How Healing Works

by Wayne Jonas

  Buettner, Dan. The Blue Zones: 9 Lessons for Living Longer from the People Who’ve Lived the Longest. Washington, D.C.: National Geographic Books, 2012. Readers are often surprised by how simple actions can have a significant influence on well-being and mentality.

  For information on Iora Health System, see iorahealth.com. Team-based, patient-centered care in action.

  For a report on the top-five percent of primary care clinics, see Petersen Health Foundation (2013). “America’s Most Valuable Care: Primary Care Snapshots.” petersonhealthcare.org/​identification-​uncovering-americas-​most-valuable-care/​primary-care-snapshots.

  Strecher, Victor J. Life on Purpose: How Living for What Matters Most Changes Everything. San Francisco: HarperCollins, 2016. Summarizes data on how meaning creates health and healing and how to bring purpose into your life. Developer of the JOOL app for purpose in life.

  CHAPTER 10: CREATING HEALING

  There are a number of health care leaders and systems redesigning the way health care and healing is delivered along the lines of integrative health. I describe some of them in this chapter; see the following for more information.

  Burnt-out providers can’t heal. Yet the problem of burnout is growing (and now estimated at nearly 50% in primary care physicians and nurses). See Shanafelt, T. D., L. N. Dyrbye, and C. P. West (2017). “Addressing Physician Burnout: The Way Forward.” Journal of the American Medical Association 317(9): 901–902; and, Dyrbye, L. N., T. D. Shanafelt, C. A. Sinsky, P. F. Cipriano, J. Bhatt, A. Ommaya, C. P. West, and D. Meyers (2017). “Burnout among health-care professionals: A call to explore and address this underrecognized threat to safe, high-quality care.” NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, D.C. nam.edu/​Burnout-Among-​Health-Care-​Professionals.

  The Commonwealth Fund’s link to “exemplars” in health care: commonwealthfund.org/​grants-and-​fellowships/​grants/​2012/​jul/​exemplars-of-​local-health-​care-delivery-​reform.

  The World Health Organization has an office of traditional medicine that tracks its use and advances research and application globally. See World Health Organization (2005). “National policy on traditional medicine and regulation of herbal medicines: Report of a WHO global survey” at apps.who.int/​iris/​bitstream/​10665/​43229/​1/​9241593237.pdf; and, World Health Organization (2014). “WHO Traditional Medicine Strategy 2014–2023. Geneva; 2013” at who.int/​medicines/​publications/​traditional/​trm_strategy14_23/en.

  Herman, Patricia M., et al. (2012). “Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations.” BMJ Open 2(5): e001046. Does adding complementary medicine save money? Apparently so, if done appropriately.

  Khorsan, R., I. D. Coulter, C. Crawford, and A. F. Hsiao (2011). “Systematic review of integrative health-care research: randomized control trials, clinical controlled trials, and meta-analysis.” Evidence-Based Complementary and Alternative Medicine 2011(pii): 636134. Most research evaluates CAM practices with little exploration of the true integration of conventional and CAM practices.

  National Academy of Medicine. Integrative Medicine and the Health of the Public: A Summary of February 2009 Summit. Washington, D.C.: The National Academies Press, 2009. The United States National Academy of Medicine calls for more integration in 2009. This echoed a White House Commission report from nearly a decade earlier. See Dean, Karen L. (2001). “White House Commission on Complementary and Alternative Medicine Policy Town Hall Meeting: Practitioners and Patients Speak Up.” Alternative & Complementary Therapies 7(2): 108–111.

  Information on medical and health education schools with integrative health activities can be found at The Academic Consortium for Integrative Health and Medicine, imconsortium.org.

  For integrative medical information in Europe, see The European Society of Integrative Medicine (ESIM) at european-society-​integrative-​medicine.org.

  Information on research in complementary and integrative medicine globally can be obtained from the International Society for Complementary Medicine Research (ISCMR) at iscmr.org.

  University of Arizona Center for Integrative Medicine, founded by Dr. Andrew Weil (integrativemedicine.arizona.edu/), is one of the first and premier university centers for integrative medicine. They have taught over 1,500 health care providers and are expanding their services. This is one of the first places physicians go for training when they want to do more integrative medicine.

  Weil, Andrew. Mind Over Meds. Boston: Little, Brown and Company, 2017. The latest book by a pioneer in natural medicine who popularized the term integrative medicine.

