Teleconference Part 2


When Pushing Stops Working
Awareness Day 2008 Teleconference

The Take Home Messages - Part 2

Elly B., MS, & J. Gilbert, NCCAOM

Our Common Message, Reiterated

    1. Having “no standard treatment” or having “no official cure” is not the same as people don’t recover. Some do. Fully. And they remain well.

    2. There are things out there that help. If you haven’t found them, keep looking. You are worth that investigation. We cover some of what we’ve observed to be helpful.

Part II: “Stress Talk -- Broadening Perspectives on Stress”
                -- by J. Gilbert

    1. Medicine around the world isn’t uniform, doesn’t always agree how to groups symptoms into syndromes. In different countries, there are different syndromes describing the same maladies.

    2. Grouping symptoms is for the benefit of the physician not the patient.
      Modern medicine has a big problem with syndromes because it is reductionist, looking for a simple answer. It has few tools for treatment of what has happened to a patient over time.

    3. People with chronic disease are often people who have pushed through until collapse and when that occurs, they are still not aware of how hard been pushing.

    4. Stress is just another word we are putting on to a series of events. Stress is a reaction, a heightened state of awareness, whether from something good or something unpleasant.

    5. In working with CFS and FM patients for 14 years, people come in and will tell me what event  (mono, car crash, etc.) gave them the condition. It doesn’t make sense. That’s only part of it.

    6. We have to look at whole people, their lives, and their stresses.

    7. Seyle’s stress model has three stages:

      Initial stage: Super heightened fight or flight, muscles get strong, coordination increases, senses increase; things not needed for immediate survival are made less, e.g. digestion, memory.

      Second Stage: Still heightened but not as much, enough to finish with the stressor, such as to kill or run completely away from a tiger. Then can return to normal state.

      Third stage: If don’t resolve the stress and remain in heightened state, one collapses. Cannot sustain it for very long, so either perish or come close to it.

    8. What is switched on with the stress mechanism is part of what we are seeing with syndromes. it accounts for what we come up against for large stresses, but not for a all the little stresses that people are living with.

    9. Seyle’s model felt incomplete, too all or nothing. He was talking about people going to war. We are looking at people under constant little bits of stress that then become the norm. What if there were a graduated response of stresses that are never resolved? And then there was a trigger, an infection or car crash?  That trigger could be the thing that leads into the spiral to a condition, but the set up was already there. It needs to be addressed in treatment.

    10. So after the trigger, what if you don’t perish, but end up in a flipped stress response with dulled senses instead of sharp ones; a hyper digestive response instead of a low one; poor coordination and muscle weakness; uncoordinated memory, brain fog, and sleep disturbance. Since everyone is different, their symptoms are different. But now we have a cohesive model.

    11. Stress isn’t all or nothing, it is a graduated response.
      In 1997, Harvard researchers confirmed my clinical observations.

    12. Because we don’t see many things that are as stressful, we can’t identify without help what is stressing us. There are many fascinating societal aspects and angles to investigate.

    13. Happiness is bound with inextricably with community
      Community is how cohesive things and people are around us. Happiness is a marker for how stressed we are. If stress is a major factor of how sick we are, then we need to pay attention to happiness.

    14. In last 50 years, much of our traditional community has been broken become fractured. Groups are important, even if secret, even if selective. Groups are supportive, and we can become less stressed when included in them.

    15. Summary so far:
      Low grade stress is affecting us. We have low grade stresses building up, and the stresses we are dealing with aren’t the big stresses that we think cause disease. Its the little ones underneath. And the first stress we look at is community. Happiness is almost our defining stress marker. The happier we are, the less stressed we tend to be. The happier we are, we better we are coping. The more isolated we are, the more stress we have and the more unhappy we are. The more isolated we are, the fewer places there are to talk about our stress and let it out.

    16. Other stresses include the rise of consumerism -- we have more stuff, more information, and the work of managing it. It is stressful that things and people are becoming more generic, and that our market squares are fake -- “town squares” in name only, not actually where we gather to talk.  While we may adapt, we’re not currently designed to live this way and we are not coping well.

    17. A society is based on its stories.
      Our voice boxes allow for a huge range for communication. When isolated, we lose our ability to tell our stories. When our stories are replaced by images of “we need more”,
      we become more lonely, more stressed.

