CHAPTER FIVE
Opening Your Heart and Reclaiming Your Health
Hearts will never be made practical until they are made unbreakable.
—THE TIN MAN, THE WIZARD OF OZ
Why are you crying, Maia?”
“Because my heart hurts.”
“Why does your heart hurt?”
“Because I miss my mommy.”
“She’s just out for the night. She will be here when you wake up in the morning.”
“Oh.”
“Does your heart still hurt?”
“Nope,” she grinned. “Good night, Auntie. I love you.”
It may not be this easy to mend a “hurt” heart when you are an adult or have a medical condition, but it is possible.
I can still recall the pain I felt in my heart after the end of one of my most significant relationships. One minute my heart was open, I felt as if I were flying high, bristling with love and joy, and the next minute, I could only feel pain; I wanted to crawl into a fetal position and withdraw from the world. My heart went from feeling full and whole to broken and incomplete. I felt tired and withdrawn, unable to think clearly or focus. Yet I also longed to love once more, and to allow that crack in my heart to open up again, rather than close.
I did everything I could to allow love in. I took care of myself through healthy nutrition, exercise, and meditation. I worked with a healer and coach to deal with my deep-seated negative beliefs and emotions. I spent time in nature and with friends to be reminded of what it felt like to belong. In the process of mending my “broken heart,” my physical health improved. My resting heart rate became that of an elite athlete (in the low 50s, from the high 60s), and my “good” cholesterol, or HDL, jumped from 65 to 103.
Mimi Guarneri, a practicing cardiologist and author of The Heart Speaks, says that loneliness, anger, and grief can break hearts as easily as high blood pressure. She writes:
No one spoke of the other layers of the heart that didn’t appear on a stress test or electrocardiogram, that are not taught in medical school: the mental heart, affected by hostility, stress and depression, . . . the emotional heart, able to be crushed by loss and grief, . . . the intelligent heart, with a nervous system all its own, . . . the spiritual heart, which yearns for a higher purpose, . . . and the universal heart, which communicates with others.1
Your heart beats about 100,000 times in one day at an average of 80 beats per minute. It works even when you are at rest and pumps almost 2,000 gallons of blood per day through about 60,000 miles of blood vessels.2 It delivers oxygen and nutrients, acts as a vehicle for chemical messengers like hormones, and removes waste products like carbon dioxide. It also acts like a “little brain,” as it feels and picks up the subtlest of changes or threats to your body’s state of balance and then communicates the information to your brain and other parts of your body.
Dr. J. Andrew Armour introduced the concept of a functional “heart brain” in 1991. In his work he showed that the heart has its own complex nervous system made up of a network of different types of neurons, neurotransmitters, proteins, and support cells like those found in the actual brain. This nerve circuitry, he found, enables the heart to act independently of the brain, to learn, remember, feel, and sense.3
You see, you have a magnificent, intelligent, powerful, yet also vulnerable heart that can teach you a lot about yourself and your world. It can feel imbalances in your environment, including changes in your emotions. It tells you when you are hurting and when you are well. It tells you when you are in harmony and when you are in disharmony. When you do not care for your heart, the disharmony can turn into dis-ease, though, especially if you have a genetic predisposition for heart disease. When you do care for your heart, it is often possible to move beyond genetic tendencies and ignite the power of your heart on every level—physically, emotionally, and spiritually—as you:
• Press the PAUSE button and become acquainted with the anatomy and functions of the cardiovascular system.
• OPTIMIZE your awareness of what can go wrong with the cardiovascular system, the signs and symptoms to watch out for that tell you to get medical help, and what you can learn from wisdom traditions and their view of the heart and its functions.
• Discover how your heart may be speaking to you as you WITNESS your physiology through guided exercises.
• EXAMINE the emotions and beliefs that your heart is holding on to that may be weakening your heart health.
• Develop the tools that will help you RELEASE negative habits and beliefs that are taxing your heart, RELIEVE your heart of its stress and worries, and RESTORE your heart’s vitality.
PAUSE and OPTIMIZE Your Awareness of Your Heart
Anatomy and Functions
As you begin to learn about the heart and the circulatory system and its functions, keep in mind the notion that the heart’s purpose is to pump the life force through you and help you ride through the ups and downs of life. For instance, it literally slows down when it is time for you to sleep and revs up when it is time for you to get up and get going. The heart’s anatomy is built in such a way as to allow for such opposite functions to occur, so that you can stay flexible and adapt to change. For example, the heart pumps and contracts with a lot of force, yet it can also become very pliant and relaxed to allow the blood to flow in. It opens and closes, gives and receives, takes in and lets go. Your heart harmonizes opposite functions.
The heart has four chambers that are surrounded by thick, strong muscular walls, walls that can stay elastic and withstand pumping large volumes of blood out to the body with incredible force. These four chambers are the upper and lower sections and the right and left sides. The upper chambers are the right and left atria, and the lower chambers, the right and left ventricles. The walls of the left ventricle are the strongest and thickest, as this ventricle has to pump the blood the farthest, to the rest of the body, while the right ventricle only has to get the blood to the lungs. The heart chambers force and relax, force and relax.
