What is holistic health?
During the first months of my PhD I struggled heavily with migraines. By then, I was 26 and knew migraines quite well since my teenage years. But during these weeks in 2015, it became unbearable due to a frequency and intensity of the attacks that I had never experienced before. First, because of the intense pain, but also because of an anxiety that came with it, when I was absent from work for 2 or 3 days, repeatedly over weeks. I was afraid that my supervisor thought I was malingering and I became more upset and angry with myself, feeling weak and inferior to other more resilient types of humans. I felt helpless, desperate, and I didn't know what to do with that body that obviously decided to work against me. Eventually, I made an appointment at the Headache Center Hirslanden. During my first appointment, the doctor carried out some neurological tests.Then, I had another appointment with the very same doctor.
Mind meets Body
This time, she asked me about my general health, my well-being and stress levels. I told her how I was afraid that I couldn't meet the challenges of accomplishing a PhD, that I was afraid to fail and I would turn out to not be smart or good enough. She didn't dig deeper into where these beliefs came from, but gave me advice to inquire if these fears were rational and humanize what I expect of myself. She told me that it is very helpful and necessary to make mistakes, not only for myself, but also for the students I would teach and work with. I remember that she was very approachable and smiled when she said, "Just imagine you never made mistakes. Your students would be very afraid of you." Next to these words, she gave me high dosage of magnesium and vitamin B2, instructions for relaxation techniques to counterbalance the pressure I put on myself, and a headache diary. Since this appointment, I had one more migraine attack a few weeks later and until today, not a single one after that.
Body/Mind: A short Primer in History
Obviously, this is my story and I am not generalizing my story to your or other peoples' here. While every story stands on it's own, this incident in 2015 made me become intensely curious how my body and mind are connected; in both health and disease. Since then, I started to think differently about body and mind. Before, it made sense to me that body and mind are two separately functioning entities. Today though, I think of body and mind as one functioning unit.
It seems though that Western Culture started to draw this very sharp line between body and mind as distinct and separable entities during the 17th century when the Philosopher René Descartes claimed that what defines mankind is thought and reason. ‘Cogito ergo sum’: We exist because we think, not because we exist as physical beings. This view was widely adopted, also by the Catholic Church, and became sort of the default perspective in Western Culture. This is true until today: There is physical health, and there is mental health.
However, in the history of thought, the idea of oneness of body and mind is anything but new. This is not only true for many forms of Eastern Philosophy, assuming that the distinction of "mental" and "physical" are unhelpful concepts to begin with, since they open up a division between body and mind that does ultimately not exist. The ancient Greek philosopher and physician Galen of Pergamon, who lived around 200AD, also claimed there is no distinction between body and mind as well as that emotions affect physical health directly.
"The Caduceus, the Western symbol of health and healing, has its origins in ancient Greece. This well known medical symbol depicts two snakes curled around the staff of the Greek god Hermes. Each snake represents one of the two essential aspects of medicine. The outer aspect is our biology. The inner aspect is consciousness: mental and spiritual life.
The Medicine Buddha is an Eastern symbol of health and healing. The wise figure of the Buddha is in a sitting position holding a branch of the Arura plant in his right hand, which symbolizes all external therapeutic approaches to healing. In his left hand, he holds a bowl containing the elixir of wisdom, the inner force of healing.
These ancient symbols, (...), are identical in meaning. They offer a universal wisdom gained by the great healers and sages of the past. It is said that a harmonious and balanced interplay of body, mind, and spirit, the inner and outer aspects of life, is the basis of a far-reaching well-being."
Quote taken from: Dacher, E. S. (2014). A Brief History of Mind-Body Medicine.
Then, with the beginning of the 20th century, Psychoanalysis contributed important ideas and findings in the area of ‘psychosomatic’ (‘soma’, Greek meaning ‘body’ ) medicine, assuming that every type of disease is always, in part and next to other factors, caused by mental processes, too. In that sense, one of the central claims of psychosomatic medicine is that we should not pay less attention to the ‘soma’ (body), but more attention to the ‘psyche’ (mind) as both are essential to health and disease. But it is just until recently, that pathways between mind and body are explored scientifically, helping us to get a clearer picture how exactly these pathways look that connect body with mind and vice versa.
