Physician De-Stress Thyself

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The regular Wednesday lunchtime training at Allegheny General Hospital is designed to keep the staff informed of the latest developments on a wide variety of medical issues. The auditorium was nearly full on a recent Wednesday for a talk by Dr. Eva Selhub, who spoke passionately about her story of stress survival, yet clinically in terminology clear to doctors, on the effects of mental and emotional stress on the physical body. She also described some simple, easy, non-invasive techniques for how to deal with it.

Although beepers chirped regularly, there was not a whisper in the room­—the medical professionals were riveted to her story. If it’s one thing doctors know about first-hand, it’s stress, and that she might have an effective way to deal with it had their full attention.

Dr. Selhub is the former Medical Director of the Benson Henry Mind Body Institute in Boston. The institute was founded by Harvard Medical School cardiologist Herb Benson, whose revolutionary book The Relaxation Response first introduced western doctors to the idea that there might actually be some sort of connection between the mind and the body.

“Herb Benson came up with the term The Relaxation Response back in 1969. He studied individuals who were meditating, noticing that their physiology changed. He really bridged the gap into the scientific community.”

Selhub, author of The Love Response, represents the next generation of mind-body medicine and embodies just how small that gap has become. When reminded that her online bio describes her “highly-developed intuitive skills” she giggles, and is quick to point out the work of her mentor. “Dr. Benson just did a study with our cardiac group. They looked at how mind-body programs actually improved spirituality in cardiac patients. The whole notion that they are studying spirituality is interesting. People come up to me all the time when I lecture in medical communities and tell me how brave I am to be talking about love, and I just find that hysterical.”

Selhub’s presentation is a follow up to training that Benson’s Institute did with AGH’s Integrated Medicine Program, according to Dr. Betsy Blazek-O’Neill, the Medical Director. Twenty AGH staff did two days of training in October and two days in March, and have since been using mind-body techniques with their patients.

Although they do meet with some resistance from the staff, Blazek-O’Neill says, “The environment here has always been fairly accepting of what we’re doing, which is really good. Even if they’re a little skeptical going in, they’re at least willing to learn more about it.”

“We have Reiki volunteers that go out into the hospital. Doctors and nurses initially had no idea what Reiki was, didn’t understand what it was about, thought it was a little fringey, but when they noticed it calmed the patients down and they used the call light less often, they were sort of interested in what that was all about.”

Even though today there is solid science for many mind-body techniques, therapies, modalities and practices, there are several major obstacles to their acceptance and use. In the past there was little science, many aren’t taught in medical school, and health insurance companies won’t reimburse for most of them. Some, like a two-minute visualization, are even difficult to describe.

According to Selhub, the internet and well informed patients are forcing change. “The patients are coming in wanting things, and at some point you gotta pay attention. They are taking a million different herbs, you gotta know what’s going on. If you want the patients to respect you and to come back, you have to change your ways. It’s the elephant in the room that you can’t ignore.”

Another factor is the suffering of doctors. Those that seek traditional forms of therapy for stress and anxiety are just as disappointed in their effectiveness as their patients. “They themselves have had to try something different, and once you’ve had that personal experience, and it’s a good one, you want everyone else to have it.”

Selhub contends that one of largest obstacles to acceptance of any new ideas may be the incredible stress that doctors themselves are under. “It’s a huge one,” she says. “The need to see more patients in a shorter period of time to pay their overhead… The money issue is really big. The fear of being sued is really big. Plus they are often up all night on-call.”

“I remember being a primary care doctor and having to see 30 patients a day. Someone would come in with a list of questions and I would freak out. I had ten minutes and they had a list! I would have panic attacks between patients.”

She describes how the blood flow to the brain changes when we are under stress. The lower “lizard” brain, which deals with fight or flight issues get extra blood, and the pre-frontal cortex gets less. “That’s the cognitive processing, intellectual reasoning—higher thinking just gets shut down because it’s impractical.” Obviously, medical staff without functional pre-fontal cortexes cannot be a good thing.

At AGH, one solution is to send nurse and mind-body practitioner Laura Crooks around to practice these new techniques with fellow staff. “My role is to teach the staff, then to support the staff that had the Harvard training as they roll it out to their staff and their patients,” she says. “What’s worked best is if I just show up at different stations and ask, ‘Is this a good time for a two-minute stress reduction?’ They started out saying ‘This can’t work. There’s no way.’ Now they know what I do, so when I come in I hear, ‘The stress lady is here! Everyone come on out that wants to do it!’”

To conclude her lunchtime training at AGH, Selhub did one of those two-minute visualizations. She had everyone close their eyes and imagine a stressful situation, and feel the physical changes in their body, the increased pulse and breathing, the tightness in the chest or belly. Then she had them imagine being in the sun, being warmed by the rays, and being filled with golden unconditional love and shielded by grace, going on in some detail about the luxurious loving rays. “There’s nowhere you have to be, there’s nothing you have to do.” They honored their feelings. They breathed deeply. They opened their eyes transformed. “Feel the difference? That’s mind-body medicine.”