Healing Visualization: Part 1 – Experiencing the Mind-Body Connection

Adapted in part from Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought, by Erik Peper, Robert Gorter, and Nancy Faass.

I saw my spine as crooked tree. On both sides of my spine, there were brick walls molding my spine into this bent position. I felt that all my muscles surrounding my spine to be hard and rigid like a brick wall. My spine had become inflexible. I began to imagine the bricks falling away one by one. I imagined the sun shining, with all its warmth, beyond the brick wall.  As each brick fell away, the sun’s rays broke through and warmed my flesh—giving my flesh life and flexibility. The more I did this, the more vivid the images became. The sun became a stronger force allowing the tree to grow upright and straight. I was even able to generate heat in my back. This intensified my relaxed state.  As bricks fell away there was less tension—allowing my spine to straighten. Over a five-week period of practdicing this regularly, my chronic back pain which I had had since the seventh grade, decreased from an average level of 7 to 2 or 3. – 22-year old college senior

In a health-care system where medication and surgery often take center stage, it may seem surprising that imagery could influence a person’s experience of a backpain, headache, fibromyalgia, or a serious illness such as cancer (Porter & Norris, 1985; Van Kuiken, 2004; Roffe et al., 2005; Menzies et al., 2006). Many people find that taking an active role in their care helps them manage symptoms, stress, or worry (Peper et al., 2002; Wang et al., 2022).

BACKGROUND

Over the years, I’ve guided thousands of students and clients in using self-healing visualization. Almost everyone can mentally picture their illness or stress, their healing process, and what it feels like to be healthy and whole. After practicing their personalized imagery, many report that their pain and symptoms have noticeably decreased. Possible mechanism include redirecting attention away from worry and discomfort, evoking a relaxation response that reduces stress-related symptoms, and triggering actual physiological changes induced by visualization. This blog post, the first of a three-part series on self-healing visualization, describes simple practices that may transform participants’ beliefs and open their minds to imagery as a powerful tool for self-healing. Future posts in this series will focus on a structured relaxation approach that to evoke hand warming, as well as detailed step-by-step instructions for practicing self-healing visualization.

For many participants, visualization is easier to accept and implement after they have experienced firsthand how thoughts and emotions affect the body and howpracticing relaxation alongside hand warming can reduce stress related symptoms. In addition, I often share case examples and drawings from previous participants whose health improved (Peper et al., 2022; Peper & Yirmiyahu, 2023). Before teaching self-healing imagery, I usually demonstrate and discuss how thoughts and emotions change the body’s physiology and how relaxation, practiced with passive attention, can increase hand warmth.

Guided Practices to Experience the Mind–Body Connection

A useful first step is to experience and know that thoughts and emotions evoked bodily changes. Depending on the person and setting, this can be demonstrated with biofeedback, guided exercises, or reflection on emotional memories. This process is is grounded in the psychophysiological principle, which states:

“Every change in the physiological state is accompanied by an appropriate change in the mental-emotional state, conscious or unconscious, and, conversely, every change in the mental-emotional state, conscious or unconscious, is accompanied by an appropriate change in the physiological state” (Green & Green, 1977). Simply put, when we purposefully change our mental-emotional state and imagery, we actively influence our underlying physiology.

BIOFEEDBACK MONITORING

Depending on the equipment available, a practitioner can monitor skin conductance, breathing, heart rate, or muscle tension. Participants might relax, recall a stressful memory, or notice their response to a brief, unexpected sound. This demonstration is usually stopped before anyone feels uncomfortable. By recording their physiology, participants can then observe and are often totally surprised by, how their body’s physiology changed of ways they were not consciously aware of as illustrated in Figure 1.

Figure 1. Example of a response to a stressor: skin conductance (SC) increased and abdominal breathing (Resp) decreased. After noticing the response, the participant practiced diaphragmatic breathing and recovered.

Seeing their own recording can prompt an “Aha” moment. It may help participants notice how internal or external events relate to their bodily responses. They can then explore strategies, such as guided breathing or calming imagery, and again observe what happens.

COMPLEMENTARY NON-BIOFEEDBACK PRACTICES

Without equipment, guided practice done, individually or in groups, can help participants experience how thoughts and imagery can change body sensations. These are explored with the following two guided practices: Lemon imagery and Muscle testing.

Guided practice: Lemon imagery

Close your eyes, get comfortable, and picture a lemon. Imagine cutting it in half and squeezing the juice into a glass. Then picture lifting the glass, tasting the juice, and swallowing. Notice any changes in your mouth or body. To experience how this visualization affects your body, try the pracdtice using the guided instructions provided in the YouTube video (Peper, July 25, 2018).

After guiding college students through this practice, more than 94% of participants report an increase in salivation and some noticed their mouths puckering. Individual responses vary in intensity.

Guided practice: Muscle testing

Pair up and stand facing each other. One person is the tester; the other is the participant. The participant extends one arm at shoulder height while the tester briefly presses down on the wrist and the participant resists. Repeat with the other arm, then use the arm that felt stronger.

Next, the participant recalls either a memory associated with feeling hopeless, helpless, or powerless, or one associated with feeling optimistic or empowered. When ready, they extend the chosen arm while the tester briefly presses down. Repeat with a memory from the other category. Afterward, take turns describing what you noticed. To experience how this recall of memories affects your body, try the practice using the guided instructions provided in the YouTube video (Peper, July 23, 2018).

After guiding college students through this practice, about 95% of participants reportedly felt weaker while recalling a hopeless or powerless memory and stronger while recalling an empowering memory. About 5% reported the opposite and those who reported the opposite pattern said they had recalled anger or resentment rather than helplessness or powerlessness.

Self-observation: How thoughts, imagery, and emotions affect the body

Many people have noticed changes in their bodies when they recall emotional charged positive or negative memories, or when they watch films or streaming videos: a thriller may make them feel frightened, erotic scenes may evoke sexual arousal, and a family drama may evoke tenderness. In a self-observation exercise, participants are asked to recall past or present emotionally experiences and observe their own body’s responses. People may notice changes in breathing, muscle tension, warmth, or sweating. Responses differ from person to person; no particular response is required.

DISCUSSION

By guiding participants through these simple awareness exercises, they may discover the intimate connections between their thoughts, emotions, mental images, and bodily responses. Experiencing this mind–body feedback loop may open the door to practical stress management and explore how our mental state shapes our health and immune function. For instance, shifting from helpless rumination to feelings of hope and empowerment doesn’t just change our mood, it boosts our vitality and resilience. When people observe how their bodies react to both internal thoughts and external triggers, they gain the objective perspective needed to interrupt negative patterns, redirect their attention, and consciously choose responses that foster healing and strength.

Without conscious awareness, our thoughts and images form the template of our future. Many of these thoughts and images were derived from the covert hypnotic suggestions give by our family, friends, and culture. Suggestions may limit our potential unless we make an effort to think otherwise. If we become aware of, accept, and change habitual thoughts that act as hypnotic suggestions, we may be able to expand our health and potential. (Peper et al., 2026, p. 292-293).

These practices form the foundation and motivation for self-healing visualization. The next two blog posts will focus on learning relaxation with hand warming and self-healing visualization.

For more on self-care strategies, lifestyle, breathing, relaxation, hope, and environmental risk factors, see Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought (2026), by Erik Peper, Robert Gorter, and Nancy Faass.

REFERENCES

Green, E., & Green, A. (1977). Beyond biofeedback. Delacorte Press. https://www.amazon.com/Beyond-biofeedback-Elmer-Green/dp/0440005833

Menzies, V., Taylor, A. G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. The Journal of Alternative and Complementary Medicine, 12(1), 23–30. https://doi.org/10.1089/acm.2006.12.23

Peper, E. (July 23, 2018). Be careful what you think. Peper Perspective. (Youtube link: https://youtu.be/5JDSmB-nroA;) https://peperperspective.com/2018/07/23/be-careful-what-you-think/

Peper, E. (July 25, 2018). Experience how thoughts affectd body. Peper Perspective. You tube link: https://youtu.be/5JDSmB-nroA https://peperperspective.com/2018/07/25/experience-how-thoughts-affect-body-with-lemon-imagery/

Peper, E., Cosby, J., & Almendras, M. (2022). Healing chronic back pain. NeuroRegulation, 9(3), 164–172. https://doi.org/10.15540/nr.9.3.164

Peper, E., K. H. Gibney, and C. Holt. (2002). Make Health Happen: Training Yourself to Create Wellness. Dubuque, IA: Kendall-Hunt. https://he.kendallhunt.com/product/make-health-happen-training-yourself-create-wellness

Peper, E. Gorter, R., & Faass, N. (2026). Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought. BiofeedbackHealth/Regent Press. https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402/

Peper, E. & Yirmiyahu, D. (2023). Transforming a “bad eye” to an “amazing eye”: a case report and protocol. Townsend Letters. The Examiner of Alternative Medicine, Saturday, July 29, 2023. https://www.townsendletter.com/e-letter-14-changing_health_outcomes_with_self_talk/

Porter, G. & Norris, P. (1985). Why Me?: Harnessing the healing power of the human spirit. Stillpoint Publishing. https://www.amazon.com/Why-Me-Harnessing-Healing-Spirit/dp/0913299197

Roffe, L., Schmidt, K., & Ernst, E. (2005). A systematic review of guided imagery as an adjuvant cancer therapy. Psycho-Oncology, 14(8), 607–617. https://doi.org/10.1002/pon.889

Van Kuiken, D. (2004). A meta-analysis of the effect of guided imagery practice on outcomes. Journal of Holistic Nursing, 22(2), 164–179. https://doi.org/10.1177/0898010104266066

Wang, R., Zhou, C., Wu, Y., Sun, M., Yang, L., Ye, X., & Zhang, M. (2022). Patient empowerment and self-management behaviour of chronic disease patients: A moderated mediation model of self-efficacy and health locus of control. Journal of Advanced Nursing, 78(4), 1055–1065. https://doi.org/10.1111/jan.15077


Be your own health detective: Uncover and Reduce the Hidden Toxins in Your Daily Life

We are continually shaped by the environmental exposures and stressors that surround us and not merely victims of our genetics. Research indicates that chemical exposures in our food and environment may contribute to rising rates of cancer and immune dysregulation (National Cancer Institute, 2025; Miller, 2023). It is time to stop being passive observers and become proactive detectives of our own health. This blog empowers you to identify the environmental risk factors that may be influencing your well-being and offers practical self-care strategies to help you reduce harmful exposure, and restore health.

For a deeper exploration that includes and goes beyond environmental factors, read Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought (Peper et al., 2026). This essential book brings together the science of environmental exposure, immunity, lifestyle, and cancer—and translates it into practical strategies you can use to make more informed, protective choices for yourself and your family.

