10 Things I Still Believe About Health & Wellness (After Debunking Everything I Now Believe Is Nonsense)

To those of you who are new to my work, you might not know that I wrote a New York Times bestselling book called Mind Over Medicine back in 2013, which led to two PBS specials, four TEDx talks, and a training program for medical doctors in the principles from that book. That got me swept into the wellness world that I’ve lately been calling out, because of the rampant corruption, lack of trauma-informed sensitivity, destructive spiritual bypassing tendencies, spiritual narcissism in its leaders, blindness to social determinants of health and social justice issues, and over-reliance on self help when it’s systems change that we often need. All of this puts too much pressure on individuals to heal themselves, when we, as tiny selves, only have so much power to control things that need to be addressed politically, like access to women’s health, medical insurance for everyone, deconstructing white supremacy and patriarchy, and other such enormously overwhelming social health and justice needs.

With that disclaimer, many of you have been asking me where I stand now. What do I still believe about health and wellness after calling out and deconstructing both conventional and alternative medicine, in addition to some worrisome tendencies in the trauma healing spaces? Are there ways people who are struggling with medical conditions can improve their outcomes without spinning their wheels or paying a fortune for expensive wellness products? Are there any babies in this bathwater? Or should everyone just throw their hands up, go to the doctor, ignore the wellness industry’s “rugged individualism” capitalistic messages altogether, and throw out all the muddy bathwater?

Since this Substack is called The Body Is A Trailhead, using that Internal Family Systems term to apply to health, I thought I’d take a stab at a series of essays, of which this is the first. But first, let me just give you a little back story and then a few summaries of where I stand now, in case it’s helpful.

When I was an arrogant young whippersnapper indoctrinated into the brainwashing of academic medicine, I honestly believed that as a Northwestern-trained OB/GYN educated in “The Northwestern Way,” I knew how to save lives. My training program was rigorously evidence-based, with weekly journal clubs and tons of training about how to interpret statistics and evaluate a medical journal article for how credible it was. Anything health-related that fell outside the rigors of evidence-based medicine was worthy of contempt and mockery.

Within ten years of finishing my twelve years of indoctrinating training, I would wind up shattered and disillusioned, morally injured and confused, and I would leave the hospital, never to return as a practicing doctor. Unlike some, I wasn’t so disillusioned that I turned my back on conventional medicine. I still believe it saves lives and I would still use it myself and recommend it to patients for many health conditions. I’m still a fan of science and I roll my eyes at the science-deniers who justify reckless disregard for health care, public health measures, and treatments that might save lives if they are implemented.

But I no longer believe that what I learned in medical school is the whole enchilada. My medical training failed to even recognize, much less appreciate, all the aspects of healing that fall more into the “subjective” category, things like bedside manner, the quality of the therapeutic relationship, the mind-body-spirit aspects of healing, trauma-informed medical approaches to disease recovery, the impact of toxic, exploitative, or narcissistic relationships on the physical body, the effect of loving relationships on health, and other hard-to-quantify aspects of healing.

I also no longer believe a lot of the nonsense people in the wellness and spirituality world tried to imprint upon me, which I’ve been actively deconstructing here on Substack with essays like this one about Deepak Chopra in the Epstein files, this one about how destructive Byron Katie’s teachings are, and this one about how I don’t believe your soul chose your cancer (or your childhood sexual abuse or the death of your child or the natural disaster that destroyed your life.)

Leaving the hospital and landing in the wellness industry left me twice disillusioned. If the Northwestern Way wasn’t the end all/ be all, and if the wellness industry is more corrupt than healing, what support can we ethically provide for those facing medical issues and wanting to do what is within our power to optimize our health outcomes? Is there grounded ethical hope that isn’t false or manipulative hope? Are there interventions sick people might not have tried, interventions that might actually make a difference if someone is chronically or life-threateningly ill? Are there any ways we do have some power to impact our health that are free of the ills of conventional medicine and the wellness world?

To suggest that I know the answer would be the very hubris I’m pointing out here. But if you’ll humor me, there are a few conclusions I’ve landed on that I think still get too little attention in the dominant narrative of health and disease recovery.

