New Under the Sun:
Volume 5, Issue 10
I write this newsletter at a time when our democratic ideals are being bludgeoned by national “leaders” who seem intent on creating a theocratic state. What does this have to do with health, you might ask? A great deal. This is forcefully detailed in Gregory S. Paul’s article “Cross-National Correlations of Quantifiable Societal Health with Popular Religiosity and Secularism in the Prosperous Democracies” in the Journal of Religion and Society (7: 2005). Paul compared the data on religiosity from surveys done among the first world democracies of Europe, Japan, Australia, New Zealand, and North America to results of health analyses of the various countries undertaken by the UN and the WHO. As Paul notes, correlation is not causation. However, the correlations he found point in the same direction and are both intriguing and disturbing. Based on the religiosity surveys, the most secular nations are France, Sweden, Norway, Denmark, and Japan. The religiosity of the US puts it on a par with democracies among the second and third world nations. The US is the only first world nation that is considered non-secular.
Those living in the most secular nation, Japan, have the highest acceptance of evolutionary theory. The population with the least acceptance of evolutionary theory is in the US. The difference in the acceptance levels of this basic fact of human biology has radically different affects on measures of health. The homicide rate in the US is so high that it is an outlier compared to the secular democracies. Lifespan is inversely correlated with religiosity: the more secular nations have significantly lower rates of infant and early childhood mortality than do the more religious nations. [See this article for recent confirmation of the poor showing by the US: http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/ ] Sexually transmitted disease rates are much higher in the US than in secular nations. And, problematically for religious leaders, the teen abortion rate is higher in the US than in secular nations.
“In general, higher rates of belief in and worship of a creator correlate with higher rates of homicide, juvenile and early adult mortality, STD infection rates, teen pregnancy, and abortion in the prosperous democracies. The most theistic prosperous democracy, the U.S., … is almost always the most dysfunctional of the developed democracies, sometimes spectacularly so, and almost always scores poorly… No democracy is known to have combined strong religiosity and popular denial of evolution with high rates of societal health. Higher rates of non-theism and acceptance of human evolution usually correlate with lower rates of dysfunction, and the least theistic nations are usually the least dysfunctional. None of the strongly secularized, pro-evolution democracies is experiencing high levels of measurable dysfunction.”
As Paul notes, the idea that religious belief improves both personal and societal health is not supported by this research since the US, the most religious of first world democracies, has significantly poorer health outcomes than do the most secular of the first world democracies. One might even say that extreme religiosity with its denial of evolution is a killer. http://moses.creighton.edu/JRS/2005/2005-11.html
Book Club: This month I will review The Instinct to Heal by David Servan-Schreiber, MD, PhD. As noted on the book jacket, Dr. Servan-Schreiber is the co-founder of the Center for Complementary Medicine at the University of Pittsburgh Medical Center where he is a clinical professor of psychiatry. I was intrigued by this book because of the subtitle: Curing Stress, Anxiety, and Depression without Drugs and without Talk Therapy. I am all in favor of limiting the use of drugs, but I was curious as to what Dr. Servan-Schreiber considered “complementary” techniques.
Based on the collection of topics Servan-Schreiber discusses, complementary medicine appears to be almost anything that is not currently part of most psychiatrists’ choices of treatments. Servan-Schreiber describes the complementary options as, “…seven natural treatment approaches that…capitalize on the mind and brain’s own healing mechanisms…” (p. 7) One of his major goals is to help psychiatric patients improve their lives without resorting to drugs. Therefore, it is worth reading what he has to say since this is also the philosophy of AnthroHealth.
For Servan-Schreiber the limbic brain (the amygdala, hippocampus, and the hypothalamus) is too often ignored when we work to optimize psychological health. The limbic brain is where our emotions are processed, allowing us to quickly respond to changes in our environment, even before our neocortex, the reasoning brain, can make a rational decision. The limbic system is constantly monitoring the body, attempting to keep the various organ systems in homeostasis. According to Servan-Schreiber, when we are psychologically out of homeostasis, it is in part because there is a disconnect between our rational and emotional “brains”.
The first methodology he espouses to reconnect the two brains is heart coherence training. This method is a combination of meditation and biofeedback. However, instead of presenting the techniques in a straight-forward manner, Servan-Schreiber cloaks them in the language of new age mysticism. I found this annoying. Then I realized that he was just saying that we need to stay in touch with our feelings and pay attention to our body’s needs.
The next technique takes us even further into what appears to be mysticism: eye movement desensitization and reprocessing (EMDR). This technique is primarily used for those suffering from post-traumatic stress disorder (PTSD). Commonly, the patient focuses on the therapist’s moving finger while the patient talks about the trauma. Sometimes the trauma, which may have plagued the patient for years, is resolved in one brief session. This seems too good to be true for many therapists, especially since our understanding has barely begun for why the technique appears to work. The current hypothesis is that the rapid eye movement (REM) mimics the REM of dreams, and that issues dealt with in dreams tend to be resolved more easily. However, sound and vibration stimulation also seem to work well. Servan-Schreiber uses EMDR and states that he’s achieved excellent results with it. A search of Medline on EMDR found numerous articles on the topic, including one published by Servan-Schreiber and co-authors just this past May. A scan of the Medline article titles indicates that the technique is in wide-spread use, but I did not see any article that provides the technique with sound, biological underpinnings.
