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Foundations of Integrative Health

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Foundations of Integrative Healing Manual
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Foundations of Integrative Healing Manual
PART 2: PRACTICE

Stress Relief & Sleep

 

There is one crucial factor more important than almost any other aspect of our health.

If it is missing from your life, it worsens almost every disease we know about. But it’s not something you can fix with a supplement or even by changing your diet. It’s more important than blood pressure, GI Index, and perhaps even what you eat. 

We now understand that your thoughts, attitudes, social networks, community, and spiritual beliefs are crucial to our nervous systems’ functioning and the way we process stress. The nervous system plays an essential role in almost every aspect of our health and well-being. It guides daily activities, including waking up, automatic activities such as breathing, and complex processes such as thinking, reading, remembering, and feeling emotions.

The nervous system controls:

  • Brain growth and development
  • Sleep & rest
  • Stress and the body’s responses to stress
  • Thought and emotions
  • Learning and memory
  • Breathing and heartbeat
  • Movement, balance, and coordination
  • Healing and rehabilitation
  • Aging

It’s probably no surprise that stress is a MASSIVE problem. It’s been linked to just about every major chronic condition. Why does this happen? Our adrenal glands start producing cortisol, our primary stress hormone, when we get stressed. When you have cortisol running through your blood, you’ll feel rushed and anxious, like you constantly want to escape your body. Chronic cortisol is so normal for most people; it’s hard to remember what it feels like without it.

Why are cortisol and stress so detrimental to chronic diseases? It’s helpful to understand why we have cortisol in the first place. Cortisol is our evolutionary reaction to physical threats. Our body’s likely evolved a cortisol response to address immediate physical threats, like a mountain lion confronting us in the wild. 

When we perceive a threat, cortisol initiates several physiological processes, including sending blood to our extremities (arms and legs), presumably so we can run faster to escape. This is very helpful if we’re running from a mountain lion.

However, this also pulls blood flow away from the center of our body, where our vital organs are located. This is vitally important, as a lack of blood flow to our vital organs disrupts many of our core day-to-day functions. When you’re running from the lion, your body isn’t thinking about digesting your lunch. It’s thinking about preventing you from BECOMING lunch. When we sense a threat, suddenly, our liver, kidneys, and digestive tract have less energy to do their job; digestion essentially shuts down. 

Physical danger is not as common today, so you might be thinking, “why is elevated cortisol so prevalent?” Cortisol is not only elevated during physical threats but also a psychological threats. When we don’t feel safe, when we feel abused, or when our bosses give us strict, impossible work deadlines, this also causes the body to produce cortisol. However, the release of cortisol is a lower-grade release happening around the clock. We call this chronic stress, and this is what we want to avoid. 

When we’re constantly in a state of chronic stress, several dangerous things can happen to the body:

  1. Digestive enzymes, stomach acid, and bile in the upper digestive tract diminish, leading to less properly broken down food as it enters the small intestine.
  2. Because food is less broken down, we absorb fewer nutrients.
  3. Because we absorb fewer nutrients, our immune system, liver, brain, and nervous system don’t function properly.
  4. As digestion stops flowing, more waste accumulates in the digestive tract, leading to dysbiosis.
  5. As dysbiosis worsens, we become more intolerant to certain foods, as we no longer have the biome to process them.
  6. We become more intolerant to foods, and everything we eat becomes more inflammatory, which begins to trigger an immune response.
  7. This chronic immune response continues attacking more parts of your body, which might lead to skin issues, chronic fatigue, hormone imbalances, or even heart disease or cancer.

You see, stress is a vicious cycle. It’s so crucial, which is why functional medicine considers it one of the primary underlying causes of disease. The link between stress and chronic illness is not novel. It’s widely accepted in both conventional and Integrative Medicine as a primary cofactor in diseases. However, the critical question is, what do I do about stress? There’s a huge difference between understanding stress and knowing what to do about it. Most people are acutely aware of stress’s dangers. However, we are largely illiterate when it comes to reducing stress.

Many have turned to meditation and mindfulness for stress relief; however, intuitively, you might know that sitting in silence will not work for you. A more thorough and targeted approach is required for stress reduction in today’s world.

