Unstuck: Healing Ourselves

Obama: Addressing the Healing Crisis

James Gordon, M.D. — Wed, 09 Sep 2009 16:52:56 +0000

Dear President Obama,

Before you even took office you asked us Americans to share our ideas about healthcare reform with your new Administration. Thousands of us, thrilled to be invited to participate, gathered in small groups and offered our vision to you. Now, tonight, as you address us, it’s time for you to give us back our vision, enhanced by your broader perspective, enriched by detail, unencumbered by fear.

I’m sure you and your advisors have seen the polls that have repeatedly shown that the vast majority of Americans (up to 85%) believe that our healthcare system needs to be “fundamentally changed and completely rebuilt,” and that almost equal numbers are concerned that “access to medical tests and treatment would be more limited” as a consequence of healthcare reform. The polls tell us that Americans know that our far more expensive healthcare system is significantly less effective and efficient than that of other developed countries, and that, in general, we like the doctors who care for us.

These apparent contradictions are best understood as Zen koans, paradoxes that work to boggle our minds prior to opening them to new ways of seeing and thinking. I hope tonight you will invite us to look at healthcare reform in such a new way; help us to find, beyond the fears that have been evoked, and the mind-numbing horse-trading and compromise of the legislative process, the vision that continues to animate your commitment to the health and wellbeing of all Americans.

The vast majority of Americans-not just “Democrats” or “progressives,” but all of us - are decent, compassionate people who really want all our fellow citizens to have the healthcare they need. We know that change is necessary, but we don’t know yet what’s actually being proposed, and we fear that the change that comes may take away the surety of care and the security of our relationship with our doctors.

Fear is an enormously powerful emotion-deeply embedded in our evolutionary heritage and in our central nervous system. It signals danger, mobilizes the fight or flight response and all the psychobiological mechanisms of survival. Fear, as this summer’s town halls illustrate, overwhelms our capacity for nuanced observation or even rational thought. The very thought of going to the doctor makes many people tremble. The possibility of failing health, or of a vulnerable old age, or a change in access to those who are supposed to care for us makes us deeply uneasy. When opponents of healthcare reform have used evocative and provocative words to summon up these specters, the fear factor has obviously jumped off the chart.

To our agitated minds, “rationing” means that we will likely lose the diagnostic tests which we hope will clear away threatening uncertainties, the treatments that may restore us to health, and the doctors whom we have literally trusted with our lives. “Death panels” signify that anonymous others will, in the name of some impersonal, financially motivated calculus, shorten our lives.

Outrage, reassurance, and careful reference to the actual texts of proposed legislation-the principal defensive strategies of healthcare reform proponents to date-only take the edge off our collective apprehension. Relaxed, even meditative, clear-eyed assessment of healthcare realities, active engagement of each person in responding to them, and a call to transcendent and common purpose are what will ultimately make it possible for us-individually and collectively- to move through and beyond the fears that have been dominating the discussion. We are an energetic, inventive people and once we know it is possible and even necessary, we will want to be actively, effectively engaged in our care, and in determining our destiny.

Think of the “terminally ill” mother, who “somehow” lives to see her daughter’s wedding, the firefighter who enters a burning building to save an endangered child, the soldiers who brave bullets to protect one another. Think too, of people with life-threatening or life burdening illnesses (coronary heart disease, diabetes and cancer, clinical depression and post traumatic stress disorder), who, in the therapeutic programs many of us have created around the country, are healing themselves: sharing their fears and developing strategies for dealing with the threats to their lives; regarding illness more as a challenge than a disaster; eating and exercising in more healthy ways; learning from and supporting one another. William James coined the phrase, “The moral equivalent of war.” Caring for ourselves individually and collectively is such an equivalent.

I’m asking you, really, all of us are asking you, to mobilize and inspire us to participate actively in our own healthcare; to insist that those professionals who are supposed to help us treat us respectfully, even lovingly, as active partners, not passive patients.

We don’t, for the most part, need more drugs or procedures, but rather doctors and other healthcare professionals who will spend adequate time with each of us, listening and creating partnerships, as well as writing orders and prescriptions. The powerful therapeutic effects - and cost effectiveness - of such instruction in self-care, of what some are calling “lifestyle medicine,” on outcomes of chronic illness have been repeatedly documented.

