As is true in all professions, we chiropractors become accustomed to a particular way of seeing things and doing things based on what we see and what we do, day in and day out. The positive side of this patterning is that we gain real expertise in the areas where we specialize. But our finely-tuned emphasis on the physical can lead us to assume that physical symptoms have purely physical causes, and that's only part of the truth.

Mind Influences Body, Body Influences Mind

Since Sigmund Freud first proposed the concept of psychosomatic illness at the dawn of the 20th century, the idea that mental and emotional problems can cause pain and other physical ailments has become widely accepted. The groundbreaking work of Hans Selye refined and expanded our understanding of the ways that stress impacts health. Selye called his theory the General Adaptation Syndrome and, from the 1930's to the 1970's, he developed an impressive body of research clearly demonstrating that stress leads to a cascade of damaging effects in animals and humans.

We all understand that a troubled mind can cause adverse effects in the body. Conversely, pain and other aspects of physical illness can be emotionally upsetting, as most of us have experienced first-hand. Mind and body are inextricably linked together. So how might a chiropractor use this knowledge to add to the potentially balancing and de-stressing effects of hands-on chiropractic care, which can play a role in the treatment of some mind-body problems but rarely constitute the entire solution?

Reaching Out Gently, Without Judging

I faced this question often in 26 years of full-time practice as a chiropractor, because I learned early from my patients that emotional unease or distress is a frequent companion to physical pain. There are actions a chiropractor can take to address these concerns. To begin with, I would suggest that a chiropractor's case history should include (as we do at the Cleveland Chiropractic College clinics) at least one or two questions about the patient's emotional status, including some variation on, "Do you feel upset about being in this much pain?"

This should be discussed gently and non-judgmentally, so that no patient interprets the question to mean that we are implying, "It's all in your head." If despite our best efforts, the patient does interpret it that way, it's important to have an effective response ready. There are many possibilities, but my own approach is usually to say something along these lines: "Mind and body are not separate. I believe that all physical ailments, including my own, have an emotional component." To me, the "including my own" phrase in that answer is central, because it indicates to the patient that I, the doctor, do not perceive myself to be up on a pedestal wielding the lash of harsh judgment. Instead, I'm sitting across the desk as a respectful equal, seeking to be of help to someone whose suffering I recognize and toward whom I feel genuine sympathy.

Forging this heart-to-heart connection is both meaningful and satisfying. For some patients, it opens the door to sharing more of themselves. Sometimes, merely lending a sympathetic ear is all that is needed, especially with patients who are lonely and may speak with few, if any, other people on a typical day. In some cases, if the psychological component of the ailment seems primary or if the patient appears to be in a serious emotional crisis, I would certainly make a referral to a psychological professional (psychiatrist, psychologist, or clinical social worker) or, in certain cases, to a pastoral counselor. As a chiropractor, I'm not expected to be a psychotherapist. As a human being and a health professional, I certainly can certainly listen attentively and offer calming, supportive words.

Relaxation Response and Other Calming Methods

I had been practicing meditation for several years by the time I became a chiropractor. As someone who grew up in New York City and absorbed its fast-paced rhythms, I benefited greatly from having a daily practice in which I learned to sit still and enter a calm state. Having seen the positive effects of this practice in my own life, I shared it with patients when I felt it would be helpful.

In a society as diverse as the United States, it’s essential to use a method that is appropriate and acceptable for patients of all backgrounds. Because many meditation methods grew out of religious and spiritual traditions, I consider it essential to use an approach that is not specifically Buddhist, Hindu, Muslim, Jewish or Christian. The last thing a stressed-out patient needs is to be pressured by his or her doctor to practice a method that seems, or is, contrary to his or her faith tradition.

Fortunately, thanks to the work of pioneers like Drs. Herbert Benson and James Gordon, a non-ideological, non-sectarian method exists, in the form of the Relaxation Response. As Dr. Benson notes, there is not a single set of directions for how to elicit the relaxation response. The point is to use some method that gets you to the desired state.

Here’s the way I’ve described one good method to countless patients over the years, adapted from what I read years ago in Dr. Benson’s landmark book, The Relaxation Response.

• Sit in a comfortable position, eyes closed, with your back fairly straight but not rigid. If you’re sitting in a chair, your feet should be flat on the floor. It’s also fine to sit cross-legged.

• Relax your body. You might start by relaxing your feet and gradually working your way up to your head.

• Breathe comfortably (don’t try to breathe deeply or quickly) for half a minute or so to get into a comfortable rhythm.

• Say a word or phrase silently to yourself several times. In Benson’s first studies at Harvard, they used the word “One.” If something else feels right to you, use that, but be sure to keep it brief. A word or a phrase is the right length, not a paragraph.

• After saying it silently several times, stop saying it, and “enter the silence.” Continue for 10-20 minutes. At certain points, you will realize that your mind has wandered off and, although you planned to be meditating, your mind is immersed in internal chatter about what to cook for dinner, what a co-worker did to you yesterday, worries about your children, etc. When this happens, it does not mean you have failed at meditation. It means you should take this realization (whether it comes after 10 seconds of internal chatter, or 10 minutes) as your cue to say “One” again once or twice and re-enter the silence.

• Continue for 10 to 20 minutes. It’s all right to open your eyes to check the time, but don’t use an alarm. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes open. Wait a few minutes before standing up unless something urgent requires it.

• Your success at this meditative approach is measured by your willingness to sit still in this manner on a daily (or close to daily) basis. It is not based on your achieving a “lake without ripples” state or being immersed in golden light or hearing choirs of angels. If that happens, fine. But it’s not the goal. What we’re after may be less ambitious, but it’s much more achievable.

Keep Expectations Realistic

This point bears repeating, because I have been told by many, many people over the years when I’ve given talks on meditation and the Relaxation Response that they tried this out in the past, but failed because they couldn’t attain a state without thought. Please understand that I’ve been doing this for more than 35 years and I don’t achieve that state except intermittently. Perhaps someone high in the Himalayas can do it (and perhaps not), but I don’t think you or I should set that as our goal.

Finally, like so many other natural health care methods, success in mind-body self-care methods like this one comes down to one key point. These methods only work if you actually use them! Come on in, the water’s fine.

Daniel Redwood, DC, is Editor-in-Chief of Health Insights Today.