New PBS Dates!

November 24, 2009

I’m pleased to announce that my PBS special based on Unstuck: Your Guide to the Seven-Stage Journey Out of Depression has been picked up on so many stations, that we had to make a new calendar available! (I announced in my last post that the dates were in my web calendar here.)

I’m so excited for you to see the great show the crew at PBS put together, and for you to learn the basic biology of stress and its effect on your body and mind, and I hope you get some wonderful relief (which you and/or your family probably need, right now) through the simple mind-body techniques which I will teach you on the air.

SO–please note, the list of my PBS “Unstuck” Special dates on the calendar here is not complete.  Find a more complete list here in PDF form, and now there’s also a partial list available at the KPBS website.

More dates are being announced every day, so check your local listings for the most up-to-date information, and support your local PBS station this year for all their great programming!

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Prison Transformations Letter and PBS Unstuck!

November 18, 2009

Hello Friends,

Here’s a letter to the editor published in the New York Times:

NYT logo

LETTER

Prison Transformations

To the Editor:

Re “Fellow Inmates Ease Pain of Dying in Jail, and Glimpse New Life” (“Months to Live” series, front page, Oct. 18):

What a tender, important story. Prisoners who commit generous acts toward dying fellow inmates awaken to their own capacity for love and, in the process, come to feel regret and compassion for those they have harmed.

I have seen this again and again in groups my colleagues and I lead overseas for war-traumatized children and adults and here at home for American troops who have been maimed and bereaved by combat. Fantasies of revenge dissolve, knots of resentment loosen.

These inmates’ stories tell us that we must make such opportunities for change available to prisoners whom we have abandoned as irredeemable. The lessons these transformations teach us are priceless.

James S. Gordon
Washington, Oct. 20, 2009

The writer is a psychiatrist and the founder and director of the Center for Mind-Body Medicine.

Also, don’t forget that my PBS fundraising special based on Unstuck: Your Guide to the Seven-Stage Journey Out of Depression will be airing nationally at the end of the month!PBS UnstuckSpecial

Take a look at my calendar (right column) to see if your local station will be carrying it. More dates & stations will be added. We’ll get you more information soon! (If you’re on our mailing lists, it will be delivered to your inbox–signup box is also in the right column.)

In the meantime, here’s the website, and here’s a short trailer via Youtube.

We hope you’ll tune in and support your local Public Broadcasting Station and all their wonderful programming by calling in and pledging during your local run.

Jim

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Stress and the Economy: My Washington Post Article

September 29, 2009

Dear readers,

My piece, “Some Simple Steps for the Stressed-Out: Psychiatrist Offers Simple Steps for Coping with Uncertainty,” on dealing with stress from the economic downturn, appeared on the front page of the Washington Post Health Section today.

A middle-aged, working-class woman recently came to my medical office complaining that her back had “seized up.” Her husband had lost both his jobs and was feeling quite disheartened; not long after, her blood pressure had “jumped though the ceiling” and she began sleeping poorly.

Another patient came to see me suffering from crippling anxiety attacks. He had lost the better part of his considerable fortune in the economic collapse. Now he was waking in the middle of each night feeling his chest crushed, unable to breathe, half fearing and half wishing he would die.

I have been practicing psychiatry for 40 years, but I’ve never seen this much stress and worry about economic well-being and the future. There is a sense that the ground is no longer solid, that a system we all thought would sustain us no longer works as we were told it would. In the past, when patients reported job-related stress, it was from unfulfilling work and the anxiety of making choices. “Should I stay in this job that I can’t stand and keep feeling so unhappy?” they would say. Now, I hear about unmeetable mortgages, months without work, fears of ending life in a low-paying, entry-level job. “What went wrong?” my patients say. “What could I have done?” “How can I manage?”

In this uncertain time, symptoms of chronic illnesses — hypertension, back pain, diabetes — that were controlled or dormant are erupting. Low-level depression, whose hallmarks are feelings of helplessness and hopelessness, is endemic.