The body is designed to heal what breaks inside, at least until we naturally begin to age and those mechanisms work less effectively. What fueled much of my career since the hospital was my curiosity about why some people get sick so young, in their twenties and thirties, in their forties and fifties. We’re all statistically likely to start having some health issues in our seventies, eighties, and nineties, because that’s just what happens to human bodies, no matter how perfectly you care for your health.

But some people’s natural self repair mechanisms seem to break down far too young. Why is that so? And some people seem to have clusters of medical symptoms that doctors can’t even really pinpoint or explain. How come? And is there any way to solve these medical mysteries?

One thing we’ve learned in the field of traumatology is that those self-repair mechanisms only operate optimally if your nervous system is in the “tend and befriend” ventral vagal parasympathetic state or the resting sleep version of the vagal state. In other words, if you’ve experienced a lot of trauma, and it’s still unhealed and unresolved, it’s practically guaranteed to cause either mental health or physical health problems if it stays untreated. So ignoring trauma in the conversation about health and wellness is ludicrous. Bypassing trauma in the conversation about healthy and spirituality is even more ridiculous. You can’t get well with magical thinking if the trauma that is dysregulating your nervous system is still underground, destroying your body’s ability to self repair.

Here’s the brass tacks. We’re all exposed to all kinds of pathogens every day, but if our bodies are working as they should, our bodies know how to protect us from being infected all the time (as long as we’re optimizing conventional medicine, getting our vaccines, and using medical science to protect us from the infections we know how to avoid.) That doesn’t mean we won’t get a sinus infection or a cold or strep throat or Covid from time to time. And it doesn’t mean we’re doing anything wrong if we do get a mild infection. But if we get infections we can no longer fight off successfully, there may be something underground making that so.

We also all make cancer cells regularly and our immune systems kill them. Autopsies have proven that 11-44% of people who die for other reasons often have undiagnosed cancers at the microscopic or macroscopic level. Most of us, at some point or another, have had cancer cells growing in our bodies and we never even know about it. (The book Overdiagnosed: Making People Sick In The Pursuit Of Health talks about this phenomenon in its argument that screening tests, while beneficial and life saving in many ways, also increase the likelihood that a cancer will get diagnosed and treated when it might have gone away on its own.) Suffice it to say, cancers come, cancers go, and if cancer stays, something has allowed that to happen, whether a genetic predisposition, the toxic waste dump next door, or a weakened immune system related to chronic nervous system dysregulation.

Also, we all have this amazing microbiome in our gut that helps keep things running smoothly. And because of psychoneuroimmunology and epigenetics, our thoughts, beliefs, and feelings affect the hormonal milieu of our bloodstream and organ function and genetic expression on a moment-by-moment basis. The human organism is a miraculous creation in this way!

But our bodies aren’t made to stay well when our nervous systems are jacked up in chronic repetitive stress responses. Anytime you’re in a “fight, flight, freeze, or fawn” state of the sympathetic or dorsal vagal parasympathetic nervous system, your body is thwarted from fixing anything that might have broken down. These powerful stress responses, which bolster survival in a real emergency but which destroy the body if firing chronically, override the body’s ability to repair what breaks, allowing chronic and life-threatening diseases to take hold and flourish, often at way too young an age.

That’s not meant to scare you or blame you, but to inspire you to care for your nervous system and its relationship to the body’s repair mechanisms with as much rigor as you might care for your body with nutrient dense foods, regular exercise, getting enough sleep, or taking vitamins.

It’s well known in conventional medicine tthat “incurable” diseases can disappear. The medical literature is full of proof that people have been cured without medical treatment from diseases as deadly and severe as almost every type of cancer, including Stage 4 pancreatic cancer and Glioblastoma multiforme. They’ve been cured from life-threatening diseases like HIV, end stage heart failure, aneurysms, heart defects, abscesses, hydrocephalus, and liver and kidney failure. They have also been cured from common chronic diseases like asthma, hypothyroidism, rheumatoid arthritis, ulcers, gallstones, diabetes mellitus, high blood pressure, ischemic heart disease, cataracts, herniated discs, and epilepsy.