If every older person were guaranteed a physician with time to talk about life and ways to live it more fully, as well as to discuss the best ways to deal with the inevitability of death, debates about “death panels” would wither from lack of fearful fuel. If doctors spent more time looking at the excess of often clashing and contraindicated medications that older people take, much of the unnecessary suffering and fear that accompanies care in old age would disappear. As we actually learn what combinations of self-care and physician-administered therapies are most effective, for which condition, most concerns about rationing-raised now almost entirely by drug companies, which fear that their products’ flaws will be revealed- will dissolve. We need to hear clearly from you that all those individuals and institutions that profit from our pain - hospitals, insurance and pharmaceutical companies, and those of us who are doctors too - can be justified and supported only as long as they serve all of us.

Finally, you must assure all of us, left, right and center, that you and your Administration will continue to give us and our health care the careful consideration we deserve, that this present effort is only the first stage of healthcare reform; the beginning of a process of national education; and a framework for the more profound and pervasive changes that we want but are not yet sure how to achieve. Tonight, we need you again to inspire us, to give us a vision not only of how we can all be safely and effectively treated, but how we can thoughtfully, lovingly, energetically, even joyously, learn to better care for ourselves and one another.

Woodstock Wisdom

James Gordon, M.D. — Thu, 20 Aug 2009 19:56:10 +0000

Hey, I know I'm a little late, but I was a little late to Woodstock too. I hadn't planned on going, but then another doctor as young as I was then called me up, desperate--actually, crazed. "You've got to get up here, man. They've got hundreds of thousands of people coming, and there's no food, no place to stay, nobody to take care of them."

"I saw on television that the roads were jammed."

"Forget about it, man-we'll send a helicopter."

And he did.

And that's how my girlfriend Sharon and I--veterans of the civil rights and anti-war movements, former residents of the Haight-Ashbury and Berkeley, and passionately committed to "health care for all"--found ourselves on the way to Bethel, New York.

Looking back this week on Woodstock, forty years later, wondering if there was anything I had to add to everything that everyone who was or wasn't there has had to say, I realized I had actually learned a lot in those three days and that the lessons might be worth sharing.

Here they are, in the order they came to me.

* Always be ready to help. When someone asks with real need, you have to pay attention. Inconvenience--dicey travel plans, the loss of a precious few days of a psychiatric resident's vacation-is really a small deal. Utter lack of knowledge about the conditions we were walking into or the support available to us once we got there-let it be, see what happens. Bottom line: if it feels right and necessary, do it.

* If you're meant to do something, it's likely, in spite of all improbabilities, that it will happen. I know, I know, this sounds hopelessly hippie-ish and "New Age," but what am I going to do? Jung gave this acausal connection between internal intention and external events the more dignified name of "synchronicity." Let's call it that.

A helicopter did indeed take us from LaGuardia to a field near Bethel. It landed to pick up some performers. Questions were raised about whether we should be debarked so that Joan Baez's mother could accompany her. "We can all go," Sharon said cheerfully, but highly insistently. "We're all needed." And indeed, we did-Joan, her mother, and the two of us.

* Be patient, if it's necessary, even when you really don't want to be. This, I have to admit, is a lesson I've had to keep re-learning many times these last forty years, but Woodstock gave me a clear, undeniable glimpse of its usefulness.

Everyone was helpful, but no one actually knew how to find our friend, the doc who called. "He's here" . . . "there" . . . "behind the stage" . . . "over by those tents." Hopelessly lost half a dozen times, we picked our way among hundreds of thousands of bodies and got righteously irritated that no one seemed to know our friend or where we should go or where supplies could be found, or who else might be in charge-"Listen, you guys flew us up here to do this job. There are already kids all over the place with cut feet, sore throats, and bad trips. It's starting to rain, and it's gonna get worse."

"Oh, wow, man," they said. "That's far out. Would you like some food, booze, hash, acid? Would you like a hug?" We had to laugh.

* If you build it-and they really need it-lots of people will come. Without supplies or shelter, we set up at the edge of the huge bowl where the bands were playing, Our spot was marked only by a sign, "First Aid."
People started lining up immediately. An hour or so later, miraculously, antiseptics and bandages, sutures, and antibiotics started arriving, Wavy Gravy, the prince of hippie self-help, sent some guys with a tent.

