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122 Cards in this Set

  • Front
  • Back
What are principles of physical medicine?
1. Restore structural integrity- if you can restore structure, you can restore function
2. Recognize value of individualization of therapy: lesion specific, constitutional treatment
3. Enhance self-regulatory systems of the body to restore functionality, well-being and reduce pain
4. Treat soft tissues and osseous (joint) structures
5. Use minimum force (do no harm! Don’t use more force to compensate for bad technique)
6. Stimulate flow (blood, lymph, nerve) to increase vitality and health
7. Magnetic treatment
8. Educate patient for self-care (docere, prevention)
According to Bastyr, what is his most important modality?
“My hands”
What is concept of unity of disease?
Disease cause by deviance from a natural lifestyle and disease is the body’s adaption to that deviation
Goal of naturopathy Tx: remove cause/obstacles to the action of the vital force and vis
Who developed unity of Disease? And What year?
Dr. Splitter, 1948
What is structural integrity?
restoration uses manual methods, instrumentation, injection, exercise/rehab, Dr./Pt. relationship (intention), surgery (refer)
What is standard american lifestyle?
no exercise, abnormal diet, physical/postural stress, injury, environmental toxins, psychological stress
What are results of standard american lifestyle?
abnormal circulation, tissue wear/tear, toxin accumulation, fibrous tissue formation, tissue impingement, pro-inflammatory metabolites
What does standard american lifestyle lead to?
abnormal biomechanics, fixation, postural distortion, misalignment, tissue texture abnormalities, pain
What is history of manipulation?
Hippocrates (“Father of Medicine”) used spinal traction and massage. Bone setters: no formal training, passed down techniques in families
HIstory of naturopathic medicine as it relates to physical medicine?
Physical medicine/ manual therapies were primarily included in original curriculum (American School of Naturopathy- Lust)
After Flexner Report (1910), decrease in botanical/homeopathic programs. Then they became include in ND programs.
In 1930s, increase in physiotherapy and visceral manipulation (bloodless surgery)
Original manual medicine techniques: Neuromuscular Technique/ General Naturopathic tonic Tx
What are therapeutic goals of natural medicine?
circulation, healing, vitality, vis medicatrix naturae
Lindlahr referred to physical medicine as:
physical culture, mechanical remedies, manipulative Tx, spinal manipulation, mechanotherapy, massage, Swedish movements, magnetic Tx
Who said: "“Permanent health through perfect circulation” "
Lindlahr
“Displacement of bones (bony lesions) putting pressure on blood vessels therefore interfering with circulation to corresponding organs.”
Lindlahr
What is the rule of artery?
manipulate the spine to restore blood flow and restore the body’s innate healing ability
What is Somatic Dysfunction?
impaired or altered function of related components of the somatic system (skeletal, arthrodial/myofascial structures, related vascular/ lymphatic/ neural elements
What is still's osteopathic philosophy?
Unity of body, healing power of nature, somatic component of disease, structure governs function, manipulation key Tx to restore function
Who said "“Pressure on the nerves which shuts off vitality of the organs supplied by the affected nerves which lead to disease”
Lindlarh
When did A.T. Still articulate osteopathic principles?
1874
Who articulated chiropractic principles? When?
D. D Palmer 1895
rule of artery
manipulate the spine to restore blood flow and restore the body’s innate healing ability
somatic dysfunction
impaired or altered function of related components of the somatic system (skeletal, arthrodial/myofascial structures, related vascular/ lymphatic/ neural elements
dr still's osteopathic philosophy
Unity of body, healing power of nature, somatic component of disease, structure governs function, manipulation key Tx to restore function
who said "“Pressure on the nerves which shuts off vitality of the organs supplied by the affected nerves which lead to disease”
lindlahr
how do you adjust displacements called subluxations?
manipulation in form of “thrusts”
What is the law of nerve?
adjust spinal ‘subluxations’ to restore nerve flow and facilitate the body’s innate healing ability
innate intelligence
all life contains innate intelligence and that this force is responsible for the organization, maintenance and healing of the body
what is naprapathy?
soft tissue technique manipulative therapy focusing on neuromusculoskeletal conditions emphasizing underlying ligaments
who developed naprapathy and when?