The medical establishment labels these unexpected cures “spontaneous remissions,” and doctors write them up in medical journals as curious flukes. But if you actually study these people, as me and my partner in writing RELATIONSICK Jeffrey Rediger, MD, MDiv have done, you’ll realize these remissions are anything but “spontaneous.” These people work so hard for their mysterious cures that we’ve come to call them “Olympians of healing’- or more simply, “health outliers.”

The sickening reality of this research is that spontaneous remission may happen more often in those with unearned privileges. If you’re a white person with class privilege and you’re able to take time off work to get well, to pay for trauma therapy, to get away from the stressors of life to go to a healing retreat center where they feed you fresh farm to table produce and you meditate for hours every day, you might have a better health outcome than an essential worker who can’t take time off work to prioritize recovery, can’t afford trauma therapy, and lives in a food desert.

And that’s not fair. It’s just not.

Conventional medicine focuses on alleviating symptoms but stops short when it comes to helping patients figure out why their bodies broke down and why self-repair failed. Treating symptoms is important: if you’re in pain, by all means take a pill or get a surgery to relieve your pain. If a vital organ stops working, by all means take a pill or submit to an intervention that will help your organ work better or replace your organ. If you get cancer, see an oncologist.

But conventional medicine does nothing to help patients enter into a period of self-inquiry after the initiating symptoms are addressed, worked up, treated, or relieved. Once the acute intervention happens and the symptoms are allayed, a secondary part of the healing process must be facilitated, and this is where conventional medicine falls short and alternative healing modalities do a better job. Good healers, who are often expensive and don’t usually accept insurance, listen. They ask about what was happening in your life when your symptoms started. They care about how your relationships might be impacting your body or whether you’re in a cult that is making you sick or whether you’re being oppressed by an abusive boss or a tyrannical political regime or an oppressive caste system or racial injustice. They look at the whole picture, not just a body part.

Good healers know that if you fix the symptom but ignore what might be underlying it, you’re likely to get sick again. Maybe it will be a different diagnosis, or maybe it will be a recurrence or exacerbation of a current diagnosis. But those underlying issues rarely go away just because someone cut out an organ or prescribed a drug.

Experts might know what’s best for a population of statistics or for public health, but you are not a statistic, so no expert knows what’s best for your individual body better than you do. Expertise is awesome. We need our experts to offer what they offer in their respective medicine bags. But someone else’s expertise does not make them the expert of how your very personal healing journey should go. Conventional medicine undermines patient intuition, and it’s understandable why they do. Intuition is imprecise and hard to validate, and fear (of a lifesaving medical intervention, for example) can masquerade as intuition and lead you astray.

But if you’re on a healing journey, your intuition- which is a somatic experience- can help, along with critical thinking and logic, guide you to making the right choices—for you, as a unique individual who is not a statistic. Mixing your own intuition with doing your own research and also trusting the opinions of trustworthy experts- and weighing that feedback in a measured way- will get you the best health outcome. Just make sure you’re not “doing your research” with pseudoscience, medical disinformation, and corrupt wellness industry con artists who make money off you believing their fake research. If you’re not trained to study journal articles and understand statistics and evidence based medicine in peer reviewed journals, it can be very hard to do your own research and interpret it accurately.

And just make sure that you can tell the difference between the genuine intuition of Self, or your wisest inner healer, and a part of you that might have an agenda, that is scared of getting medical treatment, or doesn’t want to feel out of control, or doesn’t trust authority figures and wants to ignore experts. Parts can very effectively pretend to be intuition, and they can be very convincing! Discerning the difference is one of the hardest parts of a recovery journey. Internal Family Systems offers us a way to become intimate with our “parts” so we can “unblend” and benefit from the clarity of Self.

Share

Every aspect of your life (your relationships, your work, your creativity, your sexuality, your spirituality, your relationship to money, your environment, your food, how you move your body, etc) has the opportunity to be either poison or medicine, depending on whether these aspects of your life stressfully activate or calmingly relax your nervous system. As I explain in great detail in the description of the Whole Health Cairn in Mind Over Medicine, what I call “whole health” requires lifestyle modifications that transform what might be poison into what can be medicine.