Where you live can shape your exposures

The idea that our environment can affect cancer risk is not new. In 1775, English surgeon Percivall Pott described an unusually high rate of scrotal cancer among young chimney sweeps. He associated the disease with soot that collected in the folds of the workers’ skin and contained carcinogenic substances (Benmoussa et al., 2019). Environmental exposure is not limited to the jobs people do. It can also depend on where people live, work, attend school, and spend time—sometimes without their knowledge or consent. For example, communities located near nuclear-weapons testing or nuclear-waste sites have reported increased rates of certain cancers and other illnesses (Gilbert et al., 2010; Lee, 2024; Brownstein, 2025; Leung et al., 2025).

Become a health detective and reduce avoidable exposures

History serves as a sobering reminder of the consequences of ignoring land use. Consider the Love Canal disaster in Niagara Falls, New York. A residential community and school were constructed directly atop a former industrial chemical waste dump. The subsequent, toxic migration of chemicals through the soil and groundwater led to severe health crises for residents, including increased rates of cancer, reproductive issues, and other chronic illnesses (New York State Department of Health, 1978). Research the history of land use where you live and work and where your children attend school to protect your long-term health and ask:

  • Was the land previously used for industry, waste disposal, mining, or intensive agriculture?
  • Are there publicly available environmental or health assessments?
  • Have local agencies issued advisories about soil, air, or water contamination?
  • Have many neighbors reported health issues?

What to do: If evidence indicates serious contamination, consult local environmental-health authorities and qualified professionals about testing, remediation, or relocation. Relocation may be a difficult but wise solution to avoid long term harm to you and your family.

Water can be compromised by a host of contaminants, including bacteria, parasites, industrial chemicals, and lead leaching from aging infrastructure.

A stark reminder of this vulnerability was the Flint, Michigan, water crisis (2014–2015), where a failure to properly treat the water supply resulted in severe lead exposure for over 140,000 residents (Ruchart et al., 2019).  This is particularly devastating for children, as lead is a potent neurotoxin capable of causing irreversible damage to developing brains and nervous systems, leading to long-term cognitive, behavioral, and developmental challenges (Naranjo et al., 2020)

Beyond lead, modern contaminants like PFAS (per- and polyfluoroalkyl substances) also known as the “forever chemicals” are detected in more than 45% of United State tap water (Smalling et al., 2023). Take proactive steps: check the latest water quality reports from your provider or local health agency.

What to do:

  • Have your water tested by a certified laboratory if you rely on private wells or surface water.
  • Use a filter that is certified for the specific contaminant you want to reduce. Different technologies remove different substances; no single filter removes everything. Follow the manufacturer’s replacement schedule. If appropriate, consider filtration for shower water as well as drinking and cooking water.

Lead, asbestos, pesticides, dust, sawdust, fibers, and other substances can be transported from a worksite on clothing, shoes, tools, skin, or hair. This remains a significant public health risk. A notable example involved the Water Gremlin Company in Minnesota, where between 2018 and 2019, at least 12 children were diagnosed with lead poisoning linked to lead dust brought home on the clothing and skin of their parents, who were employed at the facility (Ceballos et al., 2022).

What to do:

  • Change out of contaminated work clothing before entering common living areas.
  • Keep work shoes and equipment outside the main living space when possible.
  • Wash your hands and, when appropriate, shower before close contact with children or other household members.
  • Never handle asbestos or other hazardous materials without appropriate training and protective controls.

Storing or heating food in plastic containers may increase the transfer of certain plastic additives into food such as phthalates and bisphenols (like BPA) that are endocrine-disrupting chemicals. Research suggests that chronic exposure to these substances through diet interfere with hormonal systems, potentially leading developmental issues, reproductive dysfunction, and metabolic changes (National Institute of Environmental Health Sciences. 2026).

What to do:

  • Store and reheat food in glass, ceramic, or stainless-steel containers when practical.
  • Avoid using nonstick frying pans.
  • Replace damaged, cloudy, or heavily scratched food containers.

Pesticide residues are found in most conventionally grown foods, although the presence of a residue does not automatically mean that a food is dangerous; since, the risk depends on the substance and the amount of exposure. Even if the risk is very low, human beings are accumulators and over time it may reach harmful levels. The 2026 Shopper’s Guide to Pesticides in Produce indicated that nearly 75 percent of non-organic fresh produce sold in the U.S. contained detectable residues of potentially harmful pesticides (Environmental Working Group, 2026). This report provides list of twelve foods that are most contaminated with pesticides (The Dirty Dozen) and 15 foods with the lowest amount of pesticide residues (The Clean Fifteen).

Although the US government agencies like the EPA set permissible residue levels to ensure safety, these levels may be harmful over the long time.  They are often much higher than allowed in European Union. For example, the U.S. allows up to 30 mg/kg (ppm)  of glyphosate on certain foods, including some cereal grains, whereas the EU allows only  0.05 mg/kg, In addition, some pesticides, such as atrazine which can interfere with the endocrine system and effect fertility and fetus development, are not approved for use in the EU but are  permitted in the United States (European Food Safety Authority, 2019; Donley, 2019).

What to do:

  • Eat a varied diet rich in organic (if possible) vegetables, fruits, legumes, whole grains, nuts, and other minimally processed foods.
  • Wash produce under running water; do not use household soap or detergent.
  • Choose organic foods when affordable and practical, especially if doing so helps you eat more fruits and vegetables.
  • Reduce ultraprocessed foods high in added sugars, sodium, and refined starches.

Actionable self-audit checklist

Use this checklist to observe your environment and identify realistic next steps.

AreaQuick audit actionPotential health benefit
AirUse appropriate ventilation and consider a HEPA filter in sleeping areas, particularly when indoor pollution or wildfire smoke is a concern.May reduce exposure to fine particles and improve indoor air quality.
WaterReview your annual water-quality report; test private wells and use certified filtration when indicated.May reduce exposure to identified contaminants.
KitchenUse glass, ceramic, stainless steel, or well-maintained cookware for food storage and preparation.May reduce unnecessary contact with certain plastic additives and overheated coatings.
FoodEat a varied diet centered on minimally processed foods; wash produce and choose organic options when practical.Supports overall nutrition while potentially reducing some pesticide exposures.

Are corporations a new disease vector?

Environmental disasters often reveal failures in corporate accountability, public oversight, and timely regulation. Tracy Woodruff, Ph.D., director of the University of California, San Francisco’s Center for Environmental and Corporate Harm, has described corporations as potential drivers of disease risk, particularly when commercial incentives conflict with public health (Lawton, 2025a).

These conflicts may contribute to the suppression or selective presentation of research, delayed regulation, aggressive lobbying, or inadequate disclosure of risks. Similar concerns have been raised in relation to the tobacco industry, hazardous chemicals, industrial waste, and the marketing of highly processed foods.

Individual choices matter, but they are not enough by themselves. Our health depends as much on government policy as on personal willpower (Lawton, 2025b). Government regulations set safety standards for the air we breathe, the food we eat, and the water we drink. They define what levels of toxins are “acceptable” and determine how corporations must act and what they must disclose .– Devi Sridhar, DPhil, Professor, University of Edinburgh

Sadly, federal government regulations are usually years behind and presently they are being dismantled and thereby putting more people at risk. Smoking illustrates this interaction. Smoking rates declined substantially after governments combined public education with restrictions on smoking in public places, limits on youth access, higher tobacco taxes, and other tobacco-control measures. These policies, mainly developed and implemented at the local state level, were important contributors to reduced smoking prevalence and, over time, declining tobacco-related disease and mortality.

An integrative perspective

For an integrative perspective on environmental exposures, lifestyle, immunity, and cancer and what you can do about it, see the book: Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought.

The book presents a framework for considering how daily behavior, environmental conditions, and mind–body processes may influence health and recovery. Its practical value is strongest when its recommendations complement—not replace—evidence-based screening, diagnosis, and medical treatment. By observing your environment, making manageable changes, and developing self-regulatory skills, you can take a more active role in your health while working with qualified healthcare professionals.

Available in paperback or economical ebook from; https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402/

Additional relevant blogs

References

Benmoussa, N., Rebibo, J.D., Conan, P., & Charlier, P. (2019). Chimney sweeps cancer: Early proof of environmentally driven tumorigenicity. The Lancet Oncology, 20(3), 338. https://doi.org/10.1016/S1470-2045(19)30106-8

Brownstein, M. (2025, July 23). Living near St. Louis-area Coldwater Creek during childhood linked with higher risk of cancer from radiation. Harvard T. H. Chan School of Public Health. Retrieved July 23, 2025, from https://hsph.harvard.edu/news/living-near-st-louis-area-coldwater-creek-during-childhood-linked-with-higher-risk-of-cancer-from-radiation/

Ceballos, D. M., Spierling, E., Yáñez, N. D., & Calafat, A. M. (2022). A response to take-home lead exposure in a Minnesota manufacturing facility. American Journal of Public Health, 112(12), 1779–1786. https://doi.org/10.2105/AJPH.2022.306982

Donley, N. (2019). The USA lags behind other agricultural nations in banning harmful pesticides. Environmental Health, 18(1), Article 44. https://doi.org/10.1186/s12940-019-0488-0Gilbert, E. S., Huang, L., Bouville, A., Berg, C. D., & Ron, E. (2010). Thyroid cancer rates and 131I doses from Nevada atmospheric nuclear bomb tests: An update. Radiation Research, 173(5), 659–664. https://doi.org/10.1667/RR2057.1

Environmental Working Group (2026). EWG’s Shopper’s Guide to Pesticides in Produce. Accessed September 18, 2026. https://www.ewg.org/foodnews/summary.php

European Food Safety Authority. (2019). Review of the existing maximum residue levels for glyphosate according to Article 12 of Regulation (EC) No 396/2005: Revised version to take into account omitted data. EFSA Journal, 17(10), Article e05862. https://doi.org/10.2903/j.efsa.2019.5862Lawton, G. (2025a). Corporations are the new disease vector. New Scientist, 266(3546), 36–39. https://www.newscientist.com/article/2481125-do-corporations-actually-have-more-control-over-your-health-than-you/

Gilbert, E. S., Huang, L., Bouville, A., Berg, C. D., & Ron, E. (2010). Thyroid cancer rates and 131I doses from Nevada atmospheric nuclear bomb tests: An update. Radiation Research, 173(5), 659–664. https://doi.org/10.1667/RR2057.1

Lawton, G. (2025a). Corporations are the new disease vector. New Scientist, 266(3546), 36–39. https://www.newscientist.com/article/2481125-do-corporations-actually-have-more-control-over-your-health-than-you/

Lawton, G. (2025b). The idea that individuals are fully responsible for their health doesn’t reflect the realities of people’s lives. New Scientist, 266(3550), 38–41.  https://www.newscientist.com/article/2485021-youve-been-sold-agiant-myth-when-it-comes-to-improving-your-health/

