychologists, counselors and hypnotherapists. I talk to them about their stress coping styles and how it may affect their physical and mental health. I like Heart Math as a tool to reduce stress and induce states of self-regulation. This technique has been proven to regulate body rhythms such as heart rate and blood pressure and to reduce cortisol and increase DHEA. A psychological technique that I have found to be quite valuable in creating psychological insights and healing is called Voice Dialogue. Voice Dialogue teaches us that beneath our everyday ego are a whole collection of dominant and repressed personalities that are active in determining our behavioral and emotional responses to life.
The first case I would like to discuss is Bob (pseudonym). Bob is a 39-year-old male who came to see me with a 9-year history of migraines and depression. They started suddenly at 32 years of age. They started suddenly. They are left sided accompanied by nausea, vomiting, visual and auditory auras. At first they were incapacitating causing him to miss work every other day. He had multiple medical tests including a MRI and cerebral spinal fluid examination. They were finally diagnosed as migraines by a neurologist and he was prescribed nadolol, a beta-blocker. While they reduced his migraines by 66 % they caused side effects of fatigue, weight gain and mental dullness.
At age 34 he was given Paxil for symptoms of clinical depression.
His headaches now occur about twice weekly as opposed to every day before the medication. They seem to get worse on weekends. Bob wakes up tired in the morning and often has trouble falling asleep. He had nocturia 2 or 3 times a night. His back used to go out on him about twice a year, but this symptom stopped after the migraines started. Bob’s diet is unexceptional and average North American. He has one or two coffees a day and drinks about 3 drinks a week.
Bob is involved in the construction trade specializing in the repair of foundations in older homes. He loves his work, as it is creative, involves physical activity and management skills. Bob has been married for 12 years, has 3 children and is a practicing Christian.
I tested Bob for food allergies and I found him to be sensitive to cheese, bananas, potatoes, chicken, pork walnuts, hazelnuts and sulfites. Electrodiagnostic testing indicated stress in the gall bladder, bladder and colon. Hair Analysis revealed low magnesium and elevated mercury.
Bob was with me for a 3day assessment. On the second day, I began to probe his psychological health. Bob revealed to me a troubled marriage. HE and his wife were Christians and had met through church and family connections. However, their sexual relationship broke during their engagement. They went to marriage counseling during their engagement and several times during their marriage. His wife lost all interest in physical intimacy with him. She focused on bringing up their children and once the children were in school, she pursued a high level executive career. She was highly critical about Bob’s personality and the way he managed his business. He would constantly nag him over petty things and try to control him as much as possible. Bob had a very easy-going personality and didn’t stand up to his wife’s criticisms. They had gone to many marriage I felt he was “henpecked husband” and could see why he might be depressed and suffering from chronic migraines.
On the third day, I gave Bob my assessment and treatment plan before he returned home. I prescribed a healthy vegetarian and seafood diet with allergy avoidance. I prescribed daily exercise to reduce stress and biofeedback to help control blood flow to the brain. I gave him a high antioxidant multi-vitamin, some lipotropic and liver botanicals, 5 HTP to boost serotonin and to prevent migraines, gingko to prevent serotonin release in the cerebral arteries and magnesium to relax muscle spasms.
I also suggested something I had never done before with any patient. I told him that although it wasn’t my place to give him marriage advice, I thought that his marriage was a sham and that the stress in staying with a loveless and controlling woman was in all likelihood depleting his body of serotonin and therefore causing both his migraines and depression.
I suggested that he either bring the love and intimacy back into his marriage or divorce her. I was surprised by the boldness of my advice, but I thought it was truthful and authentic.
I saw Bob two months later. His migraines and all signs of depression had completely disappeared. He had stopped the paxil and nadolol. He had lost some weight, was sleeping better and was eating more fruits and vegetables. He was also seeing a psychiatrist. I asked him about his wife. He told his wife he was leaving her and they were now involved in a custody battle over the children. He was still living in the family home. His migraines vanished as soon as he made up his mind to leave her and had communicated this to her. Even though his stress levels had risen, Bob for the first time in many years began to take control of his life and to be honest with himself and his wife.
Bob did move out and divorce his wife. He continues to be free of migraines and depression to this day.
Dr. Stefan Kuprowsky
References
Dacher, Elliott Intentional Healing: A guide to the Mind/Body Healing System, 1996, Marlowe and Company
Khalsa, Dharma Singh and Cameron Stauth, 2002, Meditation as Medicine Fireside Books
Mate, Gabor When the Body Says No, 2003, Knopf Canada
Miller, Emmett E. Deep Healing: the Essence of Mind-Body Medicine, 1997, Hay House
Millenson, J.R. Mind Matters: Psychological Medicine in Holistic Practice, 1995, Eastland Press
Pert, Candace Molecules of Emotion, 1997, Scribner Press
Selye, Hans The Stress of Life, 1956, McGraw-Hill Book Company