Cozying up to complementary medicine

As practice stresses escalate, your colleagues turn to techniques that promise peace and calm for themselves — and their patients

By Marcello Palmieri

Complementary and alternative medicine (CAM) is making its way into the lives of many doctors who are searching for ways to cope with stress and improve overall well-being. While the terms are used interchangeably, there is a difference. Complementary medicine is used together with conventional medicine while alternative medicine takes the place of conventional medicine entirely. Not surprisingly, for the time being most physicians are more comfortable with the former than the latter. Here are a few doctors using complementary medicine and what it's done for them.

THE BREATH OF LIFE
"I have stress just like everyone else, but I will look for any method that will effectively deal with it," says Dr Jack Sniderman, who practices GP locum tenens in BC and psychotherapy in Vancouver. Some of the complementary medicine he uses in his own life as well as with patients are acupressure (acupuncture without the needles) and hypnosis. The method he finds particularly useful for dealing with stress, however, is as ordinary as taking deep, long breaths. "When you feel stress coming on, take in a deep breath, just as you would when you come out of an exam," he says. "The most important thing is to hold your breath and focus on the exhalation. You feel your body really relax," he adds.

While it sounds simple enough, many people don't breathe properly, according to Dr James S Gordon, Director of the Centre for Mind/Body Medicine in Washington, DC. He told the Washington Post that few people, other than singers and athletes, are aware that the abdomen should expand when taking in a breath of air. He also noted that by watching a baby breathe, one can see the belly moving up and down, deep and slow. Most of us shift to shallow chest breathing as we get older and this can strain the lungs and heart.

A breathing technique to reduce stress

1. Sit in a comfortable position and keep the spine straight
2. Place the tip of your tongue behind your upper front teeth (this will make exhalation last longer, which helps both mind and body experience the release of tension)
3. Inhale through your nose to a mental count of four
4. Hold your breath to a count of seven
5. Exhale slowly through the mouth to a count of eight (remember to keep the tongue in position)
6. Focus on the count, as it will help your mind from wandering

PROGRESSIVE RELAXATION
"It's like putting out a fire," is how one Montreal psychiatrist describes the way progressive muscle relaxation (PMR) makes him feel. It's the technique he uses most often to cope with stress and to keep ailments at bay. "I virtually never get headaches because I don't allow muscle tension to accumulate," he says. PMR can also help reduce symptoms of anxiety, insomnia and certain kinds of chronic pain. "It's so absolutely essential to well-being and should be part of everyone's basic toolkit," he recommends.

The basic idea is to tighten each group of muscles separately, hold the tension for about five seconds, and then relax it for 30 seconds and enjoy the sense of peace and tranquillity that comes about as the tension is released. Once someone is comfortable doing these exercises for each muscle group, it's possible to combine them all and relax the whole body at the same time. "Once you learn the technique, you can use it remarkably quickly," he says, which makes it an ideal technique for busy physicians since it can be used anytime — anywhere.

Putting PMR to work

1. Sit in a quiet place and loosen any tight clothing.Make your hands into a fist, squeeze firmly and then relax them (remember: use this pattern of tightening and then relaxing for all muscle groups)
2. Bend both arms to the shoulder and tighten the muscles
3. Move on to the forehead and raise the eyebrows
4. Tightly close the eyes
5. Press the lips together and clench your teeth
6. Bring your shoulders up to your ears
7. Press your head backward against the chair
8. For chest muscles, take a deep breath and hold it
9. Tighten the abdominal muscles
10. Tense the thigh muscles by pressing your legs together
11. Point your toes forward
12. Lastly, take a deep breath and stretch

MINDFULNESS MEDITATION
So it's no surprise that breathing properly is a key ingredient to healthy living. Breathing is also an ingredient in such practices as yoga and meditation.

Dr Greg Dubord, Director of the Toronto Centre for Cognitive Therapy, has been practising one form of meditation, called mindfulness meditation, for the past 17 years and also recommends it to his patients.

"After a session of meditation I feel amused," he says, "amused by the depth of my prior nonsense and agitations." In mindfulness meditation, the meditator observes all thoughts, feelings, perceptions and sensations and accepts whatever is happening at the present time. "All sensations are simply noted and observed with dispassionate awareness," remarks Dr Dubord.

He started meditating back in the late 1970s when he was a premed student at UBC. "It seemed to help both my grades and my acne, so I stuck with it," he jokes.

He points out, however, that meditation has its limits. "At the height of my idealism, I tried using it as a substitute for analgesics after I had my wisdom teeth out. I almost got PTSD from the experience." In spite of this, he does credit meditation as a tool that's helped him both personally and professionally. He practises about an hour a day. "It's contributed significantly to my effectiveness as a cognitive therapist," he adds.

PRAYING TO FEEL WELL
Dr Daniel J Benor, a holistic psychiatrist in Medford, New Jersey strongly advocates the use of deep breathing, progressive muscle relaxation and meditation. He also notes that things such as prayer and the less accepted laying on of healing hands can be effective tools. "At first, I was sceptical and thought it was all just nonsense," says Dr Benor. Then, in 1980, he witnessed a healer who used the laying on of hands to shrink a small lump on a man's chest in just a half hour. "It was a cure for my scepticism as well as the young man's lump," says Dr Benor. He also explains that prayer, a thread which unites the world's five largest religions, can do wonders for the human spirit and aid in the healing process. "Doctors often pray for the well-being of their patients — but not for themselves," he suggests.

FIND OUT MORE
More and more physicians are using complementary medicine in their lives and their practices. The Canadian Complementary Medical Association is a network of like-minded physicians, residents and med students. They bring the best in conventional and complementary medicine together in their own practices and also work to educate other physicians and the public about its use. That's not to say that they've abandoned alternative medicine. Rather, members explore all CAMs and try to use what's most appropriate for their patients.

Once banished to the margins of modern medicine, complementary and alternative care, fuelled by consumer demand, is quickly becoming a partner with conventional medicine.

For more about its growing influence, visit www.ccmadoctors.ca, www.canadian-health-network.ca, www.hc-sc.gc.ca/hppb/ healthcare/cahc/index.html, www.wholistichealingresearch.com