Valves and walls, called septae, separate the chambers from one another. The atria are divided by the interatrial septum and the ventricles by the interventricular septum. The tricuspid valve, which has three leaflets, separates the right atrium from the right ventricle, and the mitral valve, which has two leaflets, separates the left atrium from the left ventricle. There is another valve between the right ventricle and the pulmonary artery called the pulmonic valve, as well as a valve between the left ventricle and the aorta, called the aortic valve. The purpose of the valves is to help keep the blood flowing forward and prevent backflow. The rhythm of the valves and septae is open, then close, open, then close.
Blood from the veins flows into the right atrium and then into the right ventricle. The right ventricle then pumps the blood to the pulmonary artery. The pulmonary artery splits into right and left to deliver the blood to each lung, where oxygen is put in and carbon dioxide is taken out. Oxygen-rich blood is then delivered back to the heart via the pulmonary vein. The blood moves from the left atrium to the left ventricle and is then pumped to the aorta, the largest artery of the heart. The aorta curves up and above the left ventricle, then turns down in front of the spinal cord to the abdomen. The rest of the arteries that deliver oxygen to other cells and organs branch off of the aorta, dividing into the smaller arterioles and into capillaries in the rest of the body, where oxygen and other nutrients are delivered to the organs and carbon dioxide and other waste products are removed.
Deoxygenated blood is then carried through small venules to larger veins, then to the inferior and superior vena cavae (the largest veins in the body), and then back to the heart. Waste products are eventually removed by the kidneys, liver, or lungs. Hormones, your body’s chemical messengers, are also transported in the blood, acting as messengers that carry information and instruction from one organ to another, to and from the heart, and to and from the brain. The action here is a taking in and then a letting go.
A complex electrical system works to keep the heart beating at a regular pace and rhythm. Located in the right atrium, the pacemaker, or sinoatrial node, sends out electrical signals to initiate the contraction of the heart to set the rate, so that the rest of the heart can then follow the rhythm. Electrical pulses start in the atria and pass through the atrioventricular node, which then sends the pulses into the right and left ventricles.
In the first phase of the heartbeat, the ventricles are contracting, sending the blood to the lungs and into the body’s circulatory system. This is called systole, the top number you see on a blood-pressure reading. The sound you might hear is caused by the valves between the atria and the ventricles closing to ensure there is no backflow of blood. In the second phase, the ventricles relax to allow the blood to flow in. This is called diastole, the bottom number you see on a blood-pressure reading. The heartbeat signals movement, which is then followed by rest.
I hope you are starting to get a clearer picture of the heart and how it works, enough to understand that its opposite functions enable you to maneuver and adapt to life’s changes and challenges. These include force and relaxation, opening and closing, taking in and letting go, and regulating rest and activity. Imagine, if you will, that your heart got stiff and lost its ability to relax and stay pliant. It is not much different than when your body’s muscles get tense. How flexible are you? How easy is it for you to get up and go?
Heart Dis-harmony and Dis-ease
The problem: too much force or too much relaxation. If the heart has to work too hard to force blood out, the muscles of the heart can become too thick or even too thin, a diseased state called a cardiomyopathy. If the heart muscles are too thick, or hypertrophic, they still may be able to force the blood out well, but their stiffness makes them unable to fully receive, expand, and fill with blood. When the walls are too thin or dilated, the walls can take the blood in, but can’t force it out.
The problem: too open or too closed. The heart may also develop problems with its opening and closing capabilities, as infection, tumors, or plaque damages the valves and adjoining heart muscles. When the valves or septae are weak or malfunctioning, the result is backflow of blood. If the blood isn’t moving forward, it is causing turbulence. Turbulence makes you more prone to blood clots. Blood clots can then create all kinds of havoc, as they travel through the circulatory system to other parts of the body, blocking blood vessels and blood flow, as we see in some cases of stroke.
Heart Dis-harmony and Dis-ease Facts
• By 2005, the total number of cardiovascular-disease deaths (mainly from coronary heart disease, stroke, and rheumatic heart disease) had increased globally from 14.4 million in 1990 to 17.5 million.
• Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke.
• The World Health Organization (WHO) estimates there will be about 20 million cardiovascular- disease deaths in 2015, accounting for 30 percent of all deaths worldwide.
• Cardiovascular-disease death is today the largest single contributor to global mortality and will continue to dominate mortality trends in the future.4
The problem: a blockage preventing giving and receiving. The flow of blood and therefore the flow of life can also be disturbed by the buildup of other substances, not just clots, like the fat buildup caused by high-fat diets and high cholesterol. These fatty plaques, also called atherosclerotic plaques, can cause the muscles or walls of the blood vessels to become thick and stiff, leading to poor blood flow or poor circulation. Poor circulation means less oxygen delivery and waste clearance, leading to more damage of the heart and other body tissues. When the blood vessels of the heart are damaged and provide poor oxygenation to the heart, it is known as coronary artery disease.
The problem: too slow (rest) or too fast (movement). The electrical circuitry of the heart is also susceptible to problems, causing the rhythm of the heartbeat to become irregular, also known as an arrhythmia.