For example, your work can be poisonous to your health if you’re sucking up to a narcissistic boss every day or selling out your integrity to earn a paycheck. Or your work can be medicine as you express yourself creatively and fulfill your calling in a way that helps you (and others) heal.

But notice the privilege in that arguably true statement. The world is full of people who have to choose between sucking up to a narcissistic boss or not feeding their children. If I had to choose between fawning a boss or drilling in the rain forest and feeding my children, I would do whatever I had to do to feed my children.

But those of us with more unearned privileges often have more choice than that. I could have stayed in the hospital working as a doctor, where I was getting increasingly sick in my twenties. But as a person with a lot of unearned privileges, I was able to choose to leave that career—for mental and physical health reasons. It took me five years to figure out how to earn a living again, but the impact on my health was enormous. Not everyone has the luxury of taking those kinds of arguably reckless risks. But if you can, it could impact your health. And if you can’t, again, it’s not fair. And I struggle with that injustice every time I talk about such things.

So yes, it’s true that when we live authentically from the life force of our Self/ Inner Pilot Light, in our relationships, our work, our spirituality, our creativity, our sexuality, our relationship to money, our mental and physical health behaviors, we have the potential to make work our medicine, make relationships our medicine, make creativity our medicine, and so forth. We can sometimes convert what is potentially toxic into what is healing, and that’s an empowering kind of agency.

And…again, that’s a privilege, to have the capacity to make those choices from a place of true authenticity and integrity. It’s easier to do this when you have more privileges and less marginalizations, and that’s not fair either.

Inflammation is a normal part of fighting off infections. When the body spots a pathogen, it mounts an immune response- with fever, redness, swelling, pain, and recruitment of immune cell activation. But metabolic diseases result when there’s too much inflammation, unrelated to infection, and the inflammatory process gets stuck in a permanent “on” position.

Harvard magazine published an article that states:

Inflammatory diseases tend to cluster together as chronic metabolic diseases- such as diabetes, cardiovascular disease, stroke, Alzheimer’s, nerve degeneration, and cancer. Because chronic inflammation underlies these metabolic diseases, if a person gets one of these diseases, they’re much more likely to develop others.

And…if you’re an undocumented immigrant in the United States right now or a BIPOC young man getting stopped by a cop or a queer Black woman just trying to get by with so many strikes against her, it’s not easy to prevent chronic inflammation, because all that outer stress is going to impact the physical body, no matter how perfectly you engage in healthy behaviors. And that’s not fair either.

In medical school, I was taught that auto-immune diseases include diseases like rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, multiple sclerosis, scleroderma, psoriasis, inflammatory bowel disease, Type 1 diabetes, and celiac disease. But nobody taught me that diseases like the #1 and #2 killer in the US- coronary artery disease and cancer- are also autoimmune diseases. Long Covid also appears to be an autoimmune disease. All of these autoimmune diseases are the long term side effects of an inflammatory process that gets stuck in the “on” position, even when there’s no infection that needs to be fought off.

As Harvard magazine asserts here:

In medical school, I was taught that, if anything, inflammation was a beneficial response to invading pathogens, recruiting granulocytes, T-cells, B-cells, macrophages, fibrocytes, antibodies, cytokines, and complement, an array of circulating proteins produced in a cascade of enzymatic activity in the presence of microbes. Once the pathogens is eliminated, suppressor T-cells are supposed to turn inflammation off.

But that’s not what happens with chronic inflammation, which is different than acute inflammation, which is easier to spot because of the Latin pneumonic we did learn in medical school- calor (heat), dolor (pain), rubor (redness), and tumor (swelling). But when the acute inflammatory response fails to eliminate the offending invader agent completely, suppressor T cells don’t call off the immune system- and chronic inflammation takes hold, often without the obvious fever, pain, redness and swelling. When this happens, the immune system goes on to slowly, gradually turn on its host and attack your body, rather than protecting it. This is what we call “auto-immunity.”

As we age, we all have some degree of chronic inflammation, which is associated with degeneration of the body. But if chronic inflammation, marked by high levels of CRP (C-reactive protein) and other inflammatory biomarkers, get high, they’re associated with all kinds of diseases, most notably coronary artery disease, cancer, diabetes, and Alzheimer’s.

