The Art and Science of Mind-Body Medicine

this program is a presentation of uctv for educational and non-commercial use only I wanted to welcome you all here and to thank you all for coming I know that all of us have lots of things vying for our attention and it's wonderful to see you here and it's wonderful to see so many of you here I'm Rick McKinney I'm the chairman for this series of the osher mini-medical school program this time we have a double Osher mini-medical school program since that's the name of the main series but it is also this particular series of six sessions is being sponsored by the Osher Center for Integrative Medicine I'm a practitioner there the speaker tonight as our medical director and I'll tell you more a bit more about him in just a minute the mini medical school series has been going for a number of years now at UCSF faculty members from various departments come together and present talks aimed at the the well-informed and wanting to be better informed public tonight we I'm very privileged to introduce my good friend and colleague Kevin barrows kevin has been a part of the Osher Center for Integrative Medicine for 10 years he has been leading the programs on mindfulness of mindfulness based stress reduction programs for most of that time if not all that time he's been leader the director of group programs in general for the OSHA program and right now he's also serving as the interim medical director for the clinic at the Osher Center he has worked in mind-body medicine and especially with mindfulness based stress reduction for many years he has researched mindfulness based stress reduction in many different ways and is published on it he is a associate clinical professor at UCSF probably most important of all Kevin is an exceptionally skilled and an outstandingly compassionate clinician and I will introduce him right now we are also hearing tonight from Christie Dalia home who Kevin will introduce later she's the yoga teacher at the Osher Center and from Joseph aqua who's one of our traditional Chinese medicine practitioners and acupuncturist Kevin and so will inaugurate give me on mind-body medicine so thank you Rick for that introduction rick is a is a friend of mine in a fellow family physician and one thing and he's going to give your talk next week one thing you probably won't hear in that introduction or else anywhere else about Rick is that I'm that I admire about him as a fellow family physician is he worked in the outback in Alaska as this the sole family doc in town kind of thing and also in a rural area in Washington one of my favorite stories from his time in Alaska is the being chased by a grizzly bear and actually that's somehow that story just sticks with me because actually next week when he's up here talking if you squint take the opportunity at some point just kind of squint and you'll see he looks like a grizzly bear actually okay so this is a great opportunity because we're all here together and this is a fantastic topic and one of my favorites and I sees a couple of familiar faces in the crowd so I think this is going to be fun and I hope you enjoy at the end we're going to have a panel you'll see I've invited this is actually kind of the biggest thrill for me is I've invited two of my colleagues from the Osher Center to be with us tonight to contribute and I'll introduce them as we get later in the talk and at the end we'll form a panel and you can you can ask us questions and we'll actually I'm thinking of it more as a discussion than us telling you something and I'll explain that so I didn't know what to call this talk let me go back so that's that that's the phony title and and I thought boy you know let's this this is a topic I've thought a lot about and we're all interested in Rick's favorite topic my favorite topic let's just I wanted to sort of deconstruct it and really think brand-new about it and with you actually in a process with you so so I thought okay well the mind bottom is no no no that's not quite right mind/body/spirit medicine how hot it no no that's not quite good enough let's let's really let's really think about this mind-body non-dualism that's deep does it wait a minute that still doesn't capture some of the things I think we need to explore so I thought what the hell do I call this lecture so I've decided the best way to go is to think about this together so as we go through the evening I will put things out to you and I'd love to hear what you think so here's my tentative outline for how we would proceed so first why are we all here what is interesting attractive special about mind-body medicine that's fun to just even stop for a moment and think about that secondly before we get too far what the what is mind-body medicine anyway thirdly and and I'll try to keep this brief actually it's just my choice this time is the research I'll definitely hit some highlights but I don't want to spend the majority of our time citing the research and I can't resist because I think we should have some fun here too is talk about the mind-body medicine toys or technologies that are just fun that are out there and then at that point I'm gonna invite you to forget absolutely everything I've said and we're gonna invite Christy to actually lead us at an experience that I that I think will be emblematic of some of what mind-body medicine is and then my recently arrived colleague dr. Joseph aqua is going to present a case with us and we're gonna look at mind-body medicine from a system in a culture that never separated mind and body in the first place I think that'll be very instructive and then after that the three of us will be up front here and maybe Rick two can join us and we'll just see what kind of discussion we can have so what do you think what do you think what is attractive special interesting about mind-body medicine just just shout or raise your hand or just what do you think why are you here oh I knew it the Rodin sculpture is intimidating right alright so what do you think don't mind why are you here what's this topic you chose this topic why there's no separation so this idea of the we're on a crusade to to remember that there's mind and body are not separate maybe hallelujah sister so first of all I'm honored you're here any practitioners I'm honored that you're here and I very much this is what got me interested years ago in my body medicine it was clear to me I was doing kind of high volume family medicine about 11 years ago now at UCSF here and and I was realizing I had my mindfulness background and I was starting to see it through that lens and I was realizing wow most of the suffering that I'm seeing in my you know 20 25 patients a day were it was more in the mind actually than the ankle or the abdomen or wherever the the identified source of complaint was so yeah excellent excellent yeah I'm so interested in learning about ways that we can heal ourselves was what she said yeah yeah yeah so the the the contribution to holism okay so I thought about it myself also before I came here and you've hit on some of them so one is and I think you just said it is for me sometimes there's a sense when I'm really deeply practicing that somehow I'm making making things right I'm there's a there's a disconnection that I'm reconnecting it belongs connected I just get that sense I think many of you've probably had that experience if you've done any of the what are commonly identified as mind-body practices moments of you might experience them as peace or sort of moments that say no thought or deep immersion in a particular experience there's a sense that this is actually this is the native state this is how it's supposed to be someone else I think was addressing this hope the the idea that that there's this mysterious untapped potential is very hopeful to me we've all heard the story oh the doctor said he had six months to live and that was ten years ago so when I hear things like that I always wonder about yeah one of the many unknowns in medicine is this the power that we have to influence our own beings through the use of the mind self-efficacy is the term from psychology you might be familiar with meaning sense that you can affect your future you can affect that you have some control you can affect the outcome in your life it's actually