The result of heart disharmony can be devastating. When blood flow and oxygen supply are impeded because of blood clots or the buildup of plaques, the heart cells scream for help, as oxygen supply becomes limited and they begin to die (called ischemia). An infarction means the cells have died, and the life force of the heart has now been really compromised. This is what happens when one experiences a “heart attack.”
Red Flags That Tell You to Seek Help
Because of the high prevalence of heart disease, it is important for you to pay attention to any signs or symptoms your heart may be presenting to indicate you need medical attention. Know that your odds of surviving a heart attack improve if you seek attention within the first few hours of experiencing pain. Remember, the point of listing the red flags and warning signs is not to scare you, but to remind you that you have access to medical care that can help you. I also want to stress that learning about signs and symptoms will enable you to describe what it is you are feeling at any particular time, so that others, especially a qualified provider, can better diagnose what is going on and assist you.
For example, my dad has a long-standing history of heart disease. He is also not the best at providing his history and describing his symptoms. He tends to be stoic, says, “I’m fine,” and then pushes himself, so that on a few occasions we have found him on the floor, looking pale and really not so “fine.” After reading him the riot act several times, urging him to tell someone that he wasn’t feeling well and to describe exactly what he was experiencing, my father finally did call me and his doctor one morning. He was able to describe his symptoms, which enabled us to better diagnose and help him, so that he would not end up in the emergency room with another cardiac event.
It really is understandable to want to avoid your symptoms, especially when your fear of what could be going on is so high. Our tendency often is to ignore whatever is wrong and hope it will go away. But as you are learning, it is never a good idea to ignore the body when it is speaking to you, as whispers will eventually become screams, especially when it concerns your heart.
If you are experiencing any of these symptoms, call 911 and take an aspirin (unless you are allergic).
CHEST PAIN: Men are more likely to experience chest pain when having a heart attack than women. Usually, the pain is described as crushing or like “an elephant sitting on one’s chest.” It can also present as a mild pain, more like a pressure in the breastbone, upper back, neck, or jaw, especially for women. The pain may start in the chest and radiate down the arm, to the back, jaw, or neck and may be associated with numbness.
Note that certain types of chest pain are less likely to be of cardiac origin. These include:
Pain that increases with a deep breath or when coughing
Pain that you can pinpoint with a finger
Pain that increases with pressure on the area
Pain that is constant (doesn’t come and go), lasting hours or days
Pain that spreads to your legs
My patient Elisa’s chest pain was so severe that she went to the emergency room. While there, waiting to be evaluated, she called me, and I asked her to describe her symptoms. She complained of an ache under her left breast that had been present constantly for four days and had gotten worse. She complained of shortness of breath with exertion, feeling very fatigued, but without any fever. Her pain was localized in that one spot and did not travel anywhere, but it did get worse when she took a deep breath. Elisa was only twenty-nine years old and had no family history of heart disease. I knew from Elisa’s description that her symptoms were unlikely to be of cardiac origin, but it was good that she was getting evaluated. I suspected she had pneumonia, and a chest X-ray confirmed that.
FATIGUE: Since Elisa’s symptoms were constant and were localized to one spot that she could pinpoint, I knew to look for causes other than heart. Elisa did the right thing by going to get evaluated and not being her own doctor, especially because she was feeling such extreme fatigue, another symptom to watch out for. Women especially are more prone to having fatigue or flulike symptoms without any chest pain when having a cardiac event.
OTHER SYMPTOMS: Nausea or indigestion, the latter of which can be a version of chest pain, may also occur, as well as dizziness, fainting, shortness of breath, drenching sweats, or a sudden change in sleep patterns, like a sudden awakening in the middle of the night. Some people experience a feeling of “impending doom” and unexplained anxiety. Though this may be a panic attack without a cardiac origin, I do recommend seeking medical attention immediately, especially if you have a personal or family history of cardiac problems.
SYMPTOMS THAT GET WORSE OVER TIME: When you experience any or all of these symptoms all of a sudden, you do want to seek attention right away. Often, though, you may experience all of the above symptoms, but to a lesser extent, perhaps over weeks or months. For instance, you may experience chest pain, shortness of breath, or nausea when you are really exerting yourself. Other signs and symptoms that could indicate there is a malfunction with your cardiovascular system include hair loss, erectile dysfunction, irregular heartbeat or palpitations, swollen feet or ankles, a dry or persistent cough, and pain, weakness, or coldness in your arms or legs. Do not put off seeking medical attention, even if the symptoms do not “seem that bad.”
I will guide you to incorporate tools and techniques that can make your heart stronger and healthier, but there is no guarantee that these alone can fix an injured heart. Medications and interventions can get the cardiac system onto a better homeostatic baseline, so that the lifestyle and emotional changes you implement will have a better effect and will also allow you to someday get off the medication. This is good news, as the majority of problems can be prevented and heart harmony can be reinstilled by lifestyle changes and a reduction of risk factors.