Large numbers of people across the country are trying to quiet their apprehension with drugs or drink, or have turned to antidepressants, anti-anxiety medications and sleeping pills. But after decades working not only in Washington but also with war-traumatized populations overseas, I’ve found there are simple strategies for helping people cope that are easy to learn, practice at home and, in these stressful times, free.

1.Begin a simple meditation practice. Loss — of jobs or economic security, as well as of a beloved person — is perhaps the greatest and most common of stressors, and the most frequent cause of anxiety and depression. Slow, deep breathing — in through the nose, out through the mouth, with the belly relaxed and soft, and the eyes closed — is a sure “evidence-based” antidote to the stress response that uncertainty provokes. Practicing this “soft belly” technique several times a day for several minutes each time quiets the “fight-or-flight” response that makes people anxious and agitated, and brings us what cardiologist Herbert Benson famously called “the relaxation response.” Financial advisers, child-care workers and soldiers back from a second tour in Iraq with whom I’ve worked have all found, in this simple practice, a source of calm.

2.Move your body. With the possible exception of talking with a sympathetic, skilled human being, physical exercise may be the single best therapy for depression. It’s very good for anxiety as well. Exercise has been shown in animal studies to increase cells in the hippocampus, a region of the brain concerned with memory and emotion, which can be depleted by significant psychological trauma (and financial stress is one of the most significant traumas) or chronic depression. Exercise increases mood-enhancing neurotransmitters in our brains, and decreases the levels of stress hormones that exacerbate chronic illness.

It may not be easy to get moving when you’re feeling defeated, but every step you take, literally as well as figuratively, will encourage you to take the next one. Make sure you do something physical that you enjoy or once did enjoy. Aerobics or yoga classes may feel overwhelming or too expensive. Don’t worry: Dancing at home by yourself works just as well, and so does walking. Exercise is often the first item on my prescription pad.

3.Reach out to others. Human connection — to family, friends, co-workers in the same boat — is an antidote to the sense of aimlessness and isolation that may come from job loss or unexpected economic insecurity. Social connection also helps prevent the chronic illness that can often follow prolonged stress. I see the healing power of group membership every day in mind-body skills groups that colleagues and I organize, when a group member, demoralized and humiliated by job loss, realizes he or she is not the only one. Acknowledging and sharing (but not indulging) this sense of grief and pain is a remarkable source of strength for many people.

4.Find someone who will listen and help you take a realistic look at your situation. When the middle-aged woman with the “seized-up” back came to see me, we discussed her finances as well as her feelings. Although her husband had lost his jobs, her own job, in the health-care industry, was still secure. She and her husband would have to give up some of the “little luxuries” to which they’d been accustomed, but it was clear they could still manage. She needed to relax (using the soft-belly technique), recognize what she could and couldn’t do, give her husband a fair share of the household chores while he looked for another job, and generally unburden her mind, body and spirit. This simple exploratory conversation — and a subsequent heart-to-heart with her husband — allowed her to turn aside the cascade of anxious emotions. Her body began to repair itself.

5.Let your imagination help you find healing — and new meaning and purpose. The wealthy man who came to see me last winter paralyzed by anxiety attacks after losing much of his fortune was able to put his own trauma in perspective by using his imagination.

Though he still was, by most standards, wealthy, his sense of himself as a wise, sure-footed investor had been shattered. He did soft belly breathing to relax and began to cut out and copy pictures from magazines that seemed to him somehow hopeful. He spent days, he told me, copying a photo of a man his age, a grandfather apparently, standing with his arm around a young boy on the verge of the hole where the World Trade Center had been. “The tragedy in the picture is so much greater than my own,” he said, “and I realized that what’s really important is the connection between this man and boy, the hope for the future. I drew it, and I really started looking for this connection in my own life — a connection with meaning now, not money.”

Other patients find relief and assistance from imagining themselves in a safe place and consulting their inner “wise guide” to help them find peace, direction and meaning. This may seem kind of strange at first, but it’s an ancient process used in many indigenous cultures and is actually pretty easy.

