HOW TO COUNTERACT THE STRESS RESPONSE
“Within each of us is a spark. Call it a divine spark if you will, but it is there and can light the way to health. There are no incurable diseases, only incurable people.”
— BERNIE SIEGEL, M.D.
Although it’s common knowledge now, as recently as the 1960s, it was heresy for a doctor to suggest that stress and disease were linked. In fact, nobody even linked diseases like hypertension to stress, even though the word tension is part of the diagnosis. Doctors knew that patients tended to run higher blood pressures when they visited the doctor’s office—they called it “white coat hypertension.” But somehow, nobody thought through the implications of the fact that visiting the doctor can be anxiety-provoking and that such stress resulted in elevations of blood pressure that dropped once the patients went back home and relaxed.
Curious about whether there could be a link between stress and high blood pressure, Harvard cardiologist Dr. Herbert Benson started discussing it with his colleagues, who mostly thought he was wacko for even suggesting it. But Benson was dogged in his pursuit of the answers, and finding none, he started researching the topic himself. Inspired by the work of B. F. Skinner and Neal Miller on biofeedback and its ability to teach the body to control apparently involuntary physiologic phenomena, he started rewarding monkeys for increasing and decreasing their own blood pressures. He signaled success to them by flashing colored lights. Eventually, he was able to train the monkeys to control their own blood pressure by simply signaling them with the lights. The monkeys were able to control their blood pressure with nothing more than brainpower alone.
The study, which was published in 1969, caught the attention of practitioners of Transcendental Meditation, which had been recently popularized by the Beatles, Mia Farrow, and other celebrities. These practitioners, who had heard that Benson was studying monkeys, believed they were lowering their blood pressures when they meditated, but nobody had ever tried to prove it. Already on shaky ground at Harvard for wandering into the territory of what ultimately would be called “mind-body medicine,” Benson originally refused to do the study. But the meditation advocates were persistent.
He then heard about another researcher, Robert Keith Wallace, who was studying Transcendental Meditation for his doctoral dissertation at the University of California, Irvine. The two decided to put their curious heads together and collaborate on a study. Once they compiled the data, they were shocked. The data was incontrovertible. Striking physiologic changes accompanied meditation—sharp drops in heart rate, respiratory rate, and metabolic rate. In the initial study, the blood pressures of the study subjects didn’t drop during meditation, but overall, the study group that meditated had significantly lower baseline blood pressures than those who didn’t.
Benson named the physiological changes that meditating people experienced “the relaxation response,” a term I’ve used throughout this book as the opposite of “the stress response.” He argued that, like the stress response triggered when a part of the hypothalamus is stimulated, the relaxation response is triggered when a different part of the hypothalamus is stimulated, as a safeguard intended to counterbalance the emergency alarm the body sometimes sounds.
Benson was so impressed by the benefits he witnessed when patients practiced this simple technique that he asked himself the question—if a 10- to 20-minute meditation practice could result in such profound health benefits, what would happen with those who practiced advanced meditation? Rumors of seemingly impossible feats of physiological manipulation were swirling around at the time. Researchers who studied meditating monks had demonstrated that they were able to reduce their metabolic rate by 20 percent, something usually achieved only after four or five hours of sleep. This demonstrated that it was possible to manipulate “involuntary” mechanisms in the body exclusively through activities of the mind.
When he first approached Tibetan monks, they had no interest in being studied. Then Benson befriended the Dalai Lama, who supported his research. All of a sudden, the monks paid attention. He witnessed the monks, dressed in nothing but loincloths, wrapping themselves in wet sheets in freezing temperatures at 15,000 feet in the Himalayas. But instead of shivering, dropping their body temperatures, and possibly dying, the monks visualized fires in their bellies, raising their body temperatures enough to dry the wet sheets.
Benson realized that the fertile breeding ground of the relaxation response might be harnessed to implant thoughts in the mind by visualizing an outcome you wish to achieve—such as raising your body temperature, lowering your blood pressure, fighting your cancer, or alleviating back pain. He went on to study processes like these throughout his extensive career as a researcher. Over the years, Benson studied thousands of patients and published scores of articles in scholarly medical journals. Through this research, he elicited a list of the conditions that respond to the relaxation response. There are likely others, but he clearly proved efficacy in treating angina pectoris, cardiac arrhythmias, allergic skin reactions, anxiety, mild to moderate depression, bronchial asthma, herpes simplex, cough, constipation, diabetes mellitus, duodenal ulcers, dizziness, fatigue, hypertension, infertility, insomnia, nausea and vomiting during pregnancy, nervousness, postoperative swelling, premenstrual syndrome, rheumatoid arthritis, side effects of cancer, side effects of AIDS, and all forms of pain—backaches, headaches, abdominal pain, muscle pain, joint aches, postoperative pain, neck, arm, and leg pain.