Lee, S. (2024, July 20). Congresswoman Lee calls for extension and expansion of Radiation Exposure Compensation Act for suffering Nevadans. Congresswoman Susie Lee [Press release]. Retrieved July 20, 2025, from https://susielee.house.gov/media/press-eleases/congresswoman-lee-calls-extension-and-expansion-radiation-exposure

Leung, M., Tang, I. W., Lin, J. J. Y., et al. (2025). Cancer incidence and childhood residence near the Coldwater Creek radioactive waste site. JAMA Network Open, 8(7), e2521926. https://doi.org/10.1001/jamanetworkopen.2025.21926

Miller, F. W. (2023). The increasing prevalence of autoimmunity and autoimmune diseases: An urgent call to action for improved understanding, diagnosis, treatment, and prevention. Current Opinion in Immunology, 80, Article 102266. https://doi.org/10.1016/j.coi.2022.102266

Naranjo, V. I., Hendricks, M., & Jones, K. S. (2020). Lead toxicity in children: An unremitting public health problem. Pediatric Neurology, 113, 51–55. https://doi.org/10.1016/j.pediatrneurol.2020.08.005

National Cancer Institute. (2025, May 14). As rates of some cancers increase in younger people, researchers search for answers. U.S. Department of Health and Human Services, National Institutes of Health. https://www.cancer.gov/news-events/cancer-currents-blog/2025/early-onset-cancer-research-environment-genetics-support

National Institute of Environmental Health Sciences. (2026.). Endocrine disruptors. Accessed September 18, 2026. https://www.niehs.nih.gov/health/topics/agents/endocrine

New York State Department of Health. (1978, September). Love Canal—Public health time bomb: A special report to the governor and legislature. https://www.health.ny.gov/environmental/investigations/love_canal/docs/lctimbmb.pdf

Peper, E. Gorter, R. & Faass, N. (2026). Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought. BiofeedbackHealth/Regent Press. https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402/

Ruckart, P. Z., Ettinger, A. S., Hanna-Attisha, M., Jones, N., Davis, S. I., & Breysse, P. N. (2019). The Flint water crisis: A coordinated public health emergency response and recovery initiative. Journal of Public Health Management and Practice, 25(Suppl. 1), S84–S90. https://doi.org/10.1097/PHH.0000000000000871

Smalling, K. L., Romanok, K. M., Bradley, P. M., Morriss, M. C., Gray, J. L., Kanagy, L. K., Gordon, S. E., Williams, B. M., Breitmeyer, S. E., Jones, D. K., DeCicco, L. A., Eagles-Smith, C. A., & Wagner, T. (2023). Per- and polyfluoroalkyl substances (PFAS) in United States tap water: Comparison of underserved private-well and public-supply exposures and associated health implications. Environment International, 178, Article 108033. https://doi.org/10.1016/j.envint.2023.108033


Being safe means more than being physically and emotionally protected. It is the trust that, whatever happens, you can cope with it.

From: Pulde, A, & Lederman, M. (2026). The safest man I met had every reason not to feel safe.. https://connectiondocs.substack.com/p/the-safest-man-i-met-had-every-reason

Self-regulation is the cornerstone of biofeedback and neurofeedback and a potent tool for reducing symptoms and enhancing both health and performance. Early in my work, I hypothesized that if a participant, whether a student or client, simply mastered their self-regulation skills, they would generalize these practices into their daily lives, thereby improving their well-being. While this often leads to success, I have come to recognize that the true power of these interventions lies in the synergy between physiological techniques and psychological states.

When a person learns to master relaxation and slow, diaphragmatic breathing while intentionally adopting a state of “being in the present” that is free from the constraints of expectation and the noise of rumination, they facilitate a biological environment conducive to healing. This is because healing and regeneration are most effective when the autonomic nervous system is shifted away from the stress response (Levy et al., 2013; Budhiraja et al., 2024).

My perspective on these mechanisms was significantly expanded through the observation of a yogi and Sufi practitioners who voluntarily engaged in what would objectively be considered deliberate harm to the body, such as the insertion of skewers, without reporting pain or discomfort (Kakigi et al., 2005; Peper et al., 2005a; Peper et al., 2006–; Fuhs & Peper, 2005). Witnessing this, demonstrated that beyond breathing and relaxation, a critical ingredient is the profound “knowing” that one is safe and no harm will occur. Feeling safe is the first step in the healing process (Peper et al., 2025).

In those Sufi piercings, total trust and visceral sense of safety were anchored by the permission and blessing of their Sheikh (their spiritual guide). This dynamic illustrates that implicit and explicit trust, combined with a conviction of safety, is likely a fundamental quality underpinning the placebo effect: the embodied belief that a procedure will lead to healing .

Often, this quality is highly state-dependent, constrained to the specific setting where the safety is perceived (for the Sufis it was the permission and blessing by their Sheik). The challenge is to generalize this feeling of safety beyond the specific setting and therapeutic room. To transcend situational anxiety or future-oriented worry, one must cultivate a foundational belief that whatever unfolds is acceptable, and that the person  possess the internal resources and skills to cope with it. When one truly adopts and experience this perspective, the stressors of life can be met with resilience rather than reactivity.

This process has been exquisitely described by Drs Alona Pulde and Matthew Lederman in their inspirational substack blog, The Safest Man I Met Had Every Reason Not to Feel Safe (Pulde & Ledereman, 2026). Their blog is  reproduced with their permission from, https://connectiondocs.substack.com/p/the-safest-man-i-met-had-every-reason?r=4scjd0&utm_medium=ios

The Safest Man I Met Had Every Reason Not to Feel Safe

Dr. Alona Pulde and Dr. Matthew Lederman

What a chance encounter at an LAX rental car counter taught me about the difference between trying to control what happens and trusting myself to meet whatever does.

Sep 08, 2026

It was late when I pulled into the rental car return at LAX, probably 10 or 11 at night. I was tired, ready to be done with the day, and there was some kind of problem with my return. The woman helping me clicked around on her computer for a while before finally looking up and calling over to someone nearby.

“Hey, Moose. Can you help this man? I can’t figure out what’s going on with his return.”

I looked over and saw this massive man walking toward me. Not heavy, just big. Tall, broad, the kind of person who has a commanding presence without needing to do anything to command it. But what I noticed almost immediately was his smile. There was something warm about him, something easy.

As he started working on my problem, I asked, “Is your name really Moose?”

He laughed and told me his actual name, which seemed to contain about sixteen more syllables than I was prepared for.

“My friends just call me Moose,” he said.

I smiled. “I’m going to call you Moose, too.”

I asked where his name came from, and he told me he was from a country in Africa. I didn’t recognize the name of the place. I sort of laughed and said, “Maybe I should visit. I’ve always wanted to go to Africa.”

His expression changed.

“No. Never go there.”

I wasn’t expecting that.

“Why not?”

He told me it was dangerous. Then, standing there at a rental car counter at LAX, while he was trying to figure out whatever was wrong with my paperwork, this man began telling me his story.

When he was a child, he said, he was kidnapped from his family and forced into labor connected to the conflict diamond trade. Eventually he was rescued and placed in an orphanage. Then the orphanage was bombed and destroyed.

There was more, one impossible thing after another.

I remember looking at him as he told me all of this and thinking about the person standing in front of me. He wasn’t telling the story with bitterness. He wasn’t collapsed under the weight of it. He still had that enormous smile.

Finally, I asked him the question that had been forming in my mind.

“How are you still smiling?”

His answer has stayed with me.

He told me, essentially, that after everything he had lived through, he wasn’t very afraid of what life could throw at him anymore. He had already been through things most of us couldn’t imagine. And he had made it through them.

He trusted himself.

Whatever happened next, he believed he would find a way through that, too.

I stood there listening to him and realized he was describing something I have spent a lot of time trying to find in myself.

Safety.

 

I think about safety a lot. I notice what happens inside me when I feel safe and what happens when I don’t. When I feel safe, connection comes more easily. I listen better, I’m more present. My body feels different. When fear takes over, everything starts to narrow. I can feel myself wanting to manage, anticipate, fix, prepare.

And like a lot of people, one of the ways I have tried to create safety is through control.

If I can know what’s coming, I can prepare for it. If I can anticipate what might go wrong, maybe I can prevent it. If I make the right decisions, say the right thing, watch closely enough, think far enough ahead, maybe I can keep the people I love from getting hurt.

I feel this especially as a father.

There is a part of me that wants to make sure nothing bad happens to my kids. Of course there is. I love them. I want to protect them. I want to see the danger before they see it. I want to know that they’ll be okay.

But there is something exhausting about trying to get safety that way. Because life refuses to make that promise. There is always another thing I haven’t considered. Another possibility. Another what if. Another way something could go wrong.

I’m beginning to wonder whether some of what I’ve called my pursuit of safety has actually been a pursuit of certainty. And certainty is a brutal thing to require from life.

Because if safety depends on certainty, the conditions for relaxing are almost impossible to meet. If everything goes according to plan, I can relax. If everyone I love is okay, I can relax. If I know what is going to happen next, I can relax.

Except life never signs that contract.

And here was Moose. A man whose life had given him almost none of the certainty I keep trying to create.

Terrible things had happened to him. Things he couldn’t predict or control or prevent. Yet somehow the evidence of his survival had become stronger than his fear of what might happen next.

I don’t want to romanticize that. What happened to him was horrific. Trauma doesn’t automatically make people stronger, and suffering isn’t something we need to be grateful for. But there was something in the way he had made meaning of his own survival that I couldn’t stop thinking about.

He didn’t seem to feel safe because he believed the world was safe. He clearly knew it wasn’t.

He seemed to feel safe because he trusted himself to meet the world as it was.

That turned something upside down for me.

Maybe safety isn’t knowing that nothing bad is going to happen. Maybe safety is knowing that if something does, I won’t abandon myself in it.

I’ll hurt. I’ll grieve. I’ll get scared. I might be overwhelmed for a while. I might need help. Trusting myself doesn’t mean believing I’ll handle everything gracefully. Maybe it means trusting that even when I don’t handle something gracefully, I can still find my way back.

That feels different from control.

Control says, “I need life to go a certain way so I can be okay.”

Trust says, “I don’t know how life is going to go, but I believe I can meet it.”

As Moose and I were talking, another manager called out sick. Moose had told me earlier that he was at the end of his eight-hour shift. Now someone needed to cover another eight hours overnight.

I watched him hear the news.

There was no visible outrage. No “You’ve got to be kidding me.” No sense that the night had suddenly become something that shouldn’t be happening to him.

He smiled.

Basically: Okay. I guess I’m working tonight.

He even seemed determined to enjoy it.

And I remember thinking, He’s doing it right in front of me.

This wasn’t a philosophy he had developed for an inspirational quote. It was how he was moving through his life. Something happened that he hadn’t planned. He adjusted. Life changed. He moved with it.