* Opposition will come your way. The line is from reggae musician Jimmy Cliff (he wasn't at Woodstock) but the truth is universal. By the second evening of the festival, more than 100 people were regularly in line outside our little tent. Some needed sutures-Sharon reminded me the other day how impressed she was with my one-hand surgical ties, and I am too, though I honestly don't remember them. Others had respiratory infections and were working on pneumonias. And a very large number, quite young even to my 27-year-old eyes, had taken improbable quantities of unnamed and perhaps unnameable substances, and were deeply distressed. I went down the line triaging, and discovered about fifty of them.

"We need a bigger tent," I told a guy who'd shown up with a two-way radio, "a real big one for 50-100 people." The big tent arrived and I invited all the mentally, emotionally and psychically challenged to come inside. I spent time going from one to the other and realized the mission was truly impossible. There were simply too many, and despite Sharon's best efforts the line outside our little tent was growing long.

* Self-care and mutual help are fundamental tools of all healing. This is a lesson I've been learning ever since my first days as a student on hospital wards, and it's one that I've devoted much of my professional life to exploring and teaching to others. The couple of days in the big tent at Woodstock highlighted it luminously. Absolutely unable to care for all these people myself, and with only a couple of untutored volunteers available, I came up with a game plan. I asked all those who had taken too many ‘uppers'-amphetamines, cocaine, and the like-and were fidgety, agitated, and utterly at a loss to know what to do-to walk around vigorously, insistently holding, leading, urging on all those who had overdosed on ‘downers' like heroin, barbiturates, quaaludes, and liquor. I asked the remaining kids, who were lost in the dark forests of psychedelia to sit on the floor of the tent in pairs or threesomes or fours. "Hold each other," I instructed, "listen to each other. Take care of your brothers and sisters." I told the volunteers to keep their eyes open and to get me in case of crisis. Every half hour or so I checked in.

The walking, holding, and hugging went on all night. The next morning, some of the young people, happy and calm enough, dropped by to thank me; others simply sat listening to the music.

* Nothing is perfect. Woodstock was a triumph of peace, love, and community, says just about everybody who was there. Millions of people now regard it as a touchstone, an example of what's possible when you set aside fear and prejudice and promote love and peace. Yes. Woodstock was a self-indulgent mess, say some others, skeptical and cynical perhaps, and maybe scared of the unleashed id of the experience. And there's some truth there too.

But there were other issues. I was, amidst the pleasure of the celebration, the impressive kindness and sharing, troubled by something else I saw and felt, a certain kind of dislocation and sadness in some of the young people.

They said they were disoriented by the crowds and uneasy being away from the cities and suburbs which were their homes. These feelings, of course, had been amplified by quantities of drugs consumed, but we heard and felt it in others who seemed more or less sober-an uneasiness and loneliness that camaraderie and crowds could not assuage. I heard it, too, in the months after Woodstock, from people who felt let down by the lack of fellow feeling in the world they returned to, by the absence of the indomitable hope that seemed to them to suffuse Bethel.

* You never know who your friends and teachers will be. I was already learning this during several years of psychotherapy and meditation and from time spent ministering to the so-called "mentally ill"-as well as hippies. It was possible, I was finding, to find solace, friendship, and even wisdom in unlikely places and with unexpected people. Woodstock reinforced this mightily.

During the three days of the festival I met apparently hapless kids with remarkable skills in erecting shelters, scrounging and preparing food, and tending to the ill and crazed. I was impressed over and over again by the exuberant effectiveness of Wavy Gravy's Hog Farm tribe, the courtesy of celebrities like Joan Baez who really did believe in "power to the people," the kindness and good sense of those who volunteered to help out.

It all came home to me, appropriately enough, on the way back home, in a small plane that Sharon and I shared with the chief of police of Beverly Hills, who had come to supervise security. "Great kids," he said. "Great festival. Great view," he added as he gestured toward the Manhattan skyscrapers over which we were flying. "People will be talking about this for a long time."