(Dr. Oakley Smith, 1890s-1900s)-
What did lindlahr say about naprapathy?
“Connective Tissue Doctrine of Disease with ‘ligatights’ which are a shrunken condition of the connective tissue.”
how are ligaments corrected naprapathically?
by naprapathic “directo’s” which will stretch strands of shrunken connective tissue
How did lindlahr say about naprapathy?
Neuropathy (Dr. Lindlahr)
“Our system of manipulative Tx (naturopathic) including all that is good in osteopathy, chiropractic, naprapathy, spondylotherapy, neuropathy, massage and Swedish movements.”
what is naturopathic manipulation?
Form of manual medicine, used by Kneipp & Preznitz. Lust & Lindlahr used manipulation
which Hydropathic doctors used manipulation?
Kellogg, graham, kuhne
When was Manipulation declared part of scope of Naturopathic medicine?
(1902)
What does dr. nick say about naturopathic manipulation?
“Treats circulatory/ nerve flow dysfunctions with tissue involvement.”
how is a Naturopathic lesion (“fixation”/”restriction”) treated?
by being “released” by naturopathic corrections
Effects of manipulative tx?
stimulation, relaxation, loosening
The Practice of Nature Cure
lindlahr
How to re-establish normal mobility?
work muscles (pressure, stretching), stretch spine, apply manipulations, spondylotherapy (stim. nerve flow), active/stretching movements
What are Tx Reactions of manipulative therapies?
after removal of lesion, disease process reverses; watch for healing crisis/reaction
What did lindlahr say about Magnetic Tx (Lindlahr)?
power of intention; vital force transmitted through electric cells; body “liberates” vital energy; life force is healing force; vis medicatrix naturae
who said “The best physician in us is love”
~Paracelsus, Lindlahr
Who believed in "commitment without hesitancy"?
Johann Wolfgang von Goethe:
What was dr. nick's attitude about commitment in phys med?
do not hesitate with manipulation; commit; don’t be wimpy!
What are 7 Tx parameters for phys med?
1 Don’t ignore patient requests!
2 Follow naturopathic principles.
3 Be medically sound in your Tx plan.
4. Be economically prudent.
5 Use appropriate follow-up.
6 Treat patient with unconditional positive regard.
7 Keep in mind: ideal vs. real (practical/positive)
What are a successful physical medicine doctor's qualities?
“built on the physician’s individuality, personhood, inwardness of consciousness, empathy and compassion which is related to the physician’s maturity, personal growth, interpersonal and intrapersonal communication skills and life experiences”
• Which organon said: “Eliminating all symptoms and signs of disease”
organon 8
• Retuning the Vital Force
– Organon § 17
If the physician causes the pains to cease by a dose of Morphine, can we call that freedom?
Is the patient not made stupid beyond the recognition of the nature of his feelings?
The large doses of the old school produce anything but freedom.
James Tyler Kent, Lectures on Homoeopathic Philosophy
who said
"To the surgeon elimination means cure. To the allopath, the modern homoeopath or the pantherapist suppression, diversion or elimination means cure. But to the true homoeopath (naturopath) a cure consists of but one thing, and that is the eradication of the predisposition to the disease to be cured. When this is accomplished the disease can never return, neither can it be transmitted. This and this alone constitute a true homoeopathic cure.
Ex) Antibiotics for recurrent ear infections:
Alfred Pulford on Cure
What is reductionism?
Reducing complex systems to constituent parts; A philosophical position; Complex system is nothing but sum of parts
• It can be reduced to individual constituents
What is dynamic disease?
