Thursday, August 19, 2010

Tai Chi Chuan eases Fibromyalgia - New York Times article

August 18, 2010

Tai Chi Reported to Ease Fibromyalgia

By PAM BELLUCK

The ancient Chinese practice of tai chi may be effective as a therapy for fibromyalgia, according to a study published on Thursday in The New England Journal of Medicine.

A clinical trial at Tufts Medical Center found that after 12 weeks of tai chi, patients with fibromyalgia, a chronic pain condition, did significantly better in measurements of pain, fatigue, physical functioning, sleeplessness and depression than a comparable group given stretching exercises and wellness education. Tai chi patients were also more likely to sustain improvement three months later.

“It’s an impressive finding,” said Dr. Daniel Solomon, chief of clinical research in rheumatology at Brigham and Women’s Hospital in Boston, who was not involved in the research. “This was a well-done study. It was kind of amazing that the effects seem to carry over.”

Although the study was small, 66 patients, several experts considered it compelling because fibromyalgia is a complex and often-confusing condition, affecting five million Americans, mostly women, according to the Centers for Disease Control and Prevention. Since its symptoms can be wide-ranging and can mimic other disorders, and its diagnosis depends largely on patients’ descriptions, not blood tests or biopsies, its cause and treatment have been the subject of debate.

“We thought it was notable that The New England Journal accepted this paper, that they would take fibromyalgia on as an issue, and also because tai chi is an alternative therapy that some people raise eyebrows about,” said Dr. Robert Shmerling, clinical chief of rheumatology at Beth Israel Deaconess Medical Center in Boston, co-author of an editorial about the study.

“Fibromyalgia is so common, and we have such a difficult time treating it effectively. It’s defined by what the patient tells you,” he added. “It’s hard for some patients’ families and their doctors to get their head around what it is and whether it’s real. So, that these results were so positive for something that’s very safe is an impressive accomplishment.”

Recent studies have suggested that tai chi, with its slow exercises, breathing and meditation, could benefit patients with other chronic conditions, including arthritis. But not all of these reports have been conclusive, and tai chi is hard to study because there are many styles and approaches.

The fibromyalgia study involved the yang style of tai chi, taught by a Boston tai chi master, Ramel Rones. Dr. Solomon and other experts cautioned that bigger studies with other masters and approaches were necessary.

Still, patients, who received twice-weekly tai chi classes and a DVD to practice with 20 minutes daily, showed weekly improvement on an established measurement, the Fibromyalgia Impact Questionnaire, improving more than the stretching-and-education group in physicians’ assessments, sleep, walking and mental health. One-third stopped using medication, compared with one-sixth in the stretching group.

Dr. Chenchen Wang, a Tufts rheumatologist who led the study, said she attributed the results to the fact that “fibromyalgia is a very complex problem” and “tai chi has multiple components — physical, psychological, social and spiritual.”

The therapy impressed Mary Petersen, 59, a retired phone company employee from Lynn, Mass., who said that before participating in the 2008 study, “I couldn’t walk half a mile,” and it “hurt me so much just to put my hands over my head.” Sleeping was difficult, and she was overweight. “There was no joy to life,” she said. “I was an entire mess from head to foot.”

She had tried and rejected medication, physical therapy, swimming and other approaches. “I was used to being treated in a condescending manner because they couldn’t diagnose me: ‘She’s menopausal, she’s crazy.’ ”

Before the study, “I didn’t know tai chi from a sneeze,” said Ms. Petersen, who has diabetes and other conditions. “I was like, ‘Well, O.K., I’ll get to meet some people, it will get me out of the house.’ I didn’t believe any of it. I thought this is so minimal, it’s stupid.”

After a few weeks, she said she began to feel better, and after 12 weeks “the pain had diminished 90 percent.” She has continued tai chi, lost 50 pounds and can walk three to seven miles a day.

“You could not have convinced me that I would ever have done this or continued with this,” she said. “I wouldn’t say it’s a cure. I will say it’s an effective method of controlling pain.”

Dr. Shmerling said that though tai chi is inexpensive compared with other treatments, some patients would reject such an alternative therapy. And Dr. Gloria Yeh, a Beth Israel Deaconess internist and co-author of the editorial, said others “will say, ‘It’s too slow, I can’t do that.’ ”

But she said it offered a “gentler option” for patients deterred by other physical activities. “The mind-body connections set it apart from other exercises,” she said, adding that doctors are seeking “anything we can offer that will make patients say ‘I can really do this.’ ”

Sunday, August 15, 2010

Tai Chi Chuan and Anger

Tai Chi Chuan and Anger

While I don’t consider my own anger levels to be out of control, I do have a fair amount of Irish genes! I blame it on my genetics. There have been a few flair ups over the years. Given the New York Times article regarding research on Anger “control” and exercise, I thought I might reflect on my own experience in relation to Tai Chi.