Knowing Your Risk Factors
Some risk factors you can do nothing about, like getting older, having a first-degree relative who has heart disease or has had a stroke (before the age of fifty-five for a male relative or sixty-five for a female relative), being a man, being a postmenopausal woman (versus a premenopausal woman), and being of African or Asian descent. Having an autoimmune disease like lupus or rheumatoid arthritis may also put you at increased risk, but since lifestyle changes can offset the activity of inflammation, even this risk factor may be modified.5
These are the risk factors you have the ability to influence:
• A diet high in saturated fat is estimated to cause 31 percent of heart disease worldwide.
• Other conditions, such as high blood pressure, obesity, adult-onset diabetes, and high cholesterol (including high total cholesterol, triglycerides, and low-density lipoprotein, LDL, or low levels of high-density lipoprotein, HDL), increase your risks.
• Lack of physical activity increases your risk by 50 percent.
• Smoking or chewing tobacco increases your risk, especially if you started at a young age or are female.
• Drinking more than two alcoholic drinks a day may damage the heart muscle.
• A chronically stressful life, social isolation, anxiety, and depression increase your risk.6
You can especially address this last risk factor by looking to the medicine of wisdom traditions.
Wisdom Traditions and Heart Harmony
Wisdom traditions share the belief that the heart is the seat of our intelligence and our ability to love, communicate, heal, and maintain balance and harmony. It is believed that the heart works directly with the mind to guide us and our body to use our higher consciousness, sensations, and feelings to manage through the shifts and challenges we experience in our lives.
The heart is said to bring us into “oneness” with all of life, with the love that aligns us to all things and all beings and enables us to find harmony in opposites. When the heart is “open,” we are more easily able to adapt to life’s changes, doing so with optimism and inner tranquility. We can be forceful, yet relaxed, open to both giving and receiving, and able to know when we need to move and when we need to rest.
When the heart is “closed,” wisdom traditions say, communication between the heart and mind are out of balance, so that there is a discrepancy between what we are feeling and what we are thinking. We may find we are more vulnerable to feeling emotional pain, hurt, anger, or envy. We are not in tune with the love and harmony within our own heart, which translates into a lack of harmony and rhythm in our life. As our heart shuts down, we may feel unable to move through life or find ourselves unable to be still. As our heart closes down, we may experience heart pain; mental confusion, as we cannot take in more information; or difficulty breathing, as we cannot fully take in deep breaths.
In all wisdom traditions, the key to a vibrant and healthy life is keeping the heart “open” to love and staying connected to others, one’s spirit or soul, and the wonders or source of the universe, which some refer to as God, the Divine, or the Source. As love fills our hearts, we become stronger in mind and body, as the life force can now flow through our vessels and our hearts, which are open to connect to the infinite possibilities of life. Interestingly, today’s science is finding that love and social bonds help us stay healthy and live longer and that love and deep connections are the way to have a fulfilled life.7
As you learn more about how to POWER up your heart, you therefore want to keep in mind the theme of harmony, asking yourself such questions as:
How well do I both give and receive?
How well do I manage my energy? Do I give myself time to rest, so that I can move forward full force?
How open or closed am I to new ideas, people, or experiences?
Do I trust love?
Do I share my thoughts and ideas with others, or do I tend to keep things to myself?
Do I have a tendency to feel connected or disconnected to others or the world around me?
One day I was in session with a patient, Elaine.
“How do I make the pain go away?” Elaine asked.
“What pain?” I asked.
“The pain I feel in my heart every time my family argues or my children yell at me. I am anxious often, and I get very upset when there are disagreements in the family. The last time it happened, I had severe chest pain and I went to the emergency room. My blood pressure was really high, but there were no EKG changes, and they found no other problems with my heart. They told me it was stress and to follow up with my doctor. I take Ativan for the anxiety when I need to, but it doesn’t make the pain go away completely, and I don’t like to take it because it makes me woozy.”
“I do understand why you would be upset when there are family arguments. But why do you think you also feel so much anxiety? Has anything really bad ever happened to you, your family, or someone you love?”
Elaine thought about the question for a bit and answered, “Now that I think about it, I am not so sure. I don’t like fighting or discordance, but I am not sure why it makes me so anxious, especially when nothing bad has happened. It usually ends with apologies and a big dinner.”
“Why don’t we ask your heart,” I said.
Elaine then closed her eyes, took several deep breaths to clear her mind, and then directed her focus to her heart. She allowed herself to revisit an experience when the family had argued, and she immediately noted a squeezing sensation in her chest. I asked Elaine to ask her heart why it was creating such a sensation and to guide her to a memory that would help her understand.
Then Elaine said, “I am seeing myself at seven years old. My mom had just died from leukemia. Dad couldn’t take care of me on his own, so we moved in with his sister. My dad didn’t know what to do with me, so most of the time he would keep busy at work, and when he was home, he would spoil me with presents. My aunt’s children were jealous, and I guess maybe my aunt resented me. She yelled at me a lot. The other kids yelled at me too. I tried to be a good girl. I really missed my mother. I still do.”
Elaine began to cry. She cried because she had missed out on having an experience of being in a happy family and, most of all, because she lost her mom when she was so young.