“untunement” of vital force
– mechanical trauma
• ex: broken bones, spinal subluxation
– diseases of lifestyle
• ex: obesity, cardiovascular disease, type 2 diabetes, excessive stress, deficient nutritional substrates
– organ failure
• ex: Pancreas failure in Type 1 Diabetes
– diseases of suggestion
• ex: anorexia nervosa when negatively psychologically influenced by advertising models
Examples of non dynamic disease
advertising models
What are examples of drugs used to treat nondynamic disease?
• Example: Drugs Used in Organ Failure
i.e. Bio-Identical Hormones
• Bio-Identical Hormones
• Hypothyroidism à Thyroid Hormone
– Hashimoto’s Autoimmune Hypothyroidism
– Surgical or Radioactive Ablation
• Addison’s Disease à Cortisol
• Type 1 Diabetes à Insulin
• Menopause à Estrogen, Progesterone
• Congenital Growth Hormone Deficiency à GH
What are examples of: Mechanical Problems requiring mechanical therapies?
– Ex) broken bone must be set
– Ex) spinal subluxation requires physical medicine
– Ex) organ failure (i.e. hypothyroid) requires hormone replacement
– Problems of an untunement of the vital force require a vitalistic therapy
What is general history of pharmacology?
General History of Pharmacology
• The Ebers papyrus: Egypt 16th century B.C.
– Pharmacopia: beer, turpentine, myrrh, juniper berries, poppy, lead, salt, crushed precious stones, lizard's blood, swine teeth, goose grease, ass hooves and the excreta from various animals.
– Ancient China
– Pen Tsao, or Great Herbal
• Forty volumes - several thousands of prescriptions
• 18th Century England
– Purple foxglove, Digitalis purpurea
• One of 20 herbs used in folk remedy to treat dropsy
– Isolated cardiac glycoside digitalis
• Drug still used today to treat heart failure
– 19th Century
– Morphine isolated from opium poppy
• Papaver somniferum
– Anti-malarial quinine from the bark of the cinchona tree
• Cinchona officinalis
1908: Creation of American Society for Pharmacology and Experimental
What is the history of aspirin?
• 1897 - Felix Hoffman
• Research chemist synthesized acetylsalicylic acid (ASA)
• Worked for “Bayer and Co.”
• NOTE: Dr. Lust Started Naturopathy in approximately 1896
• February 1, 1899, Aspirin® trademarked
• March 6, 1899, Aspirin registered Patent in Berlin
• Not until 1971 mechanism of action discovered
• 1981: Sir John Vane earned Nobel Prize in Medicine
• Chemical Neurotransmission
Who was john newport langley? and what were his years?
(1852–1925)
• postulated a “receptive substance” in nerve stimulation
• Concept of chemical transmission
• Thomas Renton Elliott (1877–1961; not shown)
• Langley’s graduate student
What is history of penicillin?
• 1928: Alexander Fleming discovers Penicillin in London- Petri dish accident
• 1930: Cecil Paine, Surgeon 1st to obtain cure with PCN Topically for eye infections
• Ernst Chain and Howard Florey: The Lancet in August 1940
– 1st production and purification of PCN
– 1st animal study published (mice)
• Strep Pyrogenes and Staph Aureus
• 1945 – Nobel Prize for PCN Fleming, Florey and Chain awarded: Nobel Prize for discovery of Penicillin
HIstory of streptomycin?
• 1st Antibiotic Cures of TB and Typhoid Fever
– 1945
– Made possible to treat gram negative bacterial infections with antibiotics
• NOTE: Dr. Lust died in 1945
History of prescription insulin?
• 1922 – Insulin invented
– Frederick Banting and Charles Best
• University of Toronto
• With JJR MacLeod and JB Collip
– Eli Lilly and Co. began mass production
– Made it a pharmaceutical giant
– “Iletin”
• Early Insulin
• Types: from cattle and pigs
• 1926: Crystallized insulin
• 1936: Protamine insulin introduced
• 1954: Lente insulins introduced
• Impurities existed:
– Anaphylaxis and other reactions.
