Go for it: The journey from paraplegia to flying
Posted: November 30, 2014 Filed under: Uncategorized | Tags: biofeedback, depression, exercise, healing, hope, human potential, illness beliefs, paraplegia 2 CommentsAfter a catastrophic event occurs a person often becomes depressed as the future looks bleak. One may keep asking, ”Why, why me?” When people accept–acceptance without resignation— and concentrate on the small steps of the journey towards their goal, remarkable changes may occur. The challenge is to focus on new possibilities without comparing to how it was in the past. The limits of possibility are created by the limits of our beliefs. We may learn from athletes who aim to improve performance whereas clients usually come to reduce symptoms. As Wilson and Peper (2011) point out, “Athletes want to go beyond normal—they want to be superb, to be atypical, to be the outlier. It is irrelevant what the athlete believes or feels. What is relevant is whether the performance is improved, which is a measurable and documented event”. They have described some of the factors that distinguish work with athletes from work with clients which includes intensive transfer of learning training, often between 2 and 6 hours of daily practice across days, weeks, and months. This process is described by the Australian cross-country skier, Janine Shepherd, who had hoped for an Olympic medal — until she was hit by a truck during a training bike ride. She shares a powerful story about the human potential for recovery. Her message: You are not your body, and giving up old dreams can allow new ones to soar. Watch Janine Shepherd’s 2012 Ted talk, A broken body isn’t a broken person.
Reference:
Wilson, V.E. & Peper, E. (2011). Athletes Are Different: Factors That Differentiate Biofeedback/Neurofeedback for Sport Versus Clinical Practice. Biofeedback, 39(1), 27–30.
Shepherd, J. (2012). A broken body isn’t a broken person. Ted talk. http://www.ted.com/talks/janine_shepherd_a_broken_body_isn_t_a_broken_person
Cellphone harm: Cervical spine stress and increase risk of brain cancer
Posted: November 20, 2014 Filed under: Uncategorized | Tags: cancer, cell phones, ergonomics, health, microwaves, neck pain, posture, shoulder pain, wireless 6 CommentsIt is impossible to belief that that only a few years ago there were no cell phones.
When I go home, I purposely put the phone away so that I can be present with my children.
I just wonder if the cell phone’s electromagnetic radiation could do harm?
Cell phone use is ubiquitous since information is only a key press or voice command away. Students spend about many hours a day looking and texting on a cell phone and experience exhaustion and neck and shoulder discomfort (Peper et al, 2013). Constant use may also have unexpected consequences: Increased stress on the cervical spine and increased risk for brain cancer.
Increased cervical spine stress
As we look at the screen, text messages or touch the screen for more information, we almost always bend our head down to look down. This head forward position increases cervical compression and stress. The more the head bends down to look, the more the stress in the neck increases as the muscles have to work much harder that hold the head up. In a superb analysis Dr. Kennth Hansraj, Chief of Spine Surgery 0f New York Spine Surgery & Rehabilitation Medicine, showed that stress on the cervical spine increases from 10-12 lbs when the head is in its upright position to 60 lbs when looking down.
Figure 1. Stress on the cervical spine as related to posture. (From: Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.)
Looking down for a short time period is no problem; however, many of us look down for extended periods. This slouched collapsed position is becoming the more dominant position. A body posture which tends to decrease energy, and increase hopeless, helpless, powerless thoughts (Wilson & Peper, 2004; Peper & Lin, 2012). The long term effects of this habitual collapsed position are not know–one can expect more neck and back problems and increase in lower energy levels.
increased risk for brain cancer and inactive sperm and lower sperm count
Cell phone use not only affect posture, the cell phone radio-frequency electromagnetic radiation by which the cell phone communicates to the tower may negatively affect biological tissue. It would not be surprising that electromagnetic radiation could be harmful; since, it is identical to the frequencies used in your microwave ovens to cook food. The recent research by Drs Michael Carlberg and Lennart Hardell of the Department of Oncology, University Hospital, Örebro, Sweden, found that long term cell phone use is associated by an increased risk of developing malignant glioma (brain cancers) with the largest risk observed in people who used the cell phone before the age of 20. In addition, men who habitually carry the cell phone in a holster or in their pocket were more likely to have inactive or less mobile sperm as well as a lower sperm count.
What can you do:
Keep an upright posture and when using a cell phone or tablet. Every few minutes stretch, look up and reach upward with your hands to the sky.
Use your speaker phone or ear phones instead of placing the phone against your head.
Enjoy the cartoon video clip, Smartphone Ergonomics – Safe Tips – Mobile or Smart Phone Use while Driving, Traveling on the Move.
References:
Agarwal, A., Singh, A., Hamada, A., & Kesari, K. (2011). Cell phones and male infertility: a review of recent innovations in technology and consequences. International braz j urol, 37(4), 432-454. http://www.isdbweb.org/documents/file/1685_8.pdf
Carlberg, M., & Hardell, L. (2014). Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones. International journal of environmental research and public health, 11(10), 10790-10805. http://www.mdpi.com/1660-4601/11/10/10790/htm
De Iuliis, G. N., Newey, R. J., King, B. V., & Aitken, R. J. (2009). Mobile phone radiation induces reactive oxygen species production and DNA damage in human spermatozoa in vitro. PloS one, 4(7), e6446.
Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277-279.
Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.
