1 Summary - recommendation
The experts in prevention of illness and the promotion of wellness are complementary and alternative medicine (CAM) practitioners, so the NHS should integrate CAM into conventional medicine. They can do this by PCTs contracting with Alternative Providers of Medical Services (APMS) who offer CAM. The patient’s GP would pay for it as for any other commissioned service, (such as hospital) making it free to patients who couldn’t otherwise afford it.
This is the same recommendation as promulgated in my open letter dated 6.11.07 responding to the ‘Fit For the Future’ consultations entitled ‘Commission Complementary Therapies’, which was addressing the problem of unsafe drugs.
Polls show that 3 out of 4 patients want CAM free on the NHS, so in a patient-centred service it has to be provided. This paper states the scientific evidence base for how and why CAM prevents illness and promotes wellness, and shows how PCTs could provide a cost effective prevention of illness service.
2 NHS sickness service
The National Health Service (NHS) is mis-named, as it has always been a National Sickness Service, treating people after they have become sick. Years ago the government recognised that an ounce of prevention is worth a pound of cure, and the prevention of illness and promotion of wellness was one of the key policy drivers of the White Paper on Health of Jan 2006.
The current ‘Fit For the Future’ consultations are planning the decentralisation and relocation of all but acute services away from hospitals, and into new polyclinics around the community. Although welcome, this will not offer any new prevention services, or increase the tiny percentage spent on prevention, which is only about 4% of the total.
This paper is written in response to being told at a recent stakeholder meeting on 2.11.07 from director (Deborah Tomalin) that the Sussex Cancer Network’s (SCN) first aim is to prevent cancer. When I asked what plans the SCN has to do this, I was told that the cancer tzar, Dr Mike Richards is launching an initiative on this soon. The implicatation from this answer is that the SCN is waiting until that initiative is published before tackling cancer prevention locally.
Hitherto the government initiatives on prevention of cancer and other diseases have included:
Prohibition of smoking in public places, resulting in a total ban from July 2007,
- Promoting and subsidising treatment to quit smoking.
- The ‘five a day’ education initiative telling people that they should eat 5 portions per day of fruit and vegetables.
- Sexual health initiatives telling people to use condoms for safe sex.
- Drink/drive advertisements and setting limits on safe numbers of units of alcohol consumed per week for men and women, and advertisements about obesity and fat.
While welcome and worthwhile, these initiatives have had disappointingly low outcomes in terms of preventing disease. Despite record spending on health, the nation is not getting healthier, but sicker. 17 million (1 in 3) of the population is on permanent medication for a chronic condition. The health secretary (Patricia Hewitt), in May 2006, referred to the ‘Prozac nation’ inferring that we are inadvertent prescription drug addicts.
Incidence of smoking, drinking and obesity all seem to be going up in spite of all these public health warnings that we are killing ourselves by slow and painful deaths. Diabetes is up to epidemic proportions. After all this education nobody is sick or dying of ignorance. Why don’t we change our lifestyles to healthier ones?
The answer is fear which makes us irrational, and drugs which are counter-productive, making us worse, not better.
3 Stress from fear
To understand why people behave irrationally, we first have to understand their physiology. The conventional reductionist model (we are the sum of our parts) or the mechanistic model (people are machines, like tinmen) do not help because they are wrong. We are not tinmen, because we are more than the sum of our material parts, having non-material minds and souls.
The science of psycho-neuro-immunology (PNI) shows that our bodies are like a goldfish bowl of skin, containing about 100 trillion cells, like goldfish, swimming in about 10 gallons of water. Our behaviour is largely determined by the hormone in the water, which in turn depends on what our minds are thinking, moment to moment.
When we are stressed and fearful about our survival, we become aroused, and adrenaline is put into the water by our sympathetic nervous system. (1) This is picked up by the receptors in every cell, and the fight/flight reaction mobilises them to get us out of danger. We breathe rapidly through the mouth, with shallow panic breaths. All systems that are not needed are shut down, including:
our neocortex, so we cannot think rationally, except how to get out of danger
- our self-healing system of cell regeneration,
- our immune system, which fight bacteria, viruses and cancerous cells,
- our digestion, which absorbs nutrients from our food.