So trauma causes nervous system dysregulation, and chronic nervous system dysregulation causes chronic inflammation, and chronic inflammation leads to auto-immune dysfunction, which increases the risk of almost every chronic disease process. So in effect, trauma causes inflammation-related diseases, proving that there’s no such thing as “mind-body” because the nervous system impact of psychological, emotional, and spiritual trauma is 100% in the body- as nervous system dysregulation and chronic inflammation. We should be calling it “nervous system-body” rather than mind-body, if we want to be precise.

And…the ability to get help for treating a dysregulated nervous system is a massive privilege. Many of us simply don’t have affordability or access, and that’s not fair.

Acute inflammation typically results because of infection or a neoplastic process like cancer. But chronic inflammation is different. It tends to show up in the body for three primary reasons- an inflammatory diet (metabolic inflammation), immobility, and the physiological impact of psychological trauma. Overeating or eating nutrient-free foods stimulates an inflammatory response that kicks off a whole cascade of physiological auto-immune activity. Exercise can reverse some of this, but if your diet is poor and you’re not exercising much, the effect is amplified. Complex PTSD also increases inflammatory biomarkers (read more here and here), largely related to the excess cortisol stimulated by chronic repetitive stress responses.

The good news is that diseases caused by chronic inflammation can be reversed by reducing inflammation, although this is easier said than done. Gökhan S. Hotamisligil, Simmons professor of genetics and metabolism at the Harvard T.H. Chan School of Public Health, said:

Diet-related inflammation can be reduced by limiting overconsumption and eating an anti-inflammatory Mediterranean diet. Immobility-related inflammation can be treated with exercise, when that’s possible. And of course, trauma-related chronic inflammation requires healing and treating the underlying trauma, which is expensive, time consuming, and often inaccessible to the majority of humans who need it. (And that’s not fair.)

As is typical in the conventional medical mindset, scientists have investigated whether anti-inflammatory drugs can reverse chronic inflammation, but the body outsmarts the drugs. If you block on inflammatory pathway, the body tends to switch pathways. If you block too many pathways, you create dangerous immunosuppression. The obvious answer is to reverse chronic inflammation not by using anti-inflammatory drugs, but by treating the sources of the problem- diet, exercise, and psychological trauma.

But all of that requires not just personal buy in, but also money, access, and an awareness of social stressors that can’t be treated with an diet, exercise, or therapy.

In medical school, I was taught to work 36 hour shifts without any sleep. By the time I was a practicing physician, I was expected to work 72 hour shifts without sleep- even when I was pregnant. But optimal health requires the opposite. To achieve the best health outcomes, most people need about 9 hours of solid nighttime sleep (naps don’t make up for lack of nighttime sleep.) Our bodies need our nervous systems to spend many hours in the healthy dorsal vagal parasympathetic sleep state in order to repair what breaks down during the day.

Western culture prioritizes productivity at the expense of sleep and optimal health. But especially if you’re sick and in recovery, or if you’re interested in disease prevention, sleep is essential.

And…getting that much sleep is often a privilege many people don’t have access to. And that’s not fair.

I didn’t get one single class on nutrition in medical school. Not one. I learned more about nutrition in elementary school, when they taught us about the USDA food pyramid (bread, cereal, rice and pasta at the bottom as what you should fill up on most, then fruits and vegetables next, then milk, yogurt and cheese, with fats, oils, and sweets used sparingly at the top. This pyramid has now been officially discredited, since we now know that a high carb, high glycemic index diet is not good for anyone- and that a low fat diet is not the answer, especially since products branded as “low fat” are usually loaded with refined sugars.

But they didn’t even teach us about the food pyramid in medical school. If anything, we were taught that disease is the result of obesity, of over-nutrition from too much eating. There was no distinction between empty calories and dense nutrition. I now know that the opposite is true. The hunger mechanism is repetitively triggered when people are not getting the vitamins, minerals, fats, proteins, enzymes, and phyto-chemicals the body needs in order to operate physiological processes.

The truth is that people eating a standard Western diet are not over-nourished; they’re malnourished. It’s not just that you’re eating the wrong things that can poison you, like junk food, processed foods, trans fats, and sugar. It’s that if you’re filling up on non-nutritious food, you’re starving yourself of the nutrition the body needs in order to prevent and recover from disease.

