Go for it: The journey from paraplegia to flying

After a catastrophic event occurs a person often becomes depressed as the future looks bleak. One may keep asking, ”Why, why me?” When people accept–acceptance without resignation— and concentrate on the small steps of the journey towards their goal, remarkable changes may occur. The challenge is to focus on new possibilities without comparing to how it was in the past. The limits of possibility are created by the limits of our beliefs. We may learn from athletes who aim to improve performance whereas clients usually come to reduce symptoms. As Wilson and Peper (2011) point out, Athletes want to go beyond normal—they want to be superb, to be atypical, to be the outlier. It is irrelevant what the athlete believes or feels. What is relevant is whether the performance is improved, which is a measurable and documented event”. They have described some of the factors that distinguish work with athletes from work with clients which includes intensive transfer of learning training, often between 2 and 6 hours of daily practice across days, weeks, and months. This process is described by the Australian cross-country skier, Janine Shepherd, who had hoped for an Olympic medal — until she was hit by a truck during a training bike ride. She shares a powerful story about the human potential for recovery. Her message: You are not your body, and giving up old dreams can allow new ones to soar. Watch Janine Shepherd’s 2012 Ted talk, A broken body isn’t a broken person.

Reference:

Wilson, V.E. & Peper, E. (2011). Athletes Are Different: Factors That Differentiate Biofeedback/Neurofeedback for Sport Versus Clinical Practice. Biofeedback, 39(1), 27–30.

Shepherd, J. (2012). A broken body isn’t a broken person. Ted talk. http://www.ted.com/talks/janine_shepherd_a_broken_body_isn_t_a_broken_person


Cellphone harm: Cervical spine stress and increase risk of brain cancer

It is impossible to belief that that only a few years ago there were no cell phones.

When I go home, I purposely put the phone away so that I can be present with my children.

I just wonder if the cell phone’s electromagnetic radiation could do harm?

Cell phone use is ubiquitous since information is only a key press or voice command away.  Students spend about many hours a day looking and texting on a cell phone and experience exhaustion and neck and shoulder discomfort (Peper et al, 2013).  Constant use may also have unexpected consequences:  Increased stress on the cervical spine and increased risk for brain cancer.

Increased cervical spine stress

As we look at the screen, text messages or touch the screen for more information, we almost always bend our head down to look down. This head forward position increases cervical compression and stress. The more the head bends down to look, the more the stress in the neck increases as the muscles have to work much harder that hold the head up. In a superb analysis Dr. Kennth Hansraj, Chief of Spine Surgery 0f New York Spine Surgery & Rehabilitation Medicine, showed that stress on the cervical spine increases from 10-12 lbs when the head is in its upright position to 60 lbs when looking down.

weight of headFigure 1. Stress on the cervical spine as related to posture. (From: Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.)

Looking down for a short time period is no problem; however, many of us look down for extended periods. This slouched collapsed position is becoming the more dominant position. A body posture which tends to decrease energy, and increase hopeless, helpless, powerless thoughts (Wilson & Peper, 2004; Peper & Lin, 2012). The long term effects of this habitual collapsed position are not know–one can expect more neck and back problems and increase in lower energy levels.

increased risk for brain cancer and inactive sperm and lower sperm count

Cell phone use not only affect posture, the cell phone radio-frequency electromagnetic radiation by which the cell phone communicates to the tower may negatively affect biological tissue. It would not be surprising that electromagnetic radiation could be harmful; since, it is identical to the frequencies used in your microwave ovens to cook food. The recent research by Drs Michael Carlberg and Lennart Hardell of the Department of Oncology, University Hospital, Örebro, Sweden,  found that long term cell phone use is associated by an increased risk of developing malignant glioma (brain cancers) with the largest risk observed in people who used the cell phone before the age of 20. In addition, men who habitually carry the cell phone in a holster or in their pocket were more likely to have inactive or less mobile sperm as well as a lower sperm count.

What can you do:

Keep an upright posture and when using a cell phone or tablet. Every few minutes stretch, look up and reach upward with your hands to the sky.

