My new favorite book is Instinct to Heal by David Servan-Schrieber (Rodale, 2003). It is simple enough for most clients and innovative and interesting enough for most clinicians. I recommend it to psychiatrists, any kind of physician or "alternative" medical practitioner and all psychotherapists.
Why? Instinct to Heal gives clear explanations, references to good research and, in many cases, directions for many mood-altering treatments including guided imagery to shift heart-rate coherence; justification and dosage for Omega 3/Fish oil supplements; sufficient exercise to change mood; dawn simulation lights; EMDR & acupuncture (no self-help instructions included) some Gottman-researched communication protocols; and the Stuart & Lieberman’s BATHE questions–to help doctors and others quickly and efficiently connect, get the information, and validate and strengthen their patients. It’s all good stuff. It follows research, Servan-Schrieber’s clinical experience, and common sense. He made it clear, concise, and practical; my favorite kind of clinical book.
I’ve been hearing many researchers speak about heart-rate variability and coherence for many years. Simply, our heart-rates are constantly changing depending on changes in our activities, thoughts, state of digestion and other physiological changes, moods, and arousal states. According to research if you want to live a long time, avoid heart attacks, and avoid depression and anxiety, your heart rate should vary in a smooth, regular way, instead of a jerky, erratic way. There is tons of research to back this up. Do a search online, or buy Servan-Shreiber’s book if you want the citations. You can buy computer software, with a little hardware to test your or your clients’ heart-rate variability, and get slightly more complicated software to use your computer as a biofeedback device to create smooth "coherence" in heart-rate variability. Or you can simply, with or without high-tech help, use Servan-Shrieber’s guided imagery for heart rate coherence. I’ve modified it a bit. Here it is from pages 53 and 54:
- "Take two deep, slow breaths. . . Keep your attention focused on your breath right up until you have finished exhaling and then let your breathing pause for a few seconds before the next in-breath begins of its own accord. The point is to let your mind float with out-breath right up to the point where it lightens up, becoming mellow and buoyant inside your chest.
- . . .In about 15 seconds after your breathing stabilizes, center your attention on the region of your heart. Imagine that you are breathing through your heart (or the center of your chest, if you don’t feel or "see" your heart). As you continue breathing slowly and deeply (but effortlessly), visualize–and really feel–each inhalation-exhalation passing through that key part of your body. Imagine that each intake of oxygen nourishes your body and each exhalation rids it of the waste it no longer needs. Imagine the slow and supple movements of inhalation and exhalation that bathe the body in this purifying and soothing air. Imagine that they are helping your body make the most of the gift of attention and respite it is receiving from you. . .
- Become aware of the sensation of warmth or expansiveness that is developing in your chest, and in fostering and encouraging it with your thoughts and your breath. (This feeling may not come immediately, with more practice, it will.) One way to encourage the heart is to draw on a feeling of gratitude or of love for another being. You might think of a beloved person or a pet or a peaceful scene from nature. Or you might think of when you were in the "zone" in a sport: swinging a golf club or running, or doing a downhill run on skis. You may notice yourself smiling or feel lightness or warmth or expansion in your chest."
Servan-Schreiber suggests people do this daily. He says that people can enhance heart-rate coherence in other ways. Exercise or yoga or meditation can do the trick. He says, "Coherence in heart rhythm affects the emotional brain, fostering stability and signaling that everything is working order, physiologically. The emotional brain reacts to this message by reinforcing coherence in the heart. Coherence in the heart and the emotional brain stabilizes the autonomic nervous system, both sympathetic and parasympathetic." He talks about depressed or anxiety-disordered clients who lost all their bad symptoms with this technique. And he says that it doesn’t do the complete trick for everyone. Some people need light, Omega-3’s, better relationship, and even medication before they turn the corner. But isn’t this a sweet place to start?
Buy the book, recommend it to appropriate clients. And use some of his practical techniques yourself.