We can’t simply avoid stressful situations. We can’t quit our jobs and leave our relationships when they get hard. We must learn to take control back of our nervous systems; to become the captains of our own experiences to navigate our lives without stress. Even if this did work at reducing chronic stress (it doesn’t), it would make life less rich. Fortunately, you don’t have to.

Polyvagal Theory 

In recent years there has been a revolution in our understanding of the nervous system. Polyvagal theory is a new framework for understanding how the nervous system works and how to down-regulate it with a more precise, targeted approach.

Historically, we’ve understood the nervous system as operating in two distinct modes: the parasympathetic and the sympathetic nervous system. The parasympathetic nervous system is known as our rest and digest system. When we’re in parasympathetic, we’re naturally more relaxed, and blood flows to the center portions of the body. This improves digestion and the overall functioning of our vital organs. You’re probably in parasympathetic when you’re on vacation, lounging by the pool reading a novel. 

You’re probably in your sympathetic nervous system when you’ve got a busy week of work and dealing with stressful relationship issues. When we enter the sympathetic nervous system, cortisol production begins, blood flow is sent to the extremities of our arms and legs, and the vicious cycle of stress begins.

However, if you think about it, this is a drastic over-simplification of the nervous system, the most complex aspect of the human body. It suggests our nervous system works like an on-off switch with only two settings. It might also indicate that all we need to do to reduce stress is rest more. But if you’re stressed and have tried simply “doing nothing,” you probably know this doesn’t often work. 

Polyvagal Theory offers us a revision of this outdated framework, giving us a more specific insight into how we can move out of cortisol production and back to our optimal nervous system function. It describes the nervous system as having three distinct modes of functioning: ventral vagal, sympathetic, and dorsal vagal.

Ventral vagal:

Let’s imagine you’re having a particularly stressful month at work. Your boss gives you a new, crucial project with a hard, end-of-month deadline. As the month goes on, you’re working later and later hours, skipping meals, and don’t have time to go on your morning walk. Then, when you get back from work on Friday, your partner tells you his parents are coming into town for a surprise visit and staying with you for an entire week! On top of all this, you’ve been dealing with nagging health issues, including constipation, skin flare-ups, and joint pain. 

So you decide it’s time for you to take a solo vacation to Hawaii to let yourself unwind. When you first arrive at your resort, you find it hard to relax. You notice you’re holding tension in your body, particularly in your hips and upper back. You still feel disconnected, constantly thinking about work and all the stuff you’ll have to do when you get home.

After a long sunset walk on the white-sand beach, slowly, you feel yourself begin to slow down and sink into your body. After your walk, you head to the spa to get a 90-minute deep tissue massage, and you feel the tension begin to melt off your body. Slowly, you’re starting to feel like yourself again and get a good night’s rest for the first time in weeks. 

The following day you feel like socializing, so you sign up for a group dance class at the resort. After class, you notice how different you feel from just 48 hours ago. Your mind feels clear, natural energy and ease within your body, and you are breathing a little deeper. Now, you feel ready to socialize and start enjoying your vacation. 

That night at dinner, you strike up a conversation with one of the other guests at the hotel, a fascinating woman who had just returned from a sabbatical in Europe. You begin to lose yourself in the conversation by listening to her stories, forgetting all sense of time. Hours go by, and you’re receiving new, life-changing perspectives from your new friend.

Throughout the conversation, you cycle through moments of delight, joy, sadness, inspiration, excitement, love, and various other positive emotions. You feel a heightened sense of curiosity and openness. You’re no longer thinking about work or your plans for the rest of your trip; you’re fully present in the conversation. Naturally, you feel calm and connected, grounded and settled. It’s almost as if you’re in such a flow with this person that your problems naturally melt away.

This conversation is an example of being in the ventral vagal nervous system. This is the primary revision Polyvagal Theory offers to our understanding of the nervous system. It suggests our optimal functioning is not during rest but during “social attunement.” Attunement means we are fully present and engaged with the moment. Think of what happens when you are dancing. Great dancers don’t calculate each move; they simply connect with the music, attune themselves to it, and allow their bodies to flow with the rhythm. The same thing can happen when we create art, make music, and it can even occur while playing sports.