that as a psychological measure is very clearly correlated for example after a myocardial infarction or heart attack people with more self-efficacy people who think they can make more of a difference in their rehabilitation have less mortality then people who on surveys feel like I've had this heart attack it was out of the blue there's nothing I can do about it there's nothing I will be able to do about it in the future they actually have a higher mortality so actually very profound some of the things we're looking at here the mystery of it so I do hope one day there's no disease or illness but I kind of don't hope that there will ever be a day when we figured out the body mind completely because it just it's just an endless source of fascination for me and I think all of us and then finally and I don't know how to explain that this I don't know how to talk about this explicitly yet but clearly I think this is what draws a lot of us is there's a connection to the spiritual so I almost wonder in my mind the it's almost that same gesture of going from body to mind is going from mind to spirit in other words the recognition the the experience that mind and body are connected actually never separated is that same motion is somehow psychically what's going on with respect to spiritual that's the best I can do you might have your own words but but I it's clearly the case all the colleagues I have that are interested in mind-body medicine all have sort of spiritual inclinations and interests and actually this is interesting rick referred to some of the research that we've done on mindfulness at the Osher center there was we did three cohorts of 25 each of the health professional students here at UCSF so we put them all together dental medical nursing pharmacy physical therapy put them all together so 75 and this eight-week mindfulness meditation program and the outcomes were were favorable that I'm proud of their decrease depression decreased anxiety kind of typical findings with a mindfulness intervention but the thing that changed the most was an index of spirituality people's sense of spirituality which was defined you know it's very it can be defined very differently depending on the tool you use so ours was the components of the spiritual assessment were sense of connection to something larger than yourself sense of meaning comfort with death or the ouvea where of death these were some of the elements so actually in in our study spirituality was the was the thing that that changed the most okay so so what what is this thing anyway I don't know maybe you can help me here's how I thought about there's an old idea and that is Oh weave weave some would say it's a mistake some would just say it's the historical you know just empirically this is what happened but in in sort of Western culture the mind in the body were split many people attribute the beginning of this to Rene Descartes the French philosopher from the 17th century there were this this mind-body dualism was there were there were some it had existed previously in history in ancient Greece but but it's really since Descartes that and I'd say most of us are a product of this culture of living in post-industrial post scientific method modern America it's since Descartes that the cultural paradigm by default so it could be unconscious for most of us is mind and body are separate and Descartes was cleared the body is like a machine and the mind is sort of the the the noble organ and as his famous his most famous phrase we all identify him by I think therefore I am or or I am thinking therefore I exist so that the the the absolute preeminence of the mind and the almost almost denigration or neglect of the body another historical factor that might have contributed to this is the rise of science and the scientific method so science as powerful as it is has its it's a it's a philosophy in itself and it has certain characteristics and I would say reductionism and materialism are are some of the characteristics of science and that would also tend to tend to separate mind and body so the old idea in mind-body medicine is oh well we we separated the mind in the body let's put him back together you know like almost picture we got a head over here in a body over well Jeeves shouldn't we put those back together so that's kind of the old idea and I think part of the old idea I'll say even is and then when we put them back together we can use the mind to have an effect on the body so we can do guided imagery and improve our immune function or something like you know there's many such examples so so this idea that it's the mind still the mind in the body are separate we just happen to have connected them physically and the mind is influencing the body so there's still an inherent dualism to this old idea even though the correcting that the error of bringing them together is nice there's still a dualistic thinking just the term mind-body medicine I've actually thought a lot about how to write that word if you capitalize the B do you – ate it do you not – ate it these days I'm wanting to not – ate it now so so it really catches people's attention because then it would be grammatically sort of striking mind-body still with a capital B then to make it clear this is one thing not two things in relation actually actually it's one thing the other part of the old idea is that this relationship is unidirectional the mind we do something with the mind to influence the body so the new idea would be all wait a minute this is this let's get rid of this dualism mind and body are not separate you are just one organism and anything that we do affects the whole organism any any mood you're in any medical therapy we offer any experience you have in life it's affecting the whole package and also if you resort to the idea that these are separate parts say of the same entity that it's bi-directional you can do something with your body that will influence your mind I think we all know that we've had that experience there's a lot of research to this effect – if you do aerobic exercise you feel better and the research shows you have less depression and it affects your mood some people very acutely you can see that I always think about some of the medicines we use interferon is this wonderful product of genetic engineering that we use for mostly for chronic hepatitis treatment and it's it's it's something that your body your white blood cells naturally produce when you get infected by a virus your white cells secrete interferon to prevent infection from other viruses and the teleological reasoning is well if you've got one viral infection it's you need to not get another one and so your body secretes interferon so we've exploited this we've got bacteria producing it now and we can inject it into you to help you recover from your hepatitis and and I think it's used in other capacities as well interferon causes depression it's just that the side effect for interferon causing a person's I think it's over 30% 40% so I inject you with interferon that might be great to help with your hepatitis but it it causes depression so here's here's a chemical that your body makes that affects your mood your mind pretty profoundly and that's just I mean I bet all of us in here could relate a story of a medicine that we've tried that that had an effect on our mind even say unintentionally okay so so the new idea so to repeat so the old idea gee the mind in the body how did we do that we've decapitated ourselves let's put it back together and we've put it back together and it's it's now that it's back together we can do things with the mind to affect the body and that's the one direction here the new idea is wait a minute let's go a step further and let's really look at this this is bi-directional and non-dualistic the very old idea is how about never separating them in the first place that's why I have Christie and Joseph here because their traditions yoga and Chinese medicine respectively never separated the two and so with hearing from them I think is gonna is gonna be useful for us as we contemplate this and then what about I'm gonna leave that for just in a moment so so forgive me I'm gonna go back to the old paradigm for a moment because we just have to that's just although all the way we've been