Tucson Lifestyle August 2013 : Page 72

Medical Guide 2013-2014 » A Mind/Body of Evidence Scientists fi nally have proof that your mind “talks” to your immune system. How are local medical professionals using this knowledge to help their patients? We interviewed two experts in the fi eld. BY GEORGEANNE BARRETT PHOTOGR APHY BY KRIS HANNING a rare form of epilepsy. Dr. Sternberg and other doctors began to question if the drug was the cause of the autoimmune disease. “During that time immunologists, neurologists and endocrinolo-gists did not believe that the brain and the immune system ‘talked’ to each other,” Dr. Sternberg explains. “The notion that giving a drug that did something to the brain could in any way trigger an autoimmune inflammatory disease was considered heresy. To me it was such a graphic example, because he did not have an auto-immune disease until he was treated with this experimental drug. It changed the course of my career because I was convinced that doing something to the brain could affect the immune system.” Dr. Sternberg then embarked upon research to discover how important a part of the brain that controls the stress response was in determining susceptibility to autoimmune disease, among other health issues. By measuring rat brain stress hormones, the chemi-cals they created and how they affected the immune system, she was able to discover that the notion of stress making you sick could not be scientifically dismissed. “It has been know for thousands of years that stress makes you sick, but it was very hard to understand how this works in humans. In Western medicine, unless you can understand how something works, in general, academic scientists and physicians just don’t believe it.” Finding this proof in humans was a significant obstacle that Dr. Sternberg and other researchers faced. There were a handful of sci-entists in the ’70s and ’80s who were making these same connec-tions, but it was not accepted as mainstream. Dr. Sternberg and others doing this work faced an uphill battle — simply saying that immune molecules affect the brain, and brain hor-mones affect the immune system, was not enough Dr. Sternberg served as the — it needed to be shown Section Chief of Neuroendocrine what this meant in terms Immunology and Behavior at of disease. the National Institute of Mental “By understanding Health (NIMH) and Director of this in a very biological the Integrative Neural Immune way, how the brain stress Program at the National response can affect the Institutes of Health (NIH) and immune system, I was NIMH, where she had the oppor-able to prove that this tunity and resources to begin the communication does research that would eventually exist, how it works and lead her to Arizona. T he people of ancient Greece, and their god of healing Asclepius never questioned the idea that human emo-tions and health are intricately connected. Eventually, however, their descendants moved away from that premise with the advent of modern medicine. Today, scientists and physicians are coming back to the theo-ry that our minds and bodies actually are intertwined and work together in very precise ways to make us well … or ill. Local researchers and doctors are doing amazing work to explore new theories. One such researcher is Esther Sternberg M.D., a renowned authority on the connection of the mind and body, and how stress as well as environments and relationships influence our health. As the first Research Director at the Arizona Center for Integrative Medicine (AZCIM), she hopes to expand her already extensive research by creating new collaborations within the university, while setting her sights on applying this groundbreaking informa-tion to clinical practice. Dr. Sternberg is well known for her ability to translate scientific subjects for novices and could be thought of as a sort of rock star scientist — her lectures are typically standing room only. Long before leading the research at AZCIM, she got her start as a family practitioner. Her later work as a rheumatology consul-tant during the last year of her fellowship sparked her interest in the mind-body connection. It was there she saw a patient who had developed a painful autoimmune scarring that caused him to appear to be covered with third-degree burns. These symptoms had developed after he began taking an experimental drug to treat Stressing The Point 38 MG TUCSON LIFESTYLE www.tucsonlifestyle.com

A Mind/Body Of Evidence

Georgeanne Barrett

