Transcript Reconnecting With Self - VCU Institute for Women's Health

Jo Robins, RN, PhD, ANP-BC, AHN-C,
CHTP
VCU School of Nursing
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A holistic and
balanced
exploration of
illness and health
Both personal and
professional
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The Placebo Response
Innate healing ability
Holism- Mind, Body, Spirit
Self-care
Personal/Professional
Treating/Curing/Healing Partnership
Integrative Practice
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nccam.nih.gov
1-888-644-6226
Outstanding resource
Currently sponsored clinical trials include the
areas of acupuncture, herbs, dietary
supplements, and massage in the areas of
arthritis, neurological disorders, cardiovascular
disease, and cancer
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Alternative Systems: TCM, Ayurvedic,
Homeopathy
Biological: Diet, vitamins, supplements,
herbs
Manipulative/Body based: Chiropractic,
massage, Trager…
Energy: Healing Touch, Therapeutic Touch…
Mind-Body: Psychoneuroimmunology,
Breath work, Guided imagery, meditation, tai
chi, yoga, humor, .…
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Focus is on person
as energetic entity,
balance, breath, diet,
exercise, mind-body
techniques, yoga
Wisdom of Healing;
Return to Wholeness
by David Simon,
MD
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http://doshaquiz.chopra.com/
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http://www.whatsyourdosha.com/
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Vata = Air
Pitta = Fire
Kapha = Water
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Ancient eastern system
of medicine focusing on
balance, energy flow
Meridians
Ying/Yang
5 elements: fire, water,
air, wood, earth
Acupuncture, Massage
(Tui Na) , Herbs,
Nutrition, Qi Gong
(vital energy)
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Yang is the
“daylight”, the
“active”, the
“doing”, the
“producing”.
Yin is the
“nighttime”, the
“stillness”, the
“contemplative”,
the “refilling”.
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The flame is the
yang; the wax is
the yin.
The battlefield is
the yang; the fort is
the yin.
Doing is the yang;
being is the yin.
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Diet: Primary focus for
maintaining,
rebuilding health.
Food is Information.
Some truths about
Vitamins, Supplements,
and Herbal therapies
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Herbal PDR
Commission E Monograph
Herb Contraindications and Drug Interactions
by Brinker
Natural Medicines Database
South River Compounding Pharmacy
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Metagenics
Perque
Phytopharmica
Xymogen
New Chapter
Numerous others
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Massage: Effective
for stress
management,
reducing and
eliminating a variety
of pain syndromes.
Trager-Effective in
helping manage
Parkinson’s disease.
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Fully developed
framework
Era I, II, III Medicine
Healing Touch and
Therapeutic Touch
help decrease pain
and anxiety;
improve sleep
quality, and wellbeing
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Functional Medicine Institute
www.functionalmedicineinstitute.org
Biochemical individuality describes the
importance of individual variations in
metabolic function that derive from genetic and
environmental differences among individuals.
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Patient-centered medicine emphasizes "patient
care" rather than "disease care.”
Follows Sir William Osler’s admonition that “it
is more important to know what patient has the
disease than to know what disease the patient
has."
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An abundance of research now supports the
view that the human body functions as an
orchestrated network of interconnected
systems, rather than individual systems
functioning autonomously and without effect
on each other.
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1. Evaluate the therapy itself- can you assess
whether the therapy is probably harmless,
possibly dangerous, or potentially helpful in
some significant way (ie, does it operate in a
plausible way, is there scientific literature?).
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2. Evaluate the practitioner offering the
therapy-training, reputation within
professional networks (patients/colleagues),
Do they have expertise treating your condition?
Do they make any claims regarding outcomes?
Can they integrate with your conventional
therapy? Is the practitioner worthy of your
trust?
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3. Evaluate the quality of the service including
delivery, cost, and quality of service being
rendered.
