Meds are not enough
An interview with Jack Gomberg, MD, FAAP Executive Medical Director, Project Transition
What are the pros and cons of a traditional medical model?
: Conventional Western medicine focuses on pathology, disease, and treatment.
While this approach has been highly effective, the training that most physicians receive doesn’t
really emphasize optimal health.
The derivation of “health” connotes wholeness, balance, and resilience. The capacity for the body to heal and repair itself can be seen all the way up the ladder: DNA, cells, organs, and organ systems. Integrative medicine unites a conventional approach with healing concepts – it goes beyond treatment of disease.
One of the problems with conventional medicine is the relationship between the doctor and patient. Too often, the patient is just a passive receptacle that is treated by a doctor whose role is to cure through intervention. A more integrated approach focuses on empowerment. The challenge for both the doctor and patient is to join forces and proactively promote healing.
What is the “mind-body connection”?
: The Western convention is to define the body as everything up to the head, and
the brain is referred to as the mind. But, in a sense, the mind is everywhere. Because there are
neuroreceptors and neurotransmitters throughout our bodies, it’s hard to draw a line between
mind and body. Physician author Andrew Weil refers to our bodies as physical hardware through
which we can run different software. One fascinating example of this comes from research with
people who are seen as having multiple personalities. Each personality, or “alter”, can have
unique physiological allergies. This is an example of the same hardware hosting differing
What is the role of medicine in psychiatry?
: Conventional psychiatry is my mainstay. Many medications utilize the mind/body
connection in that they interact with neuroreceptors to help normalize deficient
neurotransmitters. Many of the recently developed drugs are more selective in their action.
the aim is to get efficacy while minimizing side effects. The newer medications are designed to
regulate naturally existing substances in the mind/body. Nothing is perfect, and side effects
still occur. While medicine’s role in correcting an imbalance may be necessary, it is often
insufficient because it is just one piece of the puzzle. There are many factors that support
optimal health: physical, cognitive-emotional, relational, and spiritual.
When faced with complex emotional challenges, we tend to embrace one solution.
: Yes… being prescribed medication can lead to the thought, “this is the answer.”
Too much faith and power are attributed to one thing. But any “one thing” is rarely enough.
Multiple elements need to be activated in order for sustained healing to occur.
What are these elements of healing? Is the medical field acknowledging them?
: The negative side effects of weight gain and diabetes associated with Clozaril
and Zyprexa have fostered a greater awareness of health risks like the Metabolic Syndrome.
Fortunately, this has resulted in a greater emphasis on health induction through lifestyle
modification. At Project Transition, we developed a program called NEST. It augments other
therapies and consists of activities that promote nutrition, exercise, and stress reduction
training. [At the end of this article, there is a link to learn more about the Metabolic Syndrome
and the outcomes of our special interventions]
Regular exercise helps everything. Research has documented the benefits of cardio-vascular and anaerobic exercise. It can alleviate depression, and it can temper mania by calming racing thoughts and anxiety. But if you’re in a manic storm, you may be tempted to over-exercise, which is not healthy. Nutrition is important, too. For example, in addition to eating right, I also take some nutritional supplements to ensure proper enzyme and immune system functioning. Another element of healing relates to relaxation and meditative techniques – daily meditative breath work is very effective. The powerful effects of positive relationships cannot be overemphasized. We are social beings - our perceptions, thoughts, and feelings are largely guided by relationships.
Other spokes of the wheel include fun and relaxation… playing with a pet and a walk in the woods are great stress busters. Spirituality is yet another aspect that contributes to optimal mind/body health. Anything that helps raise one’s spirits while reinforcing hope and reverence for life can be included in this realm.
Lifestyle can be hard to modify in the presence of psychological pain…
: Absolutely -- it requires mobilization, which psychiatric problems tend to inhibit.
Sometimes medicine can help the person get to the place where lifestyle changes are within
reach. Family members and friends can provide vital motivational support, too. The bottom
line, though, is that optimal health requires effort and practice. To get the dividends, one has
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