The Wrong Story on Karadzic

James Gordon, M.D. — Mon, 10 Aug 2009 19:35:08 +0000

On Sunday, July 26, 2009 The New York Times Magazine ran a piece on Radovan Karadzic, the now-imprisoned psychiatrist and war criminal who orchestrated the deaths of hundreds of thousands of Bosnian Muslims during the recent war in that country. The piece was called "Radovan Karadzic's New Age Adventure." I found it very disturbing-not because it addressed Karadzic's crimes, but because it chose to focus on an identity he assumed while he was living underground in Belgrade. I sent the following letter to the Times Magazine; it was the Wednesday after the article appeared. The editor explained that they only print letters that arrive within two days of publication, so I'm posting it here for you to read.

To the Editor:

"Radovan Karadzic's New Age Adventure" is wittily conceived, skillfully reported and cleverly photographed-and a shameful waste of journalistic talent and enormously valuable and influential print space. How Karadzic conned self-styled and ridiculously self-important Serbian "alternative healers" into believing in his therapeutic powers is at best a minor footnote. The Times could and should have devoted its considerable resources, and persuasive powers, to the full text itself: to an examination of how and why Karadzic, a psychiatrist ostensibly committed to healing, became the architect of ethnic cleansing; to how he used his charisma and his understanding of psychological and social vulnerability to cajole, propagandize and coerce thousands of Bosnian Serbs into committing mass murder.

The story of Karadzic's calamitous rule has not yet been fully told. It is a genuine and terrifying mystery. Its clarification might help all of us to recognize more readily the seeds of mass manipulation and destructive collective action in our own and other societies, and in ourselves. Sadly, opportunistically you eschewed challenging analysis, and offered only snide and trivial, if literate, tabloid reporting.

I ask you to please consider the editorial choices you make; how they may serve and enlighten your readers' better angels or pander to their less elevated instincts and how they reflect on a great journalistic institution.

James S. Gordon, MD

James S Gordon, is a psychiatrist and a professor at Georgetown Medical School. He and his colleagues at The Center for Mind-Body Medicine have worked extensively, during and after wars, with psychologically traumatized populations in Bosnia, Kosovo, Macedonia, Israel, and Gaza.

A Better Litmus Test for Healthcare Reform

James Gordon, M.D. — Tue, 21 Jul 2009 13:04:35 +0000

David Leonhardt’s “prostate cancer test” (The New York Times, July 8, 2009) is a good but incomplete one for healthcare reform.

In addition to removing financial incentives for high tech intervention, we need to educate clinicians in the impartial, critical analysis of all therapeutic options, and in supporting their patients as they act on the choices they make. For 10 years, The Center for Mind-Body Medicine has trained health professionals and patient advocates to do precisely this, as “CancerGuides®.”

We need as well to realize that expensive, Draconian treatment and “watchful waiting” are not our only choices. There is, as Dean Ornish is showing with peer-reviewed studies on prostate cancer- and a number of us are doing with heart disease, diabetes, chronic pain, depression and post traumatic stress disorder – a far more promising third way. It is grounded in techniques of self-care - dietary modification, physical exercise, and mind-body approaches like meditation and yoga - and in group education and support.

This approach holds great promise for treating and preventing chronic illness of all kinds and for saving large sums of money. It should be central to healthcare reform.

A shortened version of this was published in the New York Times Letters section on July 21, 2009.

Old Drug, New Drug . . . Red Drug, Blue Drug?

James Gordon, M.D. — Tue, 26 May 2009 20:21:09 +0000

Richard Friedman (“New Drugs Have Allure, Not Track Record,” May 19, 2009) is appropriately troubled by the loss of a "larger context" by physicians who prescribe newer, aggressively marketed drugs preferentially to older, less expensive but more reliable ones. His own therapeutic context is, however, far too narrow.

In evaluating treatments for mood disorders, psychiatrists (and the comparative effectiveness studies proposed by the Obama Administration) must enlarge their perspective well beyond drug therapies. My own work over the last forty years, and my reading of the "evidence-based" scientific literature, strongly suggest that an integrative, non-pharmacological approach based on self-awareness and self-care is in many cases significantly superior to drug treatment.

This kind of integrative approach, which may include meditation, physical exercise, dietary modification and supplements, and psychotherapy has been shown to enhance biological as well as psychological functioning-decreasing stress hormones, shifting electrical patterns to portions of the brain associated with optimism, and improving neurotransmitter levels along with mood-without the negative side effects that often accompany drugs.

