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Friday, May 06, 2005

Psychiatrist Uses 'Emotion Medicine' To Heal The Mind



Dr. David Servan-Schreiber. "I am not aware
of a single Western country in which acupuncture
is used in hospitals to treat anxiety and
depression. This is not logical." (Daniel Tchetchik)


Psychiatrist: Heal thyself
By Shiri Lev-Ari
April 30, 2005

He sprinkles a nice helping of olive oil on his antipasti, and orders a decaf espresso. Studies have already proved that proper nutrition is beneficial not only to the body, but also to the mind, and this is his expertise - the human mind. He pulls out his laptop, ready at a moment's notice to show the latest studies and findings on a subject he calls "the emotion medicine." The interview with him is held in the lobby of a Tel Aviv hotel, but he still insists on hooking me up to an electrode that measures the fluctuations of my heart. "I deal with materials that seem so abstract that I have to demonstrate what it is I am talking about," he explains.

Within seconds, a graph of my heart rate appears on the computer screen, giving an indication not only of the physiological state, but also of the mental state. French psychiatrist and neurologist David Servan-Schreiber looks pleased. The heart rate is normal. In order to prove his theory, he asks me to carry out a simple mathematic calculation: 1,573 minus 8. The cognitive effort turns the graph chaotic. Proof of the ease with which humans become tense. In order to regulate the heart rate and restore harmony, he gives a few pointers for proper breathing and physical
consciousness, sounding almost like a Zen teacher. The heart rate instantly returns to normal.

Emotion medicine

Servan-Schreiber is in Israel this week to promote his theory about
the emotion medicine, meeting with psychiatrists and medical professionals at the Sheba Medical Center in Tel Hashomer. He doesn't look like a revolutionary, but the idea he has been promoting in the past few years certainly sounds it. He decided to skip over the two main solutions that have been found in the West for mental problems: psychoanalysis and psychotherapeutic drugs. His route to mental health does not pass through talking or through Prozac. The body, he contends, has the ability to heal the mind, and chronic problems such as depression, anxiety and stress, including old residual tensions and traumas experienced early in life. Treatment with natural methods is usually considered to have a minor effect, providing some relief, but not a cure, but based his findings, the results are considerable, and warrant a rethinking of the subject.

Servan-Schreiber, 44, was born in France, moved to the United States
20 years ago and is a professor of psychiatry at the University of
Pittsburgh Medical School. Servan-Schreiber was a pioneer in neurocognitive research in America. He is the son of Jean-Jacques Servan-Schreiber, founder of the French newspaper L'Express. His father's side of the family ("The wrong side, I know," he says) was Jewish - a family of rabbis that left the faith and over time became journalists. Servan-Schreiber is also a founder of Medecins Sans Frontieres (Doctors Without Borders) in the U.S. He is married to an American woman, and they have a 10-year-old son. He now divides his time between Pittsburgh and Paris.

David Servan-Schreiber lays out his beliefs in "The Instinct to Heal: Curing Stress, Anxiety, and Depression Without Drugs and Without Talk Therapy," an international best-seller that has been translated into 27 languages, including Hebrew. Although psychoanalysis and drugs are in many cases effective, in many other instances, they do not offer a solution to the problem. The book suggests seven methods to heal the mind through the body, all of which have been scientifically examined and verified: eye movement desensitization and reprocessing (an effective treatment in cases of severe trauma); heart coherence, in which the heart rate is stabilized through breathing (studies indicate that during prayer, monks experience the most well-balanced heart rate); setting the biological clock by natural light (which is known to reduce depression); acupuncture (capable of blocking off pain and fear zones in the brain); use of Omega-3 fatty acids (scientifically proven to produce happiness and ease depression, and found mainly in fish, flax seeds, walnuts and soybeans; it is recommended to consume them via the food itself and not in pill form); physical exercise; and development of emotional communication.

Tibetan treatments

Servan-Schreiber at times seems to use scientific terminologies to
describe the same simple ideas that may be found in New Age practices:
breathing, meditation, yoga, acupuncture, proper nutrition. But he wields scientific studies that prove the effectiveness of these methods.

"I spent 20 years in Canada and the United States in medical schools, I developed a very conventional career as a scientist and psychiatrist," he says. "It took 20 years for me to find out that there are studies in the scientific literature on natural approaches to treatment of depression, anxiety and stress, which have been examined and verified. I began using them in my practice and realized that they are even more effective than the conventional methods, except that no one talks about them, because it is impossible to acquire them and make money from them."

Servan-Schreiber's conversion took place 10 years ago, during a visit to Dharamsala in northern India, where he volunteered for Medecins Sans Frontieres, treating Tibetan refugees. There he also saw traditional
Tibetan medicine in action: The diagnosis was made by
feeling the pulse in the palm of the hand and examining the tongue and the urine; the remedy was acupuncture and herbs. Servan-Schreiber noticed that the Tibetan treatments, at least for the chronic diseases, were at least as successful as the Western methods, except that the Tibetan drugs had fewer side effects and were also much less expensive.

"I'm interested in what works," he says. "Like every psychologist, I'm interested in good results in a short period of time, with few side effects. After all, the body has a natural tendency to heal itself. If you are injured and bleeding, the bleeding stops by itself after a few minutes
without you having to do anything, and after a while you can't even tell
where the original wound was, because the skin completely heals itself.
Everyone agrees about this in regard to the body. As a psychiatrist, I
noticed that exactly like the body, our emotional brain has a natural
tendency to heal itself."