Anytime we are fully present, listening, and responding to the moment, we are in a state of attunement. Actually, if we train ourselves, we can elicit a state of attunement through almost any activity, not just music and dance. This is the goal of many Eastern practices, including yoga, Tai Chi, and Chi Gong. When you practice qigong, you’re practicing effortless movement. You train yourself to move naturally and feel connected to the earth and your surroundings. The key to all these practices is balancing gentle effort and relaxation. That is the essence of attunement.

The Buddha once said, “The string that produces a beautiful sound is not strung too tight, nor is it strung too loose. That is how to practice meditation: not too tight and not too loose.” 

It’s somewhat obvious if you think about it. We’re not sea lions lying around resting all day; we’re designed to be social creatures and to explore the world. We know when we’re in the ventral vagal, our digestion works better, as does our immune system, circulation, and overall mood. Our peak function is when we can be fully present, listen deeply to others, feel our emotions, and connect with others. 

At this point you may be saying, “That all sounds great! However, I can’t get myself into a state of attunement. It’s too difficult to sit down and try to be fully present.” This is extremely common and why it helps to learn to navigate the other two states.

Sympathetic State:

It’s the last day of vacation. You’re finding it so effortless to connect and engage with other people. You feel effortlessly present, and oh yeah, you’re going to the bathroom twice daily and feel 10 pounds lighter! You feel calm, curious, and inspired to return home and return to your life.

When you arrive back home, you open your mailbox and find a medical bill for $10,000 for a minor medical procedure you had six months ago. Suddenly, you’re hit with a massive wave of overwhelm. You suddenly want to jump out of your skin. Your heart rate increases slightly; your breathing becomes a little more shallow. 

You spend the rest of the day creating a financing plan. You go through your savings accounts and see what you can scrape together. You visit the hospital to find out if there’s any way to reduce the payments or create a payment plan. After a long day, you find yourself unable to relax truly. All that wonderful calm you created on your vacation feels like a distant memory.

You’ve now entered the second phase of arousal, known as Sympathetic—your blood pressure and heart rate rise. In your sympathetic nervous system, you’re inclined to feel worry, fear, frustration, agitation, and anger. 

Sympathetic & Insulin

When you’re in a sympathetic state, your body reduces your sensitivity to insulin. This is a fascinating (and dangerous) piece of physiology. Insulin is a hormone created by the pancreas and sent into your bloodstream, which helps your cells convert glucose (broken down sugar molecules) into fat. It does this to create longer-term storage of energy. When your blood has glucose available, it will always use this as an energy source first. Think of insulin-like little workers packing sugar molecules away into fat cells, to be retrieved later if there’s no sugar in the blood. If you’ve ever been on the run and felt a sudden, dramatic energy shift, lightheadedness, and a general sense of depletion, this is because your body had used all the glucose available to it in its bloodstream. It then starts metabolizing its fat cells to generate energy. 

When we’re in the sympathetic nervous system, our body reduces insulin sensitivity. The little workers turning sugar into fat cells stop; it does this because it wants to make the glucose– its quick-burning fuel source – more available to the body. Think of it like this; our sympathetic nervous system is designed to be activated during immediate physical threat. Think back to the mountain lion chasing you. It prepares your body for action; it rushes blood to your extremities away from your organs, shutting down the digestive process. It makes glucose more available to your blood to access its quick fuel source.

All of this may not be a bad thing in short spurts, as these physiological processes actually aid our physical performance while working out. However, when we are in the sympathetic nervous system chronically, it reaps damages to our digestive system, and initiates the vicious cycle that turns off our digestive system, causes dysbiosis, and ultimately leads to more inflammation. 

When in sympathetic, our relational ability decreases. Ever wonder why it’s harder to connect with others when stressed? Or why do doctors often not seem to be genuinely listening to you? Well, it’s because they are overwhelmed and chronically operating from their sympathetic nervous system. But according to Polyvagal theory, things get even worse than this. There’s another, more dangerous nervous system state we want to avoid at all costs.

Dorsal Vagal:

You return from your visit to the hospital after working out a payment plan with the hospital billing manager. The thought of the bill is still nagging, but you feel able to go about the rest of your day. You’re able to breathe just a little deeper.