Keep your cell phone away from your body such as putting it in your purse or outer pocket of your coat

Use your speaker phone or ear phones instead of placing the phone against your head.

Enjoy the cartoon video clip, Smartphone Ergonomics – Safe Tips – Mobile or Smart Phone Use while Driving, Traveling on the Move.

References:

Agarwal, A., Singh, A., Hamada, A., & Kesari, K. (2011). Cell phones and male infertility: a review of recent innovations in technology and consequences. International braz j urol, 37(4), 432-454. http://www.isdbweb.org/documents/file/1685_8.pdf

Carlberg, M., & Hardell, L. (2014). Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones. International journal of environmental research and public health, 11(10), 10790-10805.  http://www.mdpi.com/1660-4601/11/10/10790/htm

De Iuliis, G. N., Newey, R. J., King, B. V., & Aitken, R. J. (2009). Mobile phone radiation induces reactive oxygen species production and DNA damage in human spermatozoa in vitro. PloS one, 4(7), e6446.

Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.

Peper, E., Waderich, K., Harvey, R., & Sutter, S. (2013). The Psychophysiology of Contemporary Information Technologies Tablets and Smartphones Can Be a Pain in the Neck. In Applied Psychophysiology and Biofeedback, 38(3), 219.

Wilson, V.E. and Peper, E. (2004). The Effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback.29 (3), 189-195.


Adjust your world to fit you: Become the unreasonable person!*

 “Reasonable people adapt themselves to the world; unreasonable people persist in trying to adapt the world to themselves. Therefore all progress depends on unreasonable people.”             

–Paraphrased from Bernard Shaw

Man at deskPhoto by Erik Peper

Having the right equipment and work environment will reduce injury and improve performance. This is true for athletes as well as for people using computers, laptops, tablets and smartphones. We look down and curve our upper spine to read the tablet, crane our heads forward to read the screen, lift our shoulders, arms and hands up to the laptop keyboard to enter data, and we bend our heads down and squint to read the smartphone—all occurring without awareness (Straker et al, 2008; Asunda, Odell, Luce, & Dennerlein, 2010; Peper et al, 2014). We are captured by the devices and stay immobilized until we hurt. At the end of the work day, we are often exhausted and experience neck and shoulder stiffness, arm pain and eye fatigue. This stress immobility syndrome is the twenty first century reward for digital immigrants and natives.

We hurt because we fit ourselves to the environment instead of changing the environment to fit us. The predominant slouched position even affects our mood and strength (Peper and Lin, 2012). Experience how your strength decreases when you slouch and look downward as compared when you sit tall with your spine lengthened at your laptop, tablet or phone. You will need a partner to do this practice as shown in Figure 1.

Sit in your slouched position while looking down and extend your arm to the side. Have your partner stand behind you and gently press downward on your upper arm near your wrist while you attempt to resist the pressure. Now relax and let your arms hang along the side of your body. Now sit upright in a tall position with your spine lengthening while looking straight ahead. Again extend your arm and gently have your gently press downward on your upper arm near your wrist while you attempt to resist the pressure.

pressing down on arm slouched erect trimmedFigure 1. Measuring the ability to resist the downward pressure on the forearm while sitting in either slouched or tall position.

You probably experienced significantly more strength resisting the downward pressure when sitting erect and tall than when sitting collapsed as we discovered in our study at San Francisco State University in with students as shown in figure 2.

subject exp rating tall slouch

Figure 2. Change in perceived strength resisting a downward pressure on the extended arm while sitting. Reproduced by permission from Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M. (in press).

Increase your power and take charge! Arrange your laptop, computer and tablet so it fits you. This usually means changing your home and office chairs and desks; since, they have been manufactured for the average person. Just like the average coach airplane seat – it is uncomfortable for most people. As my colleague Annette Booiman who is a Mensendiek practitioner has pointed out, “An incorrectly adjusted chair or table height will force you to work in a dysfunctional body position while an appropriately adjusted chair or table height offers you the opportunity to work in a healthy position.”

