The Instinct to Heal :
Curing Stress, Anxiety, and Depression Without Drugs and Without Talk Therapy
by David Servan-Schreiber, M.D.

Book Classification : Health & Fitness - Psychology -
Mental Depression - Stress Management - Alternative Medicine - Self-Help Books

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The Instinct to Heal :
Curing Stress, Anxiety, and Depression Without Drugs and Without Talk Therapy ,
by David Servan-Schreiber, M.D., Ph.D.
Hardcover - 288 pages
First Edition, February 21, 2004
Published by Rodale
ISBN 1-57954-902-0 / ISBN 1579549020

Read a book excerpt

Book Review

Despite the subtitle, the book doesn't preach the avoidance of psychotherapy or antidepressants, but it does assert that the benefits of these treatments tend to be limited and temporary. Such methods have not been adequate to treat underlying emotional and health problems, and undesirable symptoms often reappear if psychotherapy and antidepressants are discontinued. [9] The methods suggested in The Instinct to Heal are, rather, in the realm of what Western medicine has tended to exclude without a good reason. Whether or not the psychiatrist's couch and the prescription pad have their usefulness, there is no reason for medicine not to embrace certain recent discoveries which the conventional West would likely label 'alternative.'

Buy the book The Instinct to Heal : Curing Stress, Anxiety, and Depression Without Drugs and Without Talk Therapy by David Servan-Schreiber, M.D., Ph.D.

"Psychoanalysis is losing ground. Its credibility is dwindling. Psychotropic medicines dominate the field almost completely. Clearly, anti-anxiety and antidepressant medications do not 'cure' in the sense that antibiotics cure infections."

The reader will recall that Sigmund Freud pioneered the concept that we have conscious and unconscious levels of the mind. One theme throughout Dr. David Servan-Schreiber's new book is that we literally have "a brain within the brain" [10] because of "successive layers deposited by our evolutionary past." [20] You can talk with a psychiatrist all you want to, but it's only your cognitive brain, the neocortex, that participates in that conversation, while the older limbic part of the brain, which hardly responds to language [11], lies beyond access. The author recommends, therefore, "methods that act via the body and directly influence the emotional brain." [11]

A second theme that pervades the book is the author's strong advocacy of the idea of heart coherence, which was first proposed by physicist Dan Winter. [52] Coherence is the healthy condition when a graph of the number of heartbeats beats per minute varies smoothly, somewhat like a sine wave. Chaos is an unhealhy condition when a graph of heart rate versus time is a series of jagged zigzags. Note that we're not talking about the constancy of the cardiac rhythm. The frequency isn't supposed to be constant. We're talking about the smoothness of the process of speeding up and slowing down.

About the Author

David Servan-Schreiber, M.D., Ph.D., is clinical professor of psychiatry at the University of Pittsburgh School of Medicine and cofounder of the Center for Complementary Medicine at the University of Pittsburgh Medical Center. He codirected a National Institutes of Health laboratory for the study of clinical cognitive neuroscience and functional neuroimaging for several years and has published more than 90 scientific monographs. He's lectured at leading international academic centers, including Stanford, Columbia, Cornell, and Cambridge Universities. One of the original seven members of the United States board of Doctors Without Borders/Medicins Sans Frontieres, he served on the board for 9 years and provided medical relief in Kurdistan, Guatemala, India, Tajikistan, and Kosovo. He continues to develop mental health interventions for victims of crises and to train therapists in crisis areas.

- From the Publisher

The autonomic peripheral nervous system, which regulates the heart and other organs unconsciously, is composed of "two branches, beginning at the emotional brain and spreading throughout the body." [37] The sympathetic branch, which secretes adrenalin and noradrenalin, is like an "accelerator" and the parasympathetic branch, which secretes acetylcholine, is like a "brake." The first triggers fight-or-flight alarms, and the second tells the mind-body system to relax. It is a feature of all mammals to keep the accelerator and the brake in balance.