• Billy Leroy - 1923
First Patient Treated With Insulin
• Today Type 1 Diabetic Pro Atheletes
History of cortisone?
• By 1940, 28 adrenal steroids had been isolated by Kendall and Reichstein
– including
• Cortisone
• hydrocortisone (cortisol)
• corticosterone
• 11-deoxycorticosterone
• 1947 – Kendall & Merck chemists
– Economical method to synthesize cortisone
• 1949 - 1st published report of cortisone to tx rheumatoid arthritis (RA)
Had such an enormous impact on the scientific community that the Nobel Prize in Medicine was jointly awarded to Philip Hench, Edward Kendall, and Tadeus Reichstein just 1 year later.
What was the great divide in naturopathic pharmacology history in terms of ANA?
• Traditionalists vs. Modernists
• A brother’s debate
• Robert Carroll
– 1st President of Western American Naturopathic Association
• Split from Lust’s ANA
– Accused of “pseudo-medicalism”
– Embraced advances in medical training & science (i.e. physiology, etc.)
• O.G. Carroll
– Loyal to Dr. Lust
– Tried to unify the profession after brother’s organization split from ANA
– Did not believe in modern medical training
– Students should only learn Nature Cure
• i.e. hygiene (air, food, light, water/hydrotherapy)
– Father of Constitutional Hydrotherapy, Food Sensitivity Testing, & 42’s
Who said " “We don’t want iconoclasts and extremists,” he wrote. “We want to give the patient the best.” “The naturopath of the future will be a regular doctor. He will have changed his methods and adjusted his system to give complete service. Our schools must advance and our schools must teach what is right in surgery and obstetrics. There are times even when drugs are necessary. Don’t be so radical
Lust (1935)
What's significance of William Turska?
of the famous “Turska’s Formula”
• Turska “all therapeutic agents are drugs, good drugs can become bad drugs and bad, good, it’s all in how you use them”.
• Oregon Law Influenced by Turska’s legacy in Oregon. March 1993: Senate passed bill that changed term “naturopathy” to “Naturopathic medicine” and removed the word “drugless” from the practice act.
John Bastyr ND?
• Model for Modern Naturopathic Physician. First, was Chiropractor, Added Homeopathy to modern ND Curriculum. Direct descendant (5 generations) in training from Hahnemann through Adolph Lippe, best homeopath of all time. Learned Constitutional Hydro from O.G. Carroll & taught legacy to Dr. Andre Saine (greatest living homeopathy/hydrotherapy scholar) in Montreal Canada.
– Utilized latest lab techniques & wanted to prove & document naturopathic successes scientifically
Henry Lindlahr?
Philosophy of natural therapeutics. - Father of “Scientific Naturopathy”
• Diagnosed with DM2 at age 35, An incurable disease at that time
• Cured by Father Kneipp in Germany via Strict vegetarian diet
• Returned to U.S.
à worked hard to get M.D. school to try to gain acceptance of Nature Cure treatments
• “Philosophy of Natural Therapeutics”
• Founded Nature Cure school in Chicago
• Strong emphasis on conventional diagnostic techniques even if used nature cure treatments
• Dr. Krinyon is modern day Dr. Lindlahr, bringing his work current
Overview: ND Pharm History in AZ
• Vague history from 1935 forward.
• 1950’s Kuts-cheraux. Courts determined ND’s don’t have prescriptive authority. Some had been doing so since 1935.
• 1992 – Statute changed & allowed Rx authority, But it was not very clear
• 1993 - Oregon ND’s gained Rx rights in 1993.
• 1997 – DEA Licenses in AZ for controlled substances ($500 for 2 years)
• 2002 – Sunset review – specificity defines pharmacy same as everyone else except 4 classes. No Class 1 is LSD, class 2 is morphine (which is OK), but not hydrocodone, chemotherapeutic. Class 3, Class 4. NDs are considered midlevel practitioners.
