The greatest force in the human body is the natural drive of the body to heal itself—but that force is not independent of the belief system. Everything begins with belief. What we believe is the most powerful option of all.
—NORMAN COUSINS
It is New Year’s Eve. You raise your glass of Champagne and toast the New Year, pledging that this is the year that you will finally get in shape. You plan on actually going to the gym that you have been paying for monthly, eating more vegetables and less fast food, and drinking less caffeine. A month later you find yourself eating nachos and telling yourself that you will start tomorrow. Your excuse for failing again? Stress. You are too stressed out, and you need comfort.
Trying to stop old habits that help you manage through the stress you experience can be as challenging as trying to stop a shiver when you are cold. Your habits are automated patterns that have been active for a long time and have therefore become “habituated.” If these behaviors didn’t have a history of helping you feel better, at least in the short term, on a consistent basis, you wouldn’t be doing them today. Physiologically, these habits do turn the stress response off, as neurotransmitters like dopamine and serotonin are released and reward systems in your brain are activated, but it is temporary. The stress response rears its ugly head again soon thereafter, either because of your guilt or negative emotion, because the problem you’re stressed about still persists, or because the habit itself is unhealthy.
For example, you may have a tendency to overeat foods high in sugar when you feel overwhelmed or stressed. The sugar is not necessarily taking care of whatever you are worried about, but it is causing your serotonin levels to rise and stimulating the dopaminergic reward centers in your brain. The result is that you feel better. Thus the term “comfort food.” But the effect is temporary, and you are still overwhelmed by your problems. In addition, your body is also stressed by the excess sugar, the stimulation of insulin, the inflammatory response, and any negative emotions you may be experiencing, like guilt or shame for having just eaten something “bad” or for being unable to maintain the promise you made to give up sweets. Feeling worse, you eat more sweets.
I can use myself as an example. Before I started using my own prescription, I used to ignore my feelings of anxiety or inadequacy. I chose to pay less attention to my body and what I could not control and more to the things that gave me instant gratification and feedback, so that I could keep working. I poured myself into my work, into writing, spending time on the Internet, and eating delicious, yet fattening foods. I made myself so busy that I had little time or energy for other things, especially for exercise. I tried to boost my energy with more comfort foods and caffeine and then felt guilty about my actions. To override the guilt, the “What the Heck Effect” would kick in. You know the effect. You say to yourself, “I cheated and screwed up anyway. What the heck! I might as well screw up the rest of the day.” And so I ate my favorite baked or fried foods, only to find myself feeling more fatigued, out of sorts, and of course fat. And the cycle raged on until I decided to actually learn how to control my stress response.
What do I mean by controlling the stress response? Let’s use the simple example of sitting in a stressful meeting with your boss, while also desperately needing to use the restroom. You are anxious about how your boss perceives you and how he might criticize you and you are also physically stressed because your bladder is about to burst. You can barely concentrate, let alone think clearly, your heart is racing, your stomach hurts, you feel as though you can’t breathe, and your neck muscles are tight.
You finally get a break and use the restroom. Relief at last. You can at least focus and breathe now, but you still don’t want to go back into the meeting because your fears of inadequacy or of being evaluated poorly are still high. The pit of your stomach hurts, and your shoulders are still scrunched up to your ears.
But then imagine that during your break you decide instead to do a quick relaxation exercise, work on some affirmations that help you let go of your feelings of inadequacy, and remind yourself of everything you have accomplished during the past year. In other words, you manage to quiet your stress response by addressing physical, emotional, and cognitive components of it through relaxation, affirmation, and reframing your thoughts to more positive ones. You actually find yourself feeling not only physically relieved, but also more empowered as you go back into the meeting.
When the stress response is turned off, reward systems in your brain are activated, feel-good chemicals are released into circulation, and you are able to think more clearly, feel more relaxed, and be less anxious. But if you only address one component and not the underlying way you perceive and react to stress in general, this relief is temporary at best.