    18. The cycle of modern life, get more, but feel unrewarded, push more, get more, and people only think highly of us when we are pushing and getting more, we think we are winning, but really getting more lonely, never satiated and more sick. But we don’t think of it that way so it is a hidden stress, but a very real one. Being lonely in this way has been shown to be more harmful than smoking.

    19. We need to really look at how we live.
      Its not enough, either, to look at it from a therapist’s chair. For treatment, we have to look not just at “my blood is sticky” or “my adrenals are burn out” to who we are.  We have to remember and cultivate the art of living. Its going to be needed beyond the any needle, pills, or food.

    20. Why do we have a lack of free time in an advanced society? Why do we use our spare time to do more winning or losing activities, destructive things. We really manipulating the stress mechanism on our off time.

    21. Treatment includes spending time being non-competitive.
      I assign time doing a hobby the patient can’t win at. Be lousy at something. People resist and have trouble with it. They don’t know how to just enjoy something anymore.

    22. What we are doing when we spend time not having to worry about winning or losing, we are able to relax and the stress mechanism switches off.

    23. Maybe the body has been trying to protect itself from you.
      Consider how much time you spend in a state of panic? Just considering this has led to amazing things, including recovery for some.

    24. Its the way we stopped allowing ourselves to be ourselves and dealing with our stress that led to breakdowns. It makes sense, and it gives hope that something can change.

    25. There isn’t one reason people are stressed, there are hundreds. And treatment becomes treatment of the stress mechanism. Everyone is unique and has their own challenges in this.

    26. There are physical interventions one has to make, but those are only a piece of the pie.

    27. It is the way in which we see the world that makes the world stressful.

    28. Support Groups have an ability to be a community.
      And a guided support group, like a gratitude group, becomes intrinsic to how we live.

    29. A sense of self-compassion is good for relaxation.
      There is no blame. For some, stresses started building up slowly in childhood. For others, it is just that they played modern life to well and now must go through burn out for a time. This time can be used to look for the patterns of stress, the way of living that lead to it,
      and the way out to recovery.


    1. The Q&A section discussed the possibilities of phone or distance treatment, the topic of medication sensitivity, more about creating community if it feels like yours has disappeared.

    2. Q: Can you work with people when you travel? You said you are in Seattle for this call.

      A: Jonathan: Not this time. It is sometimes possible. Call me or email. One practitioner for the Seattle area is Dan Bensky, DO, director of the Seattle Institute of Oriental Medicine.

    3. Q: Could Jonathan address how to survive without that “village” support? That has been the single most difficult fallout to deal with.

      A: Elly: We can address some of that in the upcoming part about support groups. “Survival” is what you do without support.

      Jonathan: Yes, that is really all you are doing. You have to be a strategist, initially. This is almost one for you, Elly. You have to refine why you have no energy to refine with. Its almost an impossible thing to do. The first thing is allowing yourself to be sick. If you are sick you are sick, so don’t try and push too hard. Be gentle during that time when you’ve lost your job and all your friends have buggered off. And then this idea Elly has with gratitude groups that are inexpensive is really important. You have to find things that are very cheap, very possible, and very doable to make connections and find support.

    4. Q: If people are too ill to come to you, will you treat over the phone?

      A: Jonathan: No. It is illegal. In my profession it is not done. We need to see people. A lot of it is the interaction. People have flown in and it is very expensive. I like to work with people closely, as close as they want me around. A big part of doing it properly is spending time with you. On the phone we are never going to get that going. a huge part of our ethic is treating the patient with respect  You can’t give full service on the phone. It just doesn’t work.

    5. Q: I cannot tolerate even 1/8th doses of medication. Is this part of the stress sensitivity?

    6. A: Jonathan: Yes. It is, unfortunately. We become chemically sensitive. It is a stress reaction. Take hope. Unless born that way, you can be okay again. It is possible to come completely back. It is not your body dying, it is your body stressed out. It is a signal that your body is exhausted. Its okay if you cannot take these things. Your body is not broken it is just tired, and that is an important thing to differentiate. As you switch off these stressed mechanisms, you will have more capacity, more tolerance for things. We re-challenge people 6 months after doing better with things they couldn’t tolerate at all earlier and they can handle them fine. Don’t worry. Allow yourself to be who you are and these abilities do come back.

  1. Go to Notes for Part 3 - “E T Phone Home, Gratefully” by Elly B.

Go back to Notes for Part 1
Introduction & “Making Connections” by Elly B.

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