Moreover, such an approach, carefully individualized to meet the needs of each anxious, depressed, and troubled person, significantly enhances the damaged self-esteem of patients who, using it, experience the satisfaction of helping themselves.

-James S. Gordon, M.D.

Dr. Gordon, a psychiatrist, is the author of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression.

This letter of mine appeared in The New York Times yesterday (in somewhat shortened form), under the title, "Alternatives to New Drugs." I thought you might enjoy the unabridged version.

Cancer Care You Can Count On

James Gordon, M.D. — Thu, 30 Apr 2009 21:56:31 +0000

Gina Kolata's April 24, 2009 front page New York Times story ("Advances Elusive in the Drive to Cure Cancer") on the significant failure of our near-forty-year "war on cancer" provided a sobering and necessary corrective to inflated claims about cures already arrived or just around the corner. Kolata rightly chides those in the pharmaceutical, medical, and health food industries who claim that their approach promises a cure and notes our national failure to fund and launch truly innovative studies. She appropriately takes to task clinicians who use deceptive prognostic terminology: "progression free survival" does not, to the dismay of people who are so labeled, mean longer survival. On the other hand, Kolata's actual or implied dismissal of the potent preventive and therapeutic power of diet and exercise, and of the role that attitude, mood, and social support can play in enhancing quality of life and perhaps prolonging survival, is ill-informed and potentially dangerous.

Though there is indeed some disagreement about the value of "high-fiber or low-fat" [my bolding] diets in preventing cancers of various kinds, there is a general consensus, shared by the National Cancer Institute, that diet plays a significant role in at least 35-40% of all cancers. In recent years it has become abundantly clear, for example, that obesity has an important role in making us vulnerable to cancer and to its recurrence. And there is considerable evidence that certain kinds of diet can have significant anti-cancer properties and effects: epidemiological studies show that populations with diets high in the omega-3 fats that are present in fish oil have a lower incidence of several cancers; one study published in the Journal of The National Cancer Institute in 2006 shows that reducing dietary fat may increase survival time for women with breast cancer. And then there is the data on specific foods: cruciferous vegetables (broccoli, cauliflower, cabbage, etc.) have significant, repeatedly observed anticancer effects; tomatoes may help prevent prostate cancer; and soy may be useful for the prevention of breast cancer in premenopausal women.

Kolata does not, curiously, discuss exercise, but appears to marginalize it along with nutrition, as she presents the case of a fit vegetarian woman, Phyllis Kutt, whose breast cancer has recurred. Exercise is not of course a panacea, but it does appear to be a powerful tool in both preventing cancer and forestalling its recurrence. One important study published in 2005 in The Journal of The American Medical Association showed that 3-5 hours of walking per week significantly reduced the rate of breast cancer recurrence.

Stress, which Kolata also chooses to ignore, appears to be another important and perhaps remediable factor in hastening recurrence. Though the evidence is still weak that stress causes cancer (the exception may be overwhelming stress, as in bereavement, divorce, or massive trauma), studies are accumulating which show that chronic stress may speed up recurrences. In particular, it appears that high levels of hormones like cortisol that stress produces can inhibit enzymes that would otherwise help protect us against cancer.

Finally, group support, which has also been shown to be so helpful in improving quality of life, though not necessarily (here the data is mixed) extending life, is also given short shrift. Kolata tells a horror story of a support group whose members, apparently unable to deal with their own fears, rejected Kutt and forced her out of the group after her cancer had recurred.

For more than ten years my colleagues and I at The Center for Mind-Body Medicine have accepted the challenge of exploring and clarifying the limitations, as well as the benefits, of conventional cancer care and of bringing an open-minded but critical perspective to therapies that are said to complement or be alternatives to them. We have been training what we call CancerGuides®--health and mental health professionals and patient advocates who can provide informed and compassionate guidance to people with cancer and their families as they navigate among the bewildering array of therapeutic options and professional opinions. Our CancerGuides learn to cut through the hype about conventional care as well as complementary and alternative approaches. They work collaboratively with people with cancer and their families to create comprehensive programs of care which include evidence-based nutritional and herbal approaches, exercise, massage, acupuncture, and stress-reducing mind-body techniques as well as appropriate conventional therapies. They learn to help people with cancer put all therapeutic and preventive studies on a "level playing field" in which evidence for every approach, whether called "conventional" or "alternative," is looked at with the same thoughtful, critical gaze.