And somehow, because he wasn’t spending all of his energy demanding that the moment be different, he was still there to experience the moment he actually had.

I’ve thought about that a lot since. Because when safety depends on control, we don’t only suffer when things are bad. Sometimes we have trouble fully enjoying when things are good.

Things are going well and some part of the mind starts whispering, How long is this going to last? Someone you love is happy, and you imagine what could happen to them. Life feels good, and instead of settling into the goodness, you start preparing for its disappearance.

And maybe that is one of the hidden costs of trying to protect ourselves from the future: we make the present pay for something that hasn’t happened yet.

Maybe trust gives us another option.

Maybe I don’t have to use the good times to prepare myself for the bad ones. Maybe I can actually be here. Because when the hard thing comes, I can meet it then.

I still want to protect my kids. I still want to make good decisions. I still want to anticipate real risks and take care of the people I love. Trust isn’t passivity, and it isn’t pretending bad things don’t happen.

Maybe it’s simply loosening my grip on the belief that I need to prevent every painful thing in order for us to be okay.

And maybe there is something else I want my kids to learn from me. Not only that I will try to protect them from hard things, but that I believe in their ability to meet hard things too.

Because perhaps one of the greatest forms of safety we can give the people we love isn’t the promise that nothing will happen to them. It’s helping them discover, If something does, I won’t be alone. And I can find my way through.

There is a strange kind of freedom in that.

I don’t need every person I love to be okay every second in order to experience this second. I don’t need life to promise me that nothing painful is coming.

Maybe safety isn’t a promise life makes to me at all.

Maybe it’s a relationship I’m building with myself.

Eventually, whatever problem I’d had with the rental car got resolved. I barely remember what it was now. I do remember shaking Moose’s hand. I told him there was something about him I found incredibly inspiring. I told him I felt drawn to his energy and his way of looking at life. I wished him well.

And then I laughed and told him that I don’t get inspired all that often, and I definitely hadn’t expected it to happen while returning a rental car at LAX late at night.

I walked away thinking about this man who had experienced so many reasons not to trust life, yet somehow had developed an extraordinary trust in himself.

I’m still working on that. I still catch myself reaching for certainty. I still try to think far enough ahead that I can protect myself and the people I love from whatever might be coming.

But now, sometimes, I think about Moose.

And I wonder if the question isn’t, How do I make sure nothing bad happens?

Maybe it’s, Can I trust myself even when I don’t know what happens next?


The article was reproduced with permission from the blog by Dr. Alona & Dr. Matt’s Substack which is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. https://connectiondocs.substack.com/p/the-safest-man-i-met-had-every-reason?r=4scjd0&utm_medium=ios

References

Budhiraja, A., Mehta, A., Alhamo, M. A., Swedarsky, R., Dahle, S., & Isseroff, R. R. (2024). Vagus nerve stimulation: Potential for treating chronic wounds. Wound Repair and Regeneration, 32(1), 108–117. https://doi.org/10.1111/wrr.13151

Fuhs, M., & Peper, E. (2005). The limits of your beliefs are the limits of your reality. Psychophysiology Today, 2(1), 9–13. https://www.researchgate.net/publication/414300494_Limits_of_your_belief

Kakigi, R., Nakata, H., Inui, K., Hiroe, N., Nagata, O., Honda, M., Tanaka, S., Sadato, N., & Kawakami, M. (2005). Intracerebral pain processing in a yoga master who claims not to feel pain during meditation. European Journal of Pain, 9(5), 581–589. https://doi.org/10.1016/j.ejpain.2004.12.006

Levy, G., Fishman, J. E., Xu, D., Chandler, B. T. J., Feketova, E., Dong, W., Qin, Y., Alli, V., Ulloa, L., & Deitch, E. A. (2013). Parasympathetic stimulation via the vagus nerve prevents systemic organ dysfunction by abrogating gut injury and lymph toxicity in trauma and hemorrhagic shock. Shock, 39(1), 39–44. https://doi.org/10.1097/shk.0b013e31827b450d

Peper, E. (2015). Pain as a contextual experience. Townsend Letter, 388, 63–66.

Peper, E., Booiman, A. & Harvey, R.  (2025). Pain-There is Hope. Biofeedback, 53(1), 1-9. http://doi.org/10.5298/1081-5937-53.01.16

Peper, E., Gibney, K. H., & Wilson, V. E. (2005a). Enhancing therapeutic success — Some observations from Mr. Kawakami: Yogi, teacher, mentor and healer. Somatics, 14(4), 18–21. https://biofeedbackhealth.org/wp-content/uploads/2011/01/edited-enhancing-therapeutic-success-8-23-05.pdf

Peper, E., Wilson, V. E., Gunkelman, J., Kawakami, M., Sata, M., Barton, W., & Johnston, J. (2006). Tongue piercing by a Yogi: QEEG observations. Applied Psychophysiology and Biofeedback, 31(4), 331–338. https://doi.org/10.1007/s10484-006-9025-3

Pulde, A. & Lederman, M. (2026). The safest man I met had every reason not to feel safe. Connection Docs. https://connectiondocs.substack.com/p/the-safest-man-i-met-had-every-reason


Can Your Daily Choices Influence Cancer Risk and Recovery?

What if the way you eat, move, sleep, manage stress, and connect with others could influence your body’s ability to prevent disease and support healing?

Most of us have been taught to think of cancer primarily as a genetic disease. Yet an expanding body of scientific research tells a more hopeful story: while genes matter, they are only part of the picture. Our environment, lifestyle, immune system, and even the quality of our relationships can profoundly influence health.

These are the questions explored in the newly published book Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought, by Erik Peper, Robert Gorter, and Nancy Faass.

Written for people living with cancer, their families, healthcare professionals, and anyone interested in optimizing health, the book translates decades of scientific research into practical, evidence-based strategies that readers can use in everyday life.

Rather than viewing cancer through a single lens, Cancer Reconsidered brings together insights from conventional medicine with evidence-based complementary approaches. The authors explore how nutrition, physical activity, stress, sleep, environmental exposures, immune function, and social support interact to influence both cancer risk and the body’s remarkable capacity for repair and resilience.

One of the book’s central messages is both simple and empowering: although we cannot change our genes, we can often change the conditions in which our genes are expressed. Daily choices matter. Healthy habits can strengthen the body’s natural defenses, reduce inflammation, support immune function, and improve quality of life.

A particularly practical chapter explores blood sugar regulation and metabolism. Using continuous glucose monitors (CGMs) together with smartphone apps, readers can observe in real time how different foods, exercise, stress, and sleep affect their glucose levels. Instead of following one-size-fits-all advice, they become active investigators of their own health, discovering what works best for their unique physiology.

Throughout the book, the emphasis is not on fear, but on possibility. Scientific evidence increasingly shows that hope, meaningful social connections, regular movement, nourishing food, restorative sleep, effective stress management, and resilience are not simply “nice ideas”—they are biological factors that can significantly influence health and well-being.

Cancer Reconsidered invites readers to move beyond the question, “What causes cancer?” and instead ask, “What can I do today to create the best possible conditions for health?” It offers a thoughtful, scientifically grounded roadmap for anyone seeking to answer that question.

Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought is now available on Amazon in paperback and and affordable ebook Kindle editions. https://www.amazon.com/s?k=cancer+reconsidered


Managing Blood Sugar: Lifestyle Changes for Better Health

It was 4:45 p.m., and I was looking forward to swimming. I briskly walked the eight blocks from my house to the heated outdoor city pool. The pool is unusual—100 feet long instead of the standard 25 yards—and I enjoy the rhythm of swimming lap after lap.

I arrived just as the sign flipped from Closed to Open. I quickly changed into my bathing suit, locked my clothes in a metal locker, took a short shower, and jumped into the lane. The sun was still out, and only one other swimmer shared my lane. I felt energized and expected to complete my usual forty laps.

However, after about eighteen laps, my energy suddenly disappeared. There was nothing left in the tank. I swam to the side, pulled myself slowly onto the pool deck, and even slowly and unsteadily walked to the men’s locker room. I sat down on the bench feeling shaky, weak, and exhausted. This was not ordinary fatigue. After resting for several minutes, I slowly showered, dressed, and walked home with heavy, almost uncoordinated legs.

As I reflected on the experience, I remembered something similar that had happened two weeks earlier. Around 5 p.m, I had taken my son’s dog for a brisk walk. Again, I began energized, walking quickly, and then suddenly felt drained and sweaty. When I returned home, all I could do was sit down and recover.

What happened

Reflecting back, I realized that both cases I had eaten sweets—cake one time and a large chocolate chip cookie the other about two hours earlier Most likely, the rapidly absorbed sugars and refined carbohydrates caused a sharp increase in blood glucose, followed by a significant insulin response (Ludwig & Ebbeling, 2018). During exercise, my muscles then demanded additional glucose, and my blood sugar may have dropped rapidly enough to trigger symptoms of reactive hypoglycemia: shakiness, sweating, weakness, and fatigue (Morales-Brown, 2025, June 12).

The process is more complex than simply “sugar highs” and “crashes.” Carbohydrates are broken .break down into glucose during digestion, which begins in the mouth. Chewing breaks down food physically, while the enzyme amylase in saliva starts the chemical breakdown by splitting starches into sugars (Peyrot des Gachons & Breslin, 2016).  This raises blood glucose levels, which stimulates insulin release from the pancreas. Insulin helps move glucose from the bloodstream into cells. In some people—especially those developing insulin resistance or prediabetes—the insulin response may overshoot, leading to a later drop in blood glucose. Exercise can amplify this effect because active muscles rapidly consume glucose for energy (American Diabetes Association, 2024).

This experience was a wake-up call for me because my hemoglobin A1C is 5.7%, the lower threshold for prediabetes. Hemoglobin A1C reflects average blood glucose levels over approximately the previous three months (American Diabetes Association, 2026).

Like many people, I enjoy and am  even addicted to bread, potatoes, pastries, and sweets. Looking back, the subtle changes began during COVID. Before the pandemic, I spent much of the day teaching in person, walking across campus, moving, and interacting with students. During lockdown, I sat for hours teaching online. My physical activity during the day dramatically decreased while my eating habits did not significantly change.

When we are inactive, excess sugars and refined carbohydrates are less likely to be immediately used by muscles for fuel. Instead, repeated spikes in blood glucose and insulin can contribute over time to insulin resistance, weight gain, metabolic dysfunction, and increased inflammation (Ludwig & Ebbeling, 2018).