First, after breathing deeply and relaxing, imagine someplace safe and comfortable, one you know or one that just arises at the moment in your imagination. As you sit there, you allow your “guide” to appear. Accept whatever image appears — a wise old man or woman, a relative, a figure from scripture or literature, or even an animal. Mentally introduce yourself, and ask this guide a question about what’s troubling you, and then “listen” to the response that comes into your mind. Let the dialogue with you and this guide continue. Often helpful guidance will emerge from your own intuitive understanding.

6.Speak and act on your own behalf. Sometimes this produces rapid and even material benefits: One patient, a financial analyst, talked to her colleague about impending cutbacks; they forestalled a layoff by offering their supervisor a job-share alternative. Often speaking up for yourself produces valuable information and greater peace of mind and clarity: An anxious nanny finally asked her employer, who was herself experiencing a significant decrease in income, if her own job was secure and discovered it was; an IT consultant, asking his boss for a straightforward response, discovered his job was likely to be eliminated and began the search for another job, early, unsurprised and still employed.

There are two common denominators to these six strategies for dealing with and healing from financial setbacks and the unnerving feeling that the ground has shifted. All of them remind us, in times when the economy has made us feel powerless, that there are things we can do to help ourselves. And none of them costs money.

You can read the original article here.

If you like what you read, please make a comment; it’s always great to hear from you here, but it also helps if you leave one on the Washington Post article so that they know you like reading articles with a focus on prevention, wellness, and self-care. You can either do this through their website form (if you login) or by emailing health@washpost.com.  (I’m really enjoying the comments that are already there.) And for those of you who participate in social bookmarking, I also appreciate submissions to Digg, Deli.cio.us, Reddit, and other bookmarking sites.

Thanks for reading, and I hope the techniques in the article will be useful to you and to everyone in these difficult times.

Jim

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A Better Litmus Test for Healthcare Reform

July 21, 2009

David Leonhardt’s “prostate cancer test” (The New York Times, July 8, 2009) is a good but incomplete one for healthcare reform.

In addition to removing financial incentives for high tech intervention, we need to educate clinicians in the impartial, critical analysis of all therapeutic options, and in supporting their patients as they act on the choices they make. For 10 years, The Center for Mind-Body Medicine has trained health professionals and patient advocates to do precisely this, as “CancerGuides®.”

We need as well to realize that expensive, Draconian treatment and “watchful waiting” are not our only choices. There is, as Dean Ornish is showing with peer-reviewed studies on prostate cancer - and a number of us are doing with heart disease, diabetes, chronic pain, depression and post traumatic stress disorder – a far more promising third way. It is grounded in techniques of self-care – dietary modification, physical exercise, and mind-body approaches like meditation and yoga – and in group education and support.

This approach holds great promise for treating and preventing chronic illness of all kinds and for saving large sums of money. It should be central to healthcare reform.

A shortened version of this was published in the New York Times online Letters section on July 21, 2009.

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Finding Freedom Under Siege

July 7, 2009

I just returned from another trip to Israel and Gaza to visit our programs there and to plan for the future. I’ll tell you about what happened sometime soon. Right now, I wanted to share with you some testimonials from health and mental health professionals who participated in our most recent professional training in Gaza (March 7-11, 2009). It was, as you’ll see, an extraordinary five-day experience. Jamil Abdel-Atti and his Palestinian team gave just about all the lectures (I filled in some) and led all the small groups. Amy Shinal, our CMBM clinical director, and Afrim Blyta and Yusuf Ulaj, Kosovo psychiatrists and dear brothers with whom I’ve worked for ten years and I provided consultation and supervision; and Dan Sterenchuk and Lee-Ann Gallarano, from our DC office, offered invaluable administrative support. But the training and the beautiful spirit came with our wonderful Gaza team.