Dr. Servan-Schreiber believes that heart coherence is related to negative emotions [45], the feeling of being exhausted [47], the immune system [11], the rate of aging [66], and virtually everything else. The basis for this mechanism is that the heart doesn't merely pump blood, but also produces hormones [36] and nerve impulses [40] which affect the non-congitive layer of the brain which regulates both emotions and bodily organs. Therefore, health relies on a "virtuous circle" between emotions and the heart. "Coherence in heart rhythm affects the emotional brain, fostering stability and signalling that everything is in working order physiologically. The emotional brain reacts to this message by reinforcing coherence in the heart." [54]

The author also cites the work of other researchers who make claims about cardiac coherence. For example, University of Maryland researcher Stephen Porges asserts that the balance between the accelerator and the brake is responsible for mammals developing social relationships. [38]

This point of view suggests that many uncomfortable feelings, such as the nervousness, heart fluttering, and embarrassment which occur during courtship, may take place "because our sympathetic system has stepped on the accelerator, perhaps a little too much." [38] ( Please see our review of the book Why We Love for additional discussion of physiological responses during courtship and romance.)

Anxiety attacks (panic attacks) and posttraumatic stress disorder (PTSD) are also common examples of an "emotional short-circuiting" which occurs when the system "sets off the alarm too often." [28]

Many if not most people suffer years later whenever they are remember certain embassassing moments, the loss of a job, the failure of a marriage, or other painful events. The author describes posttraumatic stress disorder [70-75] not as something people either have or do not, but as a matter of degree. "Most of us have experienced what may be called 'small-t' traumas, as opposed to the 'big-T' trauma of life-threatening experiences." [71] The cognitive brain knows that the feeling is no longer necessary, but the emotional brain lags and continues to access memories which are difficult to erase. New York University researcher Joseph LeDoux discovered that such emotional traces are stored in the emotional brain, not in the neocortex [72], and also discovered that "exposure therapy" intended to make the memory trace "extinct", never completely erases it. [73] The emotional scars are ready to resurface as soon as the rational brain lowers its guard. [74] Psychotherapy tends to fail to cure PTSD because "simply remembering the trauma often seems to make people worse rather than better." [75] A study reported in the Journal of the American Medical Association concluded "that there were no truly effective treatments for this condition, only interventions with limited benefits." [75]

A more effective treatment for PTSD came from a surprising source. Dr. Francine Shapiro of the Mental Research Institude of Palo Alto developed a technique called Eye Movement Desensitization and Reprocessing (EMDR). Patients are asked to allow their eyes to follow the hand of a therapist, causing them to simulate the eye fluctuations which occur when people dream, during the rapid eye movement (REM) phase of sleep. [75, 82] In one study, patients treated for a three weeks with EMDR as a therapy for PTSD recovered in such numbers that the effectiveness was unmistakable -- "This recovery rate is comparable to that of antibiotics in pneumonia." [77-78]

How could eye exercises possibly help people with posttraumatic stress disorder? Psychiatrist and neuroscientist Dr. Bessel van der Kolk has theorized that a traumatic memory "has become locked in the nervous system almost in its original form." [80] A "pack of unprocessed information" causes distress whenever it becomes "reactivated." [81] The EMDR method is believed to induce the process of memory reorganization that normally takes place during sleep. [93] After learning about the method, te author practiced EMDR for several years, and reports remarkable results. [83] The new method was also used to help children who lived in through terror in Kosovo. [89]

Chapter 7 discusses the human body's biological clock which is synchronized with the cycle of day and night. The reader has probably heard of seasonal affective disorder, the common depression associated with the short days of winter. It can be treated with light therapy. [99-104] The author is also enthusiastic about "dawn simulation", a method to wake people in the morning with an alarm clock that slowing brightens the room instead of ringing an alarm. [104-107]