In his 1975 book The Relaxation Response, Benson announced that he had discovered a counterbalance to the fight-or-flight response Cannon had described decades earlier. Just as the body has a natural survival mechanism built in to help you run away from a wild animal, the body also has an inducible, physiologic state of quietude, which allows the body to repair damage done by the fight-or-flight response.
After his book hit the New York Times bestseller list, Benson got a lot of media attention and was admonished by his peers because “physicians at Harvard do not write popular books.” His colleagues continued to critique him, claiming that the relaxation response was merely a placebo effect. Because patients believed it would lower their blood pressure, it did. In other words, it was belief that made the technique effective, not the actual technique.
Because, at the time, he had as much disdain for the placebo effect as his colleagues did, Benson worked diligently to prove that the relaxation response was a distinct physiological state. What he found was that the relaxation response worked more than a placebo comparison; however, even though his technique was more effective than a placebo, the placebo arm of the study still worked 50 to 90 percent of the time. Benson realized that the placebo effect was not something to be scoffed at but rather something to harness. He proposed renaming the placebo effect “remembered wellness” and suggested that it was a useful counterpart to the verifiable physiological state those eliciting the relaxation response could induce.
Benson’s continued research found that regular elicitation of the relaxation response could prevent and compensate for the damaging effects of stress on the body, preventing disease and sometimes treating it. Benson wanted to know if the same response could be elicited in other activities besides meditation, so he kept up his research and found four essential components that could reliably elicit the relaxation response: 1) a quiet environment; 2) a mental device, such as a repeated phrase, word, sound, or prayer; 3) a passive, nonjudgmental attitude; and 4) a comfortable position.
Later, he discovered that only the mental device and passive attitude were necessary. A runner with a mantra and a passive attitude could be jogging down a busy street and elicit a relaxation response. The same was true for those doing yoga or qigong, walking, swimming, knitting, rowing, sitting, standing, or singing. As he continued a lifetime of research, Benson found that the majority of medical problems were either caused by or exacerbated by the chronic effects of the stress response on the body. Other studies showed that over 60 percent of doctor visits could be attributed to the stress response.1
Intuitively, we know this, and when we’re stressed out, we crave relaxation. But too often, we go about it the wrong way, seeking out unhealthy forms of stress relief like alcohol, tobacco, and illegal drugs, which only exacerbate the problem. There are, however, healthy ways to elicit the relaxation response—such as meditation—that are the best medicine we can take for treatment of life’s stresses.
To test the effectiveness of elicitation of the relaxation response on the body, Benson invented a way to teach patients how to elicit this response in a way that wasn’t as woo-woo as Transcendental Meditation or as spiritual as prayer.
HOW TO ELICIT THE RELAXATION RESPONSE
(From Herbert Benson’s The Relaxation Response)
This technique was found to be highly effective for eliciting the relaxation response and improving health. But in his latest book, Timeless Healing: The Power and Biology of Belief, Benson provides updated information on how to elicit the relaxation response. Essentially, this is all you need.
A SIMPLIFIED WAY TO ELICIT THE RELAXATION RESPONSE
This can be done while exercising, making art, cooking, shopping, driving … whatever.
Meditation
You don’t have to follow Benson’s prescription for eliciting the relaxation response. Other forms of meditation offer great health benefits, which have been well documented. All forms of meditation, to some degree, activate the parasympathetic nervous system, decrease stress-related cortisol, reduce respiration and heart rate, reduce the metabolic rate, increase blood flow in the brain, increase activity in the left prefrontal cortex (which is observed in happier people), strengthen the immune system, and lead to a state of relaxation.3
Meditation also reduces pain, work stress, anxiety, and depression, promotes cardiovascular health, improves cognitive function, lowers blood pressure, reduces alcohol abuse, improves longevity, promotes healthy weight, reduces tension headaches, relieves asthma, controls blood sugar in diabetic patients, alleviates PMS, reduces chronic pain, improves immune function, and raises quality of life.4
Lest you, like Benson’s colleagues, suspect this might all be due to the placebo effect, take note that one study even studied sham meditation and found that it wasn’t as effective in improving health variables as real meditation.5 I know you’ve heard before that meditation is a good idea, but it’s not just good for your mind, it’s a critical technique for countering the effects of chronic stress in your life and in your body.