thinking about it and all the literature all the research and stuff is in that pair so let me tell you a little bit about that these are the things that are commonly used there are many other mind/body methods but these the ones that are most commonly used and I'll just say one word about each very quickly so hypnosis think of hypnosis as a method where a practitioner or hypnotherapist in it's my preference that it be a mental health practitioner or a psychologist or something gets a sense of your subconscious mind which is different we all have our subconscious minds different from from each other and there's imagery as they say imagery is the language of the subconscious so find out so if say you're suffering from chronic low back pain what what image does your subconscious mind carry about that low back pain then the hypnotherapist can provide a suggestion to your subconscious mind that's the key it's it's bypassing the rational discursive analytic mind that says hey that's ridiculous just cuz this guy tells me I shouldn't have back pain that's why should that work it's it's really getting directly in touch with the subconscious mind and planting a suggestion based on your particular subconscious profile the research for hypnosis if you look at the clinical medical research on it it's effective for pain a lot of associated cancer symptoms like nausea anxiety pain related to cancer biofeedback is a and I want to point out we have a nurse who who's our bio feedback expert at the Osher Center Theresa Corrigan and biofeedback is described in a way much less sort of complex and elegant as Theresa would but basically monitoring some physiologic process of the body that is that is usually unconscious and suddenly your heart rate or your perspiration rate or your muscle tension and then that is that is monitored and fed back to you either on a visual just or even an auditory feedback usually with computers and you can actually see then that physiologic parameter as it changes and so you can start to try to change that parameter that previously unconscious parameter you can start to try to consciously exert influence and you can see the result and so it's basically it's a kind of a training in Teresa always says that she's there to teach people so to train people so that they can do this on their own research for biofeedback is is especially strong this is this might strike you as funny but as odd but the the strongest research and by feedback is actually incontinence urinary and fecal incontinence in fact we have the pelvic physiology Center here at UCSF and it really is the the the the method of first resort I would say four forms of those conditions also blood pressure I feel bad feedback can be effective for reducing blood pressure not in all cases and the medical literature on this is is definitely there's there's opposing view but I would say the balance of it is in favor also headache and as Theresa would say just about anything that you want to put your attention to you can probably influence with biofeedback guided imagery similar to hypnosis and that we're talking about the subconscious mind but here in this case we're using the imaginative capacity of the mind research for got imagery is especially impressive for perioperative care so if you're going to get a surgery actually it's at one point I don't know if this is true in California but it's definitely true in other states Blue Cross sends anybody going to surgery they send them a guided imagery CD because for them it's cheap right it's probably a couple of bucks to make that CD and they know they have seen research that shows that it helps outcomes and people love it so you'll be getting a whole lecture on that progressive muscle relaxation I think I'm gonna interest of time I'm going to skip over some of these breathing how many people are breathing right now good good I'm all for breathing no there are there are ways of breathing that can profoundly influence your physiology in your mental state the oldest tradition of this is pranayama they from the Ru Vedic method and from the organic system of Medicine journaling or what in the medical research is called written emotional disclosure now I must say I looked at the research on this and it's equivocal it's equivocal but there are definitely some conditions in some cases where it is it is effective and so that's interesting that just telling someone okay I'd like you to write about the the most challenging or traumatic events in your life for 15 minutes a day for the next few days that that alone just writing it not even the sort of psychotherapeutic processing about the gist that just the eliciting of it actually can improve asthma in some cases and pediatric pain meditations my favorite I could speak all night about that I feel the research there is robust and I'll just define meditation as the self-regulation of attention so you're choosing to do something very deliberate with your mind in meditation and there are different varieties of meditation my favorite for medical use is is mindfulness meditation because I always say it's more portable it teaches you how to pay attention to anything actually that comes up you start with the breath and the body and things that are immediately accessible to you but once you develop kind of a concentration and an understanding of what the qualities of attention are in mindfulness practice you can bring that mindfulness to your back pain or your anxiety or your stress at home or whatever's going on for you so that's that's that's why I like it I think that's why it's been quite successful so I'm not gonna what about these other things and and its relationship to mind-body medicine I'm just gonna ask the questions I don't even know but I just to sort of stimulate our thinking together so what about prayer and shamanic healing and the placebo effect and the nocebo effect the opposite like you're I think you're not gonna do well and then you don't do well or I think this medicine is gonna cause you a side effect and then cause you a side effect how about this this may be in a different category just blushing so you feel embarrassed you have a thought or there a certain situation you get embarrassed what happened the profound vaso dilatation of vascular event occurs I mean it's and and it's just amazing interferon I mentioned the gait theory of pain so so this is the idea that you so say we take a hammer hit my thumb ouch signal comes to my spinal cord that synapses and then goes to my brain the brain registers shouldn't have done that that hurts there are also descending fibers from the brain that synapse to meet that peripheral nerve so I there are things that my brain does that can modulate my experience of pain my mood certain medicines you you can think of the kind of the rush of athletic competition or war battle where pain is not felt actually if the tissue damage is still happening but the perception of the pain is not or it's greatly modified aromatherapy just you don't need you don't even have to be aware of this in fact the research on this a lot of it's done in Alzheimer's patients with agitation so in in skilled nursing facilities you know it's a it's very agitating for Alzheimer's patients to not know where they are and if they do if they're told and one moment later they forgot again and so so and then these strange people who happen to be the nurses that have been taking care of them for five years but to them it's a brand new strange person coming at them wanting to bathe them or something so it can be very threatening very very unsettling so they can be a lot of agitation just totally out of their awareness floating Lavin or other soothing aromas actually demonstrably can reduce their agitated behavior music we all I mean music affecting your your your mood and your body and energy therapies like reiki etc I just I feel like our Preet my point with this slide is our previous ideas of mind-body medicine are are inadequate there's a lot of it's just it's just much much bigger and much much less defined than than we think ok I've already mentioned a lot of the research actually and I want to get to my colleagues so I think so let's see I think those first four thoughts emotions social relationships and religious practice the research on those