The oncology professionals and patient advocates we train (sometimes nonprofessionals who have themselves faced the challenges of cancer and its treatment can be the most discriminating and skillful of guides) help those they are guiding to ask the right, and often hard, questions of their oncologists. We also help these CancerGuides to develop the sensitivity that is necessary to encourage and support each person with cancer to make choices that are appropriate to his or her unique situation.

We teach our trainees mind-body approaches (guided imagery, meditation, biofeedback, yoga, etc.) and expressive therapies (written exercises, drawings, and movement) that are so helpful in reducing chronic stress (and levels of stress hormones) and in dealing with the difficult choices and challenges that cancer and its treatment presents. Finally, over time, we train these CancerGuides® to lead groups that are genuinely supportive, groups that help people with cancer come to terms with their fears rather than (like Ms. Kutt's group members) shun those who provoke them, groups where true compassion trumps emotional convenience.

We as a nation have certainly not won the war on cancer. But we have learned over the last forty years that there are things each of us can do to reduce the risk of cancer and, in some instances, slow or forestall its recurrence. We have learned also that acting on our own behalf to create programs in which self-care is integral is, itself, stress-reducing and therapeutic, helping people with cancer to overcome the feelings of helplessness and hopelessness that so often debilitate them. And we have found too, as so many people with cancer would testify, that such efforts often become an opening to remarkable self-discovery and psychological and spiritual growth.

There is no silver bullet for most cancers, or sure cure for those whose cancers have advanced. But creating a comprehensive program that includes diet, exercise, stress management, and genuine support, a full array of options critically examined, may offer a measure of scientifically grounded common-sense help from which all of us can take heart.

James S. Gordon, M.D., a psychiatrist, is creator of the CancerGuides® training program and Founder and Director of The Center for Mind-Body Medicine. He is the author, with Sharon Kurtin, of Comprehensive Cancer Care: The Integrating Alternative, Complementary, and Conventional Therapies and of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression

Kolata article in New York Times:
JAMA Walking article 2005
NCI study 2006, dietary fat
Study on stress Hormones/Enzymes

Progress in Postwar Gaza

James Gordon, M.D. — Tue, 10 Mar 2009 17:34:37 +0000

I said that I would write more about our work in Israel and Gaza, but the work-and trying to find funding so that we can continue it-is taking up so much time (joyous, exciting time, to be sure) that I haven't been able to write.

Still, I thought I would send along this very brief summary that I forwarded to our US Mind-Body Medicine faculty.

Hi everyone,

Just a couple of words from Gaza City: overwhelming, amazing, touching. That's three words.

We (Jim, Amy, Afrim, Yusuf, Dan and Lee-Ann) had a great visit with our Israeli faculty. They are doing many interesting and exciting projects including groups that combine mind-body skills and Jewish spirituality, joint Israeli Jewish and Arab groups, and many groups for traumatized children and adults in Sderot. In fact, we made a visit to Sderot and had a chance to talk with teachers who are using mind-body skills in wonderfully creative ways with children in the SCIENCE AND RELIGION SCHOOL. The kids have experienced shelling on and off for eight years and are having all kinds of problems with concentration, bed-wetting and anger.

Naftali who heads up our Israeli program, is on the track of a major initiative in the South which will build on the work that he and his team have already done. We are working together on developing cooperative relationships and future funding.

Thanks to Danny Grossman, a friend to whom Aaron and Debbie Kaplan introduced us some years ago, (with able assists from Naftali and Smadar who handle the administrative work in Israel), we were all able to get into Gaza. It took a couple of extra days for Afrim and Yusuf, but Naftali and Tami and Ayelet from our Israeli faculty kept their spirits high while they waited. Once in Gaza, we began with visits with grieving families. There are whole sections of Gaza that have been completely destroyed and many thousands of people who are without homes. "I am very small," one ten year old girl told us, "but the tent the 20 of us are staying in is even smaller."