Scientists finally have proof that your mind “talks” to your immune system. How are local medical professionals using this knowledge to help their patients? We interviewed two experts in the field.<br /> <br /> The people of ancient Greece, and their god of healing Asclepius never questioned the idea that human emotions and health are intricately connected. Eventually, however, their descendants moved away from that premise with the advent of modern medicine.<br /> <br /> Today, scientists and physicians are coming back to the theory that our minds and bodies actually are intertwined and work together in very precise ways to make us well … or ill. Local researchers and doctors are doing amazing work to explore new theories.<br /> <br /> Stressing The Point <br /> <br /> One such researcher is Esther Sternberg M.D., a renowned authority on the connection of the mind and body, and how stress as well as environments and relationships influence our health. As the first Research Director at the Arizona Center for Integrative Medicine (AZCIM), she hopes to expand her already extensive research by creating new collaborations within the university, while setting her sights on applying this groundbreaking information to clinical practice.<br /> <br /> Dr. Sternberg is well known for her ability to translate scientific subjects for novices and could be thought of as a sort of rock star scientist — her lectures are typically standing room only.<br /> <br /> Long before leading the research at AZCIM, she got her start as a family practitioner. Her later work as a rheumatology consultant during the last year of her fellowship sparked her interest in the mind-body connection. It was there she saw a patient who had developed a painful autoimmune scarring that caused him to appear to be covered with third-degree burns. These symptoms had developed after he began taking an experimental drug to treat A rare form of epilepsy. Dr. Sternberg and other doctors began to question if the drug was the cause of the autoimmune disease. “During that time immunologists, neurologists and endocrinologists did not believe that the brain and the immune system ‘talked’ to each other,” Dr. Sternberg explains. “The notion that giving a drug that did something to the brain could in any way trigger an autoimmune inflammatory disease was considered heresy. To me it was such a graphic example, because he did not have an autoimmune disease until he was treated with this experimental drug. It changed the course of my career because I was convinced that doing something to the brain could affect the immune system.” <br /> <br /> Dr. Sternberg then embarked upon research to discover how important a part of the brain that controls the stress response was in determining susceptibility to autoimmune disease, among other health issues. By measuring rat brain stress hormones, the chemicals they created and how they affected the immune system, she was able to discover that the notion of stress making you sick could not be scientifically dismissed.<br /> <br /> “It has been know for thousands of years that stress makes you sick, but it was very hard to understand how this works in humans. In Western medicine, unless you can understand how something works, in general, academic scientists and physicians just don’t believe it.” <br /> <br /> Finding this proof in humans was a significant obstacle that Dr. Sternberg and other researchers faced. There were a handful of scientists in the ’70s and ’80s who were making these same connections, but it was not accepted as mainstream. Dr. Sternberg and others doing this work faced an uphill battle — simply saying that immune molecules affect the brain, and brain hormones affect the immune system, was not enough — it needed to be shown what this meant in terms of disease.<br /> <br /> “By understanding this in a very biological way, how the brain stress response can affect the immune system, I was able to prove that this communication does exist, how it works and That it is important in health and disease.” <br /> <br /> The hormone cortisol is a big piece of the puzzle, according to Dr. Stenberg. When you are experiencing stress, that center of the brain sends out molecules instructing the adrenal glands to pump out cortisol, which is a potent anti-inflammatory compound. When you are stressed you are giving yourself many shots of this antiinflammatory hormone, which in turn lowers your immune system’s ability to fight infection.<br /> <br /> Once it was understood that stress makes you sick, Dr. Sternberg explained that the flip side is incorporating salubrious activity to improve overall well-being.<br /> <br /> How to Cope With Stress <br /> <br /> To cope with stress and enhance health she recommends a good diet and 30 minutes of gentle exercise a day along with prayer, meditation, yoga, t’ai chi, psychotherapy or any other stress-reducing activity. When undergoing those kinds of activities your brain changes in such a way that the stress response reduces, anti-pain chemicals are released in the brain and breathing deepens, all of which can help boost the immune system.<br /> <br /> “Coping with stressful experiences and growing from it changes brain chemistry and changes the way the brain and the immune system talk to each other. This helps to allow the immune system to do its job, which is to heal. Lifestyle is important for health, and using ways to cope with stress can enhance your well-being.”