this this is old and it comes from the psychology literature not really sort of the integrative medicine literature about how the way we think the emotions were experiencing the degree and quality of social relationships we have and the frequency this is just frequency of religious attendance those all strongly correlate with health outcomes and I can't I can be very specific with you about that of note under emotions the old research or the original research is about negative emotions it's very it's very impressive someone again go back to the heart attack someone's had a heart attack if they're depressed they are it's somewhere it's between two and three and a half times more likely to die of a second heart attack than someone who is not depressed it's to the point now where all the cardiologists know this enough they're looking for it so after a heart attack they're gonna be aggressively looking to treat any depression now the newer research however is about positive emotions and one of our colleagues is one of the leading researchers in this area Judy Moskowitz and she's going to be speaking in your series also so I'll leave that to her toys okay so this is I just I love this I thought you'd enjoy it so so just what are some of the things you can do you can experience you can play with that that that kind of take advantage or explore some of these mind-body phenomenon so drumming is the original mind-altering technology for sure shamanic healers use it I mean it's it's it's probably the first thing humans ever did have you has anybody heard of binaural technology yeah so so it's um the the the clinical research on this is very minimal but there is some and it's I should say sort of medical research on it there's some physiologic research on it but the medical research on of this is early but it's it's so interesting and in people everybody myself included it's feel different when they do this so these are a couple I have no financial affiliations by the way with anything I'm mentioning so these are these are two ones that are out there that seem to be like leaders or popular or something I care the most hemi-sync and holo sync although you can you can get free binaural technology off the web even but the idea is to different frequency sounds are delivered to your ears it's got to be less than a thousand Hertz and the difference I think has to be less than 40 Hertz so let's say you get 400 Hertz delivered a sound of 400 Hertz delivered here and 410 Hertz here your brain but then now this is probably from the fact that we have a really as a species we are very good at discriminating where sound is coming from as long as it's below a thousand Hertz so if there's a sound I can localize it pretty fast and that's because it's arriving at a slightly different frequency right because if it's a sound is over here it's coming at a slightly different frequency in this year than it is in this year so so that's probably why the wiring is the way it is and then this binaural technology sort of exploits that so you get one frequency here another one here slightly different it your brain tries to integrate that and creates what the proponents of this claim is an entrainment wave and I do believe this there is the research proving this much that that frequency so my example it was ten Hertz difference though there will then be a ten Hertz cycle that in trains in your brain and certain areas of your brain will just fall into that and so these people the researchers and and the people selling these things claim that you can alter brainwave patterns what I could report is is everybody that I know that have tried it feels different feels relaxed or feels something so it's just very interesting more in their category of auditory for those of you who are familiar with the chakras these are the the energy energy wheels is the literal translation in the body according to our Vedic medicine so these seven wheels of energy in your body each one responds to a different frequency the theory goes and so you can actually stimulate independent chakras using you can buy a CD or even even some practitioners actually actually will do this live with you and then I just think again of music music think about music can affect you but if we played the the moonlight sonata Beethoven's moonlight sonata right now we would all get very kind of you know we'd be different what about visual so there's this product it's actually the relax mate to its and dr. norm Sealy who's an old name in in sort of alternative medicine circles it's his device and it it gives these glasses that have a little power pack with it and it will deliver light at a certain frequency that can be altered and certain colors and the claim is that this alters the state of mind there's someone right here in San Francisco Meir Schneider dr. Schneider's I just a very creative healer and he runs the school for self healing in the Outer Sunset and he was born blind and develop exercises to restore his own sight and I listen to one of his programs and we've had him lecture a little bit and he has certain exercises you can do things with your eyes that I've done that really can be deeply relaxing you know I don't know if there's other effects on the mind that that any of his work might have but but definitely that much I noticed now forgive me Teresa my biofeedback friend so this I shouldn't call this toys this should be tools or technologies or something but I called him toys because there's so much fun these are these are biofeedback programs that are commonly available they're not nearly as sophisticated as what Theresa does but these are things you can get on your your laptop and do it at home the top one is more physiologic and as you can tell sort of graphic and scientific the bottom one during 12 divine is much more kind of entertaining and you go you know depending on depending on what it's measuring which might be your heart rate variability your skin temperature the amount that you're perspiring which all reflect what your sympathetic nervous system or what your autonomic nervous system is doing in any moment you might ascend into the temple and Deepak Chopra will be there to say hello to you or you can ride on the zebra and you or you get to meet the beautiful girl and go into the temple or something I don't know but and and other other names other big names are on this – those are DVD well no there's actually their whole like software packages those are like 300 bucks theresa 300 bucks yeah so no small thing I always start with Theresa I wouldn't just go out and buy those in full around I would start with Theresa and then see if this is right for you but but they're really fun and let's move on to my colleague and friend Christy so Christy Dahlia home has been practicing yoga for twenty years teaching for over 15 she has let's see you are on the faculty at the integral yoga Training Institute she has written about yoga she's done research about yoga forget everything that I've said forget even the word yoga let's just take a ride with Christie for a little while here good evening so I have been invited to share with you the direct experience of doing some yoga this evening and in order to gauge the level of instruction that will be most effective for you I'd love to have a sense of where we're starting from so can I have a sense of those brave souls who have not yet ventured into the brave new world of yoga oh great and people who've tried it a little not too much and are their regular practitioners but pretty even mix then excellent so let's close eyes I didn't see Kevin's presentation before he gave it this evening he gave me a sense of what he would be doing but I hadn't heard it exactly and it was really fascinating to me to see how very much of it is engaged very directly in what we do in yoga and particularly his thoughts about what appeals to us about mind-body medicine the sense of reconnecting what belongs connected actually is the definition of yoga the word yoga comes from the sanskrit root word yoga which means to yoke together as you would yoke your oxen together to rejoin to harmonize so my delight this evening is to get to give you some experience of that they'll start by bringing the awareness down to the belly and try to just let it go letting go is