Become the unreasonable person and fit the world so that you are comfortable while using digital devices. There are solutions! Take responsibility and adjust your posture to a healthy one–it will make your life so much more energetic. Sit on your sit bones (ischial tuberosities) as if they are the feet of your pelvis and feel your spine lengthening as you sit tall. Alternatively, stand while working and adjust the desk height for your size. Regardless of whether you sit or stand while working, take many breaks to interrupt your immobilized posture. Install a software program on computer to remind you to take breaks and watch the YouTube  clips on cartoon ergonomics  for working at the computer.

Implement the following common sense ergonomic guidelines:

For working at a computer sit in a chair with your feet on the floor, the elbows bend at 90 degrees with the hands, wrists, and forearms are straight, in-line and roughly parallel to the floor so that the hands can be on the keyboard while the top of monitor is at eye brow level as shown in Figure 3.

Optimum sitting position

Figure 3. Optimum position to sit at a computer work station. From: http://bmarthur.files.wordpress.com/2009/03/good-posture-how-to-sit-at-a-desk.png

For working with a laptop you will always compromise body position. If the screen is at eye level, you have to bring your arms and hands up to the keyboard, or, more commonly, you will look down at the screen while at the same time raising your hands to reach the keyboard. The solution is to use an external keyboard so that the keyboard can be at your waist position and the laptop screen eye level as shown in Figure 4.

optimum laptop use

Figure 4. Optimum position to sit while using a laptop. From: http://www.winwin-tech.com/uploadfile/cke/images/6.jpg

For working with tablets and smart phones you have little choice. You either look down or reach up to touch the screen. As much as possible tilt and raise the tablet so that you do not have slouch to see the screen.

If you observe that you slouch and collapse while working, invest in an adjustable desk that you can raise or lower for your optimum height. An adjustable height desk such as the unDesk offers the opportunity to change work position from sitting to standing as shown in Figure 5.

unDesk

Figure 5. Example of a height adjustable desk (the unDesk) that can be used for sitting and standing.

Although office chairs can give support, we often slouch in them. While at home we use any chair that is available—again encouraging slouching. Reduce the slouching by sitting on a  seat insert such as a BackJoy® which tends to let you sit more erect and in a more powerful and energizing position see Figure 6.

backjoy insert sitting with spine markers a

Figure 6. Example how BackJoy® seat inserts allows you to sit more erect. Reproduced with permission from: http://www.backjoy.com/sit/

Finally, whether or not you can change your environment, take many, many short movement breaks– wiggle, stretch, get up and walk–to interrupt the muscle tension and allow yourself to regenerate. To remind yourself to take breaks while being captured by your work, install a reminder program on your computer such as Stretchbreak that pops up on the screen and guides you through short stretches to regenerate.

Suggested sources:

Cartoon videos on ergonomics: http://peperperspective.com/2014/09/30/cartoon-ergonomics-for-working-at-the-computer-and-laptop/

Healthy computing tips: http://biofeedbackhealth.files.wordpress.com/2013/01/health-computing-email-tips.pdf

Seat insert such as BackJoy®: http://www.backjoy.com/sit/

Height adjustable desk such as The unDesk: http://www.theundesk.com/

Interrupt computer program such as Stretchbreak: http://www.paratec.com

References:

Asundi, K., Odell, D., Luce, A., & Dennerlein, J. T. (2010). Notebook computer use on a desk, lap and lap support: Effects on posture, performance and comfort. Ergonomics, 53(1), 74-82.

Peper, E., & Lin, I. M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.

Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness. Biofeedback, 2(1), 16-23.

Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M.  Posture changes with a seat insert: Changes in strength and implications for breathing and HRV. Poster submitted for the 46th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback.

Straker, L. M., Coleman, J., Skoss, R., Maslen, B. A., Burgess-Limerick, R., & Pollock, C. M. (2008). A comparison of posture and muscle activity during tablet computer, desktop computer and paper use by young children. Ergonomics, 51(4), 540-555.