I recall a funny experience I had the first time I pushed with Ben Lo. Having come from the comforting environment that Maggie Newman, my teacher, provides for her students, that first Ben push was a shock. It shouldn’t have been. I was watching what he was doing to other students the whole week at his camp. He did to me what he did to them. But when it came to be my turn and I was flung 10 feet – I had an honest jolt of ANGER. It was along the lines of “That wasn’t nice!! You shouldn’t be doing that to a beginner!! How dare you!!” I remember looking at him directly in anger, shock and awe. He clearly saw my expression. And then I realized I had to go back into the ring to get another one.

Worse, it dawned on me that I was trapped. There was no way I could express my anger. There was no way this anger could be manipulated into some sort of dramatic scene. There was no way I could even channel it into some sort of useful action. There was no way I would win in the coming rounds of repeat slams. I couldn’t act on my anger or mete out revenge. I couldn’t commiserate with others on the unfairness of it all (they had a similar experience and seemed to enjoy it!) I couldn’t let the anger go, either. This was truly a losing battle.

I laugh to think of that anger reaction today: so spontaneous, so complex, so perfect. Tai chi offered yet again a laboratory to face myself and teach me a lesson: not everyone will behave in the way you would like them to and anger only gets in the way. I may be special (to me), but I’m not THAT special!

There have been other push hands interactions that have provoked my anger. It never helped the situation. Anger prevents listening (on all levels) and tai chi is about listening. If you see your anger before it becomes action, you have to admit it is YOUR anger. Sure, perhaps they helped bring it out, but it is still YOUR anger. If you can contain it and stop it from being expressed in an inappropriate way, generally this is a frustrating experience. If you act on it, generally it is a disastrous situation.

There have been others who have ended up in real fights from their anger. They acted on it before they could grasp it. It’s a hard lesson to learn, let alone incorporate into life. Yes, others can and do provoke your hidden treasure, but you are the keeper of the keys. And there are ways to move forward without denying it or acting out on it. The general pattern with anger is that one tends to blame the other for the anger and therefore want to punish or destroy the “cause” of the anger. They are doing something to me. Yes, they may be. But the anger is yours!

The deep practice of tai chi relaxation helps to release as well as alleviate anger. I remember in my earlier years of tai chi that during the form I used to get more and more angry as I worked through the form. My guess is that the relaxing I was practicing was releasing it. My angry thoughts were directed at me, and at those I was blaming at the time for whatever insult it was that I had endured. At the end of the form, I would be furious. I also shook a bit. It was like letting go of some layer of anger that was there all the time but I hadn’t noticed. My anger was being trapped in a very tense body. And believe me, when I began tai chi, I was very very tense.

Another deeply important aspect that tai chi brings out is that if you are angry, it is best that you truly feel it and acknowledge it, at least to yourself. Then you have some choice. You can stop the game and excuse yourself, or you can remain in the game and just be deeply aware of anger while maintaining as much composure and relaxation as possible. That’s a high wire act, no?

Some may need more help with their anger than tai chi can provide, but tai chi can help release it through regular practice. Anger is chi rising and we are working to let chi relax into the body. If you have anger chi, it will rise to the surface and be visible. Individuals with anger issues can see or experience their anger from a different perspective.

For me, the bottom line is that denying it or not feeling it is VERY dangerous. I would NEVER tell someone to not feel angry, or say to them “Don’t be angry.” The real question is “What Exactly Is Making You Angry?” In the meantime, just be clear when it comes to the surface and feel it. Feeling it will not necessarily create some sort of steam engine train that will create irreversible havoc. Not feeling it is the situation you want to avoid! If you need to separate yourself out to give it attention and fully feel it, then that is what you need to do.

You are lucky if you have a push hands partner that you can really express in words that you are feeling angry in this moment. But I think our culture is rather poor at discussing this as an issue. It is still considered to be a “bad” emotion, one that indicates you are not in control. Blame gets attached to it. While I am stating you are responsible for your anger reactions, I am not assigning blame. This is a subtle difference.

If someone is angry with you, an appropriate response is, “What’s going on?” If you are angry at someone, an appropriate response is, “What’s going on?”

I have just spent a few months with a certain situation that has continually brought up LOTS of anger, the kind where I need to keep breathing deeply to be with it. It is a slow process.

Anger is a very complex topic with no simple answers.

Saturday, August 14, 2010

Exercise Soothes Anger - New York Times article

August 11, 2010, 12:01 am

Phys Ed: Can Exercise Moderate Anger?

By GRETCHEN REYNOLDS

David Sacks/Getty Images

For years, researchers have known that exercise can affect certain moods. Running, bike riding and other exercise programs have repeatedly been found to combat clinical depression. Similarly, a study from Germany published in April found that light-duty activity like walking or gardening made participants “happy,” in the estimation of the scientists. Even laboratory rats and mice respond emotionally to exercise; although their precise “moods” are hard to parse, their behavior indicates that exercise makes them more relaxed and confident.

But what about anger, one of the more universal and, in its way, destructive moods? Can exercise influence how angry you become in certain situations?