often much harder than holding on so for contrast let's give it a squeeze exhale and contract the belly squeeze your navel back toward your spine and then on inhale let go exhale the abdomen contracts and helps to squeeze air out and inhale let go feel the air flow and simply repeat this technically this is diaphragmatic abdominal breathing you are breathing in a way that is allowing a nice full use of the diaphragm in practice we often call it belly breath and that flows easily into diggers for some full yogic breath inhale you'll feel the abdomen expand again and then the middle chest and the upper chest exhale upper chest contracts middle chest and then the abdomen so the inhale wave is bottom up and the exhale is top down this one is a little bit less precise than the belly breathing the belly breathing is a very direct and literal instruction the flow in the three-part breathing here is a little more gestural what will actually happen in your body is more complex than what I am describing studies have shown that when we aren't thinking about it and we just take a simple unconscious breath we move about 500 CC's of air about 500 cubic centimeters our average full capacity is 3500 centimeters so simply working with this practice can increase the amount of air moving through the body by seven times you can go days without water and weeks without food area a little time without breath think about how healing it is to the body to have seven times more I mentioned also the self-regulation of attention happens through the entire yoga practice we choose to be attentive to the breath and to link it with movement so my options in terms of movement with you are a little bit limited this evening by the fact that you're in a chair and you probably have a pile of tippy papers right in front of you so little movements just to take on the next exhale let the body curl forward on the inhale lift up to Center and arch backward a little press the hips down into the chair and lift the chest you might scoop forward a little away from the back of your chair to give a little more space for your spine to move so playing with spinal flexion and extension on the exhale rounding forward and on the inhale up and back now as you do this as you do anything that I suggest here pay attention and anywhere that you get this sense oh maybe this one is not such a great idea listen to your intuition and pass on that practice my goal when someone is practicing with me for the first time is that they always walk that without thinking oh I feel so relaxed that was lovely I would like to try that again I think I could work harder next time and not oh I need an ice pack and maybe a visit with that nice dr. barrows Golightly and then come to Center No put your right hand on the side of the seat of your chair and gently lift your left arm up overhead you get to make friends with your neighbors now press the hips down into the chair and lift more with the crown of the skull than with the arm upward and reach up and slightly over to the right so you're not having a contest here of how close can my right shoulder get to the floor but more what if there were an apple just out of my reach diving upward and then come to Center and inhale and exhale to the opposite side and come to Center now with the pace of the breath simply move from side to side if you have space you could keep lifting through the arms if that feels awkward or if you don't have space you could press the hands against the lap and simply move from side to side feel the ribs fan open away from one another and keep coming back to that deep simple and then Center now if you have shoulder injuries rotator cuff injuries very gently with the next practice or maybe just watch you'll see what you think lift the arms up and cross them on top of one another lift the fingertips to point upward now for some people this is quite a challenge just having the elbows hooked together others will find that very easily one hand will tuck under the other as you like whichever works as long as you've got one arm over the other and you take comfort in the fact that while that is a little complicated the full pose looks like this so you're getting the easy version this is the arm portion of garudasana the Eagle pose so you could hold this or you could go a little deeper the heart draws back toward the spine and the elbows reach forward so you're expanding from front to back and gently draw the elbows right arm toward the right and left arm toward the left and you might feel that spreading the upper back open again it should be comfortable and then moving up again left arm over the right arm and maybe the arms twist way maybe they don't if you have to choose where to hook the arms try the most effective thing would be to get your elbows together if you could or just to get one arm over the other close to your elbows and then inhale this time we'll try lifting up a little and lowering down a little now what kind of sensations are the good kind of ouchy stretching and which kind are the kind you should be cautious up stuff it feels like muscle meaty is a little safer bright sharp pinchy sense or sensations right up toward your joints those are the ones to be more cautious of always though trust your intuition I'd say 80% of the Sun time someone tells me they overdid it in class they tell me which oppose it was in I think Oh interesting how did you know that and they blush a little but they arms come down bring the hands to the left pay attention to your back across the shoulders nice and open across the back pay attention to the chest that practice is extremely effective at opening the back a little bit at the expense of the chest it jams up the chest a little so then we want to open the chest for balance you can bring the hands behind the back you'll need to scoop forward on your chair a little and bring the hands together and press them back and this is one of those things that some people's hands will move a quarter of an inch and they'll be sitting there thinking where are we and other hands will lift a foot and a half don't be distracted by what happens to the body in front of you just listen to your shoulders listen to your chest lift up a little and make sure your neck feels very easy and deep breath through the chest and then really give the shoulders a little shake compare the sensations in the upper half of your body which it was pretty free easy for us to move where you're sitting and the lower half of your body which hasn't had movement close your eyes and really pay attention to your mental map of the body it's all part of the body where we've done the movement already usually we feel lighter sometimes look brighter in the mind might feel larger if I were less kind I would have had you do either the left side or the right side which is much more dramatic what would be view not so happy when you were departing so this is the part of yoga which is very familiar to most people these days we moved body yoga also moves inward more and plays with the mind so next we'll come in a little more deeply try now to position the body extremely comfortably so press the back toward the chair to get support try taking your arms down off of the armrest and let them come into your lap so that the elbows can sing close the eyes come back to the breath exhale the body contracts to squeeze the air inhale the body expands both to invite the air in and as a result of the flog the area Yoga Nidra literal translation is yogic sleep we usually call it deep relaxation this involves the progressive muscle relaxation which Kevin had highlighted but didn't get much into it can involve guided imagery with time it can help us to learn to remain conscious in brain wave states which we normally experience only during sleep you may have heard of the lovely studies that show that monks can be or very well trained practitioners and regulating the mind can be sitting up and having a conversation and their mind is in a brainwave state that the average person who's not taken effort to train the mind would only experience in profound relaxation or deep sleep so this feels sweet and soothing in the moment and it can also help us adjust the state of the mind as we live there picture the body surrounded by light a little bit like Glinda