Stress - Practical Bodywork

Ben Affleck’s Hidden Power of Healing

Recently, I had a four-hour layover in Times Square. I was taking the bus up north to visit family, one of whom is critically ill, and my stress level was seismic. Times Square is not a restorative locale at the best of times; after ducking into Le Pain Quotidien for an overpriced lunch, and unwilling to stiff a long-suffering waitress by spending the afternoon there, I found myself walking the streets in a freezing drizzle, lugging a leaden backpack, and overwhelmed by chaos.

Suprisingly good for a random choice.

Urban Outfitters provided no refuge; neither did H & M, Sephora, or any of the other glamorous shops in my path. The rain kept coming. By this time my nerves were so frazzled that I couldn’t summon up the will to obtain an umbrella; for me, chaotic environments are almost as obstructive as low blood sugar, when it comes to making sensible decisions.

Finally, in desperation, I ducked into a movie theatre and bought a ticket for the next available show. (It was ‘Argo,’ : highly recommended.) As soon as I was seated, in spacious, temperature-controlled darkness, I felt my blood pressure start to descend. By the end of the previews I was feeling human again.

A movie theatre, even during an action film, is the opposite of a chaotic environment. Every element of your surroundings is aligned to give you a singular experience; sound, light, temperature, furniture, even smell. Your nervous system is receiving a coherent set of stimuli, telling you–look this way, listen to this, follow this story, feel this emotion. You are taken on a journey, and all you have to do is receive it.

By the time I emerged from the theatre, I was able to tackle the rest of my trip with an organized mind. I’ve never been a Ben Affleck fan, but now I forgive him for looking like a frat boy.

This organized neurological journey is a big part of the healing process, and one often overlooked by modern healthcare systems, although this is beginning to change. It is one of the reasons that I design the Practical Bodywork treatment space with attention to every sense; color, light, smell, sound, temperature. Every element of the environment should send the message: ‘safety, comfort, welcome, peace.’

Architects have begun taking the structure of the human nervous system into account when designing buildings. This development is particularly pertinent to hospitals:

Macagno has been testing hospital design in a virtual-reality lab, and this work could bring us closer to that elusive hospital where, for example, no one gets lost. Other findings from the kind of research he is talking about may challenge what architects have practiced for years. For instance, hospital rooms for premature babies were long built to accommodate their medical equipment and caregivers, not to promote the development of the newborns’ brains. Neuroscience research tells us that the constant noise and harsh lighting of such environments can interfere with the early development of a baby’s visual and auditory systems.

Your environment can either promote well-being, or detract from it. This is a simple idea–perhaps so simple that it is often dismissed. Certainly it seems to have been ignored by a generation or three of big-box retailers, public schools, hospitals and urban planners. Not to mention physical therapy offices.

Why Are Rehab Centers So Ugly? Part I

Why Are Rehab Centers So Ugly? Part II

How to Heal Your Space

The Myth of the Chemical Imbalance

by Sujatha Ramakrishna, M.D.

It’s been over a decade now since the pharmaceutical industry started exposing the American public to advertisements such as this one:

In that time I’ve encountered many patients who simply state, “I have a chemical imbalance,” when I ask them what brings them into the office. They don’t want to discuss their symptoms, or the details of their lives. They see a commercial on TV, decide that the description fits, and make an appointment so they can get some medication. Admittedly, these are some very effective advertising campaigns.

Thanks to the miracles of corporate marketing, we now have millions of people in the United States who are convinced that psychiatrists have deciphered the inner workings of the human mind to such an extent that we can add a little serotonin or norepinephrine to a depressed patient’s brain, and presto! Everything will be working smoothly again in no time at all.

If only our work was as simple as poking a dipstick into someone’s head, like a mechanic checking the oil in a car, and pouring a little dopamine in there if we find that they are a quart or two on the low side.