The next day, you return to work, and your boss lets you know that since you missed a week of work on your vacation, he’s making you work overtime every week this month. The feeling of stress and overwhelm ramps back up. An hour later, your partner gets a call, telling you he’s got bad news; he’s been diagnosed with a severe health condition.

One more notch up.

You feel so overwhelmed by all of this; you’re not even sure how to feel anymore. When you get home at night, you try to relax by watching some television. You flip open HBO and open the new season of Game of Thrones. It’s entertaining, addicting even, but you notice as you watch it, that your blood pressure goes up in almost every scene, as the tension, drama, and violence leave an imprint on your nervous system.

One more notch up.

Because of all the new stress, you don’t sleep well. The next morning, you’re driving to work with a Starbucks Double-Shot Espresso to keep your energy levels up to get you through your day. 

One more notch up.

You’re late to work, so you’re driving extra fast. Shuffling between your Espresso and your Spotify playlist, you fail to notice traffic coming to an abrupt halt in front of you, and you slam into the back of the car in front of you. Ouch! In shock, you step out of your car and rush to see if the person you hit is alright. Fortunately, they are okay, and nobody is hurt. But now, aside from figuring out how you’re going to get to work, you realize you’re going to have to pay another few thousand dollars for the damage. 

Another notch up.

You feel so stressed inside, you can’t even imagine a way out of all this, and you feel yourself begin to shut down inside, going numb. As all of these stressful events pile up, you move into what’s known as dorsal vagal, or the freeze state.

Dorsal vagal is downright dangerous to our health. It usually happens not from a single stressful event but a pileup of many stressful events to the point where we feel we can no longer act. When stress piles up, the body doesn’t become more active; it shuts down, almost as if it’s giving up.

When we’re in ventral vagal, insulin activity reverses. Now, because our states of activity shut down, the body rapidly converts its glucose into fat, causing us to gain weight. We begin to feel immobilized due to fear; endorphins begin to rise, which numb the body, raising its pain threshold. It’s almost as if we’re preparing ourselves to deal with the onslaught of pain and stress ahead. Heart rate and blood pressure drop, as do muscle tone, facial expressions, and eye contact. It’s almost like the body is retreating into hibernation. Our breathing becomes more shallow as the stored tension in our ribs and midsection make it difficult to breathe fully. In ventral vagal, we cannot fully connect socially or sexually. It makes us feel disconnected from our friends and loved ones. And perhaps worst of all, it severely shuts down our immune system.

How to navigate back from Ventral Vagal:

Polyvagal theory is so useful because it gives us specific insight into how to navigate ourselves down the overwhelm chain, from ventral vagal, back down to sympathetic, and finally into dorsal vagal or social attunement.

Meditation is one of the most effective forms of stress relief. However, have you ever felt unable to sit still? Does the very thought of meditating feel like torcher to you? This is likely because you’re in a perpetual sympathetic or dorsal vagal state. And when we’re in dorsal vagal, the body has a particular set of needs.

When we’re in the dorsal vagal state, it’s hard for the body to move quickly back into our attunement state. We need to be more precise with navigating ourselves back into our proper nervous system attunement. First and foremost, when we’re in the dorsal vagal, our bodies need spaciousness and time. Think back to your vacation, where you have full days to relax and unwind. What is a vacation anyway? It’s a period where we give ourselves the opportunity for spaciousness, freedom, and time away from routine activities. This is exactly what the nervous system needs to guide itself back out of the dorsal vagal.

Yes, exercise or physical movement can be a great form of stress relief, but not always if we’re in our dorsal vagal state. The reason is that the body is still shut down; the heart rate is lowered, digestion isn’t moving, and our bodies are still in hibernation mode. For the body to move out of the dorsal vagal, it first needs to feel safe, comfortable, and spacious. For this reason, you often see very skilled therapists using their first session with clients with no specific agenda. Great therapists are trained to simply begin the session and ask their clients what they want to talk about when recognizing a client in a state of nervous shut-down. And while going to a therapist is extremely helpful, it’s also essential to learn to self-regulate. When we recognize ourselves in a shut-down state, the best thing we can do is give ourselves time off.