the Good Witch you're in your own little bubble of light here feel the warmth of that light on the surface of the skin let the light begin to enter the body through the tips of the toe warming and softening the toes and the feet let the light flow up through the ankles softening the shins and the cuff knees and the thighs the hips the buttocks and the belly let the light and the ease flow through chest read the basket lungs and heart lower back middle back the upper back fingers and hand wrists and for our elbows upper arm underarms and shoulder let the light flow up through the neck and the throat face and the jaw sides of the head back the head inside of the head the brain bathed in life and the crown of the skull pay attention to the body in its entirety the mind likes to focus but we're going to try here to avoid focusing and experience the body symphonic Li just all of the senses resonant notice the breath coming and going it will be very light now body needs when we begin in yoga to gain the skill of observing the body with clarity and without attachment becomes easier to do that with the thoughts as well it's just one more event that happens in the body my thoughts like to tell me that they are who I am but they aren't I have beautiful thoughts that I would love to put on a banner and proclaim before you next terrible thoughts I wouldn't want anyone to know they're just one more thing that happens in the mind they come they go notice the thoughts coming and going but the face be saw and then go beneath that the teachings of yoga describe our innate state as bliss a baby if it is not being caused some sort of discomfort is absolutely blissful Yoga posits that there is a place always within us in an unchangeable state of bliss but your mind just sink in that direction gently let the eyes float open so there is some experience of yoga a little taste how is that useful in medicine why do I get to work over at the fabulous clinic with all of the brilliant doctors in the kind of old-fashioned body mind way we can make artful sequences of physical postures that will change the tension patterns in the body and can help to relieve pain on every level personally a lot of my work is with people with cancer and Kevin's original outline had those beautiful points about hope and mystery and spiritual connection I was quite surprised when I was invited initially to speak in medical settings and to teach in medical settings to find that the audiences were often the most receptive to the spiritual practices that Yoga has to offer because people who came there came because they were being inspired by pain by discomfort by fear and it opened them up and they were really willing to try new things yogic breathing practices have profound interesting subtle effects on the mind for the past year I've been delighted to teach in a study we're doing at UCSF to see if that might be useful for people who are receiving chemotherapy to help with their fatigue and we don't have results about that yet but I know that every single person who got to study with me loved it the practice of yoga can help to awaken our sense of hope our sense of connection and our sense of mystery we think we know so much about the world and it's really important and can be incredibly inspiring to remember how much we do not understand about what the nature of the world is and when people are facing challenges to their health these kinds of thoughts inspire optimism and those kind of positive states of mind that you'll hear about in the really inspiring work on positive thought that's being done at the Osher Center later in our lecture series those people who had heart attacks who are depressed and their outcomes are less positive yoga can help us to shine again and something within us turns and our bodies heal more effectively and it's so much fun thank you Thank You Christy so much I feel better I want to make one quick reflection on that and that is that I noticed so so mindfulness is something I'm so interested in and I practiced and that's an attentional practice so you sort of train the mind to try to stay put and when it wanders there's a whole method for dealing with that but in general you're trying to you're always trying to train it to when Christy was leading us through that for the moments that I could stay and hear her and be in my body following her instructions this was the point I'm trying to make about a tradition that never separated mind and body I certainly had that experience there was there was no there was nothing wrong there were no thoughts there were no stories that I've something has to be different or something has to change so to the extent that we can stay present I feel like I hope you two got a sense of hope every day actually you get a sense of that inner yoking to use the the yoga derivative word I also have to point out Christy Christy teaches for the yoga classes at the Osher Center one of them the gentlest one is chair yoga so it's kind of similar to what we did here probably and a whole variety she even does a little what we call many retreats on Saturdays sometimes so check us out there it is my great honor now to introduce my senior colleague dr. Joseph aqua and he's going to do a case presentation of a Chinese medicine case and and we'll see we'll see where we go from there Joseph besides being a friend and colleague is someone I look up to he has he's been at the clinic since it started he is sort of one of our anchors he also in addition to his Chinese medicine practice he is our Tai Chi master and he's teaches our Tai Chi classes as well he's been studying that and going on retreats it seems he's so devoted to Tai Chi he's going on retreats every year to learn more and be a better teacher and go more deeply into the practice so it's really an honor for me to welcome Josef aqua good evening how many of you have experienced visiting a Chinese medicine practitioner Oh wonderful yeah probably looks like about a third yeah great and so what I wanted to do this evening as Kevin talked about that this is a tradition that never separated mind and body and I think that when I when I usually get asked the question why did you go into Chinese medicine my response is that I was always looking for a medicine that saw human beings as a part of nature not separate from and not only then is there not a separation between mind and body in traditional Chinese medicine but there's also not a separation between us and nature nature is us we are nature there is just one thing and this diagram that you see before you is how the Chinese envisioned it and you can skate as coming from an agrarian society and from a society in which the seasons and the observation astute observation of how things moved throughout a yearly cycle in our lives and then looking for the relationships and seeing how those relationships were also true within the human body mind spirit unit so if you look at this chart you see the five elements now most of us I think in the West are familiar with the four elements and we say earth air fire and water and you probably you know Earth Wind and Fire made things so popular for a while people were looking for what was the decks would but so it's we do the five in the Chinese thought I was educated by a Frenchman who said and we in that four elements that we talked about earth air fire and water that there is also in the euro perspective also a fifth element called quintessence so that really there are five in that system as well the quintessence Quinn meaning five right the root being five so in Chinese medicine we said earth metal water wood and fire and the wood represents growth which they say isn't present in the four elements as we see it in the European tradition so the fifth element being water or being wood indicates growth so you took it take a look at this chart you see how all of these then get these elements then get connected to our bodies so the fire element the earth element the metal representing what we would say is sort of the comparison would make it the air element in the just water of course and then would be indifferent so there are these organ systems then and of course the foundation of duality not speaking my body but duality on a universal global sense is the idea of yin and yang