You want to be able to address every aspect of stress that you can in order to better control your response to it, as Jenna did. Jenna was forty-nine when she came to see me, complaining of insomnia that had been worsening over a twelve-year period. Recently, she had developed panic attacks as well. She complained that her doctors had put her on multiple medications for insomnia, anxiety, and depression, but these were not helping. The only remedy that worked was wine—two glasses a night to be specific.
Jenna told me that her childhood had been very difficult, because her mother was in and out of mental institutions regularly, leaving Jenna to take care of herself. With little money, provisions, or support, she often felt alone and overwhelmed. In high school, she found herself finally being accepted by a group of kids and remembered those years fondly. It was then that she discovered that alcohol soothed her nerves.
Fast-forward to adulthood. Jenna worked as a successful bank manager and was married with three grown children. She was surrounded by people who respected and adored her, yet she admitted she still harbored feelings of low self-esteem and shame. She believed she could never be “enough” for anyone and never really belong anywhere. She put extra pressure on herself to meet every deadline, take care of every complaint her children had, and please her husband. Yet she felt like a failure at everything. She worried that if she did not work hard at work or in her marriage, she would find herself alone and destitute again.
Jenna’s insomnia and anxiety were certainly problematic. But they were also symptoms of an overactivated stress response resulting from multiple stressors, including the hassles of everyday life, her underlying beliefs that she would never be good enough or belong, and her fear of not having enough to survive, despite having an overflowing bank account.
For Jenna, the first step toward feeling better was to understand the underlying cause of her stress, what stress really meant for her, and its different facets, including uncovering her underlying fears of not being loved or supported. In addition to learning new coping strategies and implementing lifestyle changes, Jenna also had to discover the ways in which her body whispered when the triggers for feeling “not enough” were activated and use healthier tools to alter the belief to one of being enough.
By addressing Jenna’s needs to feel loved, valued, supported, and relevant, it was possible to quiet her stress response, so that she could address the real challenges in her life with a clear mind and a relaxed body. Within three months, Jenna’s sleep improved and her anxiety attacks ceased, never to appear again, and she no longer needed to self-medicate with wine.
Like Jenna, many of us have underlying fears and assumptions that drive our behaviors or habits. Most of them developed early in life. Over the course of our lifetime, as one memory built upon another, a belief system formed, and we developed our own conclusions regarding how we see ourselves, others, and the world around us. Some of our beliefs hold positive expectations that our future needs will be met. Other beliefs, based on more hurtful experiences, take a more negative stance, holding negative expectations that we may never be or have enough and that the world or people can’t be trusted to help us.
For instance, if in your past your family always had enough money and money was never an issue, you will likely believe today that you will always have enough money if you should need it. In contrast, if you grew up in a home where food and clothing were always in short supply or sometimes unavailable, your experience will be that of not having enough money. As an adult now, even though you have a stable income, you still may wonder, “What if I won’t be provided for? What if I don’t have enough money? What if I can’t pay my rent?” So you worry daily and stay at a job you don’t even like, though you dream of going back to school and becoming a psychologist.
All of us desire some sense of security and safety, knowing that we have the ability to physically survive. We also want to feel loved, admired, and valued and that our life has relevancy, just like Jenna.
Anytime your desires or wants are threatened, or at least you believe they are threatened, your stress response is stimulated. If you find yourself faced with a challenge that reminds you of a hurtful memory, of a time when your wants or desires were endangered, your stress response will get triggered as well. The result can be an overactivated stress response that causes you to experience more physical, emotional, or psychological problems, like Jenna. In other words, your stress response is not just provoked by stressful situations, but also by underlying fears and beliefs that are based on past experiences.
When you address your triggers and the underlying negative beliefs that they are based on, you have a better chance of regulating the stress response, being able to maintain an enhanced peace of mind and healthier body. In essence, you are better able to assume power over your health and your life.