Peper, E., Waderich, K., Harvey, R., & Sutter, S. (2013). The Psychophysiology of Contemporary Information Technologies Tablets and Smartphones Can Be a Pain in the Neck. In Applied Psychophysiology and Biofeedback, 38(3), 219.
Wilson, V.E. and Peper, E. (2004). The Effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback.29 (3), 189-195.
Adjust your world to fit you: Become the unreasonable person!*
Posted: November 12, 2014 Filed under: Uncategorized | Tags: computer, ergonomics, muscle tension, neck pain, posture 2 Comments“Reasonable people adapt themselves to the world; unreasonable people persist in trying to adapt the world to themselves. Therefore all progress depends on unreasonable people.”
–Paraphrased from Bernard Shaw
Having the right equipment and work environment will reduce injury and improve performance. This is true for athletes as well as for people using computers, laptops, tablets and smartphones. We look down and curve our upper spine to read the tablet, crane our heads forward to read the screen, lift our shoulders, arms and hands up to the laptop keyboard to enter data, and we bend our heads down and squint to read the smartphone—all occurring without awareness (Straker et al, 2008; Asunda, Odell, Luce, & Dennerlein, 2010; Peper et al, 2014). We are captured by the devices and stay immobilized until we hurt. At the end of the work day, we are often exhausted and experience neck and shoulder stiffness, arm pain and eye fatigue. This stress immobility syndrome is the twenty first century reward for digital immigrants and natives.
We hurt because we fit ourselves to the environment instead of changing the environment to fit us. The predominant slouched position even affects our mood and strength (Peper and Lin, 2012). Experience how your strength decreases when you slouch and look downward as compared when you sit tall with your spine lengthened at your laptop, tablet or phone. You will need a partner to do this practice as shown in Figure 1.
Sit in your slouched position while looking down and extend your arm to the side. Have your partner stand behind you and gently press downward on your upper arm near your wrist while you attempt to resist the pressure. Now relax and let your arms hang along the side of your body. Now sit upright in a tall position with your spine lengthening while looking straight ahead. Again extend your arm and gently have your gently press downward on your upper arm near your wrist while you attempt to resist the pressure.
Figure 1. Measuring the ability to resist the downward pressure on the forearm while sitting in either slouched or tall position.
You probably experienced significantly more strength resisting the downward pressure when sitting erect and tall than when sitting collapsed as we discovered in our study at San Francisco State University in with students as shown in figure 2.
Figure 2. Change in perceived strength resisting a downward pressure on the extended arm while sitting. Reproduced by permission from Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M. (in press).
Increase your power and take charge! Arrange your laptop, computer and tablet so it fits you. This usually means changing your home and office chairs and desks; since, they have been manufactured for the average person. Just like the average coach airplane seat – it is uncomfortable for most people. As my colleague Annette Booiman who is a Mensendiek practitioner has pointed out, “An incorrectly adjusted chair or table height will force you to work in a dysfunctional body position while an appropriately adjusted chair or table height offers you the opportunity to work in a healthy position.”
Become the unreasonable person and fit the world so that you are comfortable while using digital devices. There are solutions! Take responsibility and adjust your posture to a healthy one–it will make your life so much more energetic. Sit on your sit bones (ischial tuberosities) as if they are the feet of your pelvis and feel your spine lengthening as you sit tall. Alternatively, stand while working and adjust the desk height for your size. Regardless of whether you sit or stand while working, take many breaks to interrupt your immobilized posture. Install a software program on computer to remind you to take breaks and watch the YouTube clips on cartoon ergonomics for working at the computer.
Implement the following common sense ergonomic guidelines:
For working at a computer sit in a chair with your feet on the floor, the elbows bend at 90 degrees with the hands, wrists, and forearms are straight, in-line and roughly parallel to the floor so that the hands can be on the keyboard while the top of monitor is at eye brow level as shown in Figure 3.
Figure 3. Optimum position to sit at a computer work station. From: http://bmarthur.files.wordpress.com/2009/03/good-posture-how-to-sit-at-a-desk.png
For working with a laptop you will always compromise body position. If the screen is at eye level, you have to bring your arms and hands up to the keyboard, or, more commonly, you will look down at the screen while at the same time raising your hands to reach the keyboard. The solution is to use an external keyboard so that the keyboard can be at your waist position and the laptop screen eye level as shown in Figure 4.
Figure 4. Optimum position to sit while using a laptop. From: http://www.winwin-tech.com/uploadfile/cke/images/6.jpg
For working with tablets and smart phones you have little choice. You either look down or reach up to touch the screen. As much as possible tilt and raise the tablet so that you do not have slouch to see the screen.
If you observe that you slouch and collapse while working, invest in an adjustable desk that you can raise or lower for your optimum height. An adjustable height desk such as the unDesk offers the opportunity to change work position from sitting to standing as shown in Figure 5.
Figure 5. Example of a height adjustable desk (the unDesk) that can be used for sitting and standing.
Although office chairs can give support, we often slouch in them. While at home we use any chair that is available—again encouraging slouching. Reduce the slouching by sitting on a seat insert such as a BackJoy® which tends to let you sit more erect and in a more powerful and energizing position see Figure 6.
Figure 6. Example how BackJoy® seat inserts allows you to sit more erect. Reproduced with permission from: http://www.backjoy.com/sit/
Finally, whether or not you can change your environment, take many, many short movement breaks– wiggle, stretch, get up and walk–to interrupt the muscle tension and allow yourself to regenerate. To remind yourself to take breaks while being captured by your work, install a reminder program on your computer such as Stretchbreak that pops up on the screen and guides you through short stretches to regenerate.