When the body is stuck in a dorsal vagal state, simply giving it time and spaciousness is enough. But if the stored stress and trauma run too deep, sometimes the body requires more.

 

Cathartic Release

There’s an interesting video on Youtube of a videographer who takes a night vision camera out to the Serengeti to film animals in their natural habitat at night. He captures footage of a gazelle being hunted down by a cheetah. After a dramatic chase, the gazelle narrowly escapes with the cheetah hanging on its back, scraping its claws into the gazelle’s back, trying to lock its jaws in its jugular vein. 

The video shows the gazelle, moments after the attack, going into a spastic series of movements and shakes, almost as if it’s being electrocuted. After about 30 seconds of this violent shake, the gazelle walks off as if nothing happened.

This is an example of catharsis, a natural response to trauma built into all mammals’ instincts, including humans. The definition of catharsis is a sudden flood of release of stress and emotion. Unfortunately, most of us have learned to suppress these urges: structured societies reward compliance, politeness, and emotional regulation. However, there are also times when we feel so much tension in our bodies that it’s extremely healthy to drop all this and let out wild, spastic movements, shaking, and release!

We learned in the imprint principle that everything we experience gets stored in our mind-body and leaves an imprint. You might not consider yourself someone who has trauma. However, if you live on earth today, trust us when we say you have some degree of trauma stored in your body. And that trauma needs to come out!

Cathartic release is often necessary when the nervous system enters a dorsal vagal state. The body is shut down, and it needs a jumper cable to get kick-started again. It’s somewhat counterintuitive, as our natural inclination during stress is to rest, but simply relaxing is often not enough. When hanging onto stored trauma, that trauma will stay within the body until we do something actively to get it out.

An excellent example of this is getting a massage. When you’re storing tension in your back, the knot will stay in your back until someone presses on it. Yes, it may be uncomfortable when the masseuse presses into the knot with their elbow. But the reason you get a deep tissue massage isn’t for the painful moment of pushing into it; it’s the relief you find after. Cathartic practices are not always comfortable; they’re not meant to be. They can bring up huge waves of emotions and massive releases of energy that have been stored in the body for years or decades. 

A good cathartic practitioner will help guide you through a gentle, progressive cathartic process that slowly enacts the autonomic nervous system. The autonomic nervous system is the nervous system that controls our unconscious functions like the heartbeat and breathing. Though we typically associate physical movements with the consciously controlled nervous system, it is possible, through guided techniques, to allow the autonomic nervous system to take over our movement. When this happens, our natural, primal instincts direct the body towards what it truly needs, which is a good ol’ cathartic shake for many of us. Doing trauma-release techniques can often open up a flood of emotions and memories. This is the moment we’re purging the body of these stored trauma and stress imprints. Most times, during and after a good trauma release session, everyone in the room will be crying! But after the releases happen, wow! The results are just incredible. In our experience, nothing can get you back to an attuned, connected, calm state like a good cathartic practice.

We highly recommend looking for a TRE trained practitioner in your area and signing up for 3-5 sessions over a month. It will change your life, physically, emotionally, and spiritually. Instead of putting your emotions and stress on your friends, co-workers, and loved ones, cathartic practices allow you a safe dumping ground for your emotions. As Mr. Rogers once said, if you don’t have a healthy place to release emotions, you’ll naturally carry them and put them on the people around you. Mr. Rogers was a big fan of cathartic release.

There are guided TRE techniques on Youtube you can do from home. This is beneficial anytime but is a great practice to do after a long day of work or right before bed. 

https://www.youtube.com/watch?v=SdQJg-HwsMQ

After your body goes through a cathartic process, whether it is physical or emotional, the relief you feel after is profound, you’ll surely feel inspired to include this as a regular practice in your overall health routine. 

Other Great Resources for Stress Reduction:

  • Yin Yoga – These guided yin yoga classes on youtube are one of the best possible practices for stress reduction.
  • HeadSpace Guided Meditations – These guided meditations are great for beginners.
  • Ambient Music – Playing ambient music throughout your day can also help reduce stress.