“It happened so long ago. I cannot believe I still carry this pain around. I went to therapy for twenty-five years. I thought I had dealt with this story.”
“I am not sure the pain ever fully goes away,” I answered. “Losing someone is painful, especially when you are so young and cannot fully understand why. Perhaps your undeveloped mind associated the pain of losing your mom with a family that fights, so when your family argues, it causes the pain to come back. We cannot know for sure, but we can try to heal the pain from your loss and see what happens. Also, if your life is not filled with other joys, love, or appreciation, especially for yourself, this hurt can take up a lot of space, which can lead to your perception of experiencing a lot of pain with the slightest provocation. When you fill your life with good—love, laughter, friends, beauty, nature, and so on—your heart can expand so that, relatively speaking, the pain in your heart is smaller. In other words, your hurt is not really smaller, but relative to the rest of the heart, it is taking up less space, so you feel it less. The pain doesn’t go away, necessarily; your heart is simply large enough to hold it.”
Over the course of several months, Elaine worked on incorporating more joy, love, and nature in her life. She learned to practice mindfulness, to be able to stay present in the moment with appreciation and grace. She also learned meditation practices that allowed her to release the pain of loss and fill her heart with love and compassion instead. Over time, Elaine discovered that she had the capacity to be more loving and present with people and be able to truly appreciate the gifts in her life. She discovered that taking care of her health was not just about exercise and eating healthy, but also healing her heart.
Elaine learned the meaning of keeping an open heart. She came to notice that when she felt separate, disconnected, and fearful, she would experience tension in her chest that signified that her heart was “closed.” At these times, she noted, her blood pressure would go up too. When she felt joyful, connected, and hopeful, in contrast, she experienced an incredible capacity to breathe more fully and deeply and the sensation that her heart was more “open.” Elaine also found that her blood pressure was always stable during these times.
Wisdom Traditions and Science Merge
If you were to think about the first time your heart was broken, do you also notice a little twinge in your chest? Why is it that your heart still “hurts” when it happened so long ago?
Although you can use reason to overcome a trauma to a certain degree, your emotions and beliefs related to the event may still be so strong that your emotional memory triggers the stress response. That stress response involves an increase in stress hormones and changes in the cardiovascular system. The resulting change—whether it is a contraction of the heart muscles or the blood vessels or a speeding up of the heart—is often palpable.
Interestingly, you don’t always have to be consciously aware of a negative situation or memory for this reaction to occur. Your heart may be able to sense that something is wrong in your environment before your mind registers it. For example, you might find you can feel “tension” in a room without knowing the reason.
Though wisdom traditions have been alluding to the heart’s power to feel and to “know” for thousands of years, scientists today are finding out why this might be true. According to the director of research at the Institute of HeartMath, Rollin McCraty, “The heart generates the largest electromagnetic field in the body. The electrical field as measured in an electrocardiogram (ECG) is about 60 times greater in amplitude than the brain waves recorded in an electroencephalogram (EEG).”8
With its large electromagnetic field, it seems the heart can sense danger before your brain does; the stress response is activated physiologically way before your executive functioning brain might comprehend why. Your heart will also sense when you are safe and feeling loved, which your mind may register as just a sense of ease. For example, you might simply feel uncomfortable around a certain person, though you do not know why; the person seems perfectly nice, and a week earlier you really enjoyed spending time together. Later you find out this individual was extremely anxious about getting a test result.
Why does this happen? How does the heart know how to “pick up the energy” of another person? Modern science is still looking into this query, but what we do know is that your memories, thoughts, beliefs, and emotions affect the internal environment of your body, and this includes your heart. And given that the heart has very complex neural wiring, its electromagnetic field can likely pick up more subtle sensations and vibrational changes, like the change in the beat of music. One theory is that the change or sensation sends a signal to the heart, which then connects that signal with an emotional memory (positive or negative), which results in a physiological response.
What do I mean by emotional memory? Let’s say deep within your memory lies an experience when you were hurt or betrayed in a relationship long ago. You have gone through therapy, and you believe you are completely healed. The problem is that every time you go out on a date, you get palpitations. You may shrug it off to just being nervous about dating, which may be true, but it may also be that you still carry underlying fears associating love with betrayal.
You can’t know until you ask your heart.
WITNESS the Physiology of Your Heart
For starters, you want to notice how your heart responds to positive or negative imagery or thoughts. You want to notice what it feels like when it is “open” and when it is “closed.”
AWARENESS EXERCISE
Close your eyes, and begin with the practice of emptying the mind.
Then bring your awareness to your chest, to your heart, and notice what your chest feels like. As the breath moves in and out, does the chest feel open or closed, relaxed or tight, heavy or light, and if so where?
Simply acknowledge your heart and notice.
Acknowledge that your heart carries all your memories, from the past and the present. Notice.
Introduce yourself, and see if the heart answers back. Open, closed, relaxed, tight, heavy or light? Where? Notice.
What happens with your breath?