Although my episodes were minor, they reminded me that lifestyle patterns especially eating ultra-processed foods can increase the risk for chronic diseases such as type 2 diabetes, cardiovascular disease, obesity, and some cancers and dementia (Lane et al., 2024; Menegassi  & Vinciguerra, 2025). The scientific literature strongly links obesity, insulin resistance, and type 2 diabetes with increased risk for several cancers, including colorectal and postmenopausal breast cancer (Peper et al., 2026; Scully et al., 2021: Lauby-Secretan et al., 2016). Ultra-processed foods and sugar-sweetened beverages are also associated with increased risk for obesity and metabolic disease; moreover, cancer survivors who consume higher amounts of ultra processed foods face a significantly increased risk of both all-cause and cancer-specific mortality (Hall et al., 2019; Bonaccio et al., 2026). However, cancer is multifactorial, and no single food alone “causes” cancer. Rather, long-term dietary patterns, inactivity, obesity, chronic inflammation, genetics, environmental exposures, sleep, and stress all interact together ( Marino et al., 2024; Dalamaga et al., 2026; Peper et al., 2026).

What to do

The encouraging news is that these processes are often reversible.

Weight, hunger, blood sugar fluctuations, and even A1C are not fixed. They can improve significantly through lifestyle changes. Research consistently shows that reducing ultra-processed foods, lowering intake of refined carbohydrates and sugary beverages, increasing fiber-rich vegetables, improving sleep, reducing stress, and exercising regularly can improve insulin sensitivity and metabolic health (Bird & Hawley, 2017; Vaezi et al., 2025; American Diabetes Association, 2024; Peper et al., 2026).

For many people, continuous glucose monitors (CGMs) can provide powerful real-time feedback (Ehrhardt & Zaghal, 2020). Seeing how specific foods affect your glucose levels can increase awareness and motivate healthier choices. Often, we do not realize how dramatically a muffin, fruit juice, or bowl of white rice may affect blood sugar until we see the data on the screen.

The goal is not perfection or rigid dieting. Instead, it is learning to observe how your body responds and gradually shifting toward foods that support stable energy, satiety, and long-term health.

Before making major dietary changes, watch the superb interview with Dr. David Unwin, a British physician known for his work using lower-carbohydrate dietary approaches to help patients improve type 2 diabetes and metabolic health. His clinical work demonstrates that many patients can significantly improve blood sugar control and sometimes reduce medications through lifestyle changes (Unwin et al., 2020). The video, The Sugar Doctor’s Warning: The “Healthy” Foods Quietly Destroying Your Body! – Dr. David Unwin, is from the podcast, The Diary of a CEO with Steven Bartlett.

The Link Between Diet, Lifestyle, and Cancer Risk: Steps You Can Take

Read the new book, Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought, by Erik Peper, Robert Gorter, and Nancy Faass. It explore the many of the lifestyle factors that can increase cancer risk—or help protect against it. The book brings together an extraordinary range of scientific research to illuminate how everyday habits and modern lifestyles influence cancer risk and healing. Drawing from both conventional medicine and integrative approaches, the authors thoughtfully examine the many factors involved in cancer causation while offering hopeful, evidence-based strategies for supporting recovery and restoring health.

What makes this book especially compelling is that it goes far beyond reviewing the science. It translates research into practical, everyday actions people can use to support healing and improve quality of life. At its heart is lifestyle medicine—the recognition that stress management, hope, physical activity, nourishing foods, supportive relationships, community, and resilience during times of crisis profoundly affect health and well-being. The book also offers a detailed and highly practical discussion of sugar metabolism and explains how continuous glucose monitoring sensors (CGMS) with the smartphone app can help people directly observe how specific foods and daily habits influence their blood sugar levels. Instead of relying on abstract nutrition advice, readers learn how to become active investigators of their own health.

Throughout the book, the message is empowering: our daily habits, social connections, attitudes, and environment may influence health as much as—if not more than—genetics alone. The book is available from Amazon: https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402

Listen to the in-depth discussion of this blog created with Google NotebookLM

Addition relevant blogs

References

American Diabetes Association. (2026). Blood glucose and exercise. American Diabetes Association. Retrieved May 24, 2026, from https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise

American Diabetes Association. (2024). Standards of care in diabetes—2024. Diabetes Care, 47(Suppl. 1). https://diabetesjournals.org/care/issue/47/Supplement_1

Bonaccio, M., Di Castelnuovo, A., Costanzo, S., Ruggiero, E., Esposito, S., Panzera, T., Di Costanzo, G., De Curtis, A., Magnacca, S., Cerletti, C., Donati, M. B., de Gaetano, G., & Iacoviello, L., for the Moli-sani Study Group. (2026). Ultra-processed food and mortality among long-term cancer survivors from the Moli-sani Study: Prospective findings and analysis of biological pathways. Cancer Epidemiology, Biomarkers & Prevention, 35(4), 664–674. https://doi.org/10.1158/1055-9965.EPI-25-0808

Dalamaga, M., Rozani, S., & Petropoulou, D. (2026). Why is colorectal cancer occurring earlier? Metabolic dysfunction, underrecognized carcinogens, and emerging controversies. Current Obesity Reports, 15(1), 24. https://doi.org/10.1007/s13679-026-00700-z

Ehrhardt, N., & Al Zaghal, E. (2020). Continuous glucose monitoring as a behavior modification tool. Clinical Diabetes, 38(2), 126–131. https://doi.org/10.2337/cd19-0037

Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., Fletcher, L. A., Forde, C. G., Gharib, A. M., Guo, J., Howard, R., Joseph, P. V., McGehee, S., Ouwerkerk, R., Raisinger, K., … Zhou, M. (2019). Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial. Cell Metabolism, 30(1), 67–77. https://doi.org/10.1016/j.cmet.2019.05.008

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, 384, e077310. https://doi.org/10.1136/bmj-2023-077310

Lauby-Secretan, B., Scoccianti, C., Loomis, D., Grosse, Y., Bianchini, F., & Straif, K. (2016). Body fatness and cancer—Viewpoint of the IARC Working Group. New England Journal of Medicine, 375(8), 794–798. https://doi.org/10.1056/NEJMsr1606602

Ludwig, D. S., & Ebbeling, C. B. (2018). The carbohydrate-insulin model of obesity: Beyond “calories in, calories out.” JAMA Internal Medicine, 178(8), 1098–1103. https://doi.org/10.1001/jamainternmed.2018.2933

Marino, P., Mininni, M., Deiana, G., Marino, G., Divella, R., Bochicchio, I., Giuliano, A., Lapadula, S., Lettini, A. R., & Sanseverino, F. (2024). Healthy lifestyle and cancer risk: Modifiable risk factors to prevent cancer. Nutrients, 16(6), 800. https://doi.org/10.3390/nu16060800

Menegassi, B., & Vinciguerra, M. (2025). Ultraprocessed food and risk of cancer: Mechanistic pathways and public health implications. Cancers, 17(13), 2064. https://doi.org/10.3390/cancers17132064

Morales-Brown, P. (2025, June 12). What is reactive hypglycemia. Medical News Today. Accessed May 24, 2026. https://www.medicalnewstoday.com/articles/reactive-hypoglycemia

Peper, E., Gorter, R., & Faass, N. (2026). Cancer reconsidered: Why environment, lifestyle, and immunity matter more than we thought. Biofeedback Health. https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402

Peyrot des Gachons, C., & Breslin, P. A. S. (2016). Salivary amylase: Digestion and metabolic syndrome. Current Diabetes Reports, 16, 102. https://doi.org/10.1007/s11892-016-0794-7

Scully, T., Ettela, A., LeRoith, D., & Gallagher, E. J. (2021). Obesity, type 2 diabetes, and cancer risk. Frontiers in Oncology, 10, 615375. https://doi.org/10.3389/fonc.2020.615375

Unwin, D., Khalid, A. A., Unwin, J., Crocombe, D., Delon, C., Martyn, K., Hasan, M., & Tobin, S. D. (2020). Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: A secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years. BMJ Nutrition, Prevention & Health, 3(2), 285–294. https://doi.org/10.1136/bmjnph-2020-000072

Vaezi, S., Freeling, J. L., de Vargas, B. O., Weidauer, L., Shoemaker, M. E., Sanders, W. M., & Dey, M. (2025). Impacts of minimally-processed omnivorous vs lacto-ovo-vegetarian diets on insulin sensitivity, lipid profile, and adiposity in older adults: Secondary findings from a randomized crossover feeding trial. Clinical Nutrition, 55, 90–103. https://doi.org/10.1016/j.clnu.2025.10.010


Improve fertility and decrease cancer risk: THE PLASTIC DETOX

In 1962, Rachel Carson published the seminal, groundbreaking book Silent Spring, which brought public awareness to the harmful effects of environmental pollution (Carson, 1962). In many cases, public awareness of environmental pollution has been driven by observations and research involving people living near or on toxic waste sites, such as the infamous Love Canal in Niagara Falls, New York. Residents living in this area experienced a significantly higher risk of developing bladder, kidney, and other cancers due to contaminated water and soil (Gensburg et al., 2009).

Equally important is the impact of environmental pollution, including ongoing exposure to plastics, on health and embryological development. Many studies report that downstream pollution from agriculture, chemical plants, and sewage causes significant harm, ranging from limb deformities in amphibians (Taylor et al., 2005) to disruptions in human reproductive health. For example, microplastics have been shown to impair ovarian function, decrease fertility rates, and disrupt hormone levels in female subjects and their offspring’s health (Inam, 2025).

Research findings suggest that many human-made chemicals reduce fertility and increase cancer risk. Many chemicals in plastics (e.g., bisphenols (BPA, BPS, BPF), phthalates, flame retardants, and nonylphenol) are endocrine disruptors contributing to reduced fertility and can act as carcinogenic initiators or promoters (NIH, 2026). Ongoing exposure to plastics is one of several factors that may contribute to declines in fertility and earlier onset of cancers such as breast and prostate cancer in younger populations.

The recently released Netflix documentary The Plastic Detox offers an eye-opening exploration of the hidden dangers of the chemicals in plastics in our homes and daily lives and how it may impact fertility. It highlights concerns ranging from hormone disruption—which may contribute to declining fertility worldwide—to increasing rates of cancer and earlier occurrences of heart attack and stroke.

In the documentary, Professor Shanna H. Swan, a research scientist at the Icahn School of Medicine at Mount Sinai in New York City, explains how microplastics and their associated chemicals may affect our health—and what steps we can take to reduce our exposure. Although the documentary is not a randomized controlled trial and it doesn’t disentangle the possible placebo effects that arise when people shift their beliefs about the cause of infertility (for example, “it’s not my fault; it’s the plastics”), its central message is valid. From a psychophysiological perspective, how we interpret the causes of our health challenges can shape both our stress responses and our sense of agency.

Even with its scientific limitations, the film points toward an important concern: that environmental exposures, including plastics, play an important role in reproductive health. I also wonder whether some of the sharp “scientific critiques” of the documentary reflect more than scientific caution alone. History reminds us that industries whose profits are threatened have often worked to amplify uncertainty and delay regulation as the tobacco industry famously did for decades despite mounting evidence of harm (Maani et al., 2022; Oreskes & Conway, 2010).