How to Meditate
If Benson’s approach to inducing the relaxation response doesn’t do it for you, there are many other ways to meditate. Dr. Deepak Chopra recommends the RPM (Rise, Pee, Meditate) approach to meditation, suggesting that those who can will be well served to meditate first thing upon arising. However, if you, like me, have young children, you may find it easier to meditate when the kids are napping or away at school. If you work outside the home, you may find it easier to meditate over your lunch break or just before bed.
Regardless of when you do it, it’s crucial to make the time in your schedule to help your body relax, whether via meditation or other activities, such as the ones we’ll discuss later in this chapter. If you’re the overachieving type like me, used to multitasking and cramming a dozen productive activities into a day, I know meditation can feel like a supreme waste of time. But remember, meditation is productive. You’re doing this for your health. It’s as important for your body as going to the gym, preparing healthy meals, and getting enough sleep—if not more important—so I strongly suggest you apply discipline and prioritize the 20 minutes it takes to help the body relax.
If your monkey mind races from thought to thought the way mine does, you may find yourself resistant to meditation. You may also find yourself tempted to skip it because the quiet time brings up emotions you’re trying to avoid, eliciting feelings like grief, sadness, or anger. Or you may just find it boring. Whatever your excuse, I encourage you to try it, not just for the health of your body but also for the other benefits meditation can bring to your life, such as a stronger spiritual connection, a deeper understanding of your authentic truth, and a greater connection to the wisdom of your intuition.
If you’ve never meditated before, start by creating a peaceful environment. I have two altars I’ve created at home, one in my bedroom and one in my home office, which I sit in front of to meditate. My altars showcase objects that are sacred to me, such as a stone carved with the words “Love Life,” a wrought-iron heart fitted into an iron box that I found in Big Sur, a piece of rose quartz a friend gave me, a condor feather, a small statue a patient gave me, a painting a dear friend made, a framed photo, a cup of sand from a sacred site, and several candles. When I sit down to meditate, I light the candles, burn some incense, and take a moment to let my altar soothe me.
Some people have rooms exclusively dedicated to meditation. Even a small closet can be tricked out to become a special space designed to help your body relax and your soul connect. Meditating outside can also be lovely. Because I live on the California coast, I often meditate by the ocean on a rocky beach that is usually deserted or in Muir Woods, among the peaceful redwoods. If you have access to quiet spots in nature, try a beach, a riverfront, a meadow, or a forest free of distractions.
The challenge is finding a quiet place where you will be undisturbed, ideally a place that helps you relax. Turn off the TV, silence your phone, and play soothing music if you like. The point is to create an environment conducive to freeing your mind from its daily clutter and relaxing your body.
If you’re new to meditation, start with just 5 minutes per day and aim to work up to 20. Set a timer so you don’t have to check your watch, and if you can, sit on the floor and close your eyes. You don’t have to sit in the lotus position unless you want to, but sitting on the floor helps you feel grounded, connects you to Mother Earth, and roots you into your body when you meditate. Feel free to use pillows, cushions, and other props that help you feel comfortable. Keep your back straight so you can breathe deeply with ease. If sitting on the floor is too uncomfortable, sit in a chair and place your feet firmly on the floor to develop a sense of grounding.
Once you find a comfortable position, close your eyes to minimize visual distractions and try focusing on your breath as you inhale and exhale. Meditation teacher Jack Kornfield suggests that if you notice yourself remembering, planning, or fantasizing, refrain from judging yourself, but do call it out. “Hello, remembering.” “Hello, planning.” “Hello, fantasizing.” Then return to the present moment, focusing on your breath. The minute you notice your thoughts starting to wander, come back to your breath and try to empty your mind. If your mind continues to wander and your breath isn’t enough to empty your mind, try counting your breaths or repeating a mantra to clear it.
To circumvent distracting images that may appear in your mind, you may also try scanning your body for any parts that don’t feel relaxed and visualizing your breath going to those tense spots. Imagine your breath as golden light flowing to the tense places and filling them with relaxation. Relax your back, your shoulders, your belly, your facial muscles. If you have trouble finding your tension, try tensing and releasing each muscle, starting at your forehead and moving down your body all the way to your toes.
You can also try visualizing a grounding cord, coming out of your bottom like an electrical cord or tree roots, dropping through the floor, coursing through the soil and into the bedrock, and landing at the core of the earth, where you can plug in. Allow anything that no longer serves you to release down that grounding cord, into the earth’s center, where it can get recycled. You can also visualize this grounding energy of the earth’s core coursing up through the grounding cord and filling you with healing light.