  Information on the Susan and Henry Samueli College of Health Sciences and University of California, Irvine can be found at uci.edu. This unique college will consist of four schools—medicine, nursing, pharmacy, and public (or population) health—all oriented toward providing education in integrative health at a major public university.

  Cleveland Clinic has two major efforts on integrative health. They are Integrative Health and Wellness Institute at my.clevelandclinic.org/​departments/​wellness/​integrative, and the Center for Functional Medicine at my.clevelandclinic.org/​departments/​functional-medicine.

  Bland, Jeffrey. The Disease Delusion. New York: HarperCollins, 2014. The latest book by a pioneer of applied nutritional therapy, using systems science approaches. Dr. Bland coined the term functional medicine.

  Information and training in functional medicine can be obtained from the Institute for Functional Medicine at ifm.org.

  The Mayo Clinic also two major efforts in integrative health housed in their Center for Integrative Health (mayoclinic.org/​departments-centers/​integrative-​medicine-health) and their Healthy Living Center (healthyliving.mayoclinic.org/​the-mayo-clinic-​difference.php).

  Tools for self-care and integrative health can be found at the Center for Spirituality and Healing at the University of Minnesota. See csh.umn.edu. Led by nurse researcher Dr. Mary Jo Kreitzer, many of these tools are free or available at minimal cost to the public.

  Also available to the public at minimal cost are tools for self-care and integrative health developed by pediatrician Dr. Kathi Kemper at The Ohio State University College of Medicine. I recommend her courses on herbs and dietary supplements (herbs-supplements.osu.edu) and, in mind-body skills training for resilience (mind-bodyhealth.osu.edu). For parents, Dr. Kemper has written the definitive guide to holistic health for children, The Holistic Pediatrician (San Francisco: HarperCollins, 2016), originally published in 1996.

  The Academic Collaborative for Integrative Health (ACIH) is an association of higher education schools in the complementary health professions—acupuncture, massage, naturopathy, and midwifery. They can be found at integrativehealth.org.

  Information on chiropractic medicine education and practice can be found at two sites: the World Federation of Chiropractic, an advocate for a broad role in health care rather than solely spinal manipulation (wfc.org) and the World Chiropractic Alliance, a chiropractic medicine organization primarily advocating for spinal manipulation (world​chiro​pract​icall​iance.org). Chiropractic medical education is overseen by the Councils on Chiropractic Education International, but each country regulates their educational and licensing requirements. In the United States, this is the Council on Chiropractic Education (cce-usa.org).

  Information on integration of conventional medicine and lifestyle can be obtained from the Institute for Lifestyle Medicine (insti​tuteo​flife​style​medic​ine.org).

  ACKNOWLEDGMENTS

  So many people deserve thanks for assisting with this work that it would take another book to acknowledge them.

  I need to start with my wife, Susan, who let me tell her story of multiple cancer survivals, including the most recent. She keeps me connected to the spirit. She is also my first editor and best critic!

  Our children are now my teachers. Our son, Chris, and daughter-in-law, Marzia,
and their beautiful child, show me how to thrive. Our daughter Maeba is always taking me deeper into life, and our other daughter Emily “E. J.” shows me how to always love learning. Thanks to you all.

  My father, Henry, and mother, Joan, still show me their wisdom. I hope I have transmitted a bit of that through this book.

  The insights in this book would not have happened without the friendship and long-standing support of Henry and Susan Samueli. Their vision for evidence-based, integrative health has been steadfast. I am confident their impact has only begun. Thanks also to Mike Schulman, who leads the Samueli office, and Gerald Solomon, who heads the Samueli Foundation.

  My colleague and coworker Doug Cavarocchi saw the value of this book long before I did and made it happen. He found our agent, Jim Levine, who has been instrumental in molding its message and contributing his passion and expertise continuously. He also found our publisher, Lorena Jones, who has taken a gamble on this vision of the future of health care. She and her team understand the urgency of the message and necessity for its widespread distribution. My co worker Jennifer Dorr helped write the practical appendices and continues to contribute to my website (DrWayneJonas.com). Thanks also to Lexie Robinson, who has supported the production at every turn.

