There is deep basic science and clinical research documenting effective treatments for chronic mental and physical disease. Most of it has not entered into clinical care, and our burden of chronic disease continues to grow. In fact, much of what is being done is not only risky, based on flawed data, and expensive but is seriously hurting people (you).
Common links to chronic illnesses
Basic science research reveals that chronic mental and physical diseases are caused by common problems occurring at the genomic (DNA) and mitochondrial level (energy generators in each cell), the most basic components of evolution and maintenance of life. The problem is that a lack of communication between the silos of knowledge and clinicians keeps critical concepts from application in the clinical domain.
Exposure to chronic stress (threat) is catabolic (consuming fuel) and inflammatory (attacking tissues). It is the reason that “stress kills.”1 The variables are the intensity and duration of the stress. The sources of threat come in an infinite number of forms and can be real or perceived.
Here is a short list of symptoms, illnesses, and disease states caused by exposure to chronic stress:
- Obsessive thought patterns
- Carpal tunnel syndrome
- Migraine headaches
- Tension headaches
- Facial, neck, thoracic, and low back pain
- Pelvic pain
- Irritable bladder syndrome (interstitial nephritis)
- Irritable bowel syndrome (IBS)
- Migratory skin rashes
- Tingling/burning sensations
- Chronic mental and physical pain
- Chronic fatigue
- POTS disease (postural orthostatic hypotension)
- Eating disorders
- Reflex sympathetic dystrophy (RSD)
- Temporomandibular joint syndrome (TMJ)
- cardiovascular disease
- Dementia/Alzheimer’s disease
- Parkinson’s disease
- Renal failure
- Autoimmune disorders – Crohn’s disease, colitis, rheumatoid arthritis, SLE (systemic lupus erythematosus), dermatomyositis, psoriasis, and ankylosing spondylitis
- Early mortality
- AODM (Adult onset diabetes mellitus)
- Metabolic Syndrome
- Obesity (core)
- Major depression/deaths of despair (suicide)
- Peripheral vascular disease
- Bipolar disorder
- Obsessive Compulsive Disorder (OCD)
- Cancer—except colon cancer and melanoma
You may be wondering how so many different symptoms and disease states can be linked by a common cause. It is because under sustained heightened threat physiology, each cell and organ system responds in its own unique way and eventually breaks down.
Each of us is unique
Chronic disease is a complex problem affected and defined by many individual variables. It is not going to be solved by information gained by prospective clinical trials on ill-defined groups of patients. There are several reasons for this problem.
Trauma of any sort is connected to a higher chance of experiencing chronic disease.2 It is worse when the trauma happens in childhood, as it ages the structure of the brain as well as causing long-term elevations of inflammatory markers. However, chronic adult trauma, bullying, or living under societal threats also keeps one in an activated threat state.3
There are at least four patient scenarios that affect one’s capacity to heal.
1. Willing and able to engage – Since the greatest factor predicting a successful outcome is willingness to engage and take responsibility, any clinical study has to begin here. If people can or will engage, will they heal? This seems to consistently play out, and we have seen hundreds of patients heal as evidenced by many powerful testimonials. This group must be clearly defined, and then various clinical interventions can be evaluated and refined with ongoing research. The “stages of change” questionnaire is one validated tool to sort this out.4
2. Emotional inability to engage – Some people have suffered so much trauma that they have incurred a significant mental illness and/or have no capacity to face incredibly unpleasant emotions. They are in a mental survival state. Eighty-six percent of people in chronic pain referred for outpatient psychiatrist care are so frail they cannot engage.5 It is a major reason why traditional psychotherapy is not very effective for treating chronic pain. There are ways to bring such people into a better state.
- Skilled somatic trauma therapy—training one to feel safe
- ISTDP — Intermediate Short Term Dynamic Psychotherapy.6 This is a specific approach designed to teach people to tolerate unpleasant emotions and also feel safe.
- Specifically stabilizing their mental health situation.
3. Don’t want to engage – Angry/frustrated. This group may be the most challenging in that they are so angry they will not engage in anything. Anger is a hyperinflammatory metabolic state that causes the neocortex (thinking centers) to be less active and the survival midbrain to become highly active. In other words, angry people cannot think clearly and process new information. The activated physiology blocks willingness to engage.
There are many approaches to bring them back “online”, but it is unclear what is the best approach for a given person.
4. Paint resources – There are other obstacles to learning new skills. They include illiteracy, low educational level, no access to computers or lack of skills, low IQ, poor access to care, poverty, chaotic family situation, and anything that causes an unrelenting state of threat (stress).
Treating the individual
We are not going to be healed from data gleaned from randomized clinical trials on general populations. Each person is “programmed” by their entire past up to the present moment and is infinitely unique. It is a little unclear how modern medicine has veered so far away from treating each person individually.
The complexity of chronic disease, the uniqueness of each person and circumstances, and the need to address multiple factors simultaneously makes it impossible to obtain meaningful data from randomized prospective studies on large ill-defined groups. The core basis for our “data” is deeply flawed.
We must think differently, as current approaches are not only ineffective but exacerbating the problem of chronic disease. “Data” didn’t help us heal. In fact, physicians, by being more focused on the data (which they may not realize is so flawed, have become more detached from their patients as they continue to administer ineffective care. Many caregivers and patients alike are frustrated by the lack of success and have somewhat given up.
Research has shown solutions for specific symptoms, but it has not helped physicians deal with the complexity of a person and his or her disease state.
This quote from Dr. Francis Peabody in 1927 is at the core of the problem.7
Disease in man is never exactly the same as disease in an experimental animal, for in man the disease at once affects and is affected by what we call the emotional life. Thus, the physician who attempts to take care of a patient while he neglects this factor is as unscientific as the investigator who neglects to control all the conditions that may affect his experiment.
We now know is that emotions reflect one’s physiological state. Peabody was well ahead of this time. In 1927, he was concerned with the intrusion of technology into the patient-physician relationship.
Big data is harming all of us because it is not granular enough. Not only is the burden of chronic disease continuing to rise, but it is also crippling our society both financially and emotionally. “Mainstream medicine” is not only actively promoting ineffective risky, expensive, and ineffective treatments, we are hurting people that trust us.
Chronic disease is solvable by applying a systematic approach that creates an alliance through which both the patient and provider can heal. Humans are not data points. The “data-based” foundation of care is deeply flawed. Is it any wonder that the burden of chronic disease continues to crush us financially and emotionally?
It is more important to know what sort of disease a person has than to know what sort of disease a person has. Hippocrates