Sickness & Disease

We all face the great matter of this impermanent body coming to an end – and the same for all others, including those we love. We can have gratitude and love and joy for the life we’ve been given, while also of course lots of other reactions. We can still welcome the arisings even as we let go into the endings.

Personally, I feel deeply that we are each a kind of wave in the ocean of the universe, everything living through us as us. So it’s OK eventually to open out into everything, which is what we were all along. And which in my experience rests mysteriously in timelessness, and profound peacefulness, and a kind of love.

I am sorry to hear about the possibility of a neurodegenerative disease.

With respect, I’d offer that multiple things can be true side by side: mental activity changes the brain, mindfulness practice has many benefits including altering brain structure and function, and sometimes illness or dysfunction still comes our way. For me, acquiring an illness is nothing to be guilty about! Instead of the self-criticism implicit in guilt, self-compassion is called for, and gladness and self-respect for all the good practices you have been doing over the years.

Last, I am not aware of any research on this (though there might be some I don’t know about), but to me it is plausible that repeated mental training focused on what might be deteriorating (such as memory or motor control) could have benefits, at least in slowing the progression of illness or in strengthening compensatory factors or processes.

Unfortunately, I can’t give any specific advice. But I could offer these general ideas:

• Focusing on having and internalizing enjoyable experiences might help sensitize your dopamine receptors so that as dopamine reduces over time, your receptors might be able to compensate some.
• If you can, take essential fatty acids (tell your doctors because they can act as mild blood thinners) as supplements.
• Avoid toxins as much as possible (e.g., insecticides).
• Avoid allergens as much as possible (e.g., mold, certain foods perhaps)
• Practice mindfulness in a serious way. There are indications it can exert a protective influence even if people start to dement.
• Perhaps explore neurofeedback to help with post-stroke recovery.
• Check out the work of Dale Bredesen, MD.

First, I try to develop my capacity to sit in both compassion and equanimity, opening the heart to pain while also being undisturbed in my core about it. A long-term project in my case, to be sure!

Second, I try to see the whole mosaic of reality, which includes both beings that will be harmed and beings that will be loved. Recognizing the good (using that word loosely) does not mean not recognizing and feeling moved by the bad; and seeing the good can help us bear and sometimes improve the bad.

When you are already everything, already partaking of the unconditioned, and always – in terms of phenomenology, the experience of the constructed world – and feeling the floor of it drop away from beneath your feet even as it is endlessly renewed, well, that is the waking from ignorance and thus the undoing of suffering.

As a psychologist, I am not giving medical advice. In that context, as a general statement, it is clear that mental factors such as stress on the one hand and gratitude or feeling cared about on the other can play a significant role in a person’s health journey . . . much as purely physical factors such as infection or cancer or effective medications can play a significant role as well.

Speaking personally, I try to approach my own health issues on both levels, mental and physical, based on sensible and individualized methods that have reasonable evidence, including the evidence of whether they are actually producing results for me.

Additionally, as an individual choice, I also include what could be called the spiritual level, distinct from the natural processes within our big bang universe, which include our thoughts and feelings, hopes and dreams . . . as well as our organs and DNA. Others may not want to do this, and I respect that choice.

I have no problem with people who include the possibility of spiritual factors in their healing of a medical condition. I do think it is foolish to do this in a way that excludes or minimizes the role of the physical level in our healing. We have real bodies, they are full of real cells and molecules and microbes, and this physical stuff really matters, and modern medicine has many effective ways to deal with it. Sure, doctors can make mistakes, and we need to be aware of the financial incentives such as from pharmaceutical companies that tilt medical treatments toward certain approaches and away from others. I turn to doctors who listen carefully, don’t patronize, individualize their approach to me rather than “one size fits all,” and recognize the potential usefulness of complementary and holistic methods. But I would not want to use the spiritual level to crowd out sensible, standard medical interventions.

As you know, there is a range of opinions about good health practices, including from highly credentialed clinicians and researchers. In that range, at one end are those who are skeptical of changes to established practices and at the other end are those who are exploring innovations. We’ve seen this range throughout history and we’ve seen it in our lifetimes.