  My former colleagues at Samueli Institute have helped shape the movement from health care to health. Joan Walter is a get-it-done professional with tremendous integrity and commitment to healing. Ron Chez taught me how to take healing into the mainstream. John Ives brought insights to the science. Thanks also to Kevin Berry, Bonnie Sakallaris, Mac Beckner, Katherine Smith, Dawn Bellanti, Barbara Findley, Alex York, Shamini Jain, Raheleh Khorsan, Kelly Gourdin, Linda Honig, Viviane Enslein, Courtney Lee, Chris Baur, Brian Thiel, and David Eisenberg, who all still carry the work of healing forward in research, action, and writing. A special call-out to Cindy Crawford, who learned evidence-based medicine from me and then took it to the new heights used in this book and elsewhere.

  There are many leaders in health care, research, health policy, and practice from whom I have learned and drawn on for this book. A heartfelt thanks to Daniel Amen, Cathy Baase, Brent Bauer, Berkeley and Elinor Bedell, Iris Bell, Brian and Susan Berman, Herb Benson, Don Berwick, Clem Bezold, Keith Block, Robert Bonakdar, Josie Briggs, Ed Calabrese, Barrie Cassileth, Richard Carmona, Vint Cerf, Bill Chatfield, Margaret Chesney, Christine Choate, Deepak Chopra, Gail Christopher, Luana Colloca, Ian Coulter, Regan Crump, Jonathan Davidson, Larry and Barbie Dossey, Bob Duggan, Howard Federoff, Mimi Guarneri, Tracy Gaudet, Mary Guerrera, Paul Funk, Jeff Geller, Bill and Penny George, Jim Giordano, Andrea Gordon, Jim Gordon, Stephen Groft, Patrick Hanaway, Adi Haramati, Larry Hardaway, Tom Harkin, Mark Hyman, Kurt and Lori Henry, George Isham, Charlotte Rose Kerr, Ruth Kirschstein, Ben Kligler, Fredi Kronenberg, David Jones, Sam Jones, Kathi Kemper, Mary Jo Kreitzer, Linnea Larson, Jeff Levi, George Lewith, Klaus Linde, Michael Lerner, Victoria Maizes, Shaista Malik, Robert Marsten, Barbara Mikulski, Will Miller, Jim Moran, Mike and Deb Mullen, Richard Neimtzow, Bill Novelli, Fran O’Connor, Dean Ornish, Mehmet Oz, Jonathan Peck, Joe Pizzorno, Bill and Frances Purkert, David Rakel, Henri Roca, Stefan Schmidt, Stephen Schmidt, Eric and Audrey Schoomaker, Eric and Patty Shinseki, Esther Sternberg, Soma Stout, Gene Thin Elk, John Umhau, Harald Walach, John Weeks, Andy Weil, Jeffrey White, David Williams, Jim Zimble, and many others. Thanks also to the people of the Bayview Marriott in Newport Beach, California, where about half of this book was written.

  And, finally, thanks to all my patients. You are the true healers. When we sit together and see together, we all heal together.

  ABOUT THE AUTHOR

  Wayne Jonas, MD, is a widely published research scientist, practicing family physician, and professor of medicine at Georgetown University and at the Uniformed Services University of the Health Sciences. He is also a retired lieutenant colonel in the Medical Corps of the United States Army. Dr. Jonas was the director of the Office of Alternative Medicine at the National Institutes of Health from 1995 to 1999 and led the World Health Organization’s Collaborative Center for Traditional Medicine. Prior to that, he served as the director of the Medical Research Fellowship at the Walter Reed Army Institute of Research. He now advises national and international organizations on ways to implement evidence-based healing practices in their medical systems and serves as the executive director of Samueli Integrative Health Programs.

  INDEX

  A

  Academic Collaborative for Integrative Health (ACIH)

  Academic Consortium for Integrative Medicine and Health

  Active listening

  Acupuncture, 1.1, 1.2, 2.1, 2.2, 2.3, 8.1, 9.1, 9.2, 10.1

  Ader, Robert

  Adverse childhood experiences (ACE)

  Alcohol

  Amen, Daniel

  American College of Lifestyle Medicine (ACLM)

  American College of Physicians

  Amygdala

  Ankylosing spondylitis (AK)