Feelings or sensations are the body’s way of letting you know when it is out of balance and needs your help. When you are feeling tired, your body is letting you know you need rest; when you are hungry, that you need food; when you are cold, that you need to be warmer. In other words, feelings relate to your state of well-being, energy, stress level, mood, or disposition. If you can take a moment to pay attention, to listen to your body’s whispers, you then might learn the language of your body, understand what your feelings mean and what your patterns are.
Your body has a unique way of speaking to you. Every one of your cells has the ability to communicate with others and ultimately with the neurons in your brain. Via neurotransmitters like serotonin and hormones like adrenalin or cortisol, cells report on the changes and challenges that are happening in your environment, both inside and outside of your body, inside and outside of each cell.
There are, for example, about a hundred million neurons lining your gut that enable you to “feel” the internal world of your gastrointestinal tract. According to Emeran Mayer, a professor of physiology, psychiatry, and biobehavioral sciences at the David Geffen School of Medicine at UCLA, these neurons are not just responsible for enabling you to digest food; they also direct your emotions.1 Ninety-five percent of the body’s serotonin lies in the gut.2 Have you ever had that feeling of “butterflies” in your stomach when you were anxious? With anxiety, dropping serotonin levels change the activity in your gut and the electrical signals going from the gut to your brain, which cause you to feel “butterflies.” This sensation is sending messages to the brain that you are in danger, so that the stress response will be activated. When your gut is healthy and feeling “happy,” serotonin levels rise and signal your brain that all is well. That is how “comfort food” gets its name. Foods rich in fat and sugar temporarily stimulate serotonin levels to rise.
There are similar dense masses of neurons throughout your body. When messages are sent to the brain, it integrates the information from these areas with its database of memories and past experiences in order to make the executive decision that will ultimately move you into action. The action will be one that is meant to bring you relief and reward, so that you feel better.
When you feel better, it is because reward centers in the brain are stimulated and neurotransmitters like dopamine are released along with feel-good chemicals like endorphins and morphinelike substances. When you don’t feel better, or rather if your bad feeling persists, neurotransmitter levels drop as the stress response keeps going into action. Rather than experiencing positive emotions, negative emotions prevail, so that your brain continues to motivate an action or behavior that will, at the very least, get you feeling better, even if it doesn’t solve the problem. If you incur this same problem repeatedly, and you repeatedly use the same action or behavior to feel better or cope, it becomes a “bad” habit or a form of maladaptive coping. In other words, it is a behavior pattern that helps you cope, but that is not adaptive for health and for thriving.
For example, let’s say that when you were a child your parents often fought. Perhaps you often experienced fear or anxiety. You did find that your parents seemed to be nicer to one another when you brought home good grades and ate everything on your plate. As an adult, you find that you cannot handle conflict very well, and when the going gets tough, you throw yourself into your work and you find solace in a pint of ice cream. Even though you realize you have become a workaholic with an ice-cream addiction, you do not know of any other way to feel as good, and you certainly don’t have time to figure it out. Right now, the rewards you receive from work and ice cream are guaranteed.
Studies show that there exists a set of neural structures, including the ventral striatum, anterior insula, anterior cingulate cortex, and midbrain, that encode the subjective value of rewards.3 This subjective value is different for everyone, as it develops over time and is also partially genetically wired. It is based upon how good you have felt or might feel when acquiring said reward.
In other words, your behavior is driven by your need for reward and relief and how bad versus how good you invariably might feel in the future. When the stress response is overactive, especially when your triggers have been activated and you are feeling really badly, you can safely bet your rational thoughts will get thrown out the window. The point here is that there really is no point in blaming or shaming yourself. What is called for here is both acceptance that you have a programmed tendency or pattern for dealing with fear or stress and knowledge that this programming can be rewired over time. It took years for the habits to form, after all. The good news is that it does not take years for reprogramming, though it does take a lot of practice. Until such time as the new tendencies kick in, you may fall into these habits again for a while. And that’s okay.