classically named something that has a front that doesn't have a back or as the character is in Chinese it says the sunny side of the mountain and the shady side of the mountain yin and yang the organ systems so that the organs the Yin organs are the solid organs the young organs are the hollow organs right times of the year seasons of the year taste colors sounds odours emotions seasons the environment developmental stages directions body types personality balances or things that indicate out of balance so how many of you recognize that when you go to see your traditional Chinese medicine practitioner that this is the paradigm from which he or she is viewing you anybody yeah and do they attempt to explain that to you and make you aware of it because awareness is very key in the whole process right bringing the awareness mindfulness attention focus to your own body mind spirit state it's another look at these with a few less so how does this work in a daily practice come back to this one on a seasonal basis so patient comes in to visit and frequently what we like to say is they come in with usually a Western diagnosis and so what we're trying to do at the OSHA Center is an integrative medicine approach is to bring the two worlds together of traditional Chinese medicine or complementary and alternative medicine with the conventional Western approach so usually a patient comes in and typically in the patient might come in with a Western diagnosis and let's talk about IBS I mean I know what that is or have any idea irritable bowel syndrome it is I think the next level of all of the drugs that you see advertised for on television nexium prevacid pepcid you know the the purple pill the yellow pill the right that indicates that there is some discomfort going on in the GI tract gastrointestinal tract the stomach right the stomach but the stomach if you look at this chart corresponds to what the earth element and we say the stomach is the center the earth is where we stand so it is the foundation for the other four elements if you will and the spleen is a organ that is connected to it now in the West we usually think about the spleen only a relationship to blood production but in Chinese medicine we say the spleen has to do with thinking has to do with thinking and there's a recent book written called the Bray the stomach the second brain the gut the second brain and it has to do with the fact that how many of you get a gut feeling about certain things right so we do think at some level there's more serotonin produced in the gut than there is in the brain and yet all of these sir all these serotonin reuptake inhibitors that we use for antidepressants are focusing on the brain serotonin when in fact there's more of it produced in our gut than there is in the brain so when we're treating depression with a serotonin reuptake inhibitor we really are affecting the gut as much as we are affecting the brain in terms of how it is related to our depression so when you come in and IBS is a pretty typical and all these GI disturbances that all these commercials are about and these drugs are on the market for is a beginning to let us know that there is something going on in the gut and that thinking and our relationship with our how we are digesting the world not just our food how are we digesting the world because digestion doesn't just take place on the one level this is how a Chinese medicine practitioner is thinking that's what I'm letting you follow me if you follow me digestion has happens to be not only with the gut and about food but it's how I'm digesting the world so the patient may come into me and have this IBS diagnosis but I'm looking from this perspective so what am i doing I'm doing a full complete history just like a Western physician will do but I'm asking certain questions I'm asking about what foods do they eat and what flavors do they like the most not foods particularly but what flavors dominate right I'm asking whether or not they have and I'm hearing how they are digesting the world right is there what level of stress that they are under in how they are digesting the world I'm listening to the sound of the voice is it a singing voice right do they sort of same I've been told that I have that sort of singing voice is that a crime voice is that a groaning voice we usually say that dampness is connected to this idea of IBS dampness what is dampness not like sort of like when you're retaining fluid but it's more subtle and it's when foods don't people bloat immediately after eating would be a sign of dampness that the digestive juices from a Western standpoint aren't doing the work immediately because they're weakened there's too much fluid there they're not able to break things down quickly and so there is dampness there's an expansion in the abdomen as the food comes in so my person comes in with this diagnosis of IBS I'm looking at all of these things I'm also looking at what time of day are they most uncomfortable and this doesn't happen to be on this chart but we say for each of these twelve organs that you see listed here there is a time of day when it has its peak energy just like there is a season when each one of these organ systems have their peak energy so I'm oftentimes concerned with when did this condition begin with you and I'm concerned then with the season did it begin in autumn that it began in the winter that it began in the summer emotionally that it began right after you had a traumatic event that you were having difficulty digesting a typical IBS patient will have either diarrhea or constipation or maybe alternating constipation diarrhea and it can progress to IBD where we see changes actually in the tissue here to a bowel disease and then usually in the West not seen on a continuum but we see it on a continuum then could progression to colitis inflammation of the colon then can progress into also typical itis where there are then sores within that that then could progress further into crohn's disease we see it as a progression and each one of those stages indicates that the imbalance has not reached has not been re-established because ultimately in our medicine disease is a imbalance it's disequilibrium we are always in a state of doing this dynamic dance we get too cold and we get goose bumps and right things close up and we get goose bumps we get too hot and our poor start to open we start to perspire because we really exists in this very narrow biological active area right a hundred and six and 107 and we're out of here and get down to about 87 and we're out of here so we we're trying to always maintain balance right he puts this bright light in my eye I get contraction of the pupils if I walk into a dark room the pupils dilate the heart is constantly in the state of so we're constantly attempting to maintain balance the emotional states that you see here also play a major role there's a statement the oldest Chinese text that we draw on mostly in our medicine is a book called the hua being Mei Chang it was written probably it was gathered together around 200 BC of data and material that had been accumulated for under 2,000 years preceding from about 1700 to 2,000 BC this material was written and it was all put together in the WOD denaturing and it is done in a conversation between the chief physician for the Emperor of the time Wandy and his chief and his physician and the physicians name is cheapo and the impro says to him I desire to hear about the way and cheapo resupply she says in order to make all occupier thorough and effective one must first cure the spirit so this idea of my embody spirit being what is the spirit of the person what's the week eight we say shin right Shanna's spirit it's what's behind the eyes yes when the patient comes and the person comes in what's behind the eyes what's coming out at me and so I'm looking to see and get some understanding you know of any of these emotional powers positive qualities virtues right I'm looking and sensing for this in individuals do all acupuncturist and practitioners focus on this not much it's my I mean some of them do but this happens to be where I find myself in as a practitioner trying to work at this level with people we said that the highest physician was the physician who treated people before they were ill yes