Here, then, is what some of our participants had to say:

The information, the relaxation techniques, meditation, and deep breathing. I deeply discovered myself and how to take care of myself. I discovered my neglected body and promised to be taken care of. I forgave my friends and relatives I have neglected and lived far from. Spirituality, I had neglected that part for so long, but realize how important it is for my healing. Grateful for the ability to apply these new techniques in my work. I met new friends. The family tree gave me a very good space to think of my relationships that I’ve ignored.
• Ensherah Zqoot
Gaza for Psychological Health Program
————————————————————————————————————

First, I want to express my feelings. I’m happy and feel like I own the world. The training was wonderful and excellent. I felt changes in my physical, psychological and mental status. The techniques were great and worth teaching and sharing in such a training. For the first time I feel involved in a training for myself. I feel safe and comfortable with the team and the facilitator Jamil, who shared his feelings with us. I want to thank him but can’t find words to express my gratitude. I won’t forget the efforts of everyone who participated in this training. I just want to say I’m truly happy.
• Jabr Hussien Theibet
————————————————————————————————————

I benefitted a lot from this training. I debriefed lots of feelings and emotions. I truly thank the mind-body medicine team especially Dr. Jim and Jamil and the rest of the faculty. I hope I will be involved in the advanced training so I can help others like you helped me.
 Mohd Abu Omirah
Psychological Support Association
————————————————————————————————————

I was asked by my professor in the university to participate in this training and I didn’t know anything about it. I felt sad and angry during and after the war, and I was furious about everything. Felt insecure and that all my dreams and rights have been violated on the beach of Gaza. I was thinking sometimes why live? And why continue living as long as we’re continually exposed to those violations? In the five days of this training my life has changes completely. I felt dreams could come true and might will not last long cause day is coming soon. I felt I was born again, like a new person. I felt like a loving human being, full of happiness and hope for the Gaza children. I have many things to say and deep happiness inside but I didn’t want to talk much and bore you. In the last moments I had in room 402 that I will never forget for I had sad and happy moments. I want to thank Mr. Ahmed Theibet and the small family I lived with for 5 days and for Jim, Jamil and the rest of the faculty. Thank you all.
 Anonymous Psychologist
————————————————————————————————————
This training provided me with the following:
1. To control my feelings when I face external stimuli
2. How to respond in a rational way and wisdom in the face of acute and difficult situations.
3. My wish that we implement this program with schools’ teachers and guidance and counseling staff at the Ministry of Education to enable them to deal with students and how to face difficult problems.
 Abeer Fathi Shareef
Supervisor
————————————————————————————————————

Thanks to Jamil and his incredible team on the fabulous training. Also thanks to Dr. Jim and his team. These techniques are consistent with our Palestinian and Islamic culture and this is the secret beyond the programs success.
 Fadel Shath
Gaza Mental Health Center
————————————————————————————————————

Training was very enjoyable in terms of changing the track of our lives and jumped with it that big leap. Therefore I have decided to change my life and to reshape my issues. I felt that the training was extremely individualized and it was directed for us as professionals, where always we are asked to care for others and in a very few occasions somebody remembered us and worked for us rather than the patients cases and clients. Thanks a lot for all of those who were behind the program.
 Tawfig Abed A Hadi
PCRP
————————————————————————————————————

This course made us realize that our hearts are like Jim’s, very beautiful and valuable. By awakening all the shine that it contains you had awakened our souls which was about to disappear in the sea of torture. We have lived moments that could be the road to the shining future.
 Sada Ghabin
Head of Guidance and Counseling in Ministry of Education

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In the Science Times

May 26, 2009

This letter of mine appeared in The New York Times yesterday (in somewhat shortened form), under the title, “Alternatives to New Drugs.”

To the Editor of The Science Times:

Richard Friedman (“New Drugs Have Allure, Not Track Record,” May 19, 2009) is appropriately troubled by the loss of a “larger context” by physicians who prescribe newer, aggressively marketed drugs preferentially to older, less expensive but more reliable ones. His own therapeutic context is, however, far too narrow.

In evaluating treatments for mood disorders, psychiatrists (and the comparative effectiveness studies proposed by the Obama Administration) must enlarge their perspective well beyond drug therapies. My own work over the last forty years, and my reading of the “evidence-based” scientific literature, strongly suggest that an integrative, non-pharmacological approach based on self-awareness and self-care is in many cases significantly superior to drug treatment.