• Current ongoing effort to modify IV language to add nutrient “IV’s, minerals, and other nutrients”
• Current, AZ ND Pharm Legal Definitions
drug definition of compounding and year? >
• Drug Definition
• Controlled Substance

• 1951: Kuts-Cheraux vs. Wilson
• Wilcox v. Carroll (1921), 127 Wash. 1, 219 P. 34, the Supreme Court of Washington said:
“Appellant is what is called a sanipractor physician, not licensed as a full sanipractor, but licensed to use the methods of treating disease known as hydrotherapy, dietetics, electrotherapy, and psychotherapy. Such practitioners are not permitted to use drugs such as physicians of the regular schools use, nor to perform operations.”
1951: Kuts-Cheraux vs. Wilson
"From the above, it seems that the practitioner of naturopathy and chiropractic is limited to nonsurgical and nonmedical methods, while the osteopathic practitioner is placed more nearly on an equal with the medical physician."
1952 washington ruling
Standard of care for a drugless healer
What were findings on 25 years of data on appendicitis in Annals of Surgery (1955)?
• Prior to antibiotics:
– Mortality rate with surgery:
• Unperforated acute appendicitis = 0.23%
• Perforated mortality rates = 18.8%
• After introduction of antibiotics:
– Mortality rate if perforated = 2.7%
• Annals of Surgery - 1955
Increase in mortality due to increase in perforation
Antibiotics did NOT play significant role in perforation
• In other words:
• If appropriate referral was made within appropriate TIME,
(during the pre-antibiotic period of history)
• There was efficacious tx for appendicitis with almost negligible mortality rate - i.e. Surgery
• What was the impact of the Kuts-Cheraux & Carroll cases on the history of naturopathic scope of practice?
limited scope of naturopathy not to include prescription drugs
What is take home message in Caroll case? What principle did he violate?
violated: FIRST, DO NO HARM
– Know your limits medically & therapeutically.
– Refer appropriately.
– By not following this principle court decisions imposed significant limitations on naturopaths by classifying them as “drugless healers”. It took 40+ years for ND’s to earn Rx rights after these cases.
Examples of safety reasons to use prescription drugs?
– Acute Asthma Attack:
– Insulin Dependent Type 1 Diabetes – UNDIE caused death of child by getting him off of Insulin, media fiasco.
– Life Threatening Acute Infectious Diseases
Where does pharm fit into therapeutic order?
Therapeutic Order
• Hierarchy of therapeutic intervention
• Ordering of the naturopathic modalities
• Concept is somewhat plastic
– evaluate patients’ unique situation
• Therapeutic Order
Pizzorno: Textbook of Natural Medicine, 3rd ed.
1. Establish the conditions for health
2. Stimulate the healing power of nature (vis medicatrix naturae)
3. Address weakened or damaged systems or organs
4. Correct structural integrity
5. Tx pathology: with natural substances or modalities

6. Tx pathology: specific pharm/synthetic substances

7. Suppress or surgically remove pathology
source of: "“The actual therapeutic order may change, depending on the individual patient's needs for safe and effective care. The needs of the patient are primary in determining the appropriate approach to therapy.”"
From Zeff J, Snyder P. Course syllabus: NM51 71, Naturopathic clinical theory. Seattle: Bastyr University, 1997–2005.
What is take home message of case discussion: "• Case Discussion
“A Young Man Suffering from Grave’s Disease” by Jamie Oskin, ND and Stephen Messer, ND ?
that homeopathy can assist with allopathic medicine... palliative and curative therapies not mutually exclusive
What is informed consent?
• PARQ: Procedure, Alternatives, Risks, Questions
• Shared decision-making w/patients. Giving patients all reasonable options & making a shared decision.
• Example:
• Did Carroll exercise full informed consent with his patient in the case?
Example of efficacy?