Do not rush this exercise. Give yourself time to identify your feelings and bodily sensations accompanying each of these words or images:
Sad
Joyful
Not enough time
Plenty of time
Open
Closed
I am bad
I am good
White sandy beach
Garbage dump
Injustice
Triumph
The face of someone who angers you or someone you dislike
The face of someone you love
Notice what you feel or sense. Notice associated emotions. Does your chest open or close, feel relaxed or tight, heavy or light, and if so, where?
You may note that joyful or positive words or images elicit a relaxed feeling in your chest and a more positive attitude or state of mind. The opposite happens with more negative or upsetting words or examples. For instance, looking at a garbage dump might lead you to feel less enthusiastic about what tomorrow will bring than if you were looking at a sunset.
Which word or image caused you to have the strongest reaction? Why would this be? Ready to find out?
EXAMINE Your Deeper Emotions and Beliefs
GOING DEEPER EXERCISE
Empty your mind as you breathe in deeply and exhale slowly and completely.
Bring your awareness to your chest again.
Notice your breath moving in and out.
Ask your heart to explain to you why it closed or became tight or constricted from one or more of the above words or images.
Perhaps you can ask your heart to show you a story from your past associated with the feeling. Maybe it was a time you felt disappointed, betrayed, or hurt.
Ask the heart to show you the imagery, the words, or the experience associated with this feeling.
Then ask your heart one or more of the following questions:
How does this situation make me feel about being loved or valued?
Did I feel safe to express myself in this situation, or do I feel safe today in ones like it? If not, why not?
Why am I scared to fully open my heart? What may happen? Why am I holding back?
Do I become more rigid in my ways when I feel this way? How do I act toward myself, loving or destructive?
When I feel this way, do I tend to force my opinions on others by being defensive or argumentative, or can I take in other people’s opinions in a relaxed way?
How flexible am I when I feel this way? Am I capable of both giving and receiving, or I do more of one than the other?
What anger or negativity am I still holding on to in my heart and why?
When I feel this way, do I feel more anxious or calm? Do I need to sit still or sleep or keep moving?
Notice what you see, hear, sense or feel. Take your time to allow thoughts and answers to come forward.
When you are ready, pick up your pen and paper and write about your experience, thoughts, and feelings. See if you can uncover the underlying belief behind this memory and what it is you really need. As you write, look for a prominent pattern or story that often appears in your life experiences. Can you accept and be accountable for your role of upholding this story?
RELEASE, RELIEVE, and RESTORE
After you have completed the examination of your heart, you may be ready to release what you have uncovered and choose to work on living with an open heart, as you also incorporate the lifestyle changes and activities that enable you to truly be healthy and happy. The goal is for you to relieve yourself of the stressors and strains, then reward your heart and restore harmony to it.
This means learning to let go of toxins and waste products that include negative emotions, thoughts, and memories; allow in only that which nurtures you. It means understanding the importance of being active, yet also resting, giving and also receiving, and staying open rather than being closed to love and life’s possibilities. By creating harmony in opposites in your life, in other words, you help your heart get healthy.
Letting Go of the Bad, Taking In the Good
You are now ready to examine the growth that came out of the negative thoughts or experiences you uncovered. Elaine, for instance, was able to see what an incredibly loving family she had created in spite of her childhood experience. You want to look at what abilities, positive qualities, or gifts you acquired as a direct or indirect result of a past experience. Here, you may choose to write about your three “Vs”: virtues, values, and victories. Elaine was able to see that she was a strong, kind, and compassionate person who had strong family values and who indeed did create the strong and loving family that she so appreciated.
Now, choose a virtue, value, or victory and then do the following exercise.
Is this story even true?
Is it true that ________ (fill in)?
What are the positive takeaways from this memory?
What is positive about me? What are my virtues, victories, and values?
When you have come up with your three “Vs,” choose one that resonates most deeply and positively with you and do the following:
OPENING THE HEART MEDITATION
Empty your mind, inhaling as you count to three, exhaling as you count to five.
Keep the same rhythm of the breath and focus on your heart.
As you exhale, imagine you are letting go of the negative memory and all the feelings and beliefs that go along with it. Do this for at least five breath cycles.
As you inhale, imagine you are filling your heart with infinite love and compassion that come from the surrounding universe. Do this at for at least five breath cycles.
On the sixth cycle, imagine your heart is free and can now bloom like a flower.
Say these words as often as you wish: “I like the feeling of _________” (fill in your chosen virtue, value, or victory).
Notice how you feel and when or if you want to, write about the experience and your intention to remember to feel this way anytime your specific negative feeling, memory, or sensation arises.
SMOKING: If you smoke, now is the time to stop. It is never too late! I know it is an addiction that is not easy to give up, and I won’t go into the reasons or the venues to do so. Do ask yourself though if you love yourself enough to live life fully and completely without numbing your feelings. Addictions are really habits that started as a way to cope. Perhaps when you instill new and healthy coping tools, you won’t need to smoke. You may want to do the Witnessing or Examining Exercise on the issue of why you smoke, what need it fulfills, and how it makes you feel. You can then use this book to help you find new outlets of relief that enable you feel calm and relaxed—maybe even more so than with nicotine.