You may also try visualizing yourself in a real or imagined place of relaxation. Allow your mind to experience the relaxing place in a multisensory way. See it, feel it, smell it, taste it, and hear the sounds. If you’re battling an illness, you might add healing visualization to your meditation. In your mind’s eye, see the part of your body affected by the illness returning to wholeness and health in as much detail as you can muster.
If you find it too challenging to still your mind in silence, try guided meditation. To download a guided meditation of my voice leading you through a healing meditation designed to elicit the relaxation response, visit MindOverMedicineBook.com. Or try Belleruth Naparstek’s Health Journeys guided imagery CDs.
Most important, don’t judge yourself as you learn to meditate. Criticizing yourself for meditating “badly” or beating yourself up because your monkey mind won’t calm down will only stress you out, defeating the purpose of making attempts to help your body relax so it can repair itself. Remain compassionate with yourself, and pat yourself on the back for any progress you make. Can’t make it more than ten breaths into your meditation? Give yourself a hug and try again the next day. Like anything, it just takes practice. As someone who resisted meditation for most of my life, I can attest to the fact that it really does get easier with regular practice, and the benefits are so worth the effort.
Other Ways to Elicit the Relaxation Response
It’s not just meditation that shuts off the stress response and calms the body. As we’ve learned, creative expression, sexual release, being with people you love, spending time with your spiritual community, doing work that feeds your soul, and other relaxing activities such as laughter, playing with pets, journaling, prayer, napping, yoga, getting a massage, reading, singing, playing a musical instrument, gardening, cooking, tai chi, going for a walk, taking a hot bath, and enjoying nature may also activate your parasympathetic nervous system and allow the body to return to a state of rest so it can go about the business of self-repair.
This is vital for every single one of us, not just as treatment for illness but for prevention of it and extension of our lives. Nearly 75 percent of people surveyed said their stress levels were so high they felt unhealthy.6 But the relaxation response can serve as a counterbalancing response.
Can’t quit your stressful job? Not ready to leave your unhappy marriage? Haven’t found the love of your life yet? Not interested in going to church? That’s okay. I’m not suggesting you have to do everything I’ve covered in this book in order to be optimally healthy. But I am suggesting that if you’re exposed to stressors you either can’t change or aren’t ready to change, you must prioritize activities that induce the relaxation response as a way to counterbalance the stresses in your life.
Back when I was seeing 40 patients a day in my very stressful job as an OB/GYN, I would spend 12 hours a day practicing medicine and then come home to my art studio, where I’d paint until bedtime. I always said, “Medicine is my hemorrhage, but art is my transfusion.”
What I didn’t understand was that I was naturally prescribing treatment for my stressful life. While my physician job triggered my stress responses all day long, my painting elicited relaxation responses. Although I wasn’t ready to quit my job, and although I wasn’t meditating, I was still giving my body medicine, calming my body into a state of rest and self-repair for up to 40 hours per week in my spare time, allowing myself to slip into a state of creative flow, during which hours passed without my awareness of the passage of time.
Parasympathetic nervous system activation is the chill-out state of the mind and body. If your sympathetic nervous system got shut off, you’d stay alive (though you’d likely get eaten by that lion). But if your parasympathetic nervous system gets disconnected, you die. So the stress response is a change from the steady state of the body. It’s the parasympathetic nervous system that quiets the mind, relaxes the body, and fosters a sense of tranquility. As Rick Hanson writes in Buddha’s Brain, “If your body had a fire department, it would be the parasympathetic nervous system.”
When the relaxation response is induced, the parasympathetic nervous system is in the driver’s seat. Only in this relaxed state can the body’s natural self-repair mechanisms go about the business of repairing what gets out of whack in the body, the way the body is designed.
The relaxation response also improves mood. It’s hard to feel anxious or depressed when the parasympathetic nervous system is in charge. The relaxation response may even alter how your genes are expressed, acting like a Band-Aid for the stressed-out body and reducing the cellular damage of chronic stress.7
How will you initiate relaxation responses in your body to make your body ripe for miracles?
Rx for Self-Healing
Now that I’ve pointed out how the stress responses that originate in your mind and damage your body function, you might be expecting me to dole out a specific prescription for exactly how you can alleviate loneliness, find love, enjoy better sex, reduce work stress, earn more, be more creative, feel happier, and relax the body. After all, I’m a doctor. We write prescriptions, right?