  Antiarrhythmic drugs

  Antonovsky, Aaron, 9.1, app1.1

  Anxiety

  Appointments

  making the most of, 10.1, app1.1

  reducing anxiety during

  Aromatherapy

  Arthritis, 1.1, 2.1, 4.1, 7.1

  Astrology

  Autoimmune diseases, 8.1, 8.2

  Ayurveda, 3.1, 4.1, 4.2, 6.1

  Ayyadurai, V. A. Shiva

  B

  Back pain, 2.1, 2.2, 4.1, 7.1

  Bauer, Brent

  Beauty Way ceremony, 7.1, 8.1

  Bedroom, 5.1, app1.1

  Beecher, Henry

  Behavioral dimension, 5.1, 6.1, app1.1, app1.2, app1.3

  Behavior and lifestyle

  changing, 6.1, 6.2, 6.3, app1.1, app1.2

  childhood experiences and

  disease and

  healthy, 6.1, 6.2, 6.3

  importance of, 5.1, 6.1

  meaning and

  monitoring

  placebo effect and

  Belief

  doctor’s

  importance of, 2.1, 8.1

  nocebo effect and

  Belly breathing

  Benedetti, Fabrizio, 2.1, 2.2, 2.3, 4.1, 8.1

  Benson, Herbert, 4.1, 6.1

  Berwick, Don, 7.1, 9.1

  Bland, Jeffrey

  Bobrow, Joseph

  Boundaries, setting

  Brain injury, 1.1, 2.1, 4.1, 9.1

  Bravewell Collaborative, 10.1

  Breast cancer, 5.1, 6.1, 7.1, 8.1

  Breathing

  Buettner, Dan

  Building Healthy Military Communities program

  Burnout

  C

  Cacioppo, John, 7.1, 7.2

  CAMbrella

  Cancer, 5.1, 6.1, 6.2, 7.1, 8.1, 8.2

  Car rides

  Casey, Michael

  Center for Integrative Medicine

  Center for Medicare and Medicaid Innovation

  Center for Spirituality and Healing (CSH)

  Chaplaincy

  Chemotherapy, 5.1, 7.1, 9.1

  Chen, Yu

  Christakis, Nicholas

  Cimetidine

  Cleveland Clinic

  Clinical pastoral education (CPE)

  Collaborative medicine

  Color, effects of

  Coma, waking up from

  Communication

  importance of

  tips for

  Complementary and alternative medicine (CAM), 9.1, 10.1, app1.1

  Conditioning, 4.1, 6.1, 8.1

  Congestive heart failure (CHF)

  Coulter, Ian, 7.1, 10.1

  Cousins, Norman, 3.1, 3.2

  Crossing the Quality Chasm, 9.1, 9.2

  Crum, Alia, 6.1, 8.1, app1.1

  Curing vs. healing

  Cytochrome c

  D

  DASH (Dietary Approaches to Stop Hypertension) diet, 9.1, 9.2

  Davidson, Jonathan, 3.1, 3.2

  Death

  causes of

&n
bsp; meaning response and

  palliative care and

  Decline effect

  Depression, 3.1, 3.2, 8.1

  Diabetes, 1.1, 6.1, 6.2, 6.3

  Diabetes Prevention Study

  Disease

  chronic, 4.1, 9.1, 9.2

  -focused approach

  from whole systems science perspective

  Doctors. See Physicians

  Dopamine, 3.1, 3.2, 3.3, 3.4, 6.1

  Doshas, 3.1, 9.1

  Dossey, Larry

  Drugs

  efficacy of

  frequent dosing

  meaning and

  side effects of, 2.1, 3.1

  testing of, 3.1, 3.2, 3.3

  use of

  See also individual drugs

  Dzau, Victor

  E

  Eating

  effects of

  mindfully

  patterns, 6.1, app1.1

  reasons for

  See also Fasting; Food

  Eisenberg, David

  Emotional connections, importance of

  Emotions

  sharing

  venting

  Entropy

  Environment

  ideal

  importance of, 5.1, 5.2, app1.1, app1.2

  setting self-care goals for

  tips for

  See also Healing environments

  Epidaurus, 6.1, 7.1, 8.1

  Errors, medical, 1.1, 10.1, 10.2

  European Society of Integrative Medicine (ESIM)

  Exceptional spiritual experiences, 7.1, 8.1

  Exercise

  benefits of, 4.1, 6.1, app1.1, app1.2

  mind-set and

  research on

  tips for

  Exposure therapy

  External dimension, 5.1, 5.2, app1.1, app1.2, app1.3

  F

  Family Empowerment program

  Fast food

  Fasting

  Fear

  Feng shui

  Fernandopulle, Rushika

  Fibromyalgia

  Fight, flight, or freeze response, 5.1, 7.1

  Flexner Report

  Followers vs. leaders

  Food

  building positive relationship with