Once you accept your behaviors and tendencies as wired, automatic responses that can be rewired, you can start taking responsibility for your role in either keeping them active or changing them. Being accountable involves understanding that your unhealthy habits are a result of fear and an underlying belief in inadequacy and that you have a choice of changing that belief. It involves understanding that this belief was formed long ago, that it is often a distorted perception of the situation and of yourself, and that, as long as you maintain it, the habits will persist.
For example, my patient Michael complained of having social anxiety. He abhorred going to social gatherings. At parties, he claimed he felt tongue-tied and awkward. When I asked Michael why he thought this happened to him, he explained that he felt he was stupid and had nothing interesting to say. When Michael said these words out loud, even he realized how outlandish they were. Michael was an avid reader. He skied competitively and participated in triathlons. He traveled the world on bird-watching trips, many of which he led. He was hardly “stupid and uninteresting.” Michael admitted that this belief had its origins in his childhood, when the children in school teased him for being shy and quiet, a habit he developed after his father told him one too many times that he was stupid.
Many of us, like Michael, hold on to thoughts that are not based in truth; also known as cognitive distortions, these are neither logical nor accurate. Rather, the thoughts are founded on past negative experiences that were beyond our abilities to understand and make sense of. As a result, rather than developing the understanding that the situations were hurtful, hard, or “bad,” we developed beliefs and assumptions that we were bad or in some shape or form “not enough.”
Being aware of this distorted belief was the first step for Michael. The second step involved accepting that it was partially responsible for driving him to learn so much and excel at everything he put his mind to, but that it was no longer needed as a driving force for success. The third step involved understanding that his belief would only have power as long as he gave it power and that he had volition over how he continued to respond. Michael had to now acknowledge that he was in the driver’s seat, and he had the choice to take the actions necessary to reprogram his beliefs, his physiology, and his behavior to get to healthy and happy.
The following is a list of a few common cognitive distortions, based on the work of Aaron Beck and discussed by David Burns in his book Feeling Good: The New Mood Therapy,4 and examples of negative beliefs that may be behind them (examples, not absolutes):
• All-or-Nothing Thinking: You perceive the events in your life in absolute categories instead of as on a continuum. For example, if you believe that something is less than perfect, you see it as a total failure, validating your underlying belief that you are a failure in general. This can indicate that you have a fear of being inadequate, being a failure, or lacking value, so you focus on some kind of absolute solution to fix the problem. Michael, for instance, felt tongue-tied at parties and concluded that he was stupid rather than simply nervous in social settings.
• Overgeneralization: You view a negative event as a part of a continued pattern of negativity while ignoring evidence to the contrary, the fact that many things in your life are positive. You may use the words “never,” “always,” “all,” “every,” “none,” “no one,” “nobody,” or “everyone” to support your belief that you don’t and never will have or be enough. This can reflect a fear of failure or inadequacy; it can also stem from fear of loss (that if you are happy, it will be taken away). Michael equated his social anxiety with being stupid, overriding the evidence that he was clearly not stupid, as he managed to have a successful career and life.
• Magnification or Minimization: You make the negative bigger and the positive smaller; for example, you exaggerate the importance of a problem, making it much larger than it necessarily is. “Catastrophizing” occurs when you tell yourself you absolutely cannot handle a given situation, when the reality is that it is really just inconvenient. A tendency to make such problems so important can indicate your underlying fears of being inadequate, unimportant, or dispensable.
• “Should” Statements: You have a precise, fixed idea of how you or others should behave, and when these expectations are not met, you exaggerate how bad it is, which causes you to feel resentment, guilt, or unhappiness. You often use “should” or “must” statements. Such behavior can reflect your own feelings of inadequacy or fear that if anything is less than perfect, your sense of safety, security, or value is being threatened.