We went on for a day of meetings with our Gaza faculty. The next day, we had more site visits including one to Dr. Izzeldin Abuelaish, whose three daughters were killed. He's an amazing man, an OBGYN who works in Israel as well as Gaza and through some miracle of wisdom and compassion, has managed to transform his suffering into a visionary project for the education of girls in Gaza-"not just so they will think, but so they will think freely"-and a mission to promote greater Israeli-Palestinian understanding.

We're now about to start the 4th day of our PTP. Our Gaza faculty, which Jamil heads up, is doing virtually all the lectures and leading all the groups and our international team is consulting/supervising. The Gaza group is doing an absolutely wonderful job. They are so open-hearted and skillful-I'd say over the last 18 months, they've each lead anywhere between 6 and 20 groups and it shows.

Participants (there are over 140 of them) are speaking of issues that they have never before discussed and beginning to solve problems that have troubled them for years-not to mention finding practical ways to ease their high levels of anxiety and deal with nightmares, flashbacks, etc. All of them-faculty and participants-are so eager to learn and to share what they are learning. They are an inspiration to all of us.

There is much more to tell and I will when I have more time. For now, I send all of you my love as well as my gratitude for being with us on this and many other adventures.

Jim

Healing in Israel/Gaza

James Gordon, M.D. — Thu, 05 Mar 2009 18:00:52 +0000

March 2, 2009

I'm returning to the Middle East after 9 months away, in the wake of the War in Gaza and the ongoing shelling of the south of Israel by Hamas. Read about our mission here.

Our team is in Israel for 4 days: Amy, who runs our program of clinical supervision for our Israeli and Palestinian faculty. Dan and Lee-Ann, who coordinate both programs on the US side and Afrim and Jusuf, psychiatrists from Kosovo, whom I first met when they we're refugees in Macedonia during the 1999 NATO bombing of Kosovo. Amy and I have worked together for 10 years. Afrim and Jusuf are like brothers. It seems that Dan and I have been everywhere together, and Lee-Ann, our newest member, has done a fabulous job with logistics for the trip.

We hit the ground running, heading to Sderot, which has been shelled from Gaza for 8 years, as soon as we wake up on the first morning after our arrival. Naftali, our Israel program director, (we've trained some 300 health and mental health professionals in Israel over the last 5 years), is doing the driving, and will be introducing us to colleagues who are dealing with the ongoing trauma in Israel's south.

First stop: the SCIENCE AND RELIGIOUS ELEMENTARY SCHOOL, a meeting with the principal, Dina Chouri as well as Miri Asoulin, a teacher who has come through part of our training program and heads up the "Havens of Calm" program. "Havens of Calm" is a room apart from the school with bean bag chairs, crayons, games, a place for kids to come express their feelings and simply hang out when they need to. Miri is exactly the kind of teacher you wish your children had-or wish you might have had yourself. She has the kind of smile that erases all the doubts you have about your own worthiness, that makes you feel that everything you do is not just alright, but really really interesting.

Over the last 7 years, while shells fell in and around Sderot, perhaps 60 percent of the kids used the "Havens of Calm" room. During the recent war, and in its aftermath, everyone does."

"For a long time," Miri tells us, "the children have been nervous and angry; they have trouble sleeping and are wetting their beds. Now, from the time the war began, there are new symptoms. Now the children tend to find scapegoats. One class had an election for what classmate they wanted to most to be dead. They cannot fight against the rockets, so the anger has to go somewhere," she says.

"In the beginning," a psychologist who consults with the school, added, "the children were crying and anxious. Now, sometimes, they go into a total freeze when the red alert (the signal that a Qassam rocket is about to fall). One eight year old girl's body was like a stone. She couldn't move her hands or feet for four hours."

Miri and a number of the other teachers and counselors in this and other Sderot schools find the techniques they learned from The Center for Mind-Body Medicine to be enormously helpful for themselves-for they too work, and often live, amidst the falling rockets-and for the kids. She shows us pictures that the children have done of huge rockets falling on their town and of Gaza burning.

The children seem more hopeful, but their parents are not. In Sderot, and in nearby Shaar Ha Negev, we hear voices of distress and disillusionment. "The people felt strong during the war," one psychologist tells us. "They thought the rocket attacks from Gaza would be over. But now the war is finished, and still we have Qassams almost every day. What was the point?"

More to come.