Suggested sources:
Cartoon videos on ergonomics: https://peperperspective.com/2014/09/30/cartoon-ergonomics-for-working-at-the-computer-and-laptop/
Healthy computing tips: http://biofeedbackhealth.files.wordpress.com/2013/01/health-computing-email-tips.pdf
Seat insert such as BackJoy®: http://www.backjoy.com/sit/
Height adjustable desk such as The unDesk: http://www.theundesk.com/
Interrupt computer program such as Stretchbreak: http://www.paratec.com
References:
Asundi, K., Odell, D., Luce, A., & Dennerlein, J. T. (2010). Notebook computer use on a desk, lap and lap support: Effects on posture, performance and comfort. Ergonomics, 53(1), 74-82.
Peper, E., & Lin, I. M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.
Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness. Biofeedback, 2(1), 16-23.
Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M. Posture changes with a seat insert: Changes in strength and implications for breathing and HRV. Poster submitted for the 46th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback.
Straker, L. M., Coleman, J., Skoss, R., Maslen, B. A., Burgess-Limerick, R., & Pollock, C. M. (2008). A comparison of posture and muscle activity during tablet computer, desktop computer and paper use by young children. Ergonomics, 51(4), 540-555.
* Adapted from: Peper, E. (in press). Become the unreasonable person: Adjust your world to fit you! Western Edition and Schwanbeck, R., Peper, E., Booiman, A., Harvey, R., and Lin, I-M. (in press). Posture changes with a seat insert: Changes in strength and implications for breathing and HRV.
Choices: Creating meaningful days
Posted: October 19, 2014 Filed under: Uncategorized | Tags: cancer, depression, healing, health, hope, palliative care 1 CommentWhen you woke up this morning, how did you feel? Were you looking forward to the day anticipating with joy what would occur or were you dreading the day as if once again you had to step on the treadmill of life?
Whenever I ask this question of college students in their junior or senior year at an urban university about 20% will answer that they are looking forward to the day. The majority answer, “Well not really”, or even “Oh shit, another day”. For many students the burden of living- working 40 hours a week to pay for rent and tuition, worrying about financial debt, and the challenge of commuting, and finding time to do the homework—feels and is overwhelming.
Asking this question about the quality—not quantity—of life is not just a question for students–it is applicable for all of us. The more one chooses to do actively what gives fulfillment and meaning, the higher the quality of life (I do not mean eating more chocolate).
In a remarkable study by Dr. Jennifer Temel and her many colleagues, patients with metastatic non-small-cell lung cancer were given the option of early palliative care versus standard aggressive end-of-life treatment. The patients who were assigned to the early palliative care group had significantly better quality of life, fewer depressive symptoms and lived on the average three months longer than the group who received standard treatment.
Even at the end of life there may be choices. Choosing quality of life and doing what gives meaning may nurture a peaceful transition in death. This process of choice has been tenderly described in the recent New York Times essay, The best possible day. Take a moment and read this article by clicking on the link. http://www.nytimes.com/2014/10/05/opinion/sunday/the-best-possible-day.html?smid=fb-share&_r=0
Then ask yourself each day, “Am I looking forward to my day and my activities?” If the answer tends to be “No,” begin to explore new options. Ask yourself, “What would I like to do and look forward to?” First begin to dream about possible options and then begin to plan how to implement your dreams so that you are on the path to where you want to be.
It is a challenging process; however, each of us can do something that will give meaning and joy to our lives. For suggestions, see the outstanding book by Dr. Lawrence LeShan, Cancer as a Turning Point, or explore the practices in our book by Drs. Robert Gorter and Erik Peper, Fighting Cancer- A Non-Toxic Approach to Treatment.
Reference:
Cartoon ergonomics for working at the computer and laptop
Posted: September 30, 2014 Filed under: Uncategorized | Tags: cell phones, computer, health, Laptop, muscle tension, neck pain, pain, posture, shoulder pain 10 CommentsI finally bought a separate keyboard and a small stand for my laptop so that the screen is at eye level and my shoulders are relaxed while typing at the keyboard. To my surprise, my neck and shoulder tightness and pain disappeared and I am much less exhausted.
How we sit and work at the computer significantly affects our health and productivity. Ergonomics is the science that offers guidelines on how to adjust your workspace and equipment to suit your individual needs. It is just like choosing appropriate shoes–Ever try jogging in high heels? The same process applies to the furniture and equipment you use when computing.
When people arrange their work setting according to good ergonomic principles and incorporate a healthy computing work style numerous disorders (e.g., fatigue, vision discomfort, head, neck, back, shoulder, arm or hand pain) may be prevented (Peper et al, 2004). For pragmatic tips to stay health at the computer see Erik Peper’s Health Computer Email Tips. Enjoy the following superb video cartoons uploaded by Stephen Walker on YouTube that summarize the basic guidelines for computer, laptop and cell phones use at work, home, or while traveling.
Adult or Child Laptop Use at Home, Work or Classroom
Healthy use of laptops anywhere.
Mobile or Smart Phone Use while Driving, Traveling or on the Move.