Although we all crave quick fixes and long to believe that some expert finally has the one secret solution to all our problems, the truth is that you’d probably be annoyed if I tried to write your prescription for you. Any efforts on my part to do so, even those based on cold, hard science, would likely come across as trite. Just picture it.
If you don’t believe you can get well, switch out your negative beliefs for positive ones. If you’re lonely, join a club, get on Match.com, and find the right spiritual community. If you’re stressed at work, quit and find a better job. If you feel creatively thwarted, start creating. If you’re broke, earn more. If you’re a pessimist, become an optimist. If you’re unhappy, get happier. If you feel stressed, relax.
Easy for me to say.
Whether you’re trying to recover from a health condition or prevent disease until you die of old age, the process is the same. In Part Three of this book, I’m going to teach you the six steps to healing yourself so you can write your own prescription. (Don’t worry! No medical-school education required.)
Remember, I’m not suggesting you ditch your doctor. You should take advantage of all modern medicine has to offer to complement your self-healing prescription. I wouldn’t recommend skipping that surgery when you have appendicitis or not taking that antibiotic when you have a severe infection. While writing your prescription will certainly increase your body’s ability to repair itself when something does go wrong, I’d never want you to risk your life by delaying treatment if you’re suffering from a potentially life- or limb-threatening disease.
Having said that, I highly recommend this process as adjunctive treatment, alongside any medical treatment plan you may make with your health-care providers, in order to speed your recovery, ensure an optimal outcome, and make your body ripe for disease remission.
Keep in mind that what I’m about to teach you works best for disease prevention and chronic health issues—not emergencies. It’s also a surefire way to boost your vitality, your happiness, and your life expectancy. Whether you’re sick and have hopes of one day getting off your daily medication, you’re technically “well” but not feeling like you’re as vital as you could be, or you’re jonesing to optimize your already good health, The Prescription you’re about to write for yourself is guaranteed to change your life.
Beyond the scope of this book, but bearing mention for those looking to achieve optimal health, are holistic and preventive health tips your conventional doctor might not bring up. While the treatment plan you’re about to create is primarily aimed at healing your mind, it’s not enough to care solely for the mind if your goal is optimal health. You can shift your beliefs from negative to positive, alleviate loneliness, eliminate work and financial stress, and treat your depression and anxiety, but if you’re still drinking, smoking, and eating highly processed microwavable dinners, that just ain’t gonna cut it. Not only does your mind need the right nutrition for healthy brain activity, the endorphins of regular exercise, and the rest of a good night’s sleep, your body also needs to be nourished and protected from the hazards of our environment.
When patients on a mission to heal themselves from a “chronic” or “incurable” illness seek my guidance, I always recommend adding green juice as a daily supplement, eating as many raw foods (go veggies!) as you can, limiting meat or at least choosing animal products wisely, eliminating processed foods, adding superfoods like chlorella, spirulina, seaweed, and wheatgrass to your diet, taking a good multivitamin, and eliminating or at least cutting back on white sugar, gluten, caffeine, alcohol, tobacco, and illegal drugs. Under guidance from my raw foods teacher Tricia Barrett, I personally do a 21-day raw foods/green juice detox cleanse once every three months as preventive medicine, and I recommend the same cleanse to anyone trying to heal from an illness. (For more juicy details about how to use food as medicine, visit Juice DietCleanse.com or read Kris Carr’s Crazy Sexy Diet.)
I also recommend optimizing the biochemistry of the body by visiting a conscious, open-minded functional-medicine or integrative-medicine doctor familiar with balancing and optimizing the body’s hormones and neurotransmitters and using natural substances to boost the immune system and foster the body’s natural healing powers.
I believe, too, that the environment in which you live affects your health. Are you living a “green” life? Are you being exposed to harmful chemicals in plastics, pesticides, lead, toxic household chemicals, mold, or asbestos? The World Health Organization (WHO) reports that 24 percent of global disease is caused by environmental exposures that could be averted. They estimate that more than 33 percent of diseases in children under the age of five are caused by environmental exposures and posit that addressing environmental issues could save as many as four million lives a year in children alone, mostly in developing countries.8
Clearly, you can do everything “right” when it comes to nurturing your mind, but if your body is full of poison, either from your diet, what you drink, or your environment, a healthy mind just won’t counteract the damage you’re inflicting upon your body.
Others address these issues in more detail, but what I’ll cover is a six-step process for how to listen to your body, diagnose the root of what might be causing or exacerbating your illness, and create a treatment plan for yourself aimed at reducing stress responses and eliciting relaxation responses so the body can be returned to its natural capacity for self-healing. Are you ready to write The Prescription for yourself?