• Personalization: You hold yourself personally and entirely responsible for situations that are not totally under your control, or you blame others without acknowledging your role in the problem. Experiencing shame or blame can be pointing to feelings of low self-worth and the belief that somehow, consciously or subconsciously, you are a bad person. For example, you blame your children for your locking yourself out of the house, because they were fighting and upset you, though you were the one who forgot to take the keys.
The end result of these cognitive distortions and negative thinking is that you end up feeling badly, which is often followed by subsequent maladaptive behaviors and actions that usually make you feel worse.
The action steps involved in empowering your ability to be healthy and happy are varied and ultimately involve reprogramming your mind and body to perceive yourself differently in life—as a victor rather than a victim. From learning to rewire underlying beliefs, to developing positive expectancy, to improving lifestyle behaviors, to taking up meditation and healthy nutrition, the end result of your actions is developing an inner trust, in mind and body, that you have the power to heal and to overcome anything. When you develop the belief that you can react to stress in a constructive way and create your own toolbox for doing so—which involves listening to your body’s whispers—you create greater resilience through trusting yourself and your ability to handle stress.
When you possess this inner trust, you are able to handle uncertainty and stress more efficiently, thus better regulating your stress response and the neurobiological mechanisms involved. You are more likely to be resilient and be able to:
• Face your fears.
• Keep your head clear so that you can problem-solve and fully appraise your situation.
• Keep up positive emotions and a positive outlook.
• Stay open to support.
• Feel competent in your actions.
• Maintain a sense of life’s purpose and the ability to make meaning of your situation.
• Stay healthy and happy, with better emotional balance, improved sleep, and more calm and peace.
In addition, changing your perception and attitude from victim to victor will also be reflected in your body’s physiology. When the stress response is less active, or down-regulated, the body may show:
• A decrease in heart rate and blood pressure.
• An improved metabolic rate.
• Less inflammation.
• Improved immunity.
• Lower levels of stress hormones like cortisol and adrenalin in circulation.
• More muscle relaxation.
• Improved mood.
• Enhanced memory.
• An improved ability to recuperate from the harmful effects of stress and to regain the natural ability to cope with additional stress.
Indeed, this latter factor should be underlined, as being able to successfully adapt to adversity, stress, or trauma is really the mark of resilience.5 When you are resilient, adversity doesn’t get you down physically, emotionally, or psychologically—at least not for too long, because you bounce back stronger and better and have an inner trust that you have the resources to handle anything.
There exists a myriad of action steps that can help you develop and cultivate this inner trust. Some of these actions you are well aware of, like regular exercise, healthy eating, and getting restful sleep. Other action steps may be new to you, as they stem from ancient or wisdom traditions, like developing a meditation practice or “opening your heart to experience love or oneness,” a state that is opposite to the experience of fear and separateness. As you read through each chapter, you will learn concrete action steps and discover which ones work for you best.
The sciences of stress physiology, neuroplasticity, epigenetics, and positive psychology are actually playing catch-up with the time-tested theories and practices of ancient wisdom that have used the concepts of love and trust to heal the body for thousands of years. In fact, science shows us that oxytocin, the hormone involved in the formation of loving attachments and social bonding, is also implicated in our ability to trust. Research shows that oxytocin shapes the nerve circuitry of trust in the brain.
In a double-blind study conducted at the University of Zurich, researchers gave subjects intranasal oxytocin and studied their behavior and associated brain changes on fMRIs. Subjects in the oxytocin group showed no change in their trusting behavior after they learned that their trust had been breached several times, while for subjects receiving the placebo, trust decreased. This difference in trust adaptation was associated with a specific reduction in activation in the amygdala and other regions of the brain associated with the stress response.6 “We now know . . . what exactly is going on in the brain when oxytocin increases trust,” says lead researcher Thomas Baumgartner. “It seems to diminish our fears.”7
What all the action steps have in common is that they offer outlets of relief for the stress response, enabling you to keep the response in better check, so that you can maintain a clear mind, positive expectancy, and a body that is full of vitality.
It is now your choice.