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American Holistic Nurses Association
(www.ahna.org)
American Holistic Medical Association
(www.ahma.org)
American Association of Integrative Medicine
(www.aaimedicine.com)
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Journal of Holistic
Nursing
Holistic Nursing
Practice
Journal of
Complementary and
Integrative Medicine
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Evidence Based
Complementary and
Alternative Medicine
Alternative Therapies
in Health and
Medicine
Journal of Alternative
and Complementary
Medicine
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Overused, non-specific
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Typically viewed as negative
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Promotes adaptation, growth, learning
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Brain integrates and coordinates behavioral
and neuroendocrine responses to “stress” and
normal diurnal rhythms.
Remarkable individual differences in coping
related to genetics, early development,
behaviors, experience….
Neuroendocrine and behavioral responses
programmed to adapt for homeostasis,
allostasis. Must efficiently turn on and off.
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CV-catecholamines (CAT) increase HR, BP,
Vasoconstriction to be upright, active
Brain-Adrenal hormones (AH), CAT increase
awareness, memory retention
Immune- AH & CAT promote cell trafficking;
modulate cyto-,chemokines
Stressor
Person Factors
Factors
STRESSOR
SocialEnvironmental
IL-6
Factors
IL-2
Limbic
System
IL-1
Hypothalamus
CRF
CRF
Cerebral
Cortex TNFa
IL-3
CRF
PVN
Pituitary
Locus Ceruleus
Proopiomelanocortin:
b-endorphin,
ACTH,
a-melanocyte
stimulating
Adren
hormone
ACTH
al
IL-2
Corte
Cortisol DHEx
ANS
Adrenal
Medulla
Enkephali
ns
A
TNFa , IL-1, IL-6
Interferons
STRESSOR
T
Mn/M
N
NKC
Norepinephrine
Epinephrine
B
Met-enkephalin
b-Endorphin
IMMUNE SYSTEM
Lymph
oid Spleen
Thymus
Tissue
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CV- prolonged BP elevations accelerate
atherosclerosis and with metabolic hormones
lead to Type II DM
Brain- HPA overactivity, excitatory
neurotransmitters reduce neuronal excitability
and atrophy, hippocampal brain cell death
Immune-Immunosuppression and immune
overactivity (autoimmune, inflammation)
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“Hidden cost of chronic stress to the body over
long time periods, which act as a predisposing
factor for the effects of acute, stressful life
events.” “Wear and Tear”
“Presents a model showing how individual
differences in the susceptibility to stress are
tied to individual behavioral responses to
environmental challenges that are coupled to
physiologic and pathophysiologic responses.”
(p. 2093)
Cumulative result of allostasis, allostatic state
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1. Repeated events
over a long period of
time (sustained
economic hardship)
2. Failure to adapt to
a repeated stressor
(never adapting to
flying or public
speaking)
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3. Failure to shut off
hormonal stress
response or return to
normal trough (sleep
deprivation)
4. Inadequate
hormonal stress
response allowing
other systems to be
overactive
(autoimmune)
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Daily diurnal patterns
(sleep-wake,
cardiovascular
changes to stand)
Genetic predisposition
LBW
Early developmentbonding, abuse
Perceived loss of
control
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Learned
helplessness
Learned behaviors/
lifestyle choicesexercise, diet,
smoking, alcohol
consumption, mindbody fitness,
spirituality
Health Disparities
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Adrenal steroids
Catechoamines
DHEA
Prolactin
Pitocin
Growth hormone
Sex hormones
Cytokines
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Once hormones are
released there are
immediate and long
term effects on
cellular function.
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Negative
Affect or Loss
of Personal
Control.
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Positive Affect;
Sense of
Personal
Control
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Learning to be, be with without doing is the path
of the feminine
Breath=Spirit
Begin by observing breathing patterns
Three deep breath upon arising and before sleep
Promotes relaxation-de-activates SNS (impacts
neuroendocrine, cardiovascular, and immune
systems
Dr. Andrew Weil audiobook “Breathing”
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From a feminine perspective, it is about process
instead of outcome
It is a process-the beauty and glory are in the
process of growing and evolving, not
necessarily the “getting there”
Own and honor therapeutic presence