When the panic is over, and our survival is no longer threatened a period of de-arousa follows. Our parasympathetic nervous system changes the hormone from adrenaline to endorphins. These calm us down and make us feel good. We enter an altered state of consciousness (known as the meditative state) in which we breathe deeply and slowly through the nose, oxygenating every cell, particularly the brain, which gets oxygen directly through the nasal cavity. All the above systems are reactivated, so that we think clearly, self heal and absorb the nutrients needed to regenerate our cells, which have variable lives from a few days (mouth) to a few years (bone).
4 How disease originates
Chronic conditions arise as a vicious spiral, the worse we get, the worse we get, as follows. Modern rat-race lifestyles do not allow the above de-arousal process to happen often enough or long enough for healing to occur. As soon as one stressful situation is over, we stress ourselves with another, keeping our body hormones almost perpetually in adrenaline, rather than endorphins, as we were designed for.
We live at too a fast pace, and eat fast food containing sugar and fat, which stress our digestive and elimination systems. We have mobile phones by which we frequently share the stressful events in friends’ and family’s lives. We watch the news, (perhaps on mobile phones) which fills our minds with fearful situations. We are conditioned to identify with whoever we are thinking about, and our bodies react as if we were that person, and we become aroused with the same adrenaline reaction as they do.
Modern urban life puts fear into our minds frequently, as in the following examples. We get a parking ticket, which triggers our fear of punishment, and we over-react with an aggressive response of ‘its not fair’. The public announcement ‘do not leave baggage unattended…’ makes us fearful that every suitcase might contain a bomb which might explode and kill us. We are reminded at every news bulletin of incidents like Madeleine McCann’s abduction, and we feel for Gerry and Kate McCann. If we get a cancer diagnosis, we may see it as a death sentence, and be so fearful that we can never think rationally again, but run on autopilot, driven by fear.
We get a headache, and wonder whether we have a brain tumour. We have nobody to tell us not to worry unnecessarily so we get het up, and go to the doctor. He takes our blood pressure, which is high because of our worry. He is fearful about being sued for negligence, so to cover himself puts us on drugs to bring our blood pressure down.
These drugs have side effects which make us feel peculiar, so we go back and are put on other drugs to reduce the side effects. We are fearful about disobeying the doctor, who we see as a parent who may abandon us. We may try to stop taking the pills, but our body has got used to them, and the withdrawl symptoms may be so awful that we have to go back to taking them. We have become unwitting prescription drug addicts.
We discover that there is a secondary gain of getting ill, such as not having to work, and getting sympathy and support from friends and relatives. To justify staying ill, we go back for tests until we get a diagnosis for a chronic condition for which there is no cure. This gives us an identity and importance in which we can bask for the rest of our lives. No wonder that many of us do not want to be healed, and lose all this.
5 The solution – de-arousal
The sooner that we can break this vicious spiral, the easier and better, but it can be broken at any point, even near death, as spontaneous remissions show. For self-healing to occur, de-arousal time is needed. If left to itself, the body would do this automatically, by going sick, which pre-NHS would have forced us to change to a quieter lifestyle. We were designed to do what a sick animal does, who crawls away into a cave and stays there until it is better.
However, our mind cannot bear to do this, as we have become addicted to the rat race. We therefore go to the doctor, and force him to give us drugs to suppress our symptoms so that we can go back to carrying on as before, Our doctor has little interest in disillusioning us about this, as it justifies his existence.
We carry on with drugs, but like a zombie, unaware that we are working against our body, perpetuating the problem, and preventing self-healing. We limp on like this for a time, but eventually our body burns out and we get a more serious breakdown of health, and a diagnosis such as diabetes, a heart attack, or cancer.
To get out of this vicious spiral, we have to ask and answer the following questions:
Why are we in the rat race? Because of our mind which wants more, no matter how much we have.
- How can we get out of the rat race? By getting beyond our mind, and seeing the bigger picture.