The truth is that doctors don’t really know how antidepressant medications work. We know that they alter the amounts of certain neurotransmitters in the synapses, and we know that they have positive clinical effects, but the exact mechanism of the process remains a mystery. Another rarely discussed fact is that the resulting improvements in mood are neither guaranteed nor permanent. Many patients experience no benefit at all from antidepressants, and even ones who do achieve satisfactory results report that the effects wear off after they have taken them for a few years.

Since psychiatrists are specialists, primary care doctors often refer patients to us after they have prescribed several different psychotropic drugs for them with minimal success, and much of what we do involves adjusting their medication regimen in an attempt to help them achieve remission. Unfortunately, I’ve had many people complain to me that they are tired of being “treated like a guinea pig,” because previous doctors have repeatedly switched them from one drug to another, as if they were conducting experiments on them to find out what worked.

The suffering that these patients endure during their frequent relapses illustrates the problem with believing in myths. In most of these cases, searching for the right mix of medications is a pointless endeavor, because describing their issues as a “chemical imbalance” is a horrible oversimplification. The human brain is not a piece of machinery. It can’t be manipulated and adjusted by a physician according to standardized specifications, as if it were the engine of a car. The biology of psychology is a much more subtle and intricate process than that. When human beings use their nervous systems in certain ways, it causes some neuronal connections to strengthen, while others are weakened. As an analogy, think of how people learn to play sports. The first time that someone throws a football, kicks a soccer ball, or swings a baseball bat, he or she might not be so great. With many repetitions, the neural pathways in the brain and body which are responsible for these acts of coordination become stronger, and the person’s performance improves.

While emotions and moods are different from motor activities, they are nevertheless functions of the nervous system, and the same principles apply. Being happy makes it more likely that a person will be happy in the future, because those neural pathways become strengthened over time. Unfortunately, sad people also tend to continue to be sad, and if the downward spiral progresses it eventually leads to clinical depression. It is theorized that the long-term administration of psychotropic medications somehow alters these pathways, and that those structural changes, rather than the the initial chemical changes, are what result in the relief of psychiatric symptoms. This is why it generally takes several weeks for the medications to start working when they are first prescribed. It’s also theorized that these drugs wear off after a certain period of time because the brain eventually reverts back to its original state, through a process resembling homeostasis.

More permanent changes in the brain can be achieved through other forms of treatment, such as psychotherapy. This is why mental health practitioners rarely, if ever, prescribe drugs as the only form of therapy for patients with active symptoms. Drugs can provide patients with a boost in mood, enabling them to work on the issues in their lives which resulted in their depression in the first place, but unless the underlying problems are addressed they will come up again when the medication effect wears off. A good counselor provides an objective voice, as opposed to a depressed patient’s inner voice of doom, and can help a patient come up with realistic ways to change his/her outlook or behavior that will eventually result in positive and long-lasting changes in his/her brain structure. Changing oneself for the better is commonly known as “personal growth” or “maturity,” and it is not achieved through ingesting chemicals. As with riding a bike, it takes time and practice, and once you learn you never forget.

There are many valid reasons that people want their symptoms to be managed with “meds only.” These include no time for therapy, no insurance coverage, and no interest in sharing their innermost thoughts and feelings with a therapist. However, if patients take psychotropic medications but opt out of other parts of their prescribed treatment plan, they rarely if ever achieve a full recovery. This is something that is left out of the drug-company advertisements, but it’s something that anyone who has ever taken antidepressants needs to know.

What to Do When You Can’t DO Anything

As many of you know, my brother-in-law, Leif, is currently battling a rare form of cancer called mantle cell lymphoma. He’s young, formidably strong and has one of the healthiest lifestyles of anyone I know. We went up to Maine to visit him last week.

It’s impossible to describe what it’s like to watch someone you love go through a terrible experience. As far too many of us already know, cancer treatment is not only brutal, but chronic; it just goes on and on. Coping with chronic is qualitatively different from coping with a crisis, like getting hit by a bus; getting hit by a bus has a narrative arc that you can move through. Getting cancer is like setting up house in the middle of a freeway.