"there is no real division between body and mind because of networks of communication that exist between the brain and neurological, endocrine and immune systems"
Oakley Ray, Professor Emeritus of Psychology, Psychiatry and Pharmacology
We came to know that the brain is not the only information processing system within our bodies: the nervous, the endocrine and the immune system have receptors that can receive information from each of the other systems. So what starts in the brain as a perception, a thought, or a feeling doesn't just stay in the brain. What starts in our minds does not only affect the activity of our mind, but our entire system and vice versa. While body and mind are essentially one because of a myriad of ways in which they connect, there seems to be one factor that is extremely influential in affecting health and disease. This factor is stress.
It was Walter Cannon who started to research what happens at a bodily level when stress is experienced in the 1920s. He was the one that found out about the "flight or fight response" which is well known today. This fight or flight response is hard-wired in every living vertebrate and is very functional in terms of survival when we encounter stressors like threat or danger. The stress response is an automatic reaction that includes increases in heart rate, blood pressure, respiration and metabolic shifts that liberate energy to fight or flight for our lives. It is a chain reaction that starts with a threat we perceive and that results in a strong activation of the sympathetic nervous system, one of two branches of the autonomic nervous systems. This all happens within less than a second. If you are curious about the details, watch this or maybe read this.
Stress!
Yet, stress is not bad per se. We all experience stress to a certain degree and that is healthy; even necessary for our daily functioning. Yet, when stress becomes excessive or persistent in our lives, the response can turn from a life-saving into a very harmful reaction, that increases morbidity and also mortality. As our body is in survival mode and the energy of the body is directed where it is needed the most, it is also lacking in other important areas of our system. Our immune system is a good example for it. Our immune system is designed to work 24/7 for us and for sustaining our health: killing cancer cells, creating antibodies, fighting off infections and so on. Every second of the day, every day. It seems it is okay to put this system to halt every now and then, but not several times during one single day. Yet, this is the amount of times that some people experience extreme stress on a day to day basis. When we experience intense strain, e.g. at work or in our relationships, our nervous system instinctively reacts as if a predator is out to get us, triggering the flight or fight response, which disables the body’s natural self-healing abilities.
To my view, this is the most important and yet least known fact about the famous flight-fight-response: the physiological and biochemical wear and tear the stress-response puts to our bodies, when experienced too frequently. Accumulated stress responses due to chronic stress, may likely lead to various pathogenic outcomes or exacerbate their symptoms, ranging from cardio-vascular disease or cancer to higher likelihood of infections and impaired wound healing, as many studies of the past decade could show. The bottom line here is: Accumulated stress is bad, worse than many of us think. But there is good news, too.
What helps?
It seems that we have, in the same way as we have a built reaction to stress, we have a physiological response set that unfolds within our mind and body when we experience relaxation. The “relaxation response” was discovered by Herbert Benson in the 1970s - interestingly enough, in the very same lab rooms at Harvard Medical School that Walter Cannon was in while researching the stress response. The relaxation response is in every possible aspect the antidote of the stress response: it is a reduction in the sympathetic nervous system excitation that marks the fight-or-flight response and a decrease in the level of stress. The relaxation response is driven by the parasympathicus and lowers adrenaline and cortisol in the body; decreases blood pressure, heart rate, and respiration; and enhances immune functioning.
A multitude of studies since have explored what exactly happens in our bodies that explains these positive consequences for one’s health that come from inducing relaxation. While all the science behind these phenomena is certainly interesting, we do not need to understand everything that is happening there in order to do good for ourselves. In the same way as we don't need to understand how exactly an engineer worked out the physics to build a bridge in order to use it and to get from one side to the other. Same is true here. We only need to know how to walk that bridge from the one side of "excessive stress" to "more relaxation" and self-care.
Relaxation Techniques and Mindful Living
Many studies since have researched which formal techniques affect health positively as they elicit the relaxation response. Those techniques range from meditation to autogenic training or progressive muscle relaxation. In these "times of continuous partial attention" as coined by Linda Stone, we benefit from coming home to our bodies and enjoying relaxed presence and focused attention on the here and now. Next to practicing these relaxation techniques, relaxation can also come from engaging in everyday routines that naturally allow us to enter that state of calm and ease. These moments when mindfulness gets us may look different from person to person. Individually, to me, cooking is something that relaxes me a lot. Cutting vegetables, amazing. The more the better. Or walking our dog in the forest; playing with him or just silently watching him explore the side of the path with such rigor, concentration and excitement.
