Tell us about yourself and what you do at the New Orleans Center for Mind-Body Health.
We help people identify unhealthy mind-body interactions and address those with self-care methods like diaphragmatic breathing, muscle relaxation and mindfulness training. I am a traditional psychiatrist, so I do a fairly traditional diagnostic assessment and evaluate (patients’) difficulties and needs. I prescribe medication if appropriate, but also a combination of psychotherapy and mind-body skills training.
What are mind-body skills?
It is a broad term which encompasses methods of using the mind to manage the body’s unhealthy stress and emotional dysregulation. Managing our stress with mind-body skills, exercise, yoga or just healthy time off can give us a greater ability to step back and make executive decisions based on clearer, more discriminatory information. Our programs include training in diaphragmatic breath, progressive muscle relaxation and mindfulness — a method of paying attention to thoughts, feelings and sensations in a way that promotes observation and reflection as opposed to repetitious reactive behaviors, relationships or interpersonal interactions. So there are two main goals: teaching people how to utilize their minds to shift out of the stress circuit and teaching them mindfulness.
What is the stress circuit?
Our autonomic nervous system has two main components: the sympathetic nervous system, which has to do with our fight-or-flight stress response, and the parasympathetic nervous system, which has to do with our relaxation response. In our culture, we spend way too much time in the sympathetic nervous system and the stress circuitry.
What effect does this stress have on the body?
When we are stressed, it affects not only our mental health, but our physical health, especially if we are under persistent stress or are having difficulty regulating that. The mind and the body are always communicating. For example, Dr. Edmund Jacobson, a doctor in the early 1900s, found that there is a neuromuscular connection between our muscles and brain. When the brain perceives tension in the body, it interprets the tension as meaning there is a threat in the environment and that it needs to rev up the stress response.
Why is it so difficult to relax, even when we know it is the best thing for us?
Our brain is built by evolution to react, not to reflect. We are bringing the past into the present all the time and reacting to present situations based on past experience that doesn’t apply to the present. Our ability to stand back and reflect is evolutionarily new, and those circuits are very tenuous and fragile. It is difficult not to get pulled into those reactions if our self-preservational brain feels there is something threatening about the situation.
What kind of effects does chronic stress have on our health?
The stress response increases cortisol, and chronic cortisol can cause immuno suppression. With immuno suppression, people are more prone to colds, viruses and other illnesses. It can cause a person to deposit more fat around the middle waist and organs and break down more muscle and bone, which can increase problems such as osteoporosis. People can also have increased adrenaline, which revs up the fight-or-flight system and promotes immune factors called cytokines, which can increase risks of a variety of illnesses. Cytokines are also released when we have the flu, so if stress increases their presence, we can feel burnt out and foggy, just like if you had a low-level flu that went on forever.
How does exercise benefit our minds as well as our bodies?
Exercise has the great benefit of decreasing stress factors and promoting a number of neurotransmitters that help diminish these long-term problems. The recommendation is to exercise 30 minutes a day and watch one’s nutrition. Yoga is a wonderful way of doing not only good exercise, but since it is focused on an attunement to the body, it is a type of meditation. Some people do better with a movement meditation like yoga, because they don’t like to sit still. Incorporating a way of paying attention to their thoughts, feelings and sensations combined with movement is something they find much more attractive and fruitful.
What changes do you see in patients who have been paying attention to breathwork, muscle relaxation and exercise?
We become more observant, less apt to live in the automatic, reactive way. We live in a more reflective way, which helps us make better decisions and judgments for ourselves. There is evidence from functional MRIs that shows how the front part of the brain is activated with this practice of paying attention and doing mind-body skills. This is the part of the brain thought to promote a higher ordered sense of self regulation and executive function. We are all coping with certain levels of stress and certain ways the brain has been encoded and developed. It takes work and constant attention to what is going on to be able to autonomously and independently regulate oneself. But with that comes a sense of internal confidence, a sense that “I have tools to manage my internal world and stress levels, and I am not just dependent on medications to regulate myself.” Being able to step back and not get pulled into those internal forces and motivations is maximized by the teaching of mindfulness. This is a long-term proposition of constantly learning to be more reflective.