Over the past few months a number of online comments I made about trauma as a risk factor for chronic illness struck a nerve. A highly exposed, tender, and irritated nerve (see comments in The Economist and on the ME/CFS blog called Health Rising (to find this comment series on Health Rising read reference “1” here: (1)you can find the conversation on Health Rising’s Post “The Core Problem in Chronic Fatigue Syndrome Identified?” by searching for “Veronique” amidst the nearly 250 comments on this specific post. This is the conversation that starts after I mention trauma and begins with, “I loved your summary Cort – what an exciting, ground breaking study.” Some of the responses challenging what I say are further down in the comments. You can find these particular responses by searching for the terms used to describe me in the comment section as well, including “psychogenetician,” “psychosomatician,” and “psychologizer.” * If you have any trouble clicking on the link or highlighting the words in this long reference you can also access it all in the reference at the bottom of this post. The rawness highlights a very real and negative side effect of mind body medicine. This is the misleading perception that people living and struggling with chronic illness (as well as cancer, pain, mental illness and other symptoms) can heal if they just implement certain practices and life-style changes. And that using the mind to heal implies these illnesses are psychological or “all in our heads.”
The feedback clarified just how different my new views are from what I knew as a doctor – and what most physicians, the field of medicine, and our society continue to believe.
In this post I’ll first define mind body medicine, its approaches and how it has been a valuable tool for some people. Then I’ll talk about its limitations, which I’ve experienced as well. I’ll end with how this summer’s statements and suggestions have shaped an upcoming series about my views, which address – and offer a context for understanding – the limitations of mind body medicine.
The Benefits of Mind Body Medicine
Wikipedia defines mind body medicine as an approach that “uses the mind to alter physical function and promote overall health and well-being.“
Many people, including myself, have experienced improvements in their health – and in their lives – through such approaches as:
- slowing down,
- yoga, meditation, Tai Chi or other methods of stress reduction,
- counseling and / or support groups,
- making time for intimate friendships and supportive connections with others,
- incorporating alternative and complementary medicine,
- dietary changes,
- and / or creating more balance in work and daily life.
The benefits of mind body medicine are not to be scoffed at:
- Physician Dean Ornish showed that heart disease is indeed reversible for many by making the kinds of changes listed above (2)Ornish, D., et al. (1990). “Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial.” Lancet 336(8708): 129-133., (3)Ornish, D. (2012). Dr. Dean Ornish’s Program for Reversing Heart Disease New York, Ballantine Books.
- Donna Jackson Nakazawa has begun to reverse the effects of her severe autoimmune and other illnesses through mind body medicine, stress reduction and other tools and perspectives (4)Nakazawa, D. J. (2015). Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal. New York City, Atria Books.
- Dr. George Jelinek, whose mother committed suicide following years of debilitating multiple sclerosis, recovered from MS himself and has helped many others who have followed his program.
- The 2014 documentary on mind body medicine, The Connection, interviews leaders in the field and tells the stories of individuals who have recovered from very serious illnesses, including cancer in very late stages as well as autoimmune diseases. Journalist Shannon Harvey’s film describes the science and the fact that over 10,000 research studies have reproduced and supported the findings of mind body practices. These approaches have been used by cultures all over the world for centuries. She first learned about mind body medicine after trying many things. Her own symptoms of lupus have improved significantly as a result.
The Downside of Mind Body Medicine
Many people with chronic illness, like myself, have been unable to recover, improve or to heal despite implementing many or all of these practices. Many, like me, have continued to get worse despite incorporating such changes. And many, again like me, have developed one, two, or more additional chronic illnesses or disturbing additional symptoms as time has progressed.
In addition, people who have been unable to recover have often been stigmatized.
The conversations I referred to above – and which I hear of and read about everyday from people living with chronic illness – reflect some of the critical limitations of mind body medicine.
It’s not just that it doesn’t work for everyone. It could be in part because, for some like me, it is difficult to succeed at implementing all of them. But a big part of it is also because so many health care professionals as well as family members, friends, and colleagues have come to use such perspectives to blame, shame, and judge those who have failed to recover from chronic illnesses and symptoms. Or whose symptoms cannot be diagnosed or explained.
People are still told every today, even now in subtle and overt ways, that if they’re sick it’s because they haven’t tried hard enough. Or because they have too little will power or are weak (see this recent article in the New York Times by Rivers Solomon, a woman struggling with type 2 diabetes).
That it’s because they can’t deal with their emotions. Or have personality flaws.
Or, perhaps even worse, they are disbelieved when they have no visible or objective evidence of illness that a doctor (or relative, friend, or employer) can recognize or understand.