 

* Adapted from: Peper, E. (in press). Become the unreasonable person: Adjust your world to fit you! Western Edition and Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M. (in press). Posture changes with a seat insert: Changes in strength and implications for breathing and HRV.


Choices: Creating meaningful days

When you woke up this morning, how did you feel? Were you looking forward to the day anticipating with joy what would occur or were you dreading the day as if once again you had to step on the treadmill of life?

how do you feel

Whenever I ask this question of college students in their junior or senior year at an urban university about 20% will answer that they are looking forward to the day. The majority answer, “Well not really”, or even “Oh shit, another day”. For many students the burden of living- working 40 hours a week to pay for rent and tuition, worrying about financial debt, and the challenge of commuting, and finding time to do the homework—feels and is overwhelming.

Asking this question about the quality—not quantity—of life is not just a question for students–it  is applicable for all of us. The more one chooses to do actively what gives fulfillment and meaning, the higher the quality of life (I do not mean eating more chocolate).

In a remarkable study by Dr. Jennifer Temel and her many colleagues, patients with metastatic non-small-cell lung cancer were given the option of early palliative care versus standard aggressive end-of-life treatment. The patients who were assigned to the early palliative care group had significantly better quality of life, fewer depressive symptoms and lived on the average three months longer than the group who received standard treatment.

Even at the end of life there may be choices. Choosing quality of life and doing what gives meaning may nurture a peaceful transition in death. This process of choice has been tenderly described in the recent New York Times essay, The best possible day. Take a moment and read this article by clicking on the link. http://www.nytimes.com/2014/10/05/opinion/sunday/the-best-possible-day.html?smid=fb-share&_r=0

Then ask yourself each day, “Am I looking forward to my day and my activities?” If the answer tends to be “No,” begin to explore new options. Ask yourself, “What would I like to do and look forward to?” First begin to dream about possible options and then begin to plan on how to implement your dreams so that you are on the path to where you want to go.

It is a challenging process; however, each of us can do something that will give meaning and joy to our lives. For suggestions, see the outstanding book by Dr. Lawrence LeShan, Cancer as a Turning Point, or explore the practices in our book by Drs. Robert Gorter and Erik Peper, Fighting Cancer- A Non-Toxic Approach to Treatment.

Reference:

Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., … & Lynch, T. J. (2010). Early palliative care for patients with metastatic non–small-cell lung cancer. New England Journal of Medicine, 363(8), 733-742.

 

 

 


Cartoon ergonomics for working at the computer and laptop

I finally bought a separate keyboard and a small stand for my laptop so that the screen is at eye level and my shoulders are relaxed while typing at the keyboard. To my surprise,  my neck and shoulder tightness and pain disappeared and I am much less exhausted.

How we sit and work at the computer significantly affects our health and productivity. Ergonomics  is the science that offers guidelines on how to adjust your workspace and equipment to suit your individual needs.  It is just like choosing appropriate shoes–Ever try jogging in high heels?  The same process applies to the furniture and equipment you use when computing.

When people arrange their work setting according to  good ergonomic principles and incorporate a healthy computing work style numerous disorders (e.g., fatigue, vision discomfort,  head, neck, back, shoulder, arm or hand pain) may be prevented (Peper et al, 2004). For pragmatic tips to stay health at the computer see Erik Peper’s  Health Computer Email Tips.  Enjoy the following superb video cartoons uploaded by Stephen Walker on YouTube that summarize the basic guidelines for computer, laptop and cell phones use at work, home, or while traveling.

Adult or Child Laptop Use at Home, Work or Classroom

Healthy use of laptops anywhere.

Mobile or Smart Phone Use while Driving, Traveling or on the Move.


