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Healing without Freud or Prozac

by By Dr David Servan-Schreiber

listed in mind body

As prescriptions for antidepressants in the UK have tripled in the last decade alone, as record numbers of people seek help to combat anxiety and stress, and as evidence of the links between stress and disease increases exponentially – leading US psychiatrist Dr David Servan-Schreiber brings fresh hope and promise to the arena even from the front cover of this book:

"Natural approaches to curing stress, anxiety and depression without drugs and without psychoanalysis."

"The New Medicine of the Mind", it says. I wonder, is this another misguided attempt to capitalize on our rapid increase in insights to the functional neuroscience of the mind – or does he really 'mean it'? Overall I think that he does…

And he should know – he is a clinical professor of psychiatry, University of Pittsburgh School of Medicine, with a PhD in Cognitive Neuroscience, and Medical Director for a hospital-based centre for Complementary Medicine. It becomes evident, again, that a very high level of understanding of all aspects of traditional and CAM approaches, as well as a very significant related exposure to the neuroscience are providing the freshest insights within this highly marketable arena. No wonder it has taken this long.

But it isn't new – at least the 'medicine' isn't. Most of it is centuries old. And sensibly so – Dr Servan-Schreiber has entered this 'market' – with what I hope will be a landmark publication (already a bestseller in France, Germany, Switzerland and Canada) – with what many would consider to be a highly controversial book.

The seven healing methods described are: heart coherence, EMDR (eye-movement desensitization and reprocessing), the energy of light, the control of Qi, omega-3 fatty acids, physical exercise and emotional communication. After much deliberation, having read the book word by word, cover to cover, I have decided not to discuss these at all – because you really should just buy the book! That way there is no risk of diluting the superbly presented evidence, and of providing potentially ineffectual 'how-to summaries'. This in itself is a huge endorsement of this text.

Is it controversial? Well, not really. It could only be controversial to the close-minded, at least as long as those individuals who actually need medical attention still present to their doctors. David has largely been judicious in selecting methods which are bathed in evidence of effectiveness, studies which demonstrate that where applicable the benefits at least equal, if not exceed, those expected using pharmaceutical approaches. Without the side-effects, and the costs.

At the outset he presents a refreshingly comprehensible platform of the neuroscientific basis of 'psychological stuck-ness' (with all its physiological consequences). Perhaps not a light read for many but it is extremely well written and if this is a book which is relevant to you, it should not anyway be skim-read. He describes for the first time in the public arena (to my best knowledge) how two of the most important and huge facets of the brain (the rational 'cognitive mind' and the 'emotional' whole-body-commanding 'Limbic System') can stop working co-operatively. In this respect, issues 'stuck' or 'inappropriately-encoded-in-the-now' in the Limbic System – and over zealous efforts by the cognitive mind to smother its 'output' – are key. What a relief! At last…

What I believe is lacking – to a very discerning eye, which may matter not one bit to anyone else – is a lack of effective 'backward reflection' of the methods Dr Servan-Schreiber describes to the fabulous, exciting (and in my opinion 'spot-on') assertions about the neuro-scientific basis for stress, anxiety and depression that he makes at the outset of the book. Astonishingly he avoids mentioning 'psychoneuroimmunology' (PNI) throughout. Hence the book lacks the understanding afforded by this massive field of research about how the Limbic System affects the body (including relevance to all seven methods) – and our total appreciation of how-it-all-works.

In this respect the assertion that reduction in stress achieved by 'cardiac coherence' is attributable to the heart-brain relays (which allow physiological optimisation of heart function) is, in my view, dilutionary. This matters because the cardiac coherence is merely a 'symptom' or reflection of an improved Limbic sense of well-being achieved by relatively minor 're-programming' of negative thoughts by intentional switches to positive emotions. While the book places emphasis on the computer software for demonstrating the positive effect on the heart, it does not allow the reader to fully integrate that the action at the Limbic level is key – easy and very effective in improving physiological well-being, as all the studies show. However on 'mechanisms' the chapter on EMDR entirely compensates (but that does not involve the brain —>body—> brain axes).

Where there is perhaps another deficit is in the comparison between the described methods and psycho-therapeutic approaches – on which, despite the title, there is surprisingly no data in this book. Traditional Freudian Psychoanalysis is a very specific form of psychotherapy (both in its form and in its focus) which, in my view, is the poorest and least effective of all such therapies in bringing about changes at the 'Limbic' level. Even Freud recognized that. Hence why it is so excruciatingly slow.

Dr Servan-Schreiber explains that Limbic level sources of stuck-ness are traditionally the least accessible through language – indeed one of the central premises of this book is that it is virtually impossible to deal directly with problems which are 'Limbic' linguistically or otherwise directly (although through his case studies this is contradicted time and time again) – except through the body.

However on this point, with respect, I could not disagree more congruently. There are non-psychoanalytical forms of psychotherapy which are extremely effective in facilitating enhanced Limbic-Cognitive resonance. The most recent additions to the psychotherapeutic field in this respect (such as Applied Transformational PNI™, or 'psycho-neurology'™ – which are powerful neuroscientifically-informed means of rapidly 'decoding' Limbic stuck-ness) are, largely, not yet even recognized.

One key problem here is that the psychotherapy associations do not yet class the different approaches according to the functional neuroscience or, indeed, in any such 'user-friendly' way, and until now there has not been a popular book which brings the need to do so firmly to the very top of the agenda. In this respect I believe that this potentially far-reaching 'spin-off' from this text could engineer one of the greatest advances within the field of 'psychological well-being' – it should be a loud wake-up call for a clear functional stream-lining of psychotherapeutic approaches.

And the same is absolutely true of course of doctors. As a doctor myself, and as Dr Servan-Schreiber so humbly describes, I understand that these approaches and how they might work have to this point been so far outside of the medical model that they at first seem inconceivable. Which is precisely why we have such a gaping gap between required needs and the provision of effective medical services.

And so, given the rapidly escalating demand for effective sustainable treatment approaches (and the related exorbitant costs, with all the implications), and with all the potential consequences for stress- and depression-related clinical disease, and in the face of poor long-term efficacy of treatments in the face of stress, anxiety and depression – as well as the more global economic impact of under-performance and absenteeism, I believe that Dr David Servan-Schreiber's book is a must-read for just about every member of the medical and therapeutic communities – and a gift for every member of the population who seeks greater well-being, psychological and physiological.

Dr David Servan-Schreiber has an open heart, an open mind, and – with a conscience to do the very best he can for his patients – he has sought out approaches with avid curiosity and presented them concisely and with humour. I wish him every success.

Dr Alexandra Concorde (formerly Pandolfino)
Rodale/Pan Macmillan.

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