• Situations when drug therapy (or surgery) is a reasonable option with a high likelihood of cure and natural treatments do not offer a comparable alternative in terms of evidence for efficacy:
• E.g. Chemotherapy for testicular cancer – 90% cure rate
give examples of Severity/Intensity of progression of disease where drug therapy can effectively alter the prognosis, via palliation or cure
Can you think of some examples?
Ex) Grave’s case – palliate heart sx’s to prevent CHF
Ex) Severe Acute Flairs of Auto-immune Diseases
Crohn’s, Ulcerative Colitis, Rheumatoid Arthritis, Lupus
Ex) Severe Acute Emergencies
Status Asthmaticus  Albuterol Inhaler
Why is osseous manipulation used?
: To:
Restore motion (joint play)
Restore alignment
Repair tissue texture abnormalities
Reduce pain
Reflex effects (visceral)
Psychosomatic conditions
To stimulate vis medicatrix naturae
What is pain?
A: The natural consequence of tissue injury
Unpleasant sensory/emotional exper: actual/potential tissue injury
Most common reason for physician visits
Graded on a visual analogue scale (vas): 0 – 10
What are 3 types of pain? Describe each type
: Nociceptive: Most Common, Acute
 In connective tissue (somatic), skin, &internal organs (visceral)
 Causes: mechanical, thermal, chemical stim. (injury) to tissues
 Produces sharp, dull, achy, throbbing pain
 Can be treated w/physical medicine/medications
 When damage heals: pain ends
 2. Neuropathic: Chronic, Phantom - May Be A Disease Itself
 Involves damage to pns & cns fibers
 Causes: dm, spinal cord injury, entrapment neuropathies (e.g. Carpal tunnel), shingles
 Produces shooting, burning, tingling, pain, & numbness, e.g. What you feel like after you fall asleep on your leg
 Difficult to treat, may respond to medications (e.g., nsaids, ca+ channel blockers-/anti-seizure meds, topical lidocaine, cayenne, medical cannabis), & phys. Med.
3. Psychogenic: Still Real
What provides our bodies with proprioception?
A: 4 types of mechanoreceptors
• Four types: 1,2,3,4
o Types 1,2,3 encapsulated& found in joints/periarticular tissues
o Type 4 is a free nerve ending, a nociceptor
• Responds to tissue injury
Found in skin, joint capsules, organs, ct and muscles
What is manipulation, why do we use it?
: Use manipulation to restore alignment and joint mobility
Controlled Motion To Restore Joint Play (Release Fixation) Through Proper Musculoskeletal (Somatic) Alignment
• Restricted Joint Motion (Loss Of Joint Play) -> Increased Nociceptor Firing (Type 4) -> Pain Sensation
• Stimulation Of Mechanoreceptors (Types 1,2,3) (Through Motion) Inhibits Nociceptors (Type 4): Reduces Pain
• Manipulation stimulates mechanoreceptors (type 1,2,3) which inhibits nocieptors (type 4): reduces pain & hyperexcitable central state leading to a state of relaxation or feeling of well being (parasympathetic remains higher, by contrast).
How do we get into a hyper excitable state? What does it cause?
: Nociceptive activity (joint fixation) reflexively activates sympathetic and leads to a hyperexcitable central state.
Leads to:
 Pain, sweating, palor, nausea, vomiting, abdominal pain, sinus congestion, dyspnea, palpitations, chest pain
What are the benefits of manipulation?
¼ patients get positive Non-musculoskeletal Benefits After Manipulation From “Gating” Of Sympathetic Nervous System:
 Easier to breathe
 Improved digestive function, reduced abdominal pain
 Clearer /sharper vision & improved hearing
 Improved circulation
 Improved acne & eczema
 Therefore: improved sense of well-being
What stimulates mechanoreceptors?