A breath of fresh air-Improve health with breathing

“My breathing was something that took me a long time to adjust. I had been breathing almost entirely from my chest and my stomach was hardly moving when I breathed. I made a conscious effort all throughout the day to breathe slowly and with my stomach relaxed. I’ve noticed that my mood is much better when I am breathing this way, and I am much more relaxed. Immediately before I feel like I would have a seizure, if I would change my breathing technique and make sure I was breathing slowly and with my stomach. It would avoid the seizure from developing… This is a huge improvement for me.”  –24 year old student who previously experience 10 epileptic seizures per week

“I blanked out and could not remember the test material. I then reminded myself to breathe lower and slower while imagining the air slowly flowing down my legs. After three breaths, I could again process the information and continue to take the exam. A week later I got my grade back– an A-. Better than I had expected.”  –21 year old student

Breathing occurs without awareness unless there are specific problems such as asthma, emphysema or when we run out of air while exercising. Breathing is more than just the air moving in and out. It is the boundary between the conscious and the unconscious—the voluntary and involuntary nervous system– and affects the sympathetic and parasympathetic activity of our body. The way we breathe,  such as chronic low level hyperventilation,  may contribute to increasing or decreasing anxiety, pain, epileptic seizure, exhaustion, abdominal pain, urinary incontinence or fertility.

We usually think of breathing occurring in our chest. Thus, during inhalation, we puff-up our chest so the lungs will expand. Observe that many people breathe this way and call it normal. Experience how you breathe:

Put your right and on your stomach and your left hand of your chest. Now take a quick big breath. Observe what happened. In most cases, your chest went up and your abdomen tightened and even pulled in.

This breathing pattern evokes a state of arousal and vigilance and activates your sympathetic nervous system. You tend to automatically tighten or pull in your stomach wall to protect your body. When we’re in pain, afraid, anticipate danger or have negative and fearful thoughts, “Do I have enough money for the rent,” or “Feeling rushed and waiting for a delayed Muni bus,” we instinctively hold our breath, slightly tense our muscles and breathe shallowly. Unfortunately, this makes the situation worse—symptoms such as pain, anxiety or abdominal discomfort will increase. This type of breathing is the part of the freeze response—a primal survival reflex. It may even affect our ability to think.  Experience how dysfunctional breathing effects us by doing the following exercise (Peper & MacHose, 1993; Gorter & Peper, 2011).

Sit comfortably and breathe normally.

Now inhale normally, but exhale only 70 percent of the air you just inhaled.

Inhale again, and again only exhale 70 percent of the previously inhaled volume of air. If you need to sigh, just do it, and then return to this breathing pattern again by exhaling only 70 percent of the inhaled volume of air.

Continue to breathe in this pattern of 70 percent exhalation for about forty-five seconds, each time exhaling only 70 percent of the air you breathe in. Then stop, and observe what happened.

What did you notice? Within forty-five seconds, more than 98 percent of people report uncomfortable sensations such as lightheadedness, dizziness, anxiety or panic, tension in their neck, back, shoulders, or face, nervousness, an increased heart rate or palpitations, agitation or jitteriness, feeling flushed, tingling, breathlessness, chest pressure, gasping for air, or even a sensation of starving for air. This exercise may also aggravate symptoms that already exist, such as headaches, joint pain, or pain from an injury. If you’re feeling exhausted or stressed, the effects seem even worse.

On the other hand, if you breathed like a happy baby, or more like a peaceful dog lying on its side, the breathing movement occured mainly in the abdomen and the chest stays relaxed. This effortless diaphragmatic breathing promotes regeneration by allowing the abdomen to expand during inhalation and becoming smaller during exhalation as shown in Figure 1.

Figure 1

Figure 1. Illustration of diaphragmatic breathing in which the abdomen expands during inhalation and contracts during exhalation (reproduced by permission from Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic).

The abdominal movement created by the breathing improves blood and lymph circulation in the abdomen and normalizes gastrointestinal function and enhances regeneration. It supports sympathetic and parasympathetic balance especially when the breathing rate slows to about six breaths per minute. When breathing slower, exhaling takes about twice as long as the inhalation. When you inhale, the abdomen and lower ribs expand to allow the air to flow in and during exhalation the abdomen decreases in diameter and the breath slowly trails off. It is as if there is an upside down umbrella above the pelvic floor opening during inhalation and closing during exhalation.