<br /> <br /> Dr. Sternberg says there is no question that the wall of resistance she met early in her career has lifted. In 1997 she led an international conference and exhibition on emotions and disease at the National Library of Medicine that asked the audience why Western medicine not only ignored but rejected the notions that people for thousands of years had accepted — emotions can affect disease, and disease can affect emotional health. The conference also led to research that culminated in her first book.<br /> <br /> “We explored it in a three-dimensional historical manner and there was enough solid, rigorous science at that point that it was clear to at least many of the skeptics that this is real. It is incontrovertible that the brain and the immune system talk to each other and we need to maintain those connections to maintain health. We understand it now in a much deeper, molecular, biochemical way. It required the development of methodologies that could study the living human brain at work and that could view our genes and immune molecules and immune cells.” <br /> <br /> Dr. Sternberg sees the next evolution of her mind-body research as taking it into medical practice and health care — the basis of integrative medicine. As the first Research Director at AZCIM her main goal is to identify mechanisms by which integrative interventions work and to find the best ways to apply them.<br /> <br /> “The ultimate goal is to help people maintain wellness and find a sense of wellbeing and healing at whatever stage they are in their lives or in illness or health,” she explains. “It really is providing the evidence — the quantitative, measurable evidence — that this sort of lifestyle change and mindbody interventions work and how they work. In that way we can help people find their balance and healing place.” <br /> <br /> Getting “Hyp” To It <br /> <br /> Although Dr. Sternberg is leading the way in the research of mind-body healing, the patients of some local health care providers already are reaping the benefits.<br /> <br /> Dr. Steven Gurgevich is one such practitioner, having dedicated his career to the connection of the mind and body. He is a Clinical Assistant Professor of Medicine at the Arizona Center for Integrative Medicine and the owner of Behavioral Medicine, Ltd. Just as it was for Dr. Sternberg, it was a singular experience that ended up changing his career and his life.<br /> <br /> “In 1970 I developed panic attacks,” he explains. “The doctor I saw said, ‘You aren’t having a heart attack, it’s just stress.’ This was brand new to me, the idea that stress could cause illness. So I started looking into the concept and by using my mind, hypnosis in particular, I was able to deal with the anxiety. I changed what I was doing in graduate school and put together a program of psychology, sociology, counseling and medicine. All I have done since then is really explore the mind-body connection, one of which involved the examination of patients with tuberculosis and their stress levels.<br /> <br /> When I attended pharmacy school I never heard the word stress mentioned. They just taught that the body was a bag of chemicals and you just tweaked it with more chemicals. The connection between tuberculosis and stress was a very novel idea. If people were stressed their immune systems were diminished and they were much more vulnerable.” <br /> <br /> Dr. Gurgevich does not focus on research, but instead on clinical applications with an emphasis on hypnosis. He treats patients’ medical and psychological conditions including side effects from cancer and chemotherapy, radiation therapy, skin disorders, emotional problems, gastrointestinal issues and chronic pain. Additional therapies that he uses are cognitive behavioral therapy and biofeedback, but he has found that if patients have an open mind and motivation, that hypnosis can be very effective. He says that he sees most patients only once and they observe results immediately.<br /> <br /> “There has to be motivation, but with something like the side effects of chemotherapy, patients are very motivated to get help. If people have something that they would like to escape, as well as motivation to go toward something, that’s still motivation. The next ingredient is belief. They have to have some degree of belief … and pretending counts. Even if they are just pretending that something works — something that is going to comfort them, turn off pain or change their condition — that qualifies.” <br /> <br /> Devorah Morris Coryell is a patient of Dr. Gurgevich and has seen him for gastrointestinal as well as some emotional issues. She was no stranger to mind-body healing as a former faculty member at AZCIM, but Finally was able to receive relief from lifelong GI issues, thanks to hypnosis.