This kind of integrative approach, which may include meditation, physical exercise, dietary modification and supplements, and psychotherapy has been shown to enhance biological as well as psychological functioning—decreasing stress hormones, shifting electrical patterns to portions of the brain associated with optimism, and improving neurotransmitter levels along with mood—without the negative side effects that often accompany drugs. Moreover, such an approach, carefully individualized to meet the needs of each anxious, depressed, and troubled person, significantly enhances the damaged self-esteem of patients who, using it, experience the satisfaction of helping themselves.

-James S. Gordon, M.D.

Dr. Gordon, a psychiatrist, is the author of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression.

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When Depression is Treated as a Disease

May 15, 2009

Memoirs of depression like Daphne Merkin’s in The Sunday Times (May 10, 2009), and for that matter like William Styron’s Darkness Visible, make me sad. Of course I feel sadness for the writers’ dense and burdened suffering, set off so strikingly against their lucid, often spritely, prose. But more important, and far more troubling, I feel sad for the inadequacy of the therapeutic approaches they use, for the lack of understanding their suffering yields them, and, especially, for the fact that inadequate approaches and limited understanding are offered to readers as “state of the art.”

Daphne Merkin and her doctors seem to have concluded that depression is a disease characterized by inadequacies in brain chemistry and best treated by drugs that raise the levels of neurotransmitters like serotonin and/or norepinephrine. In fact, the evidence that depression is a disease is mixed at best, and the weight of the research evidence-negative studies on antidepressant drugs have notoriously been unpublished-suggests that antidepressants are little, if any, better than simple placebos.

What is absent from Merkin’s account, and, most sadly, from her experience, is an effort to address the fundamental biological, psychological and social processes that may precipitate depression and contribute to its persistence: the severely impaired response to stress that may indeed be the consequence of the kind of prolonged early life deprivation and trauma Merkin describes; nutritional deficiencies (apparently untested in Merkin’s case) that can cause or contribute even to the most severe depression; and the need for the healing power of sustained and sustaining support and intimacy that may have been absent in early life.

Nor do her therapists suggest other powerful, non-pharmacological modalities that are proving effective in significantly improving mood; for example, exercise, which is at least as effective as antidepressant drugs (it appears among other benefits to stimulate neuron growth in areas of the brain where cells have been destroyed by chronic stress and depression); and meditation which enlarges our perspective on the role of suffering in our lives and shifts brain activity from cortical areas connected with pessimism and depression to those associated with happiness and optimism.

Finally, the saddest thing about Merkin’s account is the passive role she assumed, one which it appears was acquiesced in, if not encouraged, by her therapists. “Do what we say; take the pills we tell you to,” they seemed to have said, “and all will be well.” In fact, therapeutic interventions in which we actively participate are doubly powerful. They have the kinds of inherent benefits I suggested above. Equally important, acting on our own behalf, working in concert with physicians and therapists who value our efforts, we overcome the helplessness and hopelessness that are the hallmarks of depression. Moving forward, as Merkin finally and unexpectedly does, we discover the possibility of change, to see, perhaps for the first time, light in the darkness which had seemed to surround us.

Warmly,

Jim

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“Unstuck” E-book release!

April 17, 2009

Dear friends,

I have some exciting news—thanks to numerous requests, my latest book, Unstuck: Your Guide to the Seven-Stage Journey Out of Depression is being released as an e-book! In my publisher’s own words:

your e-book will be with retailers tomorrow; it should be on sale within 48 hours on Amazon and by the end of next week everywhere.”

“Unstuck” is on Kindle at Amazon.com here (or will be soon).

A warm thank you to everyone who helped by requesting this format. I hope this additional release will allow me, through Unstuck, to help many more people struggling through depression and anxiety (and perhaps, antidepressants) to move toward health and wholeness.