At this point in my reading, I was wondering whether to continue the book, but I decided to persevere. The power of light to affect biological rhythms was the next topic. There is a great deal of solid research to support this, so it appeared that we had at last moved past mysticism, or the need to use mystical language. Before the development of artificial lighting, our waking and sleeping cycles were governed by the sun. Since humans evolved in the tropics, this means we are adapted to a day fairly evenly-divided between light and dark periods. For most of us, our lives are out of sync with our biological adaptations. In order to provide some more balance to our lives, Servan-Schreiber suggests that we awaken to a dawn simulator instead of an alarm clock. About 45 minutes before you need to be awake, the dawn simulator gradually increases the light level in the bedroom. By the time the room is fully lit, you are totally awake. Servan-Schreiber says that those using the device also report increased alertness and energy levels. This is logical since being abruptly jerked to attention by an alarm clock is more likely to set one’s heart racing causing the day to begin soaked in stress rather than bathed in calm.
Unfortunately, Servan-Schreiber feels it necessary to return to mysticism with his next technique: acupuncture and the power of qi. Yes, I know millions have felt relief from pain with acupuncture. But what is qi? What makes this mysterious, undetectable force any more real than the ley lines of England? A study recently published in BMJ serves notice on acupuncture. In this study, 270 adults suffering for at least three months from repetitive strain arm pain received one of two “treatments” for six weeks. Half the group were given “acupuncture” treatments with a needle with a retractable tip. The other half received a placebo pill that looked like an antidepressant often given for pain. Both groups self-reported pain relief, although those receiving sham acupuncture had the most relief. Oddly, 25% of the “acupuncture” group and 31% of the placebo pill group reported side effects from the treatments. For 3 subjects, the side effects were so severe they had to withdraw from the study. Servan-Schreiber is correct in stating that the limbic system, the emotional brain, is powerful. It can cause treatments that have no actual physiological value appear to be effective. The authors of the placebo vs. placebo study concluded that medical rituals themselves can have a positive effect; and that the more involved the procedure, such as with sham acupuncture (or even actual acupuncture), the greater the positive effect.
After the detour back to mysticism, Servan-Schreiber again returns to well-grounded biology and a discussion of diet, behavior, and mood. I believe that the brain development of our early hominid ancestors was spurred in part by a diet based on shellfish and eggs of waterfowl. This diet would have been rich in the omega-3 fatty acids that are necessary for brain growth and that moderate inflammatory reactions. As Servan-Schreiber points out, our current diet, instead of being a balance of omega-3 and omega-6 fatty acids is overwhelmingly tipped to the omega-6. This changes the 1-to-1 ratio for which we are adapted to a 1-to-10 up to 1-to-20 ratio, putting us out of homeostasis. This imbalance is associated with conditions caused by inappropriate inflammatory reactions including cardiovascular problems, cancer, Alzheimer’s disease, and arthritis. It also appears to play a role in depression and thus is of interest to Servan-Schreiber. There is nothing mystical about eating the diet for which we adapted, although there are evidently still physicians who put their faith in potions and who do not appear to understand the role of diet in optimizing health.
After diet, Servan-Schreiber moves on to exercise as a method to both reduce anxiety and aid the immune system. He describes several studies where patients showed more improvement in elimination of depression due to exercise than to taking drugs such as Prozac or Zoloft. Servan-Schreiber further notes that stress, anxiety, and depression have a negative impact on the immune system, leaving us more open to infection. This is probably familiar to anyone who has developed a cold close to a major final exam or other deadline. Exercise, by reducing stress, etc., helps to protect the functioning of the immune system. Humans are adapted to higher levels of exercise than most of us manage to achieve on a daily basis. Therefore, it should not be surprising that insufficient exercise should have systemic, anti-homeostatic effects.
The last technique Servan-Schreiber describes involves positive, emotional communication with family, friends, and co-workers. He recommends the STABEN method for handling conflict. Before reacting to a stressful situation, use STABEN. S stands for Source: deal directly with the person who is the source of the problem. T is for Time and Place: choose a quiet time and place to deal with the conflict. A is for Amicable Approach: state the person’s name and try to phrase the issue in a positive manner. B is for Objective Behavior: address the behavior, not the person’s character. E is for Emotion: express how you felt about the behavior. N is for Need: state clearly what you need from the person to avoid future conflict. Servan-Schreiber suggests writing this information down on a card you always carry with you so that you are able to refer to it when a conflict arises. Following this methodology reduces the heat of the conflict and should lead to more successful resolutions of those conflicts.
It is probably apparent that my feelings about this book are quite mixed. On the one hand Servan-Schreiber suggests several techniques that are totally in sync with what we know of human biology and our evolutionary adaptations. On the other hand, he seems compelled to inject mystical elements into what could be a straight-forward advice book. I presume his intent is to appeal to those individuals in the general public who are attracted by alternative medicine. However, in attempting to appeal to them, he may drive away more scientifically-minded readers who could derive some benefit from his recommendations on diet, exercise, dawn simulation, and conflict resolution.
Kaptchuk, et al., Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ. 2006 Feb 18;332(7538):391-7.
AnthroHealth Tip of the Month: Servan-Schreiber and I agree that you should eat more foods rich in omega 3 fatty acids. If eating fatty fish such as sardines and salmon is too much for you to stomach, then the autumn harvest provides you with perfect alternatives: walnuts and pumpkin seeds. Add some almonds for calcium and raisins for sweetness and you have a terrific snack.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.