A breath of fresh air-Improve health with breathing
Posted: September 11, 2014 Filed under: Breathing/respiration, Pain/discomfort, stress management, Uncategorized | Tags: asthma, Breathing, pain, regeneration, relaxation, respiration, stress management, yoga 12 Comments“My breathing was something that took me a long time to adjust. I had been breathing almost entirely from my chest and my stomach was hardly moving when I breathed. I made a conscious effort all throughout the day to breathe slowly and with my stomach relaxed. I’ve noticed that my mood is much better when I am breathing this way, and I am much more relaxed. Immediately before I feel like I would have a seizure, if I would change my breathing technique and make sure I was breathing slowly and with my stomach. It would avoid the seizure from developing… This is a huge improvement for me.” –24 year old student who previously experienced 10 epileptic seizures per week
“I blanked out and could not remember the test material. I then reminded myself to breathe lower and slower while imagining the air slowly flowing down my legs. After three breaths, I could again process the information and continue to take the exam. A week later I got my grade back– an A-. Better than I had expected.” –21 year old student
Breathing occurs without awareness unless there are specific problems such as asthma, emphysema or when we run out of air while exercising. Breathing is more than just the air moving in and out. It is the boundary between the conscious and the unconscious—the voluntary and involuntary nervous system— and affects the sympathetic and parasympathetic activity of our body. The way we breathe, such as chronic low level hyperventilation, may contribute to increasing or decreasing anxiety, pain, epileptic seizure, exhaustion, abdominal pain, urinary incontinence or fertility.
We usually think of breathing occurring in our chest. Thus, during inhalation, we puff-up our chest so the lungs will expand. Observe that many people breathe this way and call it normal. Experience how you breathe:
Put your right and on your stomach and your left hand of your chest. Now take a quick big breath. Observe what happened. In most cases, your chest went up and your abdomen tightened and even pulled in.
This breathing pattern evokes a state of arousal and vigilance and activates your sympathetic nervous system. You tend to automatically tighten or pull in your stomach wall to protect your body. When we’re in pain, afraid, anticipate danger or have negative and fearful thoughts, “Do I have enough money for the rent,” or “Feeling rushed and waiting for a delayed Muni bus,” we instinctively hold our breath, slightly tense our muscles and breathe shallowly. Unfortunately, this makes the situation worse—symptoms such as pain, anxiety or abdominal discomfort will increase. This type of breathing is the part of the freeze response—a primal survival reflex. It may even affect our ability to think. Experience how dysfunctional breathing effects us by doing the following exercise (Peper & MacHose, 1993; Gorter & Peper, 2011).
Sit comfortably and breathe normally.
Now inhale normally, but exhale only 70 percent of the air you just inhaled.
Inhale again, and again only exhale 70 percent of the previously inhaled volume of air. If you need to sigh, just do it, and then return to this breathing pattern again by exhaling only 70 percent of the inhaled volume of air.
Continue to breathe in this pattern of 70 percent exhalation for about forty-five seconds, each time exhaling only 70 percent of the air you breathe in. Then stop, and observe what happened.
What did you notice? Within forty-five seconds, more than 98 percent of people report uncomfortable sensations such as lightheadedness, dizziness, anxiety or panic, tension in their neck, back, shoulders, or face, nervousness, an increased heart rate or palpitations, agitation or jitteriness, feeling flushed, tingling, breathlessness, chest pressure, gasping for air, or even a sensation of starving for air. This exercise may also aggravate symptoms that already exist, such as headaches, joint pain, or pain from an injury. If you’re feeling exhausted or stressed, the effects seem even worse.
On the other hand, if you breathed like a happy baby, or more like a peaceful dog lying on its side, the breathing movement occured mainly in the abdomen and the chest stays relaxed. This effortless diaphragmatic breathing promotes regeneration by allowing the abdomen to expand during inhalation and becoming smaller during exhalation as shown in Figure 1.
Figure 1. Illustration of diaphragmatic breathing in which the abdomen expands during inhalation and contracts during exhalation (reproduced by permission from Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic).
The abdominal movement created by the breathing improves blood and lymph circulation in the abdomen and normalizes gastrointestinal function and enhances regeneration. It supports sympathetic and parasympathetic balance especially when the breathing rate slows to about six breaths per minute. When breathing slower, exhaling takes about twice as long as the inhalation. When you inhale, the abdomen and lower ribs expand to allow the air to flow in and during exhalation the abdomen decreases in diameter and the breath slowly trails off. It is as if there is an upside down umbrella above the pelvic floor opening during inhalation and closing during exhalation.
Most people do not breathe this way . They suffer from “designer’s jean syndrome”. The clothing is too constricting to allow the abdomen to expand during inhalation (Remember how good it felt when you loosened your belt when eating a big meal?). Or, you are self-conscious of your stomach, “What would people thinks if my stomach hung out?” Yet, to regenerate, allow yourself to breathe like peaceful baby with the breathing movements occurring in the belly. Effortless diaphragmatic breathing is the cheapest way to improve your health. Thus observe yourself and transform your breathing patterns.
Interrupt breath holding and continue to breathe to enhance health. Observe situations where you hold your breath and then continue to breathe. If you expect pain during movement or a procedure, remember to allow your abdomen to expand during inhalation and then begin to exhaling whispering “Shhhhhhhhh.” Start exhaling and then begin your movement while continuing to exhale. In almost all cases the movement is less painful and easier. We observed this identical breathing pattern in our studies of Mr. Kawakami, a yogi who insert unsterilized skewers through his neck and tongue while exhaling—he did not experience any pain or bleeding as shown in Fig 2.