Chapter 8 [109-121] takes a look at acupuncture, although it's not a do-it-yourself therapy as nutrition (chapter 9) and exercise (chapter 10) are. Studies have proven that anesthesia produced by acupuncture was not a placebo effect. In each of several experiments, the cerebrospinal fluid of a rabbit anesthetized by acupuncure was injected into another rabbit, causing the second rabbit to be anesthetized also. [112] Like a true scientist, Dr. Servan-Schreiber stops short of endorsing the mystical Chinese model of the Qi life force and a system of meridians in the body, but something real is definitely going on. A study at Harvard confirmed that acupuncture can "block the regions of the emotional brain that are responsible for pain and anxiety." [120] Most startling is the scientific confirmation that acupuncture stimulation of a toe can improve vision, an effect "pronounced enough to pass all statistical tests." [116] Tying the subject in with the book's main theme: accupuncture "promotes coherence in cardiac rhythm," the author writes. "A session of acupuncture seems to have a direct effect on the balance between the two branches of the autonomic nervous system" [120]

The topic of chapter 9 [123-143] is about "the revolution in nutrition" which, according to the author, is the recent discovery that "omega-3 fatty acids feed the emotional brain." [123]

Fatty acids are the primary brain components, largely because they are the primary substances of the brain's cell membranes. [125] The author asserts that, because polyunsaturated fats are liquids at room temperature, unlike like butter or animal fats or other saturated fats, the brain's "nerve cells' sheaths are more fluid and flexible, and communication between them is more stable." [125]

What will be its effects of your mood? Research has demonstrated that "a diet rich in omega-3 -- such as the Eskimo's, consisting of up to 16 grams a day of fish oil" brings about " increased production of neurotransmitters for energy and positive mood in the emotional brain." Conversely, "a diet low in omega-3 reduces the capacity for pleasure." [125] A study published in the Journal of the American Medical Association found that children who received omega-3 supplements in addition to having been breastfed "have a higher IQ than others 20 or 30 years later." [125-126] The book describes the case of a man who oscillated between manic and depressive phases, and also committed sexual misbehaviors. After all other treatments failed [126-128], his emotions and his life were normalized only after two years on a program in which he takes "no other medication than his fish-oil capsules" [129]

Refer to the useful chart of various foods and the amount of omega-3 in them. [139] As for buying supplements, see to the author's discussion of the optimum ratio of one kind of omega-3 (EPA) relative to the other kind (DHA), and his conclusions about the hypothesis that the distructive oxidation of the omega-3 can be prevented by adding vitamin E supplements. [141]

Chapter 10 [145-159] is about exercise, now known to be one of the best treatments for depression and anxiety. [147-148] You have probably heard of the 'runner's high.' [151] Jogging is better than Zoloft as an antidepressant, the author asserts. [152] Exercise stimulates secretion of endorphins, which are like opium in the pleasant feeling they produce. But endorphins are unlike opium in the fact that opium loses its effect without increasing the dosages, whereas endorphins leave a lasting sense of happiness without producing such dependency. [154-155] Exercise leads to heart coherence, that is, an improved balance between the accelerator and the brake. [156] The doctor says: "In addition to relishing sex and life's other big pleasures, people who exercise regularly actually get more pleasure out of the little things in life: their friendships, their cats, their meals, their hobbies, or even the smiles of passers by in the street." [155]

The book offers numerous exercise hints, of which I shall mention three. "First of all, you do not have to get a lot of physical exercise, what's important is regularity." [157] Recent evidence does not show that such 'aerobic' exercises as jogging are better than such 'anaerobic' exercises as weightlifting. Studies show that they are "equally effective, at least with respect to depressive symptoms." [158] The author even provides hints for what kind of movies are best to watch on the VCR or DVD player when using a treadmill, exercise bike, etc., in view of the physiological effects they produce. [158-159]