What is the emotional brain? The human brain, he explains, consists
of two parts - the more "developed" part, which is responsible for
consciousness, speech and thought, "but that is only the surface of the
brain, which evolution built at a very late stage," he says. The main part
of the brain, the "animal" brain, is responsible for instincts and reflexes
and controls everything that happens in the body - heart function, blood
pressure, hormones, the digestive system, the immune system. The emotional brain, he argues, has the inborn ability to restore balance and good feeling.

"If a person goes through a painful romantic separation," Servan-Schreiber says, "if his child is sick and he is concerned about the child's health, if he loses someone dear to him, then it is clear that for a while he dreams about it, can't sleep well at night, has recurring upsetting
thoughts - but after a while, for most people these things begin to fade
away. Even when serious events happen that are etched into the brain, the individual still has a natural mechanism that can heal them."

In especially tough cases, he uses
eye movement desensitization and
reprocessing (EMDR), in which the eyes are moved from side to side.
It turns out that during the eye movement the emotional brain enables the absorption of information from the present that places the traumatic event in a new and proper context.

Health, says Servan-Schreiber, is simply a
good relationship between
the parts of the body.
Hippocrates, the father of modern medicine, called this pneuma; in Chinese medicine, it is called chi. The brain, he says, is a collection of neurons linked to one another; thoughts are networks of neurons. "You're asking me if I at times think that this vitality originated in the creation? I don't know. I do think that God is found in the relationship between the organs of the body, between the different systems."

On the computer screen, he shows three pac-man figures. There is no
connection between them. In the next picture, they are arranged such that a triangle is formed between them. "Life is created when all of the pac-mans form some sort of meaning between them. In this case, the triangle is life," says Servan-Schreiber. "When there is no connection between the parts in the picture - that is death. The meaning lies in the relationship between the parts. The medicine in which I am interested is medicine that helps to rehabilitate the connection between the parts of the body."

His treatment approach focuses on the present, and tends not to pry into the past. This strongly contrasts with psychoanalysis, in which the basic premise is that most mental troubles are formed in the first years of life, when the individual is by and large helpless. Servan-Schreiber presents a highly optimistic approach that does not take into account this sort of mental determinism. "When we are babies, we do not know how to
govern our emotions, so we have to be in contact with someone with a better ability to govern the emotions, and he or she shows us how to do it. However, later on we can learn to do it by ourselves and to reclaim control of our emotions. I have had patients who suffered from anger, anxiety and panic attacks, who learned to enter a state of heart rate coherence. We helped them digest their emotions and get a perspective. So there is still a lot of hope."

No backing

If the methods proposed in the book are so effective and inexpensive, why aren't they being used in hospitals?

"Some of these methods, like EMDR, have been proven to work, but we
don't really understand how. The psychologist in me is happy only because it works, but the scientist in me is unhappy, because I don't know how it
works. Most of my colleagues are bothered by this, it seems silly to them to tell people to move their eyes from side to side."

The other, and perhaps most important, reason is that these natural
methods do not have the backing of a money-based industry, and nobody in the West is promoting them. "There is no one handing out colorful brochures to psychiatrists and selling them something," he says. "But acupuncture really can help in depression and in anxiety. There is a Harvard University study that shows that if you stick a needle into the hand between the thumb and the index finger in a spot in which people have been claiming for 5,000 years stores anxiety, then it extinguishes the specific area in the brain that is responsible for anxiety. That is impressive. We are not completely expert in the mechanism, but it happens. Right now, I am not aware of a single Western country in which acupuncture is used to treat anxiety and depression in hospitals. In my opinion, this is not logical."

We are what we eat

In its present state, Servan-Schreiber believes that the world
encourages depression and anxiety. He enumerates three primary factors that promote depression. The first is diet. "What we eat builds parts of our brain. Omega-3 fatty acids, for instance, are very important, and they have nearly disappeared from our diet. We eat eggs, meat, milk, cheeses, butter -but none of these have any Omega-3 fatty acid.

"The second factor is that none of us have learned how to govern our
emotions. When you are seething with anger, losing control, when you are in a state of anxiety or tension, nobody teaches you to identify it, or to deal with it. Conversely, the consumer society is constantly sending the
message - if you buy this thing or do that thing then you will be happy. A
consumer society has no interest in teaching you that you will be happy if
you learn to control your body and your emotions, because then we would not have to buy anything. The consumer society causes you to believe that happiness lies in the acquisition of things from the outside; we only learn
how to run away from the emotions."

Now you're sounding like an Indian guru.

"That's a little frightening... But it reminds me of a book written by an Indian researcher, called `Flow.' He studied which activities made people happy. He outfitted them with pagers that were hooked up to their
brainwaves and which beeped in accordance with what they were doing. They only had to write what they were doing each day and what they felt. It turned out that the thing they did the most was watch television, but they didn't feel any happiness when they watched television. They spent a lot of time shopping, but that didn't make them happy, either.

"The activity that makes people happy is basic things like being
with friends and favorite people, playing games, like cards. The problem is that it doesn't force them to spend money, so you won't see advertisements in the street calling out to you to spend more time with people you like.

"The third cause of depression is our attitude toward one another. One study conducted in France found that 90 percent of people hit their children. Nobody teaches us to resolve conflicts, what to do when we
disagree with something, when somebody hurts us. Either we are over-aggressive or we are passive."

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