Figure 2. Demonstration by Mr. Kawakami, a yogi, who inserted non-sterile skewers while exhaling and reported no pain. When he removed the skewers there was no bleeding and the tissue healed rapidly (by permission from Peper, E., Kawakami, M., Sata, M. & Wilson, V.S. (2005). The physiological correlates of body piercing by a yoga master: Control of pain and bleeding. Subtle Energies & Energy Medicine Journal. 14(3), 223-237).
Shift shallow chest breathing to slower diaphragmatic breathing. Each time you catch yourself breathing higher in your chest. Stop. Focus on allowing your abdomen to expand during inhalation and become smaller during exhalation as if it was a balloon. Allow the air to flow smoothly during exhalation and allow the exhalation to be twice as long as the inhalation. Over time allow yourself to inhale to the count of three and exhale to the count of 6 or 7 without effort. Imagine that when you exhale the air flows down and through your legs and out your feet. As you continue to breathe this way, your heart rate will slightly increase during inhalation and decrease during exhalation which is an indication of sympathetic and parasympathetic restorative balance. A state that supports regeneration (for more information see, Peper, E. & Vicci Tibbetts, Effortless diaphragmatic breathing).
For many people when they practice these simple breathing skills during the day their blood pressure, anxiety and even pain decreases. While for other, it allows clarity of thought.
Evoking your healing potential: You are your placebo
Posted: August 31, 2014 Filed under: Uncategorized | Tags: health, hope, illness beliefs, mind-body, nocebo, placebo 3 CommentsBe careful what you think. You may get what you wish.
The power of the placebo and nocebo are remarkable and often overlooked in medicine. With a placebo, severe chest pain disappears with mock surgery, Parkinson’s tremors stop, knee pain is eliminated following mock arthroscopic knee surgery and even of lymphosarcoma can be affected (Beecher, 1961; Benedeteti, 2007; Moseley et al, 2002; Kirkley et al., 2008; Klopfer, 1957; Moerman & Jonas, 2002). On the other hand, nocebo can increase pain, accelerate cancer growth, and cause death (Cannon, 1942; Klopfer, 1957; Benedeteti, 2007). These are demonstrations of the self-healing and non-healing potential intrinsic within each of us.
The placebo response (from Latin, “I shall please”) is the beneficial physiological or psychological effect that results from the administration of an otherwise ineffective or inert substance, procedure, instruction. and/or environment. An example of placebo on neuron activity is demonstrated with a patient who has Parkinson’s disease (see figure 1).
Figure 1. Recording the activity of single neurons from the brain of an awake patient suffering from Parkinson’s disease. Both the recording apparatus (a) and the electrode track (b) can be seen. In (c), the activity of a single neuron in the subthalamic nucleus can be seen before and after placebo administration (reproduced from: Benedeteti, F.(2007). The Placebo and Nocebo Effect: How the Therapist’s Words Act on the Patient’s Brain. Karger Gazette, 69).
The nocebo response (from Latin, “I will harm”) may evoke the non-healing process and reactivate symptom/disease producing process and experiences. The nocebo response can be evoked by ineffective or inert substances, procedures, instructions, and internal and external environments which by themselves have no known effects.
The placebo/nocebo response is modulated by our covert cultural, familial and personal beliefs, limitations and expectations. The placebo/nocebo effects are the actual demonstrations that the limits of our beliefs are the limits of our possibilities. This process is well described in the recent published book, You are the Placebo: Making Your Mind Matter, by Chiropractor Joe Dispenza.
Dr. Dispenza describes the classic studies of placebo, mental processes and possible mechanisms by which placebo effects occur and disappears and how our thoughts and expectancies create our reality. The placebo transforms the inner beliefs and give the person the experience of improved health which transforms beliefs. In many cases we can experience improvement but are pulled back into our previous beliefs and self-images of illness by inner and outer cues which are associated with disease process.
The book describes of the covert conditioning process by which we return to our old self and may maintain illness. It is challenging to maintain new beliefs and act/think in new patterns. The internal mental chatter and doubts flood our awareness. Even the question, “How long will the improvement last?” re-evokes the associative mental conditioned disease patterns. If it is possible to interrupt and transform our thoughts moment by moment, minute by minute, hour by hour, day by day and not just for 15 minutes of practice, remarkable changes are sometimes possible. Every thought that triggers an association of the illness state needs to be interrupted and redirected. When patients somehow transform their thoughts, it may result in reversing and eliminating illnesses such as polyostotic fibrous dysphasia, Hashimot’sthyroiditis or chronic lympocytic thyroiditis, and secondary progressive multiple sclerosis.
I highly recommend this book for its outstanding description of placebo/nocebo and cognitive a model of the conditioning processes that underlie it. The book offers hope and inspiration for many patients who accept “what is/was” and are open to the present and future possibilities without judgement.
The book’s cases show that it is possible to reverse chronic “incurable illnesses.” Patients and health care providers should read the book–it provides hope, empowerment, and possibility. It is an antidote to the feeling that there is nothing one can do except to live with the illness. Medicine needs to explore and study the unusual patient who has reversed the disease process and ask, “How can we understand this process and teach it to other patients.”
