By Joan Schonbeck
"I'm not having a heart attack, and I don't need that damn stretcher.....I can walk", Marin remembers snapping at the two EMT's, embarrassed and annoyed by all the fuss. Someone had passed her office door, saw that her head was down on the desk, and her face was gray. The person dialed 911. "That's denial, you know", the EMT muttered, checking Marin's pulse. "No one ever wants to believe they're having a heart attack." But overnight cardiac monitoring backed Marin's belief. "I have to be honest.....I don't know what happened to you", the cardiologist from the Emergency Room told her the next morning as they discharged her from the hospital. "But I do know it wasn't a heart attack."
A year later she re-experienced that frightening pain. She was at the mall, shopping. "When that knifelike pain ripped across my chest, I told myself to stay calm", she remembers, despite her dismay that it was happening again. "You know its nothing.....the doctor told you......it will pass..... just sit down until it does". Then she passed out and awoke to hear that the ambulance was on its way.
This time a Cardiac Stress Test, Echocardiogram and eventually a Cardiac Catheterization were added, but the results were the same-still a healthy heart. But now there was something new, fear. A year ago it was a fluke, a freak occurrence. Now she knew it could return without warning, rendering her completely helpless and frighteningly vulnerable. Could it kill her, too?
The Joseph Benedict Building at University of Massachusetts Medical Center in Worcester is where the Stress Reduction Program meets. The Benedict Building looks out on a modern campus overlooked by the Clocktower Spire of Worcester State Hospital, circa 1830, one of the oldest psychiatric hospitals in the country.
It's an appropriate view. Most modern thought regarding stress reduction combines ideas even more ancient than that Clocktower. Most of the people in the room are care-takers of one sort or another, everything from physicians to middle-aged housewives taking care of elderly parents.
Most of these are Strong people, who drive themselves very hard. Some had already reached the same conclusion as Marin: that their strength is making them ill, even killing them, and they need to change.
Mindfulness-Based Stress Reduction is the first widely accepted alternative to traditional treatment of stress with medication. Now used all over the country, it began at UMMC, the brainchild of Jon Kabat-Zinn, founder of this program, and author of "Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness". The program usually involves eight weekly 2 ½ hour classes.
Kabat-Zinn is quoted as describing the goal for students of his course "to become more aware, more in touch with life, and with whatever is happening in your own body and mind when it is happening." This is learned through developing your own personal practice of yoga and meditation, and homework includes a commitment to sit still for 45 minutes each day developing and learning that practice.
"Imagine the top of your head is like the blowhole on a whale....". the instructor conjures up the image as the class-members lie on mats in a dimly-lit room. "Clean, healing and refreshing air is coming in through that hole each time you breathe in. It courses through your body. Negativity and toxins are pushed ahead of it, and out through your fingers and toes as you breathe out."
The body scan, another meditation, surprised Marin as she realized two things she'd never noticed before. "I saw that I'd never known how my body felt, and that there was perpetual tension in my right arm." "Don't judge the feelings.....just feel them", the instructor advises. But later, thinking about it, Marin began to see that she had always perceived caring for herself as being selfish. She had never given validation to how she felt.
"Its time to stop separating the mind from the body." The words are Tipper Gore's. It is written on the blackboard at the Benedict Building that first day. Marin began to see that the tension in her right arm came from feeling that she had to be in control, ready to do what needed doing. "Now.......everything let go......a good deep exhale to let all the tension out....".
The instructor's soft voice and those words were often as good as it got in the early stages of learning yoga. "You want me to do what?" Marin's horrified mind asks as the instructor described and demonstrated yet another position. In her late fifties, Marin initially complained that she had arthritis and couldn't do the pose. The instructor simply smiled and said, "That's fine. Just do what you can".
Yoga is actually a general term for several Hindu and Buddhist spiritual disciplines in existence since 200 BC. They are generally divided into three types: 1. Jnana Yoga, a path to wisdom 2. Bhakti Yoga, the path to love and devotion to a personal God 3. Karma Yoga, the path to selfless action.
Hatha Yoga, widely practiced in the Western World, is one means of following these paths through postures and physical control of your body. Kundalini Yoga is psyiology-based, and seeks to open centers of psychic energy called "Chakras" along the spine and to activate "Kundalini", a force located at the base of the spine.
Yoga means yoke in Sanskrit, and suggests a yoking together of body and mind. It is considered a form of meditation. Mindful Yoga involves honoring your body and the messages it is giving you, exploring your limits but not exceeding them, dwelling at the boundaries.
Marin soon found herself doing the postures she thought she couldn't do, perhaps not perfectly, but perfection is not what this is about. It became for her a matter of stretching both muscles and limits. "I had no idea how stiff my neck was until I discovered that I could turn my head further and see more peripherally when I was driving."
Marin's face colors as she continues. "This is harder to explain. I'm middle-aged with a middle-aged body. I guess I'd grown ashamed of my body, but gradually I began to notice a subtle increase in muscle-toning. I never lost the twenty-five pounds I'd still like to lose, but today I can feel (and like) every part of me much better."
"How does your body feel right now? Look at the muscles in your left leg as you do this pose......Remember to breathe!" People report amazement at realizing they never knew how they felt, or saw the miracle of muscles at work-or even that they needed reminding to do something as elemental as breathing!
The notion of using your eye and mind like a camera, zooming in on one small thing, focusing entirely upon that one thing, OR taking a panoramic view-all of this was new. The worrisome, obsessional, or even mundane thoughts that wander aimlessly into a meditation, they were told, were like butterflies. They could look at them, see them for what they were, and then dismiss them, returning to meditation.
Sidebar
"Dying Of A Broken Heart"........ Research On Stress And Meditation Indicate It May Be More Accurate Than We Knew:
-Stress is more powerful than diet in influencing cholesterol levels. Several studies, including one of medical students around exam time, and another of accountants during tax season, have shown significant increases in cholesterol levels during stressful events, when there was little change in diet. Dr. Paul Rosch, Professor of Medicine, New York Medical College.
-75-90% of employee visits to hospitals are for ailments linked to stress. American Institute of Stress.
-Those who reported a history of workplace stress over the past ten years developed colon and rectal cancers at 5.5 times the rate of the control group. Joseph Courtney, UCLA School of Public Health, Epidemiology
-High levels of stress cause nerve factor growth (NGF), which hinders the ability of disease-fighting cells to ward off infections, suppressing the immune system. Reported in Psychology Today
-Meditation significantly controls high blood pressure at levels comparable to widely-used prescription drugs, and without the side effects of drugs. Hypertension, American Health Association Medical Journal.
6) Twenty-eight people with high levels of blocked arteries and high risk of heart attack were placed in a program with regular practice of meditation, yoga, a low-fat vegetarian diet, and exercise. Twenty people in the control group received conventional medical care endorsed by the AMA. At the end of a year, most of the experimental group reported that their chest pains had virtually disappeared, for 82% of the patients, arterial clogging had reversed. Those who were the sickest at the start showed the most improvement. The control group had an increase in chest pain and arterial blockage worsened. (Follow-up studies suggest that the stress-reduction element may be the most significant factor in achieving these results.)
Dr. Dean Ornish, San Francisco Medical School, University of California, Lancet Journal.
Joan Schonbeck is a registered nurse and writer.
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