For example, there is a joke in medicine about how progress occurs:
Stage 1: That’s crazy, it should be outlawed, anyone who does that should lose their license.
Stage 2: It shows promise but needs more studies.
Stage 3: We knew it all along.

In my view it is important to find a middle way between dogmatic resistance to innovation on the one hand and wild-eyed adoption of dangerous unproven methods on the other. For me, there are three markers of this middle path:

1. The proposed innovation (e.g., reducing carbohydrates to treat Type 2 diabetes) has proposed mechanisms of action that are grounded in an underlying frame of biological science (rather than, say, some kind of mysterious cosmic energy from Mt. Shasta).
2. The innovation is not recommended to be done instead of a well-established medical technique (e.g., if your leg is broken, don’t think that rubbing essential oils into your leg will make the bones reknit properly).
3. The risks of the innovation are relatively low (e.g., if you’re not pregnant, supplementing vitamin D up to 5000 I.U./day has next to no risks, and it might help reduce the consequences of getting Covid-19).

Regarding #3, if the risks of a medical intervention are high, then the evidence for it should be equally high. On the other hand, if the risks are low, then the threshold of evidence for trying something can be low as well. This is a key point.

For example, the third leading cause of death in America is medical error, causing about 200,000 deaths per year, mainly involving medications. (Which is a more serious problem, the Goop Lab or deaths due to medical error?) The tools used by physicians are powerful, so they need to be very very well justified. Interestingly, in the Lancet a few years ago, it was acknowledged that about half of the methods that medical professionals use every day, in hospitals and outside them, do not have a single study that supports them. This does not mean they are malpractice. But I think it suggests that there should not be a double standard in which high risk medical interventions – often backed by the potent lobbying efforts of pharmaceutical companies – are used routinely with minimal research evidence while low risk health recommendations such as “reduce carbohydrates and eat more whole foods” are challenged for not having enough studies behind them.

As to what is “unscientific,” if this term means that something requires multiple excellent studies to be credible…then that view is itself truly unscientific. First, many things are true that no scientific study can prove.

For example, if you love someone, no study in the world can prove it. Second, just because there wasn’t yet a study that vitamin D may reduce the consequences of Covid-19 did not mean that this was not true all along. As the genuinely scientific saying puts it: “The absence of evidence is not evidence of absence.” For me, “unscientific” means something contrary to what science has clearly shown to be true, such as biological evolution.

In terms of soothing and calming the alarms, there are happily many good things that can really help. They are all practical and simple, and you’ll see the results quickly:

• Do whatever you can to keep your physical body well-fed and well-slept. Try to avoid things that are inflammatory (a kind of alarm process in the immune system that is connected to the nervous system). Consider supplementing nutraceuticals such as GABA, tryptophan, and/or 5-hydroxytryptophan (talk with an experienced healthcare professional about this).
• Do some biofeedback with Heartmath’s Inner Balance device, to shift your resting state toward greater calm, and to recover faster from getting alarmed.
• A couple times a day or more, notice that you are basically alright right now. Really register this feeling, let it sink in. Whatever happened in the past and whatever the future holds, in the present you are basically OK.
• As you do your various practices, deliberately let go of any anxiety, any uneasiness, any defending against the next moment. Keep reminding yourself that you are strong and basically OK in the present. You can cope with challenges without getting worried or alarmed about it.
• Accept that sometimes you will feel alarmed. Don’t get alarmed…about getting alarmed. Try to regard the alert/alarm response as a kind of impersonal wave of experiences passing through awareness. Try not to identify with it; it’s there, yes, but kind of at arm’s length in your mind. You don’t have to move through your day afraid of getting triggered; if it happens, it will pass and you will remain.
• A few times a day, take one or two breaths to marinate in the sense of you caring about others, and others caring about you. This will be calming and supportive.
• Also a few times a day, look around and notice some of the many things that are working fine. Try to see the big picture, from a bird’s-eye view.