The major limitation of the book is the absence of data; namely, what percentage of the patients/participants who have practiced Dispenza’s techniques have actually benefited and transformed their illness? The book would be more useful if it included both successful and the many unsuccessful cases. This would help patients who do the practices and do not improve. These patients sometimes blame themselves and failed at their self-healing—a process that increases depression and hopelessness. We need to realize that many factors affecting our health and illness are beyond our control.
Although I agree with Dr. Dspenza’s basic premise that our beliefs, acceptance of what is and being open to the present and future supports healing. This perspective is only part of the whole picture. Health and illness are multi-factorial and many factors are not within our control.
Read the book and skip chapter 8, The Quantum Mind. This chapter attempts to describe the physics of the healing process using quantum physics. As I did not understand quantum physics and quantum mind, I asked my colleague, James Johnston, PhD, who is an expert in quantum physics, to read it for accuracy. He confirmed my gut reaction when he said, “the quantum physics description of how energy changes is pseudo science, involving an incomplete understanding of quantum theory.”
Beecher, H.K. (1961). Surgery as Placebo. JAMA, 176(13), 1102-1107.
Cannon, W. B. (1942). “Voodoo” death. American Anthropologist, 44(2), 169-181.
Dispenza, J. (2014). You are the Placebo: Making Your Mind Matter. Hay House, Inc.
Decrease procrastination! Increase productivity and energy!*
Posted: August 2, 2014 Filed under: Uncategorized | Tags: energy, mental rehearsal, procrastination, visualization 6 Comments“I felt more motivated to get things done.”
“After practicing this exercise for a week, my productivity significantly increased.”
“I felt more in control of my life in a fun way that made me feel successful.”
“Every time it increased my mood, confidence and energy levels.”
— Reports by participants after practicing “transforming failure into success”
Putting off something we set out to do can leave us feeling unproductive, drained of energy, and guilty. Procrastination can also contribute to dysphoria, depression, and self-recrimination. When people reflect on their own activity, they often using blaming language such as “I should not have done that,” “That was stupid,” or “What was I thinking.” The challenge is how to change this blaming language — through which the person continues to rehearse how they have failed — to positive and empowering language and images.
For many years, we have taught students a useful daily practice,Transforming Failure into Success, to transform the self-blame into optimizing performance. When the students as well as athletes practices this for a week, they report significant improvement in study habits, dealing with anger, and even sports performance. This year we systematically measured the effect of this practice and compared it to a control group. The students, just as previous athletes and clients, reported a significant decrease in procrastination and increase in productivity and energy as compared to the control group as shown in figure 1.
Figure 1. Change in self-report of procrastination, productivity and energy level. Reprinted from: Peper, E., Harvey, R., Lin, I-M, & Duvvuri, P. (2014). Increase productivity, decrease procrastination and increase energy. Biofeedback, 42(2), 82-87.
When we procrastinate or blame ourselves, we increase our chances of repeating that same behavior. We often forget that our ongoing thoughts and framing of past experiences become the template for our future behavior. It is easy to look back and criticize yourself for not having done something you feel you should have done, or having done something you later regretted doing. Unfortunately, this strategy only strengthens the memory of the mistake. The more you mentally rehearse/imagine yourself performing the desired (or undesired!) behavior, the more likely you will actually perform that behavior.
Thus the first step is to accept that what we actually did was the only thing we could have done given our history, training, maturity, and circumstances. The key is to rehearse what you would like to do or achieve. This practice is illustrated by a golfer who hits a ball into the pond. Instead of cursing himself and constantly repeating, “I should not have hit the ball into the pond,” the golfer acknowledges the problem and then asks , “What was the problem?” He then considers that he might not have hit the ball hard enough or that he might not have accounted for the cross winds. Or, he did not know the cause of the problem and needed to ask a consultant for suggestions. He decides that he did not account for the cross winds and then asks, “How could I have done it differently to get the outcome I wanted?” He then imagines exactly how hard and in what direction to hit the ball. He mentally rehearses the appropriate swing a number of times, each time seeing the ball landing on the green just a short putt away from the fifth hole. As he images this perfect swing, he feels it in his body. Later that day when his golfing partner asks him what happened when his ball went into the pond, he answers, “It went into the pond, and let me now tell you how I would hit it now.” Thus, the past error becomes the cue to rehearse the desired behavior.
Instructions for transforming failure into success
Each time when you observe yourself thinking, “I wish I’d done that differently,” Stop! Give yourself credit that you did the only thing you could have done and that you could NOT have done it any differently given your history, skills, and environmental factors at that moment. Accept what happened and recognize that you are now ready to explore new options. Next, breathe and relax, then ask yourself, “If I could do this over, how would I do it now given the new wisdom I have gained?” Then imagine yourself doing it in the new way.
Each time you observe an action which upon hindsight could have been improved, mentally rewrite how you would like to have behaved. Use the following five-step process:
- Think of a past conflict or area of behavior with which you are dissatisfied.
- Accept that it was the only way you could have done what you did under the circumstances.
- Ask, “Given the wisdom I have now, how could I have done this differently?”
- See yourself in that same situation but behaving differently, using the wisdom you now have (rehearse this step a number of times). When rehearsing, it is important to see and feel yourself completely immersed in the situation. Be very specific, and engage as many of the senses as you can.
- Smile and congratulate yourself for taking charge of programming your own future.