 

Sleep:

Sleep is more impactful to our health than we could possibly imagine. Sleep is another source of research that’s exploding, as we realize how much sleep impacts our stress levels and just about all of our physiological processes.

Every year there’s a fascinating global sleep experiment that takes place with 1.6 billion people worldwide called Daylight Savings. In the spring in the northern hemisphere, when we lose 1 hour of sleep, and on the following day there is an astounding 24% increase in relative heart attack rates. In the autumn, when we gain an hour of sleep, we see a 21% reduction in heart attacks the following day. There’s a similar profile for road accidents and suicide rates. One study even showed an increase in the harshness of the sentencing of federal judges! So if you are sentenced the day after daylight savings in the spring, you’re likely to receive a harsher judgment, because of the bad mood the judge is in because of loss of sleep. And that’s just one hour! Our bodies are very, very sensitive to losing sleep.

People who work overnight shifts and adapt to abnormal sleeping cycles often report serious health problems. One study showed that people working overnight shifts were an astounding 42% more likely to be depressed than those working during the day. Night work may also contribute to the risk of heart disease and cancer, according to research*.

 

Master Sleepers Guide:

  1. The #1 way to improve sleep, according to research, is regularity.  Go to bed and wake up at the same time each day. This trains your circadian rhythms to ramp and and down at the proper times, making it easier for you to fall asleep, and stay asleep. 
  2. Turn off the television and computer by 8pm at the latest. Turn down or dim the lights in the house 1 hour before bed, to start to reduce the amount of visible light, perhaps light some candles. This helps your body gradually produce more melatonin. 
  3. Use your bed for sleep and romance only, not for working, television, or even reading. 
  4. Get a blue light eliminator such as Flux for your desktop computer and phone to eliminate blue light on your screens after sundown. 
  5. Create total darkness and quiet with window shades and ear plugs. If you don’t have window covers, consider using eyeshadow and earplugs. 
  6. Stretch before bed. Try a Yin Yoga Class on youtube.
  7. Avoid caffeine, particularly after 2pm in the afternoon. The effects of caffeine, even if we don’t feel them consciously, stay in our body for hours after we consume it. 
  8. Avoid alcohol. It may help you get to sleep initially, but it causes interruptions throughout the night, resulting in poor-quality sleep. 
  9. Get at least 20-minutes of exposure to daylight daily, particularly on your stomach region. The light from the sun enters your eyes and triggers your brain to release specific chemicals and hormones like melatonin that are vital to healthy sleep. 
  10. Eat no later than three hours before bed. Eating a heavy meal prior to it throws off digestion, and messes with our circadian rhythms. Try eating earlier meals, your dinner should be finished by 7:30 PM at the latest. 
  11. Don’t exercise vigorously after dinner. It excites the body and makes it more difficult to get to sleep. 
  12. Try journaling. One hour before bed, write down the things that are causing you anxiety and make your to-do list for the next day to reduce your worry. It will free up your mind and energy to move into a deep and restful sleep. 
  13. Take a hot salt/soda aromatherapy bath. Raising your body temperature before bed helps to induce sleep. A hot bath also relaxes your muscles and reduces tension physically and psychically. By adding 1 to 1 ½ cups Epsom salt (magnesium sulfate) and 1 to 1 ½ cups baking soda (sodium bicarbonate) to your bath, you will gain the benefits of magnesium absorbed through your skin and the alkaline balancing effects of the baking soda, both of which help with sleep. 
  14. Warm your midsection with a heating pad or warm water bottle. Raising your core temperature helps trigger the proper chemistry for sleep. 
  15. Try 200 mg of passion flower, or 320 mg to 480 mg of valerian root extract one hour before bed. 
  16. Take 200 mg to 400 mg of magnesium citrate or glycinate before bed. This relaxes the nervous system and muscles. 
  17. Try a guided Yoga Nidra recording before sleep.

 

Action Steps:

  1. Begin to monitor your nervous system states. Notice when you are in social attunement, sympathetic (active) or a shutdown state.
  2. Give yourself regular time for vacation or time off when you notice yourself shut down.
  3. Experiment with cathartic practice by hiring a TRE professional, or trying the guided youtube videos. 
  4. Use the steps from the Master Sleepers Guide.