Most people do not breathe this way . They suffer from “designer’s jean syndrome”. The clothing is too constricting to allow the abdomen to expand during inhalation (Remember how good it felt when you loosened your belt when eating a big meal?). Or, you are self-conscious of your stomach, “What would people thinks if my stomach hung out?” Yet, to regenerate, allow yourself to breathe like peaceful baby with the breathing movements occurring in the belly.  Effortless diaphragmatic breathing is the cheapest way to improve your health. Thus observe yourself and transform your breathing patterns.

Interrupt breath holding and continue to breathe to enhance health. Observe situations where you hold your breath and then continue to breathe. If you expect pain during movement or a procedure, remember to allow your abdomen to expand during inhalation and then begin to exhaling whispering “Shhhhhhhhh.” Start exhaling and then begin your movement while continuing to exhale. In almost all cases the movement is less painful and easier. We observed this identical breathing pattern in our studies of Mr. Kawakami, a yogi who insert unsterilized skewers through his neck and tongue while exhaling—he did not experience any pain or bleeding as shown in Fig 2.

Figure 2

Figure 2. Demonstration by Mr. Kawakami, a yogi, who inserted non-sterile skewers while exhaling and reported no pain. When he removed the skewers there was no bleeding and the tissue healed rapidly (by permission from Peper, E., Kawakami, M., Sata, M. & Wilson, V.S. (2005). The physiological correlates of body piercing by a yoga master: Control of pain and bleeding. Subtle Energies & Energy Medicine Journal. 14(3), 223-237).

Shift shallow chest breathing to slower diaphragmatic breathing. Each time you catch yourself breathing higher in your chest. Stop. Focus on allowing your abdomen to expand during inhalation and become smaller during exhalation as if it was a balloon. Allow the air to flow smoothly during exhalation and allow the exhalation to be twice as long as the inhalation. Over time allow yourself to inhale to the count of three and exhale to the count of 6 or 7 without effort. Imagine that when you exhale the air flows down and through your legs and out your feet. As you continue to breathe this way, your heart rate will slightly increase during inhalation and decrease during exhalation which is an indication of sympathetic and parasympathetic restorative balance. A state that supports regeneration (for more information see, Peper, E. & Vicci Tibbetts, Effortless diaphragmatic breathing).

For many people when they practice these simple breathing skills during the day their blood pressure, anxiety and even pain decreases. While for other, it allows clarity of thought.

 

 

 

 


Evoking your healing potential: You are your placebo

Be careful what you think. You may get what you wish.

The power of the placebo and nocebo are remarkable and often overlooked in medicine. With a placebo, severe chest pain disappears with mock surgery, Parkinson’s tremors stop, knee pain is eliminated following mock arthroscopic knee surgery and even  of lymphosarcoma can be affected (Beecher, 1961; Benedeteti, 2007; Moseley et al, 2002; Kirkley et al., 2008; Klopfer, 1957; Moerman & Jonas, 2002). On the other hand, nocebo can increase pain, accelerate cancer growth, and cause death (Cannon, 1942; Klopfer, 1957; Benedeteti, 2007). These are demonstrations of the self-healing and non-healing potential intrinsic within each of us.

The placebo response (from Latin, “I shall please”) is the beneficial physiological or psychological effect that results from the administration of an otherwise ineffective or inert substance, procedure, instruction. and/or environment.  An example of placebo on neuron activity is demonstrated with  a patient who has Parkinson’s disease (see figure 1).

Fig 1.Figure 1. Recording the activity of single neurons from the brain of an awake patient suffering from Parkinson’s disease. Both the recording apparatus (a) and the electrode track (b) can be seen. In (c), the activity of a single neuron in the subthalamic nucleus can be seen before and after placebo administration (reproduced from: Benedeteti, F.(2007). The Placebo and Nocebo Effect: How the Therapist’s Words Act on the Patient’s Brain. Karger Gazette, 69)

The nocebo response (from Latin, “I will harm”) may evoke the non-healing process and reactivate symptom/disease producing process and experiences. The nocebo response can be evoked by ineffective or inert substances, procedures, instructions, and internal and external environments which by themselves have no known effects.