The more senses you invoke in your imagination and visualization, the more real the experience will feel and the more it will be become the new pattern. Imagine every small step, sensation, and thought—everything that would occur when you actually do the task. How you image the task is not important. Some people see it in living color while others only have a sense of it. Just take yourself through the new activity. Rewriting the past takes practice. During the mental rehearsal the old pattern often reasserts itself. Just let it go and practice again. If it continues to recur, ask yourself, “What do I need to learn from this; what is my lesson?”
This practice only applies to one’s own behavior–you can only change yourself. Remember that others have the freedom and the right to react in their own way. In your imagery, see yourself changing. Others may also change in their response to your change; however, they have the right NOT to change.
Finally, there are many settings in which we had no control and, regardless of our behaviors, nothing would be different (e.g., being abused as a young child). In such cases, the adaptive response is to acknowledge what happened, reaffirm that you are no longer the same person as when the experience occurred. Then take a deep breath and relax, and let go while knowing that this personal experience has taught you a set of coping skills that have nurtured your own growth and development.
This blog is adapted from our recent published article, Increase productivity, decrease procrastination and increase energy, which describes the background, methodology and research findings.
*Adapted from our published article: Peper, E., Harvey, R., Lin, I-M, & Duvvuri, P. (2014). Increase productivity, decrease procrastination and increase energy. Biofeedback, 42(2), 82-87.
Technohealth reminder
Posted: July 26, 2014 Filed under: Uncategorized | Tags: cell phones, digital devices, insomnia, microwaves, muscle tension, wireless Leave a commentDigital devices connect us to each other, provide information from the outside world, allow us to work anywhere as long as there is Wi-Fi, and foster a 24/7 live style. It is almost impossible to remember driving without a smartphone that guides us to where we are going, or using it to find a restaurant or a place to stay. Being captured by the screen and the useful information, we may not be aware of the possible deleterious effects. Depending how the devices are used, they may contribute to disturbed sleep, increased attention deficit disorder in children, increased pedestrian death rates when the person is captured by the screen and not attending to the environment surrounding them, and increased cancer risks through antenna radiation. Some of the dangers have been integrated in a new poster, Mobile Phones: Ringing up the Danger, reprinted below from the website, http://www.cheapnursedegrees.com/mobile-phones-danger/
At the bottom of this poster are my suggestions to optimize technohealth while working with digital devices.
Poster reprinted with permission from: http://www.cheapnursedegrees.com/mobile-phones-danger/
Suggestions to improve technohealth
Reverse and interrupt Stress Immobilization Syndrome
- Interrupt your computer work every few minutes to wiggle and move
- Breathe diaphragmatically
- Get up and do large movements (stretch or walk) for a few minutes.
- Take a short walk or do other movements instead of snacking when feeling tense or tired.
- Smile and realize that work stress it is not worth dying over
- Install a computer reminder program to signal you to take a short stress break such as StressBreak™.
- Eat lunch away from your computer workstation.
- Stand or walk during meetings or when talking on the phone.
- Turn off LED, TV or computer screens an hour before bedtime to promote restful sleep.
Reduce the possible harm from digital device’s antenna radiation
- Keep your phone, tablet or laptop in your purse, backpack or attaché case. Do not keep it on or close to your body.
- Use the speaker phone or plug in earphones with microphone while talking. Do not hold it against the side of your head, close to your breast or on your lap.
- Text while the phone or tablet is on a book or on a table away from your body.
What to eat? Low fat foods, high fat foods…..?
Posted: July 12, 2014 Filed under: Evolutionary perspective, Nutrition/diet, Uncategorized | Tags: cancer, diet, evolution, health, heart disease, vitamins 4 CommentsMeat for sale (tongue and liver) at a traditional market (photo by Erik Peper).
Should I eat vegetables or meats? Should it be steaks or organ meats such as liver, heart, sweet breads? What foods contributes most to heart disease or cancer? Should I change my diet or take medications to lower my cholesterol?
Despite the many years of research the data is not clear. Many public health dietary guidelines and recommendations were based upon flawed research, researchers’ bias and promoted by agribusiness. Starting in the 1950s there has been a significant change in the dietary habits from eating animal fats to plant based oils and fats. It is so much cheaper to produce plant based polyunsaturated salad or cooking oils (e.g. Wesson and Mazola) and hydrogenated hardened oils (e.g. margarine and Crisco) than animal fats (e.g., butter, beef tallow, and lard). Despite the many claims that lowering animal fat intake would reduce heart disease and possibly cancer, the claims are not supported by research data. It is true that consuming liquid plant based oils lowers the cholesterol, but with the possible exception of olive oil, polyunsaturated oils are associated with an increased cancer and death rates in large population studies (Multiple Risk Factor Intervention Trial Research Group,1982; Shaten, 1997).
We assume that lowering cholesterol is healthy; however, it is usually a surrogate marker representing a hypothesized improvement in health. A short term apparent reduction in cholesterol levels or other illness markers may mask the long term harm. Only long term outcome studies which measure the total death rate– not just from one disease being studied but from all causes of death–provides the objective results. When looking at the results over a longer time period, there appears to be no correlation between fat intake and heart disease. In fact lowering fat intake seems to be associated with poorer long term health as described in the outstanding book, The Big Fat Surprise–Why Butter, Meat & Cheese Belong in a Healthy Diet, by the science writer, Nina Teichol. Her superb investigative reporting describes in detail the flawed and biased research that underpinned the United States Department of Agriculture (USDA) and the American Heart Association (AHA) recommendations to reduce animal fats and use more plant based oils.