All my best,

Jim

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Interview on “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression”, on The Broad Perspective

April 7, 2009

James S. Gordon, M.D. Interview on “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression”, on The Broad Perspective with Vivian Komori
Location: Internet Radio, Friday April 10, 2009

This week on The Broad Perspective™:
We have  Dr. James S. Gordon, MD,  Psychiatrist and author of “Unstuck, Your Guide to the Seven-Stage Journey Out of Depression”

 “Depression is not a disease”. With this simple but revolutionary assertion, James S. Gordon, M.D., a Harvard-trained psychiatrist and a pioneer in integrative medicine, challenges the perceived wisdom on how depression is viewed and treated.  He goes on to explain that depression “is a sign that our lives are out of balance, that we’re stuck.  It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives.”  During our program Dr Gordon will discuss and powerfully illustrate how to heal depression without the use of antidepressants and outlines the practical steps we can take to exert control over our own lives. 

Radio show airs each Friday at 11:00 AM PST (2:00 PM EST) on 1380AM (based in Palmdale CA)

If you are unable to tune in on your radio, you can stream it live on your computer and tune in. 

1.  Go to http://www.highdesertbroadcasting.com/

2.  Click on “News Talk 1380 Radio”

3.  Click on “Listen Live” Banner

Hey, too busy to listen during the day? Now listen anytime you want, day or night. Just click on over to www.thebroadperspective.com  This is where you will find all of the show archives from our earliest broadcast to our most recent ones.

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Healing in Israel

March 5, 2009

March 2, 2009

I’m returning to the Middle East after 9 months away, in the wake of the War in Gaza and the ongoing shelling of the south of Israel by Hamas. Read about our mission here.

Our team is in Israel for 4 days: Amy, who runs our program of clinical supervision for our Israeli and Palestinian faculty. Dan and Lee-Ann, who coordinate both programs on the US side and Afrim and Jusuf, psychiatrists from Kosovo, whom I first met when they we’re refugees in Macedonia during the 1999 NATO bombing of Kosovo. Amy and I have worked together for 10 years. Afrim and Jusuf are like brothers. It seems that Dan and I have been everywhere together, and Lee-Ann, our newest member, has done a fabulous job with logistics for the trip.

We hit the ground running, heading to Sderot, which has been shelled from Gaza for 8 years, as soon as we wake up on the first morning after our arrival. Naftali, our Israel program director, (we’ve trained some 300 health and mental health professionals in Israel over the last 5 years), is doing the driving, and will be introducing us to colleagues who are dealing with the ongoing trauma in Israel’s south.

First stop: the SCIENCE AND RELIGIOUS ELEMENTARY SCHOOL, a meeting with the principal, Dina Chouri as well as Miri Asoulin, a teacher who has come through part of our training program and heads up the “Havens of Calm” program. “Havens of Calm” is a room apart from the school with bean bag chairs, crayons, games, a place for kids to come express their feelings and simply hang out when they need to. Miri is exactly the kind of teacher you wish your children had-or wish you might have had yourself. She has the kind of smile that erases all the doubts you have about your own worthiness, that makes you feel that everything you do is not just alright, but really really interesting.

Over the last 7 years, while shells fell in and around Sderot, perhaps 60 percent of the kids used the “Havens of Calm” room. During the recent war, and in its aftermath, everyone does.”

“For a long time,” Miri tells us, “the children have been nervous and angry; they have trouble sleeping and are wetting their beds. Now, from the time the war began, there are new symptoms. Now the children tend to find scapegoats. One class had an election for what classmate they wanted to most to be dead. They cannot fight against the rockets, so the anger has to go somewhere,” she says.

“In the beginning,” a psychologist who consults with the school, added, “the children were crying and anxious. Now, sometimes, they go into a total freeze when the red alert (the signal that a Qassam rocket is about to fall). One eight year old girl’s body was like a stone. She couldn’t move her hands or feet for four hours.”

Miri and a number of the other teachers and counselors in this and other Sderot schools find the techniques they learned from The Center for Mind-Body Medicine to be enormously helpful for themselves-for they too work, and often live, amidst the falling rockets-and for the kids. She shows us pictures that the children have done of huge rockets falling on their town and of Gaza burning.

The children seem more hopeful, but their parents are not. In Sderot, and in nearby Shaar Ha Negev, we hear voices of distress and disillusionment. “The people felt strong during the war,” one psychologist tells us. “They thought the rocket attacks from Gaza would be over. But now the war is finished, and still we have Qassams almost every day. What was the point?”

More to come.

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