it's a different kind of concept for us but it's if I can keep you healthy if we can suggest to you ways in which you can eat flavors in which you can do exercises and things throughout the summer throughout the winter throughout the spring right how you can digest the world better then you can remain healthy and so a person with IBS coming to visit me that's ultimately where I want into go ultimately where I'm wanting to go I have to treat their symptoms I have to try and stop the diarrhea get the constipation moving and all of that but ultimately this is how I'm thinking this is how all of us who are attempting to be the best and the highest level of Chinese medicine practitioners are attempting to practice you see called the there's a term in Chinese medicine circles called the Shen dr. right that's what I'm ultimately trying to be from a Western standpoint it might be the combination of what one might call a priest physician right attempting to really help the spirit of legend each individual's to remain whole complete connected to their source having proper compassion propriety integrity selflessness and wisdom ultimately I think I'll stop there so that we can have time for other panel and discussions thank you as we organize this and turn up the lights and turn off the slides and Christy and Joseph and dr. McKinney please come down I just want to say one last thing you know if you think about human history say Homo sapiens I don't know two hundred three hundred thousand years the mind body splits as a cultural paradigm say in the last 400 years that's less than one-half of one percent of human history where we've been thinking mind and body are separate furthermore today if you took a snapshot of all the cultures around the world still the majority of cultures never they're not operating with a mind-body split so when Joseph looks at a patient and he never just sees oh you've got diarrhea he actually sees oh this is IBS large intestine grief is associated with that so to me it's it's an exquisite statement of I guess what I'm when I'm stumbling around with you to try to point to which is this this this was never so you can't separate this it never was separate so so how do we how do we live in the light of that fact so let's talk briefly I could probably go on for hours about Tai Chi because I've spent the last thirty years practicing and training under just a wonderful third generation master and I like to say it in a couple of ways one is that if you move fast all of the large muscles of the body do the work when you move very slowly each and every muscle fiber has to do its fair share of work so we say it strengthens from inside out just like Yoga Yoga you do postures progressive Tai Chi you do postures progressive strengthening from inside out and then there is the mind and the focus that doesn't allow you to waver we get peripheral circulation which then lowers then the overall cardiovascular output so that there's expansion in the periphery and therefore the blood pressure gets lowered and I'll stop there it's very interesting what you're saying thank you so much so it's in our circles it's called New Age guilt that's right it's just the term it's just the term they've coined so I do not believe I won't speak for other kind of members but I'm guessing we're at Gordon's it's there's there's sort of a new age school of thought out there that you can influence that everything your thoughts everything's derived from your thoughts and if you just have the right thoughts you can you can cure yourself you can do anything you can change the world you can make yourself wealthy all this I'm much more humble I don't I just know none of us are wealthy I just know that as a healer trying to practice my art that like them when when I go into this arena profound healing even transformation is possible for people more commonly it's smaller things but smaller but important things so absolutely I agree with you that if if for example so say my example of a heart attack that if someone's depressed after a heart attack they increase it okay so so but there's so many other factors involved it's definitely true that one of the factors that would increase chance of articles depression post mi but that certainly isn't that person's fault you know and and too and and so I wouldn't say they well that's you know they blame they should be blamed because they couldn't get themselves out of their depression or something but just to know that's the big guy to me the awareness is the first step just to know that oh here I am after my heart attack my mood is kind of low that's important I now have a choice I can try to do something about it or maybe maybe I'm too afflicted and I just can't I don't know but I would certainly wouldn't blame I absolutely I'm with you yeah do you guys have any comments yeah the healing can take place on many levels as well I deal with us a lot particularly in teaching yo to people with cancer you know there's the and if you just believe hard enough you can make all of your tumors go away and I know people who have had that experience who have been given a terminal diagnosis and have had full spontaneous remission and I know people who have worked very diligently and have been unable to stop the disease process that's happening in the body and that has been the apparent cause of the end of their lives but their healing practice has allowed them to come to such peace but the quality of life that they experience during the time that they have is totally different and the experience of what you have during your life whether you can cure the disease or not the healing that you can experience within yourself in the time that you have is just as valuable to us as what's happening in the body


  1. Try these meditation books too… Practical Meditation and The way and goal of Rajyoga… these are from Brahma Kumaris (omshatistore).

  2. I am very happy that the presenter actually used the the word "hypnosis" in his talk and that he lead with it while talking of the modalities involved in mind-body medicine. As a lay hypnotist I can tell you that a degree in medicine or psychology doesn't make one a better hypnotist as it is a different modality then these other forms of treatment. Therefore the practitioner needs to respect it and get the appropriate training to allow it work correctly. This is proven by the hundreds of clients that I have seen whose psychologist tried to do hypnosis with them and failed miserably because they had no idea how to practice it competently. It is also much more sophisticated then the mere giving of suggestions when done well. It is really the interaction between the practitioner and the client that allows the real transformations to occur. It is quick and without invasion of the body of substances that cause harm.

  3. My name is Dr. Tom Leigh and as a student of hypnotherapy back in 1993, I was fortunate to begin my own career by studying Earnest Rossi's methods. This was when Rossi came over on his tour of the Psychotherapy and Hypnosis teaching schools of Great Britain. Rossi as a student himself in the last year of Milton Erickson's life, was privy to all the secrets of the 'father of modern hypnosis and hypnotherapy' had to teach. From the many recordings of Ericson's method that Rossi made in that time, both modern Hypnotherapy and Neuro Linguistic Programming are based. The above video does not give Rossi's methods credit, for it does not show the actual healing part. This is a great pity for watching Ernest Rossi is an eye opener all hypnotherpists need to improve their own success rates a thousand fold.

  4. This is an invitation to see an artist theory on the physics of light & time
    Based on:
    1 Is that the quantum wave particle function Ψ or probability function represents the forward passage of time itself photon by photon continuous creation a continuously renewing process!

    2 Is that HUP ∆×∆p×≥h/4π that is formed by the w-function is the same uncertainty we have with any future event within our own ref-frame that we can interact with turning the possible into the actual!

  5. It's and old idea. Refer to Charkra Healing from India.
    It is the imbalance of these charkra that create sickness.

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