The placebo/nocebo response is modulated by our covert cultural, familial and personal beliefs, limitations and expectations. The placebo/nocebo effects are the actual demonstrations that the limits of our beliefs are the limits of our possibilities. This process is well described  in the recent published book, You are the Placebo: Making Your Mind Matter, by Chiropractor Joe Dispenza.

Fig 2Dr. Dispenza describes the classic studies of placebo, mental processes and possible mechanisms by which placebo effects occur and disappears and how our thoughts and expectancies create our reality.  The placebo transforms the inner beliefs and give the person the experience of improved health which transforms beliefs. In many cases we can experience improvement but are pulled back into our previous beliefs and self-images of illness by inner and outer cues which are associated with disease process.

The book describes of the covert conditioning process by which we return to our old self and may maintain illness. It is challenging to maintain new beliefs and act/think in new patterns. The internal mental chatter and doubts flood our awareness. Even the question, “How long will the improvement last?” re-evokes the associative mental conditioned disease patterns. If it is possible to interrupt and transform our thoughts moment by moment, minute by minute, hour by hour, day by day and not just for 15 minutes of practice, remarkable changes are sometimes possible. Every thought that triggers an association of the illness state needs to be interrupted and redirected. When patients somehow transform their thoughts, it may result in reversing and eliminating illnesses such as polyostotic fibrous dysphasia, Hashimot’sthyroiditis or chronic lympocytic thyroiditis, and secondary progressive multiple sclerosis.

I highly recommend this book for its outstanding description of placebo/nocebo and cognitive a model of the conditioning processes that underlie it. The book offers hope and inspiration for many patients who  accept “what is/was” and  are open to the present and future possibilities without judgement.

The book’s cases  show that it is possible to reverse chronic “incurable illnesses.” Patients and health care providers should read the book–it provides hope, empowerment, and possibility. It is an antidote to the feeling that there is nothing one can do except to live with the illness. Medicine needs to explore and study the unusual patient who has reversed the disease process and ask, “How can we understand this process and teach it to other patients.”

The major limitation of the book is the absence of data; namely, what percentage of the patients/participants who have practiced Dispenza’s techniques have actually benefited and transformed their illness? The book would be more useful if it included both successful and the many unsuccessful cases. This would help patients who do the practices and do not improve. These patients sometimes  blame themselves and failed at their self-healing—a process that increases depression and hopelessness. We need to realize that many factors affecting our health and illness are beyond our control.

Although I agree with Dr. Dspenza’s basic premise that our beliefs, acceptance of what is and being open to the present and future supports healing. This perspective is only part of the whole picture. Health and illness are multi-factorial and many factors are not within our control.

Read the book and skip chapter 8, The Quantum Mind.  This chapter attempts to describe the physics of the healing process using quantum physics.  As I did not understand quantum physics and quantum mind, I asked my colleague, James Johnston, PhD, who is an expert in quantum physics, to read it for accuracy. He confirmed my gut reaction when he said, “the quantum physics description of how energy changes is pseudo science, involving an incomplete understanding of quantum theory.”

Beecher, H.K. (1961). Surgery as Placebo. JAMA, 176(13), 1102-1107.

Benedeteti, F. (2007). The Placebo and Nocebo Effect: How the Therapist’s Words Act on the Patient’s Brain. Karger Gazette, 69.

Cannon, W. B. (1942). “Voodoo” death. American Anthropologist, 44(2), 169-181.

Dispenza, J. (2014). You are the Placebo: Making Your Mind Matter. Hay House, Inc.

Kirkley, A. et al,. (2008) A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine. 359:1097-1107

Klopfer, B. (1957). Psychological Variables in Human Cancer. Journal of Projective Techniques, 21, (4), 331–340.

Moerman, D.E., & Jonas, W.B. (2002). Deconstructing the Placebo Effect and Finding the Meaning Response. Annals of Internal Medicine. 136 (6), 471-476.

Moseley, J.B., et al, (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine. 347(2), 81-88.

 

 

 


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