Most of us, of course, want to be able to walk into a crisis and fix it. Feeling helpless in the face of suffering is thus one of the most difficult states of mind we endure. So what can we do about that? Here are a few suggestions.

• Never underestimate the healing value of mundane service. Wash dishes, clean floors, do laundry, run errands, cook a healthy meal. These tasks are particularly helpful by virtue of the fact that they are infinitely renewable, and can be done without thinking too hard.

• Just be around. Send notes, send gifts, make phone calls. They’re appreciated.

• Don’t say, “If there’s anything I can do, give me a call!” Instead say, “Would it be helpful if I brought a meal, did laundry?” People under stress are often too overwhelmed to be proactive in asking for help. Use your common sense, double-check, and listen to the answers.

• Meditate. Here is Ken Wilber:

…Foremost among these practices is the one known as tonglen, which means “taking and sending.” The practice is as follows:

In meditation, picture or visualize someone you know and love who is going through much suffering–an illness, a loss, depression, pain, anxiety, fear. As you breathe in, imagine all of that person’s suffering–in the form of dark, black, smokelike, tarlike, thick, and heavy clouds–entering your nostrils and traveling down into your heart. Hold that suffering in your heart. Then, on the outbreath, take all of your peace, freedom, health, goodness, and virtue, and send it out to the person in the form of healing, liberating light. Imagine that they take it all in, and feel completely free, released, and happy. Do that for several breaths. Then imagine the town that person is in, and, on the inbreath, take in all of the suffering of that town, and send back all of your health and happiness to everyone in it. Then do that for the entire, state, then the entire country, the entire planet, the universe. You are taking in all the suffering of beings everywhere and sending them back health and happiness and virtue.

When people are first introduced to this practice, their reactions are usually strong, visceral, and negative. Mine were. Take that black tar into me? Are you kidding? What if I actually get sick? This is insane, dangerous! When Kalu first gave us these tonglen instructions, a woman stood up in the audience of about one hundred people and said what virtually everybody there was thinking:

“But what if I am doing this with someone who is really sick, and I start to get that sickness myself?”

Without hesitating Kalu said, “You should think, Oh good! It’s working!”

…

A strange thing begins to happen when one practices tonglen for any length of time. First of all, nobody actually gets sick. Rather, you find that you stop recoiling in the face of suffering, both yours and others’. You stop running from pain, and instead find that you can begin to transform it by simply being willing to take it into yourself and then release it. The real changes start to happen in you, by the simple willingness to get your ego-protecting tendencies out of the way.

–Ken Wilber, ‘Grace and Grit,’ 247-49

This doesn’t have to be a big dogmatic deal. You don’t have to let anyone know you’re doing it. It’s a practice that may help you to be more present, less anxious, and less visibly freaked out. Lots of us want to ‘be strong’ for our loved ones, but what does that mean? Stoicism? False cheer? Pretending nothing’s wrong?

Tonglen meditation can help you stop ‘doing’ and move into ‘being,’ which is where authentic connection lives.

The You-ness of Rolfing

Theresa Zordan is an expert Rolfer and visionary blogger from Denver, CO who graciously offered to swap guest posts with Practical Bodywork. We are pleased as punch to have her.

It may be hard to believe, but sometimes I forget about Rolfing and how helpful it can be. It’s especially hard to believe considering I am a Rolfer. This is what I do all day, every day. But you see, I have this weird thing in my brain about Rolfing: I think it can help just about everything, for just about everyone. Except me.

Someone tells me how their knee’s been bothering them; I think to myself, “I can help with that.” Someone tells me how they feel out of whack and off kilter; I think to myself, “I can help with that.” Someone tells me how they get headaches a few times a week; I think to myself, “I can help with that.” Someone’s freaking out about work and their house and their boyfriend; I think to myself, “I can help with that.” Then, I break my toe, sprain my shoulder, get emotionally wrapped up into a giant-multi-colored-extra-knotted ball of string and I think to myself, “Whatever am I going to do?!? Who could possibly help me with this!?!”