I strongly recommend watching the documentary and taking steps to reduce exposure to plastics and other environmental toxins (such as glyphosate and the chemicals in air and water pollution) to support your health and that of your children. Watch it on Netflix: https://www.netflix.com/title/82074244

Listen to the in-depth discussion of this blog created with Google NotebookLM

References

Carson, R. (1962). Silent Spring.  Houghton Mifflin Co. https://www.amazon.com/Silent-Spring-Rachel-Carson/dp/0395075068

Gensburg, L. J., Pantea, C., Fitzgerald, E., Stark, A., Hwang, S. A., & Kim, N. (2009). Mortality among former Love Canal residents. Environmental Health Perspectives, 117(2), 209–216. https://doi.org/10.1289/ehp.11350

Inam, Ö. (2025). Impact of microplastics on female reproductive health: Insights from animal and human experimental studies: A systematic review. Archives of Gynecology and Obstetrics, 312(1), 77–92. https://doi.org/10.1007/s00404-024-07929

Maani, N., van Schalkwyk, M. C. I., Filippidis, F. T., Knai, C., & Petticrew, M. (2022). Manufacturing doubt: Assessing the effects of independent vs. industry-sponsored messaging about the harms of fossil fuels, smoking, alcohol, and sugar-sweetened beverages. SSM – Population Health, 17, 101009. https://doi.org/10.1016/j.ssmph.2021.101009

NIH. (2026). Endocrine disruptors. National Institute of Environmental Health Sciences. Retrieved May 7, 2026, from https://www.niehs.nih.gov/health/topics/agents/endocrine/index.cfm

Oreskes, N., & Conway, E. M. (2010). Merchants of doubt: How a handful of scientists obscured the truth on issues from tobacco smoke to global warming. Bloomsbury Press. https://www.amazon.com/Merchants-Doubt-Handful-Scientists-Obscured/dp/1608193942/

Taylor, B., Skelly, D., Demarchis, L. K., Slade, M. D., Galusha, D., & Rabinowitz, P. M. (2005). Proximity to pollution sources and risk of amphibian limb malformation. Environmental Health Perspectives, 113(11), 1497–1501. https://doi.org/10.1289/ehp.7585


Breathing for Health: Four Part Audio Series for Regeneration and Well-Being

Adapted from Peper, E. (1990). Breathing for Health with Biofeedback. Mont­real: Thought Technology Ltd and produced by Larry Klein.

Breathing is the most intimate rhythm of life. From the moment we are born until our last breath, our breath is always there—quietly sustaining us. And yet, most of the time, we are unaware of how we breathe or how profoundly it shapes our health. Learn how to use your breath to optimize your health and enhance your well-being.

Dysfunctional breathing patterns contribute significantly to a range of illnesses, ranging from chronic pain and anxiety to fatigue and stress-related disorders. For example, when anxious, breathing often becomes rapid and shallow; when calm, breathing tends to slow and deepen. Symptoms can often be reduced, and health, resilience, and a deep sense of well-being can be enhanced after mastering and implementing effortless breathing. Breathing affects the mind, body, emotions, and spirit; when you change your breathing, you change your state of being.

The audio series by Erik Peper was conceived and produced by Larry Klein co-founder of Thought Technology, Ltd in 1990 to make the science and practice of breathing with biofeedback accessible to everyone. Although it was recorded more than 35 years ago, the principles and instructions remain as relevant and evidence-based today as they were then.

It was designed to help you observe your own breathing patterns and cultivate the foundational skill of effortless diaphragmatic breathing. Even more importantly, it guides you in integrating this breathing pattern into daily activities so that it becomes your default—whether you are working, speaking, exercising, or resting.

The discussion and guided practices are both simple and profound. When you change how you breathe, you change how you regulate yourself. Breathing both reflects and influences your physiology, emotions, and cognitions—often outside of conscious awareness.

As you listen to and practice the techniques in this four-part audio series, you will develop greater awareness, appreciation, and mastery of effortless breathing. Enjoy applying these practices in everyday life until they become automatic. Like any skill, effortless breathing is learned through gentle, consistent practice—practice makes permanent.

Part 1: Background Information on Breathing
Listen once to understand the scientific foundations and underlying rationale

Part 2: Learning Slow Diaphragmatic Breathing
Listen repeatedly and practice consistently until the skill becomes natural, effortless, and reliable.

Part 3: Integrating Breathing in All Conditions
Alternate between Parts 2 and 3. Practice during everyday activities so the skill generalizes beyond formal sessions and becomes your default way of breathing.

Part 4: Integrating Breathing, Imagery and Meditation for Health
Experience how guided imagery and meditative awareness deepen and amplify the benefits of effortless breathing.

Additional Recommended Blogs to Support the Learning and Generalization of Effortless Breathing

Additional Recommended Blogs: How Breathing Can Help Relieve Pain


Hope for dry eyes and eye strain

Adapted from: Peper, E., Yoshino, A., & Harvey, R. (2026). Hope for dry eyes and eye strain: How breathing-blinking patterns Influence dry eye experience. Biofeedback. 54(1), 25-30. https://doi.org/10.5298/1081-5937-54.01.25

Many times during the day, I let my shoulders and face relax, and with each exhalation I feel the upper eyelids slightly dropping down at the same time as I am relaxing my jaw and mouth while sitting tall. I sense my tongue and throat sinking and feeling an increase in the space between my upper and lower molars. At the same time, I sense my eyes becoming soft and sinking down as my face muscle relax and are pulled down by gravity while sensing a gentle smile. My eyes are not trying to focus on anything. I continue to breathe slowly allowing a pause before inhaling and feel totally safe and at peace. While doing this, I sense moisture at the lower eyelids. After I have inhaled and as I exhale, I slowly open my eyes, and return to my work.  My eyes feel slightly moist and as I blink, the eyelids glide smoothly over the corneal surface.

Background

Dry eyes and eye strain are far more common than most people realize. More than 50% of adults in the United States and Europe experience irritated or burning eyes, dryness, eye strain, headaches, tired or heavy eyes, sensitivity to bright light, and general eye discomfort (Wozniak et al., 2025). The prevalence increases with age and is higher among people who smoke, wear contact lenses, or spend excessive time looking at screens—typically more than six hours per day (Uchino et al,, 2013).

Prolonged, intense screen use—often referred to as digital eye strain or computer vision syndrome—occurs when people focus and concentrate, and the muscles involved with near vision contract and do not relax (Chu et al., 2014). During near vision, the ciliary muscles tighten around the lens to allow near focus, and the medial rectus muscles contract to converge the eyes. These muscles stay contracted and only relax when looking into the distance.  This ongoing tension and increased sympathetic activation combined with reduced blinking decrease tearing, and contribute to dry eye symptoms because the tears are not able to provide adequate moisture.  As a result, the eyes may become irritated, red and inflamed, which increases eye discomfort (Sheppard & Wolffsohn, 2018; Portello et al., 2012; Sheedy et al., 2003).

When someone is vigilant, fearful, or anticipates a threat, sympathetic activation increases (Ranti et al., 2020) and “eye blink are inhibited at precise moments in time so as to minimize the loss of visual information that occurs during a blink. The more important the visual information is to the viewer, the more likely he or she will be to inhibit blinking” (Ranti et al., 2020).  

Without being aware, many people are in a chronic state of vigilance and unknowingly are scanning the world for threats to which they must react.  Clinically, I often observe this when guiding clients in relaxation.  For example, when I give the instruction, “Let me lift your hand,” some clients immediately lift their hand towards me. This nonverbal response suggests that they are constantly vigilant and are monitoring the world around them—always ready to act instead of trusting that they do not have to act and that the world is safe. In most cases, their breathing pattern tends to be shallow and thoracic.

Would it be possible that this ongoing vigilance,which increases sympathetic arousal contributes to the experience of dry eye syndrome? It could be one factor explaining why women have a higher incidence of dry eye disease as well as anxiety than men since the world is often less safe for women, and they breathe more thoracically and less diaphragmatically (abdominally) than men. Shallow chest breathing is also associated with increased in anxiety (Fugl-Meyer, 1974; Mendes et al., 2020; Wilhelm et al., 2001; Banushi eat al., 2023; McLean et al., 2011; Jalnapurkar, et al., 2018).

Note: The risk of dry eye can also be further increased by a wide range of medical conditions and medications, such as diabetes; glaucoma and glaucoma medications; allergies; autoimmune diseases; arthritis; thyroid disease; high cholesterol; acne treatments; antihistamines; antidepressants; and a history of refractive surgery, conjunctival infections, or corneal abrasions. Dry eye also occurs more frequently in women (Mohamed et al., 2024).

What is usually recommended to resolve dry eyes

The primary and effective first-line treatment to reduce the symptoms of dry eye disease is the use of artificial tears (lubricating eye drops) to provide relief (Maity et al., 2025).  Another recommendation to reduce eye strain associated with computer use is to implement the 20/20/20 rule developed by the American Optometric Association–take a 20-second break every 20 minutes and look at something 20 feet away (AOA, 2026). Although the 20/20/20 practice can reduce eye strain and momentarily reduce some of the symptoms associated with dry eye disease especially if the eyes are closed, how we orient, breathe and look may contribute to the experience of dry eye discomfort.

Experience how to evoke dry eyes

Sit comfortably, look around, and observe how your eyes feel. Close your eyes. Now imagine there is a threat. Take a very quick gasp through an open mouth by inhaling into your upper chest and keep breathing very shallowly and irregularly. At the same time, open your eyes wide while being vigilant and looking for danger. Simultaneously, tense your body, inclining it slightly backward as if trying to avoid something.  Do not blink, as you may miss the potential threat approaching you (adapted from Lemeignan et al., 1990; Bloch, 2017). A sample physiological recording of this pattern is shown in Figure 1.

Figure 1. Breathing pattern in response to a threat; a rapid gasp into the chest and pulling the abdomen in to protect while breathing shallowly and rapidly.

Most participants report that almost immediately they feel their eyes getting cooler and after 15 seconds, drier. This facial, breathing, and posture pattern is an exaggeration of the somatic expression of fear that is evoked when we are vigilant and feel unsafe, and it increases sympathetic arousal (Kalawski, 2020).

In most cases, this pattern is automatic, and occurs without awareness, and increases sympathetic activity (Narkiewicz et al., 2006). On the other hand, slow diaphragmatic breathing tends to reduce sympathetic activity (Harada et al., 2014; Lehrer & Gevirtz, 2014). Clinically, the vigilance pattern can often be observed as a person slightly lifts and expands their chest during inhalation and drops and constricts it during exhalation, while breathing shallowly and rapidly without any abdomen expansion or constriction. It is often punctuated with brief breath holding and a reduced blinking rate during concentration.

To investigate these observations more systematically, we compared the practice of gasping while opening the eyes with gentle exhalation while opening the eyes—a pattern that may reduce sympathetic activation and alter the subjective sensation of eye dryness.