What should I eat now?
Diet recommendations used to be simple: Reduce animal fat intake and eat more plants. Now, there are no simple recommendations because they may depend upon your genetics (e.g., digestion of milk depends whether you are lactose tolerant or intolerant), your epigenetics (e.g., maternal malnutrition during your embryological development is a major risk for developing heart disease in later life), your physical and social activities (e.g., exercise reduces the risk for many diseases), and environment. The recent popularity of the hunter and gatherer diet, often known as the paleo diet, is challenging–it may depends on your ancestors. What hunter and gatherers ate depended upon geography and availability of food sources. The Inuit’s diet in the Arctic consisted of 90% meat/fish diet while the !Kung Bushman’ diet from the Kalahari desert in Africa consisted of less than a 15% meat/fish diet as shown in Figure 1.
Figure 1. The food content of hunter gatherers varied highly depending on geography. From: Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.
Use common sense to make food choices.
- Eat only those foods which in the course of evolution have been identified as foods. This means eating a variety of plants based foods (fruits, tubers, leaves, stems, nuts, etc.) and more organ meats. Ask yourself what foods did your forefathers/mothers ate that supported survival and reproductive success. Carnivores usually ate the internal organs first and often would leave the muscles for scavengers.
- Eat like your great, great grandparents. They were not yet brainwashed by the profit incentives of agribusiness and pharmaceutical industry. For more information, read the outstanding books by Michael Pollan, The Omnivore’s Dilemma: A Natural History of Four Meals and In Defense of Food: An Eater’s Manifesto.
- If possible eat only organically grown/raised foods. Non organic foods usually contain low levels of pesticides, insecticides, antibiotics and hormones which increases the risk of cancer (Reuben, 2010). They may also also contain fewer nutrients such as essential minerals, vitamins, and antioxidants (Barański et al, 2014). The beneficial effects of organic foods have been challenging to demonstrate because it may take many years to show a difference. Preliminary data strongly suggests that organic foods as compared to non organic foods increases longevity, improves fertility and enhances survival during starvation (Chhabra, Kolli, & Bauer, 2013). For more information, see my blog, Live longer, enhance fertility and increase stress resistance: Eat Organic foods.
- Adapt the precautionary principle and assume that any new and artificially produced additives or chemically processed foods–most of the foods in boxes and cans in the central section of the supermarket–contain novel materials which have not been part of our historical dietary experience. These foods may be harmful over the long term and our bodies not yet know how to appropriately digest such foods such as trans fats (Kummerow, 2009).
- Be doubtful of dietary recommendations especially if you know of counter examples and exceptions. For example, the low fat diet recommendations could not explain the French or Swiss paradox (high butter and cheese intake and low heart disease rates). If examples exist, the popular dogma is incomplete or possibly wrong. Be skeptical about any health food claims. Ask who has funded the research, who decides whether a food can have a label that states “it is heart health” and can prevent a disease, and who would benefit if more of this food is sold.
My final comments on nutrition (source unknown).
- The Japanese eat very little fat and suffer fewer heart attacks than us.
- The Mexicans eat a lot of fat and suffer fewer heart attacks than us.
- The French eat lots of butter and drink alcohol and suffer fewer heart attacks than us.
- The Chinese drink very little red wine and suffer fewer heart attacks than us.
- The Italians drink a lot of red wine and suffer fewer heart attacks than us.
- The Germans drink a lot of beer and eat lots of sausages and fats and suffer fewer heart attacks than us.
Conclusion
Eat and drink what you like especially if you enjoy it with company…speaking English is apparently what kills you!
References:
Jabr, F. (2013). How to Really Eat Like a Hunter-Gatherer: Why the Paleo Diet Is Half-Baked. Scientific American, June 3.http://www.scientificamerican.com/article/why-paleo-diet-half-baked-how-hunter-gatherer-really-eat/
Kummerow, F. A. (2009). The negative effects of hydrogenated trans fats and what to do about them. Atherosclerosis, 205(2), 458-465.http://www.atherosclerosis-journal.com/article/S0021-9150%2809%2900208-1/abstract
Multiple Risk Factor Intervention Trial Research Group. (1982). Multiple risk factor intervention trial. JAMA: The Journal of the American Medical Association, 248(12), 1465-1477. http://jama.jamanetwork.com/article.aspx?articleid=377969
Pollan, M. (2006). The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin Press. ISBN: 1594200823
Pollan, M. (2009). In Defense of Food: An Eater’s Manifesto. New York: Penguin Press. ISBN: 978-0143114963
Reuben, S. H. (2010). Reducing environmental cancer risk: what we can do now. DIANE Publishing. http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf
Shaten, B. J., Kuller, L. H., Kjelsberg, M. O., Stamler, J., Ockene, J. K., Cutler, J. A., & Cohen, J. D. (1997). Lung cancer mortality after 16 years in MRFIT participants in intervention and usual-care groups. Annals of epidemiology, 7(2), 125-136. http://www.annalsofepidemiology.org/article/S1047-2797%2896%2900123-8/abstract
Teicholz, N. (2014). The big fat surprise-Why butter, meat & cheese belong in a healthy diet. New York: Simon & Schuster. ISBM 978-1-4516-2442-7 http://www.thebigfatsurprise.com/