And so, last week, I found myself with said broken toe (my first broken bone!), and sprained shoulder (thanks for nothing, yoga), and emotional ball of knots and I finally (finally!!!) remembered that Rolfing might be able to help me. So, I called up my bud, Dave Sheldon, a Rolfer in Boulder, and asked if he could fit me in. He said yes and I walked into his office with a laundry list of complaints. It was one of those sessions (do you do this?) where you go in, planning to mention just those two or three things that are really bothering you, and by the time you’re five minutes into the session you’ve listed 23 things instead. “AND my roommate’s dog is driving me crazy! AND my sister’s coming to visit next week and it’s stressing me out! AND my sacrum feels all wonky! AND I’ve been wearing flip-flops for two weeks now and I’m sick of it, but I can’t wear any other shoes without my toe hurting and I can’t exactly walk into the bank barefoot, can I?” And so on, and so forth.

Then, the funniest (and at the same time the most natural) thing happened. I got on the table and closed my eyes, and Dave started working. All of a sudden, it felt like all these layers were falling away from me. Like I’d been wearing a suit made out of 23 layers of tissue paper. So light that I hadn’t thought to take it off, but enough that it was affecting the way I looked and that rustling noise was really getting to me. And one by one, Dave gently cut each layer away, and let it fall to the ground. Some layers were wrapped tightly around my foot, keeping it stable, but I didn’t need those anymore. Some of them were wrapped all around my shoulder, all the way down to my wrist and around my ribs and spine. I didn’t need those anymore either. Most of them were wrapped around my heart, or my solar plexus, or my throat, or my head, getting me caught up in unnecessary worry and fear and distress. I didn’t need a single one of those tissue paper layers.

And I realized there, on the table, why it was that I fell in love with Rolfing in the first place. Dave wasn’t taking away anything that I needed, or anything that was inherently me. And he wasn’t adding anything to me, either. He was simply uncovering the real me, and giving me permission for that to be enough. I didn’t need any of this tissue paper to make me stable or pretty or to cover anything up. I was perfectly me, without all that other stuff. He was reminding my shoulder and my toe that they already knew how to recover from an injury quickly and with ease. He was reminding me that worry and fear were good intuitive signals to listen to, but there was no reason to walk around spinning in them all day. And the greatest part was that he did all that without saying a word. He worked with the physical tissues and the energetic patterns and gently unwound them until there I was, just the way I should be. And when I came from that centered, more-me sort of place, I realized, my sister and I had shared a house (and usually a bedroom) for 16 1/2 years. We could probably figure out 3 days just fine. Oh, and my sacrum felt better, too.

It was funny. When I walked into his office, I didn’t feel like someone other than myself. But when I walked out…the change was drastic and clear. I’d walked in like a papier-mâché doll of myself and walked out as me. And that right there is some good shit, yo.

–Theresa Zordan, Rolfer extraordinaire

The Roots of Chronic Pain

New research shows direct hormonal links between childhood trauma and adulthood disease:

There are two pieces of information that really provide the bridge to understand the connection between emotional trauma and adult disease, and the HPA axis is one of those pieces. The other is epigenetics. It starts with the hypothalamus in the brain, so that when we perceive any kind of threat to ourselves through the senses, through eyes or ears or nose or touch or whatever, that message comes into the brain and hits the hypothalamus. Then hypothalamus sends the message to the pituitary gland, which sits just below it, which in turn sends the message to the adrenal glands, which sit on top of each of the kidneys. This generates the flow of adrenaline and cortisol in the body. Adrenaline and cortisol are the hormones of stress. So there’s a connection between the hypothalamus, the pituitary, which is part of the endocrine system, and the adrenal gland, which is part of the immune system. That means that what happens to us emotionally affects our immune and endocrine functions.