Participants: 13 males and 13 females; average age, 39 years

Procedure: While sitting comfortably with their eyes closed, participants were guided through the following two practices:

1.Gasp while opening the eyes

Sit comfortably and look around and observe how your eyes feel. Now close your eyes. Now imagine there is a threat. Take a very quick gasp through an open mouth by inhaling into your upper chest and keep breathing very shallowly and irregularly. At the same time, open your eyes wide while being vigilant and looking for danger. Simultaneously, tense your body, inclining it slightly backward as if trying to avoid something.  Do not blink, as you may miss the potential threat approaching you. Repeat three times.

2. Gentle exhalation while opening the eyes

Sit comfortably and look around and observe how your eyes feel. Now close your eyes. Breathe comfortably and inhale by allowing your abdomen to extend and widen while feeling your eyes sinking in their sockets and becoming softer as you gently start exhaling. While gently exhaling, begin to open your eyes very slowly, looking down through your eyelashes without caring what you see, allowing your jaw and face muscles to relax and feeling a slight smile. When you feel the urge to inhale, allow your eyes to close and let your abdomen expand as you inhale slowly. Repeat three times.

After these two practices, the participants filled out a short assessment questionnaire in which they rated how their eyes felt on a scale from -5 (dry), 0 (normal), to 5 (moist/tearing), and rated which eye-opening procedure allowed their eyes to be more relaxed and moist.

Results

92.3% of the participants reported that opening their eyes during exhalation significantly increased eye relaxation and moisture, as shown in Figure 2. A one-way analysis of variance (ANOVA) revealed a significant difference between the inhale condition (M = −0.19, n = 26) and the exhale condition (M = 1.00, n = 25), F(1, 49) = 9.65, p = .003. The experience of eye irritation was correlated (r = 0.64) with the self-rating of experiencing anxiety and fear during the last three months. 

Figure 2. Gently opening the eyes during exhalation increases the experience of moisture and relaxation in the eyes.

Discussion

The results suggest that increased moisture and eye relaxation could be evoked by changing breathing-blinking patterns. Nearly all participants experienced an increase in tearing and eye relaxation; however, long-term benefits most likely occur if the person implements this practice many times during the day. By changing the breathingg-blink pattern and peacefully looking at the world with a smile, one would decrease sympathetic arousal and increase parasympathetic activity.  This approach should be taught as the first self-care intervention to reduce eye irritation.

Recommendations to decrease dry eye and improve eye health

  1. Experience how the two different breathing and eye-opening practices described above affect your eye dryness or moistness. 
  2. When you sense the first onset of minimal eye discomfort or when looking at screens on your computer or cellphone, implement the following practice for about 10 to 15 seconds. Allow your eyelids to close.  Be aware of the sensations in your eyes, let your face and jaw relax as if they are being pulled down by gravity while sensing the eyes becoming soft and sinking into their sockets. Breathe diaphragmatically by allowing the abdomen to expand when you inhale. While gently exhaling, slowly open your eyes slightly while looking down with a gentle smile and sensing the moisture beginning to occur in the eyes. Repeat twice.
  3. During the day, implement the 20/20/20 vision-regeneration practice (every 20 minutes, take a 20-second break and look at something 20 feet away without caring what you see), as shown in Figure 3.
  4. Read and incorporated the many practices described in the superb book, Vision for Life; Ten Steps to Natural Eye Improvement, by Meir Schneider (2012).

Figure 3. The 20/20/20 rule poster to prevent eye strain (AOA, 2026).

Do these practices many times and be aware of the sensations in your eyes and face. This passive awareness, in conjunction with slower breathing, tends to reduce sympathetic arousal and increase parasympathetic activity, which facilitates increased tearing. As one participant reported when she practiced this:

What a surprise it was when I closed my eyes and breathed slowly and diaphragmatically, and then, as I began to exhale, I very slowly began to open my eyes while looking down and through my eyelashes, while feeling my eyes sink into their sockets. Tearing occurred spontaneously, and my eyes felt lubricated. What a relief. It provided hope that I could help myself instead of only depending on lubricating eye drops whenever my eyes felt dry and irritated.

Two books to maintain and improve vision and reduce techstress

Vision for Life: Ten Steps to Natural Eye Improvement by Meir Schneider (2016) offers many strategies you can immediately incorporate into your daily life to improve and restore your vision. It provides guidelines on how to reverse developing vision issues before they cause damage and how to remedy existing problems, including near- and far-sightedness, lazy eye, as well as more serious conditions such as cataracts, glaucoma, optic neuritis, detached retinas and retinal tears, macular degeneration, and retinitis pigmentosa.

TechStress: How Technology is Hijacking our Lives, Strategies for Coping, and Pragmatic Ergonomics by Erik Peper, Richard Harvey, and Nancy Faass (2020) offers practical tools to avoid the evolutionary traps that trip us up and address the problems associated with technological overuse. It includse effective strategies and practices that individuals can use to optimize their workspace, reduce physical strain, correct posture, and improve vision. It provides fresh insights on reducing stress and enhancing health.

Listen to the expanded podcast based on this blog produced with Google Notebook LM.

Additional blogs that offer strategies to improve vision

References

AOA. (2026). 20/20/20/ to prevent digital eyes strain. American Optometric Association. https://www.aoa.org/AOA/Images/Patients/Eye%20Conditions/20-20-20-rule.pdf

Banushi, B., Brendle, M., Ragnhildstveit, A., Murphy, T., Moore, C., Egberts, J., & Robison, R. (2023). Breathwork interventions for adults with clinically diagnosed anxiety disorders: A scoping review. Brain Sciences, 13(2), 256. https://doi.org/10.3390/brainsci13020256

Bloch, S. (2017). Alba Emoting: A scientific method for emotional induction. Scotts Valley, CA: CreateSpace Independent Publishing Platform. https://www.amazon.com/Alba-Emoting-Scientific-Emotional-Induction/dp/154254884

Chu, C.A., Rosenfield, M., Portello, J.K. (2014).  Blink patterns: reading from a computer screen versus hard copy. Optom Vis Sci., 91(3),297-302. https://doi.org/10.1097/OPX.0000000000000157

Craig, J. P., Nichols, K. K., Akpek, E. K., et al. (2017). TFOS DEWS II definition and classification report. The Ocular Surface, 15(3), 276–283. https://doi.org/10.1016/j.jtos.2017.05.008

Dartt, D. A. (2009). Neural regulation of lacrimal gland secretory processes: Relevance in dry eye diseases. Progress in Retinal and Eye Research, 28(3), 155–177. https://doi.org/10.1016/j.preteyeres.2009.04.003

Fugi-Meyer, A.R. (1974). Relative respiratory contribution of the rib cage and the abdomen in males and females with special regard to posture. Respiration, 31(3), 240–251. https://doi.org/10.1159/000193113

Harada, D., Asanoi, H., Takagawa, J., Ishise, H., Ueno, H., Oda, Y., Goso, Y., Joho, S., & Inoue, H. (2014). Slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with chronic heart failure: from modeling to clinical application. American Journal of Physiology-Heart and Circulatory Physiology, 307(8), H1159–H1168. https://doi.org/10.1152/ajpheart.00109.2014

Jalnapurkar, I., Allen, M., & Pigott, T. (2018). Sex differences in anxiety disorders: A review. Journal of Psychiatry, Depression & Anxiety, 4, 011. https://doi.org/10.24966/PDA-0150/100011

Kalawski, J.P. (2020) The Alba Method and the Science of Emotions. Integr. Psych. Behav. 54, 903–919. https://doi.org/10.1007/s12124-020-09525-4

Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, Article 756. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104929/

Lemeignan, M., Guitart, L., & Bloch, S. (1990). Autonomic differentiation of emotional effector pattern of 6 basic emotions. Proceedings of the Fifth International Congress of Psychophysiology, Budapest, July 9–14, 199

Maity, M., Allay, M. B., Ali, M. H., Basu, S., & Singh, S. (2025). Effect of different artificial tears on tear film parameters in dry eye disease. Optometry and Vision Science, 102(1), 37–43. https://doi.org/10.1097/OPX.0000000000002206

McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035. https://doi.org/10.1016/j.jpsychires.2011.03.006

Mendes, L. P. S., Vieira, D. S. R., Gabriel, L. S., Ribeiro-Samora, G. A., Dornelas de Andrade, A., Brandão, D. C., Goes, M. C., Fregonezi, G. A. F., Britto, R. R., & Parreira, V. F. (2020). Influence of posture, sex, and age on breathing pattern and chest wall motion in healthy subjects. Brazilian Journal of Physical Therapy, 24(3), 240–248. https://doi.org/10.1016/j.bjpt.2019.02.007

Mohamed, Z., Alrasheed, S., Abdu, M., & Allinjawi, K. (2024). Dry eye disease prevalence and associated risk factors among the Middle East population: A systematic review and meta-analysis. Cureus, 16(9), e70522. https://doi.org/10.7759/cureus.70522

Narkiewicz, K., van de Borne, P., Montano, N., Hering, D., Kara, T., & Somers, V. K. (2006). Sympathetic neural outflow and chemoreflex sensitivity are related to spontaneous breathing rate in normal men. Hypertension, 47(1), 51–55. https://doi.org/10.1161/01.HYP.0000197613.47649.0

Peper, E., Harvey, R., & Faass, N. (2020). TechStress: How Technology is Hijacking our Lives, Strategies for Coping, and Pragmatic Ergonomics, North Atlantic Books. https://www.amazon.com/Beyond-Ergonomics-Prevent-Fatigue-Burnout/dp/158394768X

Portello, J.K., Rosenfield, M., Bababekova, Y., et al. (2012). Computer-related visual symptoms in office workers. Ophthalmic and Physiological Optics, 32, 375–82. https://doi.org/10.1111/j.1475-1313.2012.00925.x

Ranti, C., Jones, W., Klin, A. et al. Blink Rate Patterns Provide a Reliable Measure of Individual Engagement with Scene Content. Sci Rep 10, 8267 (2020). https://doi.org/10.1038/s41598-020-64999-x

Schneider, M. (2016). Vision for Life: Ten Steps to Natural Eye Improvement. North Atlantic Books. https://www.amazon.com/Vision-Life-Revised-Eyesight-Improvement/dp/1623170087

Sheedy, J.E., Hayes, J.N., & Engle, J.(2003). Is all asthenopia the same? Optom Vis Sci, 80, 732–9. https://doi.org/10.1097/00006324-200311000-00008

Sheppard, A. L., & Wolffsohn, J. S. (2018). Digital eye strain: prevalence, measurement and amelioration. BMJ open Ophthalmology, 3(1), e000146. https://doi.org/10.1136/bmjophth-2018-000146