If there’s one thing people living with chronic diseases learn, it’s that the inability to recover is not for lack of trying.
And so I’ve been asked – sometimes politely – to butt out and stop sabotaging the conversation about the real science. To stop sullying research results and biochemical findings that might finally explain what is really going on with our so frequently incurable, invisible or routinely questioned illnesses.
The Limits of Mind Body Medicine
For many people living with chronic illness, mind body medicine has contributed to pain and suffering.
Because of too many – and ongoing – negative medical experiences, mind body medicine has come to be seen by many people with devastating chronic illnesses as an inadequate, insufficiently complex and judgemental paradigm. One that offers hope without delivering the actual goods. One that suggests that when non physical influences – such as trauma – are mentioned, it means that an illness is psychological or psychosomatic. Or that when a doctor is unable to provide treatment that makes a difference, the disease must therefore be “all in our heads.”
The perspective that the effects of trauma are entirely and exclusively psychological offends and insults people with very real, life-altering, debilitating, and ultimately difficult-to-treat diseases.
And rightly so.
Here is where a different understanding of trauma comes in.
It stems from new and well-established research that has yet to be incorporated into integrative or mind body medicine, let alone into “regular” medicine and training.
While our minds and bodies are remarkably interconnected even though medicine still tends to think of and treat them as separate, the belief that emotional problems cause chronic illness is inaccurate. Or at the very least, it is incomplete.
As is our generalized understanding of trauma.
And both are out of date.
There is a need for care when using the word trauma outside of this context until I can better explain the new definitions and what we have learned. But it doesn’t mean that the new science is putting the blame on patients or saying it’s psychological. It’s not.
The Discovery Process
And so begins a new chapter in my story: one that describes the process of discovery that has lead to a different understanding of chronic illness. Instead of providing my conclusions, I need to share the research and show what lead me to reach these conclusions. And let you interpret it for yourselves.
It’s a story that might explain why mind body practices and the reduction of stress may be so helpful yet still insufficient to enable some of us to improve or even heal.
I write because I want to know if these other fields of research make sense of anything people with chronic illness have experienced. Whether a different understanding has any positive impact on how others experience their symptoms of chronic illness.
I want to know whether these unexpected and well-respected but poorly known studies (in the medical field) explain why certain approaches don’t work. And if they offer any new insights, support or clues that make life any easier.
Factors that Influence Symptoms
Sometimes chronic illnesses begin following an easily identifiable event. Some of these events are clearly traumatic. But many others are not. Some triggers of onset include infections. Others include exposures, such as to toxins or vaccines. Some involve stress. And for many, the onset of symptoms comes out of nowhere.
The 64 million dollar question at hand (5)I had to combine the metaphors because the price tag on understanding disease has gotten so very high is, “Can we explain how these kinds of completely different factors, including the mysterious, are related?” And, ultimately, ARE they related?
This is the story of how I came to an entirely new way of thinking, and one that is emerging in bits and pieces throughout the scientific world.
It’s Not Psychological
When I first sought to understand more about what drives and underlies the development of chronic illness, I was intrigued by one particular question:
I wondered whether symptoms could stem from an intelligent process gone awry.
Not as the result of a psychological problem. Nor as a set of physical symptoms caused by emotions. And not as a simple stress response.
But as a process that starts in our cells or in our fluids or in our nerve pathways or enzyme cascades.
The next chapter of my story begins with the “Causes of Chronic Illness” series.
What has your experience of mind body medicine and its practices been, whether in relation to chronic illness, cancer, chronic pain, mental illness or other symptoms?
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References [ + ]
|1.||↑||you can find the conversation on Health Rising’s Post “The Core Problem in Chronic Fatigue Syndrome Identified?” by searching for “Veronique” amidst the nearly 250 comments on this specific post. This is the conversation that starts after I mention trauma and begins with, “I loved your summary Cort – what an exciting, ground breaking study.” Some of the responses challenging what I say are further down in the comments. You can find these particular responses by searching for the terms used to describe me in the comment section as well, including “psychogenetician,” “psychosomatician,” and “psychologizer.” * If you have any trouble clicking on the link or highlighting the words in this long reference you can also access it all in the reference at the bottom of this post|
|2.||↑||Ornish, D., et al. (1990). “Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial.” Lancet 336(8708): 129-133.|
|3.||↑||Ornish, D. (2012). Dr. Dean Ornish’s Program for Reversing Heart Disease New York, Ballantine Books|
|4.||↑||Nakazawa, D. J. (2015). Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal. New York City, Atria Books|
|5.||↑||I had to combine the metaphors because the price tag on understanding disease has gotten so very high|