The average American over 100 years ago consumed two pounds of sugar per year. No big deal. Now the average American consumes 152 pounds of sugar per year. Our bodies were not made to handle that kind of load, because sugar is highly inflammatory. Such a high load of sugar in the bloodstream means that these sharp-edged little sugar crystals go coursing through our blood vessels and cause little cuts in the arteries, which then marshall your immune cells to come in and repair the micro-cuts. When you’re consuming a high load of sugar, year after year, this means you’re repairing cuts on top of scars, and you wind up with scars that we doctors call “atherosclerosis.”

There’s no single healing diet that works for everyone, but in general, high density, mostly plant-based nutrition that includes a broad range of nutritional value and includes low glycemic-index carbohydrates is your best bet. Think Mediterranean diet with loads of vegetables, fruits, legumes, nuts, olive oil, seafood, and chicken, minus red meat, sugar, and filler foods that are nutrient-free.

[NOTE: The Public Health Nutrition Department at Harvard and the professor at Harvard who became the head of the FDA were paid by the sugar industry to say that fat is the problem and “low fat” is the solution, but it was the sugar industry funding that to divert attention away from the research showing that sugar was the problem. Learn about that scandal here.]

And…eating this kind of nutrient dense diet is a massive privilege. Most of the world simply doesn’t have that option. Even most people in the US don’t have that option. I’m growing my own vegetables now, but even that is time consuming, requires the good weather we have in Sonoma County, and costs money to get started. We’re lucky in West Sonoma County that we have a farm swap at the Sebastopol Grange where the food insecure are invited to enjoy excess produce from some of our gardens—at no charge. But that still requires enough privilege to afford to live near Sebastopol, which is a far more expensive place to live than much of the rest of the world. If you have to buy your organic groceries at health food stores or CSA’s or farmer’s markets, it’s even more of a luxury good. And that’s not fair.

Nutrition as medicine, exercise, getting enough sleep, following doctor’s orders, and other traditional wellness behaviors are essential building blocks of whole health, but on their own, they’re insufficient for optimal health outcomes. You can eat the world’s most pristine anti-inflammatory diet, work out every day, sleep 9 hours per night, take 100 supplements, and get the best conventional, alternative, or integrative medical treatment in the world. But if there’s untreated trauma impacting your nervous system, or if you’re making lifestyle choices that continuously retraumatize you- like staying close to an abusive narcissist or living under the influence of coercive control, you’re unlikely to be permanently cured from any chronic or life-threatening illness.

If you have poor boundaries and stay in toxic relationships, you’re effectively marinating the cells of your body in the stress hormones of epinephrine, norepinephrine, and cortisol, rather than the healing hormones of endorphins, oxytocin, dopamine, and serotonin. This ultimately causes your cells to misfire, break down, malfunction, and fail to do their jobs of self-repair. Instead, they will begin to attack the body that they are sworn to protect.

Not everyone can leave an abusive marriage, find a better job, get enough sleep, get the right trauma therapy, and create a life your body will live. If you can, by all means, see what happens if you practice nervous system hygiene, if you create the conditions for optimal self repair. At least anecdotally, this approach has optimized outcomes for many of the people Jeff and I have studied, and many people who have put the principles of my books Mind Over Medicine and Sacred Medicine and Jeff’s book CURED into practice.

With all my previous disclaimers, I still want to encourage you to read RELATIONSICK if you think your physical health condition might be related to relational trauma, past or current. With health equity and accessibility in mind, we did our best to boil down the best advice the two of us can come up with into an actionable treatment plan for anybody who can afford the cost of a book. We know it doesn’t replace the best trauma therapies, and we won’t make any grand promises.

But if that’s one aspect of improving your health you haven’t tried, I encourage you to at least consider reading our point of view on this overlooked aspect of health that few doctors or wellness industry providers are talking about.

And if you are a doctor, therapist, or health care provider yourself, please consider reading it in case it might help your patients, as a way to get them started and as an adjunctive supplement to the kind of treatment you provide. You can preorder anywhere you get books and learn more about the book here.