A: Manipulation, Exercise, Body work
 Physical activity decreases risk of cvd, dm, htn, colon cancer, depression
 Physical activity increases mental health, fosters healthy muscles & bones
 Early n.d. literature: exercise a fundamental pillar of health
 Lindlahr describes exercise as: active & stretching (swedish) movements & curative gymnastics
 Compared to detox, more toxins released from exercise (active) sweat than from sauna (passive) sweat
 Increases # of mitochondria in muscle cells -> increases energy for muscle contraction, relaxation, & healing of tissue damage
 In conjunction with electromagnetic force (emf) exposure, exercise increases the efficiency of the cell membrane potential (na+/k+ pump): enhances exchange of nutrients & waste material across cell membrane
Who was the proponent for "physical culture"? What is it?
A: Bernarr Macfadden: 1868-1955
It is combination of Bodybuilding w/Nutrition & Health Theories, e.g. Fasting; publishing empire
 Favorite Exercise Was Walking Barefoot Because Energy Of Earth Came Up Through His Feet
 Dew Treading – Earthing - Grounding
 Physical Culture Was Replaced By Terms: Physical Education, Fitness Training, Exercise
The perpetual sitter refers to what?
: With changes in society since industrial revolution, sedentary lifestyle increased: ‘the perpetual sitter’-> initiated physical activity as exercise
 supported by increase of literacy and democratization of printing
o Magazines and books on exercise and health
 supported by mass production & commercial sale of exercise equipment
What is "green exercise"?
A: connecting to nature through informal physical activity in presence of nature
 Physical exercise undertaken in relatively natural environments
 Additive effects w/H2O and blue/green color
 Studies show benefit from as little as 5 minutes of exposure
 Effects include an increased sense of self-esteem, well-being, calmness, and a decreased sense of stress and anxiety
 Can be combined with earthing
What is forest bathing, where was it started, and what was its benefits?
Started in japan, called shinrin-yoku: Walking in a forest environment with Aromatherapy: Inhale volatile substances ‘phytonices’ (wood essential oils)
 Boosts immunity, NK cells, anti-cancer proteins
 Decreases cortisol, pulse rate, BP
Q: Who first used ‘biophilia’ ‘Love of nature/life or living systems’, who expanded upon it and What is it?
A: It is an innate connectedness to nature
 At the heart of green exercise
 Eric Fromm first used to describe psychological orientation of being connected to all that is alive & vital
 Expanded by E.O. Wilson to describe connections that human beings inherently seek with Life
Q: What are the 3 proven ways exercise claims to improve cognition (neurogenesis-neurons/neuroplasticity – synapses)?
1. A: Physical exercise: Walking 45 minutes 3x/week
2. Meditation/mindfulness – attention (the elixir of neuroplasticity) – Einstein had same number of neurons, but had way more synapses & connections. [Switching attention among different tasks.] Caffeine increases neuroplasticity.
3. Some video games for memory and decision making: “Space fortress”, “Rise of Nations”, (lumosity.com cognitive training – SK’s suggestion)

Turmeric and pomegranate juice may increase memory.
Who coined the term nature deficit disorder?
Richard Louve, coined term
how do you define health?
a state of complete physical, mental, and social well-being and not merely absence of disease (WHO).
how do you define disease?
An expression at somatic level in physiological or biochemical pathology of body function or structure
define illness?
In contrast to disease pathology, illness is our experience (subjective perception) of dysfunction from the disease
semantics: which of these terms would you prefer to be?
 Medical provider vs. Health Care Provider – health care provider term has much larger umbrella.
 Physician vs. Doctor – all physicians are doctors, not all doctors are physicians (word physician means “from nature”, doctor means “teacher”).
 Patients vs. Clients – depends if you are in a licensed or unlicensed state, also patient implies personal healing relationship, vs. client may seem impersonal, like a doctor doing your taxes.
 Cure vs. Heal – cure comes from the outside, healing considered a subjective process.
 Adherence vs. Compliance – adherence is more long term, compliance is more short term.
 Agreement vs. Comittment – agreement is an understanding where people are on the same page, but commitment seems more solid and long-term
What is an exercise of self-inquiry?