When that happens early in life and chronically, it disregulates that whole system. “Trauma” means that stress is occurring over and over again chronically, so the HPA gets revved up and stays in the red zone. It upsets literally all of our physiology, activating the genetic proclivity we might have for whatever disease, setting the stage for it in the beginning, and oftentimes those systems don’t appear later in our lives until after our reproductive years. There is often a total disconnect between those diseases and its root in early chronic emotional trauma.

This is something I’ve suspected for years. I’ve noticed a strong correlation between my clients with chronic pain conditions–fibromyalgia, migraines, PTSD, anxiety, and vague neurological disorders such as primary lateral sclerosis(PLS)–and explicit or implicit childhood trauma. Often these clients have been further abused at the hands of a Western medical system which dismisses their pain and disability as ‘psychosomatic’ because doctors cannot pinpoint a specific cause.

As the linked article goes on to discuss, it is much harder to reverse this process than to prevent it. But that doesn’t mean there’s no way of addressing it in adulthood. The nervous system is plastic; if it is possible to mess it up through repeated stress, it is also possible to re-wire it. Bodywork is an excellent place to start. Massage therapy, craniosacral therapy, andnetwork spinal analysis all work directly and gently upon the nervous system to stimulate release of trauma and deep relaxation.

This is not a rapid process. Generally speaking, the more deeply rooted the trauma, the longer it takes to unwind. Our ‘silver bullet’ medical system tends to want to treat everything with surgery or a pill; nobody likes to hear that chronic conditions are, well, chronic. On the other hand, spending an hour or four a month on a massage table is a lot more enjoyable than pills or surgery. Isn’t that a piece of good news?

The Body Remembers

I am so thankful for the treatment that I received!!! I walked in the office a horrific mess, and Stephanie showed her concern and learned what the issue was that I was having and in four short weeks, my body responded to the gentle, yet firm work that she was putting into it. My recovery was felt within the first visit, and continuously improved with each visit.

—Camille A., on Yelp.com

More than a year ago, Camille was struck by a car while she was crossing the street on foot. Most of the impact was sustained by her left hip. She underwent a plethora of treatments at the time, and reduced her pain to almost nil. Then one afternoon she ‘turned her head the wrong way,’ and it all started up, worse than before.

When Camille first came to me, she was stooped at nearly a 60 degree angle. She couldn’t lie prone with her back straight; she couldn’t lie on her back at all. She was in continuous pain in all positions. and I was concerned that she had problems outside of the scope of my ability to treat.

But she’d been to chiropractors, MDs and physical therapists, and the most recent chiropractor recommended massage. So I worked on her in the most non-invasive manner possible, adjusting positions to compensate for her pain. The entire left side of her body was in an extreme state of spasm, particularly her left piriformis and adductor muscles.

After her first session with me, she felt some relief, and decided to book a Crisis Intervention package. I didn’t find evidence of active trauma, such as inflammation, a slipped disc or scar tissue, so I simply encouraged her spasming muscles to calm down.

And ultimately, this seemed to be all that was required. By the end of her treatment, she was moving normally, the spasming had ceased, and she was nearly pain-free.

As I told Camille (and as I wrote to her lawyer, at her request), my belief is that she was suffering from post-traumatic stress. Memory of trauma is actually stored in our cells until it can be safely released; sometimes the smallest twitch is all that is required to re-activate the signal.

What does this mean, for clients and for therapists? Well, the good news is that it’s not permanent. Over time, and with patient engagement, the tissues will literally ‘release’ both the memories and the pain.

But at the same time, it’s important to remember that not all pain can be resolved by actively ‘fixing’ a problem. Some treatments, such as drugs and surgery, can make it worse. All too often, people take a hammer to a problem that merely needs a bit of unwinding.