We Must Consider CAM for Depression

James Gordon, M.D. — Fri, 30 Jan 2009 17:55:57 +0000

Dear Readers,

Despite a hectic schedule this January, I'm hoping to keep my blog up-to-date with the exciting events in my practice and at The Center for Mind-Body Medicine (CMBM).

A quick look at my schedule/to-do list:

I'm just finishing leading (along with Kathie Swift, MS, RD, LDN, my co-director) The Center for Mind-Body Medicine's professional training program in nutrition, Food as Medicine, in San Francisco.

We're also moving forward with our exciting work with the US Military training health and mental health professionals who are working with active-duty military as well as in the Veterans Administration to use mind-body techniques with vets returning from Iraq and Afghanistan with severe depression, PTSD, and traumatic brain injury. Over 100 of these professionals came to the first phase of our professional training program in mind-body medicine in Minnesota in October 2008. Here's some data on the difference our training made to them. Most of them are returning for our advanced training--where we teach them how to lead the same kind of mind-body skills groups in which they participated in the first training-this weekend, from January 31-February 4th, once again in Minneapolis.

We're also moving ahead with a research study funded by the Department of Defense on the use of our model with traumatized veterans and their families.

Last but not least, 30 of us--health professionals, policy makers, and just plain folks--gathered together in my home to develop a report to make recommendations for a National Health Plan to the Daschle/Obama Health and Human Services Administration. We're continuing to explore ways for CMBM to be involved in creating a top-down support for truly universal and integrative health care for all Americans.

In other news, a recent op-ed of mine was published in the Clinical Psychiatry News, entitled "We Must Consider CAM for Depression." You can read this succinct argument for wider use of integrative therapies, versus drug-centric treatment, here (you will have to create a free account on this website to access it if you don't already subscribe to CPN, though--sorry.) I was also published in the New York Times science section, writing about a friend and colleague of mine in Gaza going through the terrible bombings there. Read that one here.

Let me know your thoughts about what we're doing, how we're doing it, and how we're bringing it out into the world! I'll be in touch too.

Jim

New Natural Approaches to Depression Every Day

James Gordon, M.D. — Thu, 08 Jan 2009 21:07:44 +0000

I just finished The UltraMind Solution, a wonderful, ground breaking book that gives new and eminently practical insight into the causes and treatment of mood, behavior, and cognitive disorders. It's a book I recommend to all of you without reservation.

The UltraMind Solution is by Mark Hyman, MD, a highly skilled, integrated Family physician who is a Center for Mind-Body Medicine Board Member, and a core faculty person in our Food As Medicine training. In The UltraMind Solution , Mark suggests that the most effective and, indeed, scientific way to address the epidemic of psychiatric disorders (affecting 1.1 billion people worldwide) is not with psychotropic drugs that treat postulated alterations in neurotransmitters, but with nutritional therapies that address the underlying biological imbalances that ultimately may disturb neurotransmitter functioning.

The UltraMind Solution is based on the principles of "functional medicine," a systems approach to chronic disease and to the physical and emotional problems that beset our population. It is a road map for both patients and practitioners, a clear, thoughtful, guide to the ways the body can become imbalanced, and to the simple, natural methods-largely food and supplements-that can be used to restore the imbalances in the entire body, and most particularly, the brain. It's a book that significantly deepened my own understanding of biological factors in depression. I believe, as well, it will enhance the information on biology that I present in my book Unstuck: Your Guide to the Seven Stage Journey Out of Depression.

In a series of clear, well documented chapters, Mark discusses the "7 keys" to his program, and the ways that readers can use them. These keys include optimal nutrition, hormone balancing, decreasing inflammation, improving digestion, enhancing detoxification, increasing energy metabolism, and calming the mind. In The UltraMind Solution, Mark includes more than 400 well-chosen scientific references and dozens of case studies, together with diagnostic questionnaires. He offers as well clear steps that readers can take to use this information to help and heal themselves. You can learn more about The UltraMind Solution by going to the following website: http://www.ultramindhealth.com/cmbm

Mark is also presenting a six part webinar series for clinicians on applications of functional medicine to brain and mood disorders. In particular, he will discuss diagnostic and therapeutic approaches to ADD/ADHD, autism, dementia, and depression. Access to these webinars is complimentary for practitioners who obtain a copy of The UltraMind Solution by going to the website above.