Love, "a biological need" [161], is the subject of chapter 11 [161-174] Conflicts, even conflicts with neighbor or casual contacts, attack the emotional brain [161-162] The author identifies the source of the need for love in mammal evolution, and the long duration of the dependency of babies on parents for their survival. This has led to the formation of a brain structure not present in reptiles. [163-164] He sites the case in which the babies in incubators who developed much better than others were found to be those babies who were touched by a nurse who disobeyed the 'do not touch' signs on the incubators. [165-166] Not all the evidence is anecdotal -- there are actual numbers to document the effect of love on health. "Out of 1,000 women diagnosed with breast cancer, twice as many who said they lacked affection were dead within 5 years." [169]

Knowing the importance of love to good health, the author started a (humorous, to me) controversy at a hospital in Pittsburg by prescribing the ownership of pets and houseplants to certain patients. ( Please click here to read an excerpt from this section of the book. ) Dr. Servan-Schreiber writes, "I received slightly irritated calls from the residents in orthopedic or cardiovascular surgery. 'We asked you to recommend an antidepressant, not a zoo. What are we going to write on the discharge prescription? There aren't any household pets at the pharmacy.'" Instead of backing down, the author "prepared a document summing up the various scientific studies on the question." [170-171]

Chapter 14 [207-213] considers the evidence that social interdependence, such as community involvement or volunteer work, has a positive effect on health. [211-212] The author explains that "our very genes are altruistic" [211] and he discusses the concept of sociobiology. He feels that the global trend toward "autonomy, independence, individual freedom, and self-expression." [208] has gone too far, to the point of "isolation" and "a loss of meaning." [209]

"Getting started" and "building your own plan" are outlined in chapter 15. [215-229] Along with the resources listed in the appendix [239-250], the book provides a rather complete program for improving anyone's mental and physical health.

My fields are physics and engineering, and I don't know medicine, but I'm acquainted with the reporting of research results in peer-reviewed journals. Anyone who knows the scientific method will recognize that Dr. David Servan-Schreiber's case is clear and persuasive. If The Instinct to Heal doesn't radically transform the way Western doctors and ordinary folks approach whole mind-body wellness, then they just aren't paying enough attention.

Book review by Mike Lepore for

15 chapters + appendices; 14-page 2-column index; B&W sketches.

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This is an link for
The Instinct to Heal : Curing Stress, Anxiety, and Depression Without Drugs and Without Talk Therapy
by Dr. David Servan-Schreiber
ISBN 1-57954-902-0 / ISBN 1579549020

Book Description from the Publisher's Press Release

Americans seek therapy in record numbers and consume more medications than ever before, yet stress, anxiety and depression continue to rise to epidemic proportions. People can spend years on the psychoanalytic couch without making any progress. And for many psychiatrists, the prescription-writing reflex has become almost automatic, despite the fact that benefits often disappear as soon as drug treatment stops. Standard treatments simply aren't long-term solutions.

But psychiatrist/neurologist David Servan-Schreiber, M.D., Ph.D., knows that we can cure our emotional pain. He's seen certain natural methods produce tremendous results in his clinical practice, in that of his peers, and even in war-torn regions where horrific memories can leave deep scars.

Numerous studies in prestigious scientific journals have documented the amazing benefits of these methods on anxiety and depression, but because the mechanisms through which they operate remain poorly understood, they've remained largely excluded from mainstream medicine and psychiatry. Dr. Servan-Schreiber explains how each of the natural methods in this ensemble treatment plan can help us escape the therapy/drug trap by working through the body to tap into the emotional brain's self-healing processes rather than relying on the cognitive process of language.

Book Reviews

"David Servan-Schreiber has done a brilliant job of bringing together insights and information of vital importance for well-being. The Instinct to Heal is itself an instrument of healing."

-- Daniel Goleman, PH.D., bestselling author of Emotional Intelligence

"The scientist and physician David Servan-Schreiber has provided a wonderful manual to help reconcile our emotional and rational brains . . . [he] bases his advice about how to improve our lives on a profound understanding of how the human brain works, on a broad synthesis of the latest knowledge in neuropsychology, as well as his own clinical and research experience. The book is deeply satisfying intellectually, yet crystal-clear and user-friendly . . . Written with grace and elegance, this book might well become the most important mental health landmark of this generation."