OTHER MEDICAL PROBLEMS: If you have high blood pressure or any other forms of heart disease, do see your doctor and take your medications. As you develop better lifestyle habits, including a meditation practice, you may very well be able to get off the medications or at least lower the dosages. Until you have built up your tools though, you want to keep your heart and blood vessels in as much homeostatic balance as possible.
The same goes if you are diabetic. Hemodynamic or blood-sugar instability presents a big stress on the body, which means more stress response reactivity and a higher allostatic load on your heart. It is absolutely possible, in many cases, to work closely with your doctor to wean yourself off medications as you create other outlets of relief that enable your body to be in homeostatic balance.
If you have high cholesterol, you may be able to keep it down with a healthy diet and exercise routine. If you are at high risk for heart disease, please check with your doctor, as medications are recommended to keep your LDL below a certain level.
Finally, studies are now connecting some instances of heart disease with poor dental hygiene.9 Follow healthy dental hygiene practices and follow up with your dentist for regular teeth cleaning.
Regulating Rest and Movement
MOVING YOUR BODY: Your heart needs movement. Exercise helps keep your blood pressure, blood sugar, and cholesterol down, while helping your mood stay up. If you do have heart disease, check with your doctor to see what sort of exercise restrictions you may have. In general, you want to always choose an activity that you enjoy and that you are most likely to do. Your goal is to accomplish about two and a half hours of moderate exercise (you can have a conversation) or seventy-five minutes of vigorous exercise (conversation is not possible) per week. Moderate exercise can include brisk walking for twenty-plus minutes a day. If you do it out in nature, you will likely keep going and not notice that you are tired. If you like running, swimming, cycling, or interval training, you really just need about fifteen minutes a day of such vigorous aerobic activity or twenty-five minutes three times a week.10 I always find that exercise is more likely to happen if you have a buddy, so rally some of your friends to get fit with you, or join a walking, biking, running, dancing, or other group exercise that suits you.
If you are usually a couch potato, start slowly and do something fun. Park your car farther from the store, so that you have to walk more. Turn on the music and dance.
LOVING LIFESTYLE CHOICES: The heart enjoys being nurtured. You can do so by ensuring you give it time to rest. Get adequate sleep, and even consider a regular meditation practice, which will bring your stress response down, along with adrenalin and cortisol levels. Taking breaks throughout the day to walk out in nature, do some deep breathing, or socialize with a friend all a happy heart doth make. You need quiet time in your very busy life to rest and recondition your heart. Remember the cycle of the heart is to get up and go and rest. If you are having a hard time resting, consider getting a massage or some form of relaxing bodywork during which the gentle touch can soothe you into resting.
You may also develop a meditation practice of some sort, as there is increasingly more evidence pointing to the benefits of relaxation techniques for cardiovascular health.11 You can choose to do the above Opening the Heart Meditation as a daily practice.
Eating to Fuel and Perform
There are a multitude of resources for you on bookshelves and online that offer guides to following a nutrition plan that can boost your heart health. As you learned in the previous chapter, you want to work on avoiding foods that can tax your system and increase inflammation. In this section, I want to concentrate on what you want to eat to power your heart. The key is to enjoy yourself, but to also remember that food is the fuel that enables you to perform functions from lifting heavy weights and fighting infection to getting through a stressful day. Try to focus on this notion rather than on food as a way to relieve your stress.
There are definitely food groups that can boost your heart health. The following are the common questions my patients ask and what I tell them (you can visit the NIH website, www.nhlbi.nih.gov, for more information on recipes for a healthy heart12):
What fats are good for my heart?
Fatty acids like omega-3 fatty acids—as I mentioned, found in fatty fish like salmon and tuna and nuts like almonds—and alpha-linolenic acid—found in plant foods like Brussels sprouts, kale, spinach and salad greens, ground flaxseed, and walnuts—help lower inflammation, reduce blood clots, and protect against heart disease and can increase your good cholesterol, or HDL, levels. If you cannot get enough omega-3 in your diet, you can choose to take a supplement, though you want to check with your doctor for the best dosage for you, especially if you are already on a blood thinner.
I heard that nuts and seeds are good for me. Is that true?
Nuts like almonds and walnuts are high in omega-3 fatty acids and also offer phytosterols, minerals (like magnesium), and other vitamins (like vitamins E and C), which can act as antioxidants, protecting your heart cells from oxidative stress damage, as I discussed in the previous chapter.
I know fruits and vegetables are good for my heart, but which ones and why?
Surprise, surprise—dark leafy greens help your heart stay healthy. As you have also learned in the previous chapter, greens provide you with a multitude of vitamins, minerals, and antioxidants (like polyphenols). Spinach, bell peppers, asparagus, and broccoli, for example, are loaded with carotenoids, a heart-protective antioxidant. Vegetables like spinach and asparagus are also a great source for folic acid and B-complex vitamins (like B12 and B6), which can help protect against clots and hardening of the arteries. B3, also called niacin, can help lower your bad cholesterol, or LDL.