And it seems for my individual case, this state of letting go of excessive stress can be also brought about by a neurologist in a white coat in a headache center, letting me know that it is okay to make mistakes in life. What a revelation. Amazingly relaxing. You see that I am joking here. Of course I knew before that no one is perfect and most of all, that it is an unhealthy standard to measure ourselves against. Yet, I somehow worked out a nice double standard that made me an exception to the rule and enabled me to make perfectionism my personal agenda without even being aware of doing so. It was largely unconscious to me and yet drove my thoughts and feelings and behaviour. And created a huge amount of stress. So it was incredibly helpful for me to be mirrored by that doctor and that she could make something explicit that was unconscious before.
What I want to say here is: mindful living and relaxation obviously induce relaxation, but often enough, there are false beliefs or dysfunctional thought patterns that kind of block the entry door to engaging in relaxation, because they are the very basis of the stress we experience in life. Because after all, stress - when it is not an instinctual reaction to a predator or something like that - comes from thinking, from evaluation and perceptions, from thought patterns we have crafted over time during our lives in our brains. And while we will never be able to not react with the flight or fight response when we find ourselves alone in the wild meeting a tiger, we do have the ability to change our ways of how we deal with our inner stressors that eventually cause outer symptoms. While it may feel impossible to "just relax" in times of crisis and sorrow, relaxation and ease are likely the byproduct of having a closer look at the things that cause my stress, to inquire one's own mind and emotions and to learn new ways of coping.
We do have a say in how we deal with stressors
We experience intense stress in depression and anxiety, we experience stress in relational conflict and also when we feel lonely or isolated. We feel stress when we have secrets to keep from others, when we feel ashamed or guilty. We experience stress when we feel there is just too much on our plate: responsibilities, work, family and too little time, when we feel helpless, desperate and close to being burned-out. Maybe not all together at once, but all things above are part of the human experience. We don't choose these situations that create stress at first, but we can decide how we react to and deal with them in the next step. I strongly believe that talking about it helps. This is why I started Mindful Body. But it is not only counseling or psychotherapy that can help - there are self help groups in many many cities (e.g., here in Zurich), there is spiritual welfare in local communities, there are forums that can be used anonymously (e.g., on reddit) or help lines, that can be consulted from basically everywhere on the planet...
Finding a healthy way of life in a stressful world
Some final thoughts. So yes, one of the best things you can do to care about your overall and physical health is to take your mental health and emotional well-being seriously. After everything we know today, it is not only our genes, not only our diet and exercise routines, our staying away from unhealthy habits like smoking or drinking, but also our how we take care of our mental ease and emotional well-being that substantially affects health. I think this is important to remember in this very complex and fast-paced world we find ourselves in. While I would never wish for the "good old days", we should still acknowledge that life did not only become easier because more opportunities exist. Today, it is not uncommon that people move from one country to another to start a job in a different city, in a different culture, where they don't know a single soul; that social media and media in general connects us to everyone and everywhere around the globe, that relationships and careers became more temporary and demands of what we could or should be are on the rise. This is all good. And also not so easy to handle at the same time. I think it is fair to say that it is easy to get a bit stressed in this world. What do you think?
A Good Read
Finally, I would like to recommend the book "Mind over Medicine" by Lissa Rankin on this very topic. I felt sceptical at first because of its title. I thought the title would indicate that this is a book that would argue how each and every disease could be controlled and thus healed by mental processes. Spoiler: It does not. I very much appreciate how Lissa Rankin, being a medical doctor herself, explains the complex biological underpinning of how body and mind are connected and how she manages to give a very comprehensive and easy to understand overview of these mechanisms. She also expands a lot on the placebo effect, which again shows how powerful our mind is in affecting bodily health and gives a lot of practical advice and actionable plans on how to restore balance for body and mind, if that might be something that interests you…