 Write down: what are predisposing (e.g. genetic factor), contributing (continue to smoke if you have lung problems), and maintaining (persisting in your behavior) causes of your symptoms?
 Look for stressful events, conflicts around time of the onset
 Become aware how every aspect of your life influences your health
 Look at your health as your responsibility
 Ask “what does this illness permit you to do that you would not usually let yourself do?”
What is bach's philosophy?
 Edward Bach, MD created Bach’s Flower Remedies: “disease is often result of conflict between one’s learned (conditioned) personality and one’s basic inherited nature.”
 Whenever one acts so that one’s actions are in harmony with one’s underlying basic nature, health and happiness will ensue. If not, disease/illness may manifest
 How to restore health: restore lost harmony between one’s actions & basic nature
Who stated: “Organs will weep tears that the eyes cannot shed.” Somatization
sir william osier
What is somatization, and what are some examples?
Illness as sign of emotional repression

 Emotions and body are deeply intertwined
 Link between physical symptoms and suppressed emotions:
 Anger, anxiety, fear, resentment, betrayal, low self esteem,
 Emotional repression can exacerbate or complicate: treatment of simple conditions
Constipation Holding on
What is betrayal? What are the ordeals associated with it?
Betrayal: Universal experience. Emotional reactions, emotional ordeals, tests and trials of the betrayal-to-trust initiation of the soul. Sometimes we feel our health or purpose betrays us.
 Ordeal 1: Resentment
 Ordeal 2: Denial – keep ignoring your sen
 Ordeal 3: Cynicism – “men are a*****s” “women are b*****s”
 Ordeal 4: Self-Betrayal – you lose self-trust
 Ordeal 5: Paranoia
What is the causation model and who innovated it?
George Engle, MD: Biopsychosocial Field of Disease
What is the concept of psychological stress and disease?
Psychological stress occurs when an individual perceives that demands tax or exceed his or her adaptive capacity
What concept is Walter Cannon known for?
Fight or Flight (SAM – Sympathetic Adrenal Medullary)
What is significance of hans selye?
General Adaption Syndrome (HPA Hypothalamic Pituitary Adrenocortical).
What is stress linked to?
Depression, Cardiovascular disease, HIV/AIDS, Immune and autoimmune system disorders, Cancer
What is compensated stress?
(PNS rebound) e.g. roller coaster ride is fun and you want to experience the thrill again vs. Non-compensated stress.
what is difference between chronic vs. brief focal traumatic
chronic traumatic: events that continue to be experienced
Stress
negative reaction to adversity
eustress
positive stress
Self-defeating behavior?
Dysfunctional behavior may simply be a bad habit or related to deeper negative feelings or indirectly expressed feelings, e.g. procrastination, alcohol, drugs, negative self-talk.
Tools as a practitioner you can use to help your patients with self-defeating behavior:
 Somatization
 Motivational Interviewing
 Transformative Learning
what are techniques to facilitate reflectivity perspective transformation?
1. Self-examination
2. Exploration of new roles
3. Development of a plan of action
4. Acquisition of knowledge and skills for implementing the plan
5. Tryout of the plan
6. Development of competence and self-confidence
7. Experience of life (health) on the basis of new perspectives
How do you seize control of self-defeating behavior?
1. Identify health risk or dysfunctional behavior.
2. Mobilize ‘motivation’.
3. Create change strategy and contract for specific action.
4. Practice/learn alternative responses to triggers & build more adaptive behaviors.
5. Discover support in your environment to continue behaving in new way.
What are attributes of self-management?
Self awareness, realization and acceptance; Goal specification; Situational control; Incentive modification; Rehearsal/resolution
What are stages of change? Hint Dr. Rick taught us these in Q1 orientation
Stage 1: Ignorance -> Stage 2: Recognition -> Stage 3: Planning -> Stage 4: Action -> Stage 5: Repetition