Blueberries and many other berries, dark plums, dark grapes (the reason red wine is so good for you!), and apples are a great source of polyphenols, antioxidants that protect blood vessels, lower blood pressure, and lower LDL. Other fruits such as cantaloupe, for instance, give you antioxidants like carotenoids and vitamin C as well as potassium. Potassium is crucial for powering your heart function, as it promotes good muscle contraction and transmission of nerve impulses.
What about grains? Which ones are good for my heart?
A variety of grains offer the needed vitamins, minerals, and antioxidants, like brown rice, which is a great source of B vitamins, or oatmeal, a great source of omega-3 fatty acids and heart-healthy fiber.
Something to keep in mind when you are adding starches to your diet is that you want to choose those that are low on the glycemic index. The glycemic index is a measure of how foods affect your blood-sugar levels. If a food group has a high glycemic index, it means it is absorbed quickly, so that your blood-sugar levels spike, followed by a fast rise in insulin. Higher insulin levels are associated with more inflammation and other diseases, including heart disease. Foods high on the glycemic index include natural sugar, syrups, and fruit juices, not just cookies and chocolate cake.
Foods that are low on the glycemic index, in contrast, are absorbed more slowly and allow for milder release of insulin without the associated inflammatory response. Because some grains can be fairly high on the glycemic index, I generally recommend keeping your daily grain intake to no larger than the palm of your hand and focusing on getting most of your carbohydrates from plants and fruits. Two of my favorite carbohydrate sources are sweet potatoes and yams, which are good sources of carotenoids, vitamins, and fiber.
Learning to Give and Receive, Staying Open and Not Closed
CONNECTING WITH OTHERS: Studies have shown an association between heart disease and a lack of social support or social isolation.13 We certainly know that social support plays an important role in how you react and handle stress, which may be one explanation for why folks do better when they have love and support. A study of forty-six patients who had suffered a severe stroke, for instance, showed that those individuals who had a good social support system scored 65 percent higher on mobility tests and their ability to perform daily tasks six months later. They also improved faster compared to those individuals who had less social support.14
Support comes in many forms. It enables you to feel less alone and overwhelmed and literally gives you the actual help you need. Support can be emotional, physical, mental, spiritual, or informational.
I am guessing many of you are good at offering help or an ear to listen, but not so great at receiving. Well, support has to be a two-way street. Work on receiving from friends or family. Join a group, perhaps a spiritual group or community, where you share like passions. Meet with a therapist or counselor if you want someone to talk to who can be objective. And last but not least, get or borrow a pet. There is nothing like the unconditional love you can get from your animals.
GRATITUDE, COMPASSION, AND GENEROSITY: Acts of gratitude, compassion, and generosity all stem from an open heart, from a mind-set or belief that you have so much already, that you want to give and share. Studies in fact show that individuals who practice gratitude have stronger immune systems, more joy, and more positive emotions and attitudes and feel less lonely.15 Science also shows that generosity, or helping others, buffers stress and lowers mortality.16 It seems also that when you show more compassion, including to yourself, you just might live longer, as stress response reactivity and inflammation are lowered.
It doesn’t take much to be generous or compassionate, and it certainly is quite easy to find snippets of gratitude in your life. It may mean slowing down a bit and taking the time to appreciate what you have, rather than what you don’t. You can commit a random act of generosity—an extra dollar in your tip to the server; an extra minute or more to your colleague who has a problem that needs to be discussed; some room for your child to make a mistake; a smile to a stranger on the street.
Keep a gratitude journal. Every day, write three to five things you feel grateful for. Perhaps you feel lucky that you found a great parking spot. Perhaps you appreciate the beautiful blue sky, that you enjoyed the healthy food you put into your body, and that you were able to spend some time with someone you adore. As you accumulate your list, you may find you can step back and view events in your life with a different eye, perhaps see the blessings in disguise even in challenging situations.
Try waking up every morning ready to savor the day. Tell yourself that you are so looking forward to having another beautiful day! From the minute you open your eyes and begin the activities of your day, savor each moment. Notice beauty. Notice tastes. For instance, perhaps you find yourself feeling frustrated at work. Taking a moment to remember how delicious your breakfast was will counteract the negative emotions and feelings and enable you to maintain a better outlook and perhaps even problem-solve better.
COMPASSION TOWARD YOURSELF: Most of us live in a constant state of comparing ourselves to others, to our own expectations, or to the expectations of others and labeling ourselves as either “good” or “bad.” I encourage you now to throw away all labels and begin to simply appreciate and love yourself as who you are. In other words, practice self-compassion. Self-compassion enables individuals to accept who they are and to view their circumstances as manageable. Catch yourself when you put yourself or someone else down and instead remember you are a human being who is living, learning, and loving every day.
LAUGHTER: In my opinion, there is often no better remedy for maintaining a healthy heart than laughter and the ability to fully enjoy life. The research is inconclusive as to why laughter is so good for you. Some studies have pointed to blood cells becoming less sticky; others, to improvement in blood flow.17 But you know what I say to that? Who cares? Laughter feels good, and it is usually social, so other people are feeling good with you. You can feel your own heart opening just by thinking of laughing. Try it—you might like it.