Stern, M. E., Gao, J., Siemasko, K. F., Beuerman, R. W., & Pflugfelder, S. C. (2004). The role of the lacrimal functional unit in the pathophysiology of dry eye. Experimental Eye Research, 78(3), 409–416. https://doi.org/10.1016/j.exer.2003.09.003

Swamynathan, S. K., & Wells, A. (2020). Conjunctival goblet cells: Ocular surface functions, disorders that affect them, and the potential for their regeneration. The Ocular Surface, 18(1), 19–26. https://doi.org/10.1016/j.jtos.2019.11.005

Uchino, M.,  Yokoi, N.,  Uchino, Y., Dogru, M., Kawashima, M.,  Komuro, A., Sonomura, Y.,  Kato, H., Kinoshita, S.,  Schaumberg, D.A., & Tsubota, K. (2013). Prevalence of Dry Eye Disease and its Risk Factors in Visual Display Terminal Users: The Osaka Study. American Journal of Ophthalmology, 156(4), 759-766.e1, https://doi.org/10.1016/j.ajo.2013.05.040

The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. , 5(2), 93-107. https://doi.org/10.1016/s1542-0124(12)70082-4

Wilhelm, F. H., Gevirtz, R., & Roth, W. T. (2001). Respiratory dysregulation in anxiety, functional cardiac, and pain disorders: Assessment, phenomenology, and treatment. Behavior Modification, 25(4), 513–545. https://doi.org/10.1177/0145445501254003

Wozniak, P., et al. (2025, September 12–16). Dry eye symptoms, severity, treatment and unmet needs: An analysis of the United States of America and a multinational snapshot (NESTS Study) [Poster presentation]. 43rd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), Copenhagen, Denmark. https://www.sciencedaily.com/releases/2025/09/250914205829.htm

Ziemssen, F., & Ruprecht, K. W. (2005).Autonomic dysfunction in dry eye syndrome. Ophthalmologe, 102(8), 744–749. https://doi.org/10.1007/s00347-005-1169-1


Breathe Away Menstrual Pain- A Simple Practice That Brings Relief *

Adapted from: Peper, E. Harvey, R., Chen, & Heinz, N. (2025). Practicing diaphragmatic breathing reduces menstrual symptoms both during in-person and synchronous online teaching. Applied Psychophysiology and Biofeedback, Published online: 25 October 2025.  https://rdcu.be/eMJqt  https://doi.org/10.1007/s10484-025-09745-7

“Once again, the pain starts—sharp, deep, and overwhelming—until all I can do is curl up and wait for it to pass. There’s no way I can function like this, so I call in sick. The meds take the edge off, but they don’t really fix anything—they just mask it for a little while. I usually don’t tell anyone it’s menstrual pain; I just say I’m not feeling well. For the next couple of days, I’m completely drained, struggling just to make it through.

Many women experience discomfort during menstruation, from mild cramps to intense, even disabling pain. When the pain becomes severe, the body instinctively responds by slowing down—encouraging rest, curling up to protect the abdomen, and often reaching for medication in hopes of relief. For most, the symptoms ease within a day or two, occasionally stretching into three, before the body gradually returns to balance.

Another helpful approach is to practice slow abdominal breathing, guided by a breathing app FlowMD. In our study led by Mattia Nesse, PhD, in Italy, the response of one 22-year-old woman illustrated the power of this simple practice.

“Last night my period started, so I was a bit discouraged because I knew I’d get stomach pain, etc. On the other hand, I said, “Okay, let’s see if the breathing works,” and it was like magic — incredible. I’ll need to try it more times to understand whether it consistently has the same effect, but right now it truly felt magical. Just 3 minutes of deep breathing with the app were enough, and I’m not saying I don’t feel any pain anymore, but it has decreased a lot, so thank you! Thank you again for this tool… I’m really happy!”

The Silent Burden of Menstrual Pain

Menstrual pain, or dysmenorrhea, affects most women at some point in their lives — often silently. For many, the monthly cycle brings not only physical discomfort but also shame, fatigue, and interruptions to work or school. It is one of the leading causes of absenteeism and reduced productivity worldwide (Itani et al., 2022; Thakur & Pathania, 2022).  In addition, the estimated health cost ranged from US $1367 to US$ 7043 per year (Huang et al., 2021). Yet, despite its prevalence, most women are never taught how to use their own physiology to ease these symptoms.

The Study (Peper et al, 2025)

Seventy-five university women participated across two upper-division Holistic Health courses. Forty-nine practiced 30 minutes per day of breathing and relaxation over five weeks as well as practicing the moment they anticipated or felt discomfort; twenty-six served as a comparison group without a specific daily self-care routine. Students rated change in menstrual symptoms on a scale from –5 (“much worse”) to +5 (“much better”). For the detailed steps in training,  see the blog: https://peperperspective.com/2023/04/22/hope-for-menstrual-cramps-dysmenorrhea-with-breathing/ (Peper et al., 2023).

 What changed

The results were striking. Women who practiced breathing and relaxation showed significant decrease in menstrual symptoms compared to the non-intervention group (p = 0.0008) as shown in Figure 1.

Figure 1. Decrease in menstrual symptoms as compared to the control group after implementing slow diaphragmatic breathing.

Why does breathing and posture change have a beneficial effect?

When you stay curled up, your abdomen becomes compressed, leaving little room for the lower belly to relax or for the diaphragm to move freely. The result? Tension builds, and pain often increases.

To reverse this, create space for relaxation. Gently loosen your waist and let your abdomen expand as you inhale. Uncurl your body—lengthen your spine and open your chest, as shown in Figure 2. With each easy breath, you invite calm and allow your body to shift from tension to ease.

Figure 2. Curling up compresses the abdomen and prevents relaxation of the lower belly. In contrast, lying flat with the body gently expanded allows the abdomen to move freely with each breath, which can help reduce menstrual discomfort.

In contrast, slow abdominal or diaphragmatic breathing activates the body’s natural relaxation response. It quiets the stress-driven sympathetic nervous system, calms the mind, and improves circulation in the abdominal area. With each slow breath in, the abdomen gently expands while the pelvic floor and abdominal muscles relax. As you exhale, these muscles naturally tighten slightly, helping to massage and move blood and lymph through the abdominal region. This rhythmic movement supports healing and ease, as illustrated in Figure 3.

Figure 3. The dynamic process of diaphragmatic breathing.

The process of slower, lower diaphragmatic breathing

When lying down, rest comfortably on your back with your legs slightly apart. Allow your abdomen to rise naturally as you inhale and fall as you exhale. As you breathe out, imagine the air flowing through your abdomen, down your legs, and out through your feet. To deepen this sensation, you can ask a partner to gently stroke from your abdomen down your legs as you exhale—helping you sense the flow of release through your body.

Gently focus on slow, effortless diaphragmatic breathing. With each inhalation, your abdomen expands, and the lower belly softens. As you exhale, the abdomen gently goes down pushing the diaphragm upward and allowing the air to leave easily. Breathing slowly—about six breaths per minute—helps engage the body’s natural relaxation response.

If you notice that your breath is staying high in your chest instead of expanding through the abdomen, your symptoms may not improve and can even increase. One participant experienced this at first. After learning to let her abdomen expand with each inhalation while keeping her shoulders and chest relaxed, her next menstrual cycle was markedly easier and far less uncomfortable. The lesson is clear: technique matters.

“During times of pain, I practiced lying down and breathing through my stomach… and my cramps went away within ten minutes. It was awesome.” — 22-year-old college student

“Whenever I felt my cramps worsening, I practiced slow deep breathing for five to ten minutes. The pain became less debilitating, and I didn’t need as many painkillers.” — 18-year-old college student

These successes point out that it’s not just breathing — it’s how you breathe by providing space for the abdomen to expand during inhalation.

Practice: How to Do Diaphragmatic Breathing

  1. Find a quiet space. Lie on your back or sit comfortably erect with your shoulders relaxed.
  2. Place one hand on your chest and one on your abdomen.
  3. Inhale slowly through your nose for about 3–4 seconds. Let your abdomen expand as you breathe in — your chest should remain relaxed.
  4. Exhale gently through your mouth for 4—6 seconds, allowing the abdomen to fall or constrict naturally.
  5. As you exhale imagine the air moving down your arms, through your abdomen, down your legs, and out your feet
  6. Practice daily for 20 minutes and also for 5–10 minutes during the day when menstrual discomfort begins.
  7. Add warmth. Placing a warm towel or heating pad over your abdomen can enhance relaxation while lying on your back and breathing slowly.

With regular practice and implementing it during the day when stressed, this simple method can reduce cramps, promote calm, and reconnect you with your body’s natural rhythm.

Implement the ABCs during the day

The ABC sequence—adapted from the work of Dr. Charles Stroebel, who developed The Quieting Reflex (Stroebel, 1982)—teaches a simple way to interrupt stress reactions in real time. The moment you notice discomfort, pain, stress, or negative thoughts, interrupt the cycle with a simple ABC strategy:

A — Adjust your posture

Sit or stand tall, slightly arch your lower back and allowing the abdomen to expand while you inhale and look up. This immediately shifts your body out of the collapsed “defense posture’ and increases access to positive thoughts (Tsai et all, 2016; Peper et al., 2019)

B — Breathe

Allow your abdomen to expand as you inhale slowly and deeply. Let it get smaller as you exhale. Gently make a soft hissing sound as you exhale while helps the abdomen and pelvic floor to tighten.  Then allow the abdomen to relax and widen which without effort draws the air in during inhalation. As you exhale, stay tall and imagine the air flowing  through you and down your legs and out your feet.

C — Concentrate

Refocus your attention on what you want to do and add a gentle smile. This engages positive emotions, the smile helps downshift tension.

The video clip guides you through the ABCs process.

Integrate the breathing during the day by implementing your ABCs

When students practice relaxation technique and this method, they reported greater reductions in symptoms compared with a control group. By learning to notice tension and apply the ABC steps as soon as stress arises, they could shift their bodies and minds toward calm more quickly, as shown in Figure 4.

Figure 4. Change in symptoms after practicing a sequential relaxation and breathing techniques for four weeks.

Takeaway

Menstrual pain doesn’t have to be endured in silence or masked by medication alone. By practicing 30 minutes of slow diaphragmatic breathing daily and many times during the day, women may be able to reduce pain, stress, and discomfort — while building self-awareness and confidence in their body’s natural rhythms thereby having the opportunity to be more productive.

See the following blogs for more in-depth information and practical tips on how to learn and apply diaphragmatic breathing:

REFERENCES

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Huang, G., Le, A. L., Goddard, Y., James, D., Thavorn, K., Payne, M., & Chen, I. (2022). A systematic review of the cost of chronic pelvic pain in women. Journal of Obstetrics and Gynaecology Canada, 44(3), 286–293.e3. https://doi.org/10.1016/j.jogc.2021.08.011

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*Edited with the help of ChatGPT 5