-- Mihaly Csikszentmihalyi, PH.D., bestselling author of Flow, Being Adolescent, The Evolving Self, and Creativity

" The Instinct to Heal is a fascinating account of unorthodox approaches to treating the emotional brain and mind. I learned a lot."

-- Joseph LeDoux, PH.D., the Henry and Lucy Moses Professor of Science at New York University and author of The Emotional Brain and Synaptic Self

" The Instinct to Heal is an inspiring overview of the internal healing potential that exists within everyone -- and that this potential is our birthright and is not dependent on drugs, surgical procedures, or high-tech manipulations . . . The Instinct to Heal will help anyone expand their concepts of health and health care to a more majestic level."

-- Larry Dossey, M.D., bestselling author of Healing Beyond the Body, Reinventing Medicine, and Healing Words

"A brilliant, absorbing synthesis of science, experience, and thought by an internationally known neuroscientist and clinician . . . essential reading for all those who want to understand the frontiers of mind-body health."

-- Michael Lerner, PH.D., author of Choices in Healing

"David Servan-Schreiber is one of those rare scientists who truly listens with his heart and perceives the larger connection."

-- Gerald G. Jampolsky, M.D., bestselling author of Love Is Letting Go Of Fear

"This book, the translation of research findings into meaningful clinical insights and practice, bears the unmistakable signature of Dr. Servan-Schreiber's unique abilities and voice, which echo with humor, wisdom, and compassion."

-- Jonathan D. Cohen, M.D., PH.D., director of the Center for the Study of Brain, Mind and Behavior at Princeton University

"This book has love on every page."

-- Professor Francine Lecas, chair of Pediatric Cardiovascular Surgery, Sick Children Hospital, Paris, France

"Dr. Servan-Schreiber is sending an important message to those talking therapists who appear to rely on the rational brain and language as the sole route to our emotions. This timely and comprehensive review opens many doors and may be read with pleasure by a wide audience."

-- Judith S. Schachter, M.D., past president of the American Psychoanalytic Association

"Why is The Instinct to Heal such a success anywhere it has been published? Because people are eager to find new ways to deal with the wear and tear of coping with a stressful social environment; and because this book, written by a traditionally-trained psychiatrist who dares to think untraditionally, offers an alternative that may work, and, by so doing, offers hope."

-- Antonio Damasio, M.D., PH.D., author of Looking For Spinoza, The Feeling of What Happens, and Descartes' Error

"Servan-Schreiber's stunning book takes a leap beyond conventional psychiatry and integrates contemporary neuroscience research with a deep understanding of the emotional brain's innate tendency to heal. He shows how one can 'reprogram' the emotional brain so that it adapts to the present, instead of continuing to be stuck in one's painful past. In this book, he shows that for healing to occur, one needs to not exclusively depend on traditional methods of language and understanding, but directly influence the emotional brain by acting directly on bodily experience."

-- Bessel Van Der Kolk, M.D., professor of psychiatry, Boston University School of Medicine

" The Instinct to Heal is engaging and highly readable, and packed with concrete suggestions about how to relieve stress, anxiety, and depression. Servan-Schreiber's advice is culled from top-notch scientific journals and his years of clinical and scientific experience. His accounts of patients, along with his easy narrative style, help readers see beyond the research studies he cites."

-- Robin S. Rosenberg, PH.D., clinical psychologist and coauthor of Psychology: The Brain, The Person, The World

"David used to talk often about the great masters, such as Erikson, whom he admired specifically for their combination of intellectual prowess, personal depth, and caring disposition. I was able to understand exactly what he meant, for I was fortunate enough to have the opportunity to observe, in him, a young example of just such greatness."

-- Jonathan D. Cohen, M.D., PH.D., director of the Center for the Study of Brain, Mind, and Behavior at Princeton University

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This is an link for
The Instinct to Heal
by Dr. David Servan-Schreiber
ISBN 1579549020 / ISBN 1-57954-902-0