- How can we do that? Meditation,
6 What is meditation?
The word ‘meditation’ comes from two latin words, ‘medici’ to heal, and ‘medi stare’ to stand in the mid point, or centre of the being. It has an evidence base for its healing effect which is many millennia old. The eastern religions of Buddhism, Jainism, Zen practice meditation to find the divinity within themselves. There have been hundreds of studies confirming its healing effects. The National Institute for Clinical Excellence (NICE) have recommended mindfulness meditation (watching the breath) as an alternative to antidepressant drugs.
Meditation is relaxing the body and mind into an altered state of consciousness in which the hyper-activity of the mind switches off. If wired up to EEG machines it can be shown that our brain wave frequency halves from its normal beta (c20Hz) to alpha (c10Hz) It is infectious, so that a class of beginners can have their brain wave frequencies pulled down in sympathy by one meditation leader. This process has been shown by quantum physics to be possible, called ‘entrainment into coherence.’
The science of PNI shows that in meditation the body chemistry is changed, and endorphines are released, which promote self-healing. They also stimulate the neaocortex to work so that we can think clearly, and understand the above mentioned vicious spiral that has got us to where we are. The ‘penny drops’ and in that moment we are released from the obsessional compulsions to which we were previously captive. All problems (such as fear, suffering) disappear if we accept them. Transformation and healing starts from that moment.
The process is most easily explained by the metaphor of the computer. In meditation we come to see ourselves as three parts. Our body is the hardware, our mind is the software, and our self is the operator. In meditation we experience that our self (our soul or consciousness) is neither our body, nor our mind, but simply a watcher of the screen of our mind.
In the practice of meditation we learn the knack of watching as if we were in a cinema, and we are just watching a movie. We then do not get identified with the actors, so our body does not suffer the same hormonal reaction that they have, for example adrenaline when they are in danger. We can then watch people in a detached way, say those who are angry without getting angry ourselves. We no longer need to make ‘knee jerk’ reactions to those who push our buttons (eg to insults) as we previously did, but can chose a more appropriate behaviour. Our attitude to life can be transformed from seeing ourselves as a victim of our circumstances, in hell, to being a beneficiary of life, in heaven.
7 How can meditation be included in public health?
By copying the Chinese, who have instituted the widespread daily practice of tai chi in parks in cities, at which hundreds of people participate before going to work. Tai chi and chi gung are ancient meditative practices derived from Buddhism in which we learn to watch our body and its movements in a conscious way, as if we were closely observing someone else. This promotes the altered state of consciousness and endorphin production described above. The more people doing it together, the stronger the subtle energy field, and the greater the infectious effect.
Tai chi clearly works in China. It clearly works in UK too, as there are regular tai chi and chi gung classes in every health centre and community hall, for which people pay a few pounds to meet the costs of room hire and the leader. If the PCTs paid the costs so that it was free to everyone to drop in, it would be popular, and might well attract large numbers as in China.
Meditation is an integral part of yoga, which has also become very popular. My local health centre puts on more than 20 yoga classes every week, catering for every type of person’s ability, at about £7 per person per hour. If the GPs could provide vouchers enabling their patients to attend for free, it would be a more cost-effective treatment than Prozac.
Like tai chi, exercise produces endorphins, but many people are afraid to walk in town in case they get mugged. If GPs would give them vouchers for gyms, it would be more cost-effective than prescriptions for beta blockers.
The way to prevent illness and promote wellness is meditation. The active ingredient in all CAM is meditation, so CAM should be prescribed for all patients, and indeed all conventional healthcare professionals, who need the prevention of illness and the promotion of wellness (healing) as much or more than the general population does.
1 Central government should desist from creating fear in the population, for example by ceasing public announcements to ‘not leave baggage unattended’. This is not effective in deterring terrorists, and creates unhealthy adrenaline reaction in the public.
2 PCTs should commission complementary therapies by contracting with local health centres as Alternative Providers of medical Services (APMS) to provide CAM free at the point of use to patients. In particular, PCTs should pay leaders to provide free drop in meditation classes, such as tai chi, chi gung, active meditations, (2) yoga, pilates etc.
1 Book ‘The Endorphin Effect’ by William Bloom 2001
2 See website reginaldkapp.org. section 9.3
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