Mind-Body Methods 'Unstick' Depression, Heal Trauma

James S. Gordon, MD, is a busy guy. A Harvard-trained psychiatrist, he's the founder and director of the Center for Mind-Body Medicine (CMBM) in Washington, DC; and he chaired the White House Commission on Complementary and Alternative Medicine Policy. Over the past few years, he has been training mental health professionals to care for traumatized children and families in Bosnia, Kosovo, Israel and Gaza, as well as post-9/11 New York.

At the same time, he decided that writing a book was also a top priority. Over the he past 30 years, Gordon has developed successful methods to help people who are experiencing depression and stress/trauma, without medications. "It felt like the right time to share this model," he says. "I thought it was important also to put to rest the widespread notion that depression is a chemically based disease, comparable to insulin-dependent diabetes, a disease whose treatment of choice is antidepressant drugs. To me that seems like the emperor's new clothes, and I wanted to be the little kid who says it isn't so."

Unstuck: Your Guide to the Seven Stage Journey Out of Depression, was published in 2009.

In an honest and moving preface, Gordon describes his own experience as a medical student with clinical depression. "I spent many of my days alone, crying for lost opportunities," he writes, "... and yet I felt something new, something very necessary and overdue, was growing in me." As he returned to medical school, and helped care for people who were dealing with even worse situations, "sometimes helping them find strength they'd forgotten they had, I began to discover my own strength and purpose and meaning," he writes.

Symptoms of depression, lethargy, pessimism, and helplessness should serve as a wake-up call, Gordon says. "These are actually signs that let us know we're out of balance: physically, psychologically, spiritually. They alert us that we need to do something to restore balance."

In this book he outlines what he calls "a comprehensive practical, individualized nondrug approach to depression." It includes:

• effective meditations that can enhance the biology of brain and body
• ways to use words, images, drawings, yoga and dance to mobilize a person's intuition
• plans for using food, supplements, and Chinese medicine to balance physical and mental functioning
• ways to include spiritual wisdom and practices as part of a healing journey
• strategies for tailoring these approaches to each person's unique individual situation

Obviously, Gordon has integrated a wide range of comple­mentary therapies into his approach towards depression. "Complementary medicine practitioners have an important role to play in working with people who are depressed. They're in a position to have a very powerful influence," he says. "Just communicating the fact that it is possible to move through and beyond depression to their patients is extremely important. They help their patients through their professional skills, and also by serving as a reliable source of human support for people who are experiencing depression." CMBM offers professional training programs for CAM practitioners and others who seek additional training in mind-body methods and in nutrition.

Antidepressant Medications: A Last Resort
Antidepressant medications should be a last resort, Gordon says. In a chapter called "The Dark Night of the Soul," he notes that even extreme depression can be part of a natural process of change, and most often "yields in time to brighter feelings."
However there are times "when even the most skeptical and parsimonious of prescribers, like me, considers recommending antidepressant drugs." He recommends using nonprescription remedies such as SAMe, tryptophan, and Saint John's wort first when symptomatic relief is needed. If antidepressant medications are used, they should be regarded "as a temporary aid on your journey, not a cure-all or endpoint."

I was particularly impressed by the chapter "Surrender to Change." It discusses five methods to facilitate change:

• conventional physical exercise such as walking, jogging and swimming
• yoga, used in a relaxed and meditative way
• free dance
• what Gordon calls "the somewhat strange but highly effective shaking meditation"
• Dynamic Meditation

"All of these techniques put energy into the stuck system that is depression," Gordon writes. Through effort they all help to open us where we've been closed. They give us a taste of a more creative and celebratory way of moving and being, and mobilize our natural healing power."

As I read through this chapter, I'm struck by how useful it can be for many people... not just those with clinical depression. Don't we all carry habitual patterns where ancient emotions prevent us from full functioning? Aren't we all, in some places, "stuck"?
 
This is a book that's worth reading slowly (more than once). This is a book that's worth putting into practice.

Using Mind-Body Care to Heal Trauma in Gaza
When I spoke with Gordon, he had recently returned from a trip to Gaza, where he and an international team of psychotherapists and physicians are training local health and mental health workers to cope with the psychological trauma of war. The team relies on a CMBM model that integrates meditation, guided imagery, biofeedback, and yoga with self-expression and small group support. Children and adults learn to use slow deep breathing to quiet anxiety, and to use drawings and movement to express their feelings and recover from traumatic stress.

I asked Gordon how he found the strength to do this work on a continuing basis, and his answer surprised me. He reminded us that while people living in Gaza (and other places traumatized by war) are facing enormous challenges, we here in the United States are coping with a different set of challenges.

"Here we have lots of choices and opportunity, but also a great deal of apprehension, and a society that isn't very supportive," he said. "Not to mention that we don't exercise much, we eat so much garbage and live under so much stress. All those things combine to create the biological, psychological, spiritual, and social imbalance that we wind up diagnosing as clinical depression."

People who live in a place like Gaza face a situation that is overwhelming and threatening, Gordon observes. They are dealing with external threats and civil discord. "At the same time, they have tremendous resources. There's a quality of faith that is remarkable and sustaining. They have a strong level of social connection; their extended families and the community form a reliable network of human support. Perhaps our great-grandparents had something like that."

At this point, the CMBM team has trained more than 2,000 doctors, nurses, psychologists, and teachers in United States and around the world to use the mind-body model for self-care, and to integrate it into their work. "In Gaza we've created a network of healers who are continually learning from and supporting each other, as well as working with the population. That's a model for what I'd like to do here, too," he says. "Clinicians in the United States are working in an isolated setting. They do their private practice, and they may or may not have a partner, but they don't have a tremendous amount of support. One reason our program in Gaza has been so successful is that over the past five years we've been able to set up networks of ongoing mutual support. That's the model that we want to use more and more everywhere in the world, including here in the United States."

Resources
Unstuck: Your Guide to the Seven Stage Journey Out of Depression, published by Penguin Press, is available online and from local bookstores. The book includes 36 pages of additional resources.

A PBS special, UNSTUCK, based on the book, has been airing around the country on public television stations. It will be available for sale from PBS on DVD at the end of 2010, and Gordon has developed a series of educational CDs to support and expand upon the program.

James S. Gordon, MD: www.jamesgordonmd.com.

The Center for Mind-Body Medicine: www.cmbm.org.
Check www.cmbm.org for more information on CMBM Professional Training Programs. Currently scheduled:
Food As Medicine – Professional Nutrition Training Program, June 2010, Washington, DC.
Professional Training Program (initial training), October 2010, Washington, DC.