<br /> <br /> “For many years my GI issues were treated as a stress response,” she explains. “After my symptoms worsened Dr. Andrew Weil (director and founder of AZCIM) recommended meeting with Dr. Gurgevich and he cured my symptoms with one session.” <br /> <br /> Throughout his practice Dr. Gurgevich has found that the mind is an incredibly powerful tool, and it has been proved that it can have both positive and negative effects on our health.<br /> <br /> “We have two minds. One is our conscious thinking mind, that’s the part of you that can make change, tell time, add and subtract and get through college,” he explains. “Then there is the mind of your body, or the subconscious, which is above and below the thinking awareness. The subconscious mind is the mind of the body.<br /> <br /> That is the part of us that regulates the chambers of our heart, our skin, lungs, digestion — we aren’t thinking to make it happen. But if we add our thoughts or imagination to it, we can improve it or we can mess it up. Our mind can make us sick, or it can make us well.” Like others in his field, he has relied on hard evidence found by research to back up the idea of mind-body healing, and counter resistance Based on misinformation.<br /> <br /> “The biggest misconception of mindbody healing is that it is all imaginary, and it’s not. We now have neuroimaging studies that show where in the brain this is happening. One of the biggest myths about hypnosis is that it’s ‘done’ to somebody. Patients have everything they need to do this within them — it’s just helping them discover it.” <br /> <br /> According to Dr. Gurgevich, studies and reports done in the early ’90s said 72 percent of Americans were using alternative and complementary modes of health care, but they were afraid to tell their doctors.<br /> <br /> “The thing that got integrative, alternative and complementary modalities of medicine moving was not the field of medicine, it was the patients,” he says.<br /> <br /> Building Better Health <br /> <br /> In her second book, Healing Spaces: The Science of Place and Well-Being, Dr. Sternberg examines how mind-body medicine is greatly affected by something often overlooked — our environments. In the book she explains, “Implicit in an understanding of the mind-body connection is an assumption that physical places that set the mind at ease can contribute to well-being, and those that trouble the emotions foster illness.” <br /> <br /> Dr. Sternberg shows concrete evidence that environments can heal. One simple example is that patients in hospitals who have windows looking out on nature tend to heal faster than those who look out at a brick wall.<br /> <br /> “It is not only what goes on inside of us or between us, but also our environment that has an effect on health. This goes beyond removing toxins from the environment, but actually designing places that support well-being,” Dr. Sternberg explains.<br /> <br /> One of her objectives as Research Director at AZCIM will be helping to create the Institute of Place and Well-Being, a collaboration between AZCIM and the College of Architecture, Planning and Landscape Architecture.<br /> <br /> “The goal will be to have research, curriculum and community outreach practice together in order to define the gaps in knowledge, as well as fill in those gaps. We also hope to train the next generation of designers, planners, architects and landscape architects, as well as the next generation of medical practitioners, in the Importance of the environment on health,” she explains.<br /> <br /> She is excited about the collaboration of two very different entities and having the opportunity to do research to provide more evidence to patients about the effect that environment plays on our health.<br /> <br /> The next step is putting all the research she has done into practice, and she is currently doing this on a very large canvas. In addition to her role at AZCIM she is advising the U.S. Green Building Council to include health outcomes on LEED certification of green buildings; advising the America Institute of Architects on including health outcomes in licensing of design professionals; and advising the General Service Administration, which builds all the government buildings, on incorporating health outcomes on government green building design.<br /> <br /> She has even spoken to the military about these issues as well as the Vatican to assist the Pontifical Council for Healthcare Workers on how to incorporate these plans and principles in the 120,000 hospitals that are run by the Catholic orders around the world.<br /> <br /> “We are talking about a huge swath going from the Vatican to the military, and yet that is what is going to change health care and well-being in America and the world,” she explains.<br /> <br /> Dr. Sternberg served as the Section Chief of Neuroendocrine Immunology and Behavior at the National Institute of Mental Health (NIMH) and Director of the Integrative Neural Immune Program at the National Institutes of Health (NIH) and NIMH, where she had the opportunity and resources to begin the research that would eventually lead her to Arizona.

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