A study presented at the most recent annual conference of the American College of Sports Medicine provides some provocative if ambiguous answers. For the study, hundreds of undergraduates at the University of Georgia filled out questionnaires about their moods. From that group, researchers chose 16 young men with “high trait anger” or, in less technical terms, a very short fuse. They were, their questionnaires indicated, habitually touchy.

The researchers invited the men to a lab and had them fill out a survey about their moods at that moment. During the two days of the study, the men were each fitted with high-tech hairnets containing multiple sensors that could read electrical activity in the brain. Next, researchers flashed a series of slides across viewing screens set up in front of each young man. The slides, intended to induce anger, depicted upsetting events like Ku Klux Klan rallies and children under fire from soldiers, which were interspersed with more pleasant images. Electrical activity in the men’s brains indicated that they were growing angry during the display. For confirmation, they described to researchers how angry they felt, using a numerical scale from 0 to 9.

On alternate days, after viewing the slides again (though always in a different order), the men either sat quietly or rode a stationary bike for 30 minutes at a moderate pace while their brain patterns and verbal estimations of anger were recorded. Afterward, the researchers examined how angry the volunteers became during each session.

The results showed that when the volunteers hadn’t exercised, their second viewing of the slides aroused significantly more anger than the first. After exercise, conversely, the men’s anger reached a plateau. They still became upset during the slide show — exercise didn’t inure them to what they saw — but the exercise allowed them to end the session no angrier than they began it.

What the results of the study suggest is that “exercise, even a single bout of it, can have a robust prophylactic effect” against the buildup of anger, said Nathaniel Thom, a stress physiologist who was the study’s lead researcher.

“It’s like taking aspirin to combat heart disease,” he said. “You reduce your risk.”

When the men did not exercise, they had considerable difficulty controlling their racing emotion. But after exercise, they handled what they saw with more aplomb. Their moods were under firmer control.

The question of just how, physiologically, exercise blunts anger remains open. Mr. Thom and his colleagues did not test levels of stress hormones or brain chemicals in the test subjects. But earlier work by other scientists suggests that serotonin, a neurotransmitter in the brain, probably played a role, Mr. Thom said. “Animal studies have found that low levels of serotonin are associated with aggression, which is our best analogue of anger in animals,” he said. “Exercise increases serotonin levels in the rat brain.” Low serotonin levels in humans are also thought to contribute to mood disorders.

Changes in the activity of certain genes within the brain may also have an impact. In a 2007 experiment at Yale University, researchers found that prolonged running altered the expression of almost three dozen genes associated with mood in the brains of laboratory mice. Mr. Thom says he hopes that future studies by himself and others will help to determine the specific underlying mechanisms that link exercise and a reduction of anger.

But for now, the lesson of his preliminary work, he said, is that “if you know that you’re going to be entering into a situation that is likely to make you angry, go for a run first.”

Tuesday, August 3, 2010

The Summoned Self - New York Times Article OpEd by David Brooks

This article really has nothing to do with tai chi directly. The non goal oriented approach that he describes, however, is VERY much like tai chi. I found this interesting.

August 2, 2010

The Summoned Self

By DAVID BROOKS

This is a column about two ways of thinking about your life. The first is what you might call the Well-Planned Life. It was nicely described by Clayton Christensen in the current issue of the Harvard Business Review, in an essay based on a recent commencement talk.

Christensen advised the students to invest a lot of time when they are young in finding a clear purpose for their lives. “When I was a Rhodes scholar,” he recalls, “I was in a very demanding academic program, trying to cram an extra year’s worth of work into my time at Oxford. I decided to spend an hour every night reading, thinking, and praying about why God put me on this earth.

“That was a very challenging commitment to keep, because every hour I spent doing that, I wasn’t studying applied econometrics. I was conflicted about whether I could really afford to take that time away from my studies, but I stuck with it — and ultimately figured out the purpose of my life.”

Once you have come up with an overall purpose, he continues, you have to make decisions about allocating your time, energy and talent. Christensen, who is a professor at the Harvard Business School and the author of several widely admired books, notes that people with a high need for achievement commonly misallocate their resources.

If they have a spare half-hour, they devote it to things that will yield tangible and near-term accomplishments. These almost invariably involve something at work — closing a sale, finishing a paper.

“In contrast,” he adds, “investing time and energy in your relationship with your spouse and children typically doesn’t offer that same immediate sense of achievement. ... It’s not until 20 years down the road that you can put your hands on your hips and say, ‘I raised a good son or a good daughter.’ ” As a result, the things that are most important often get short shrift.

Christensen is a serious Christian. At university, he was the starting center on his basketball team and refused to play in the championship game of an important tournament because it was scheduled for a Sunday. But he combines a Christian spirit with business methodology. In plotting out a personal and spiritual life, he applies the models and theories he developed as a strategist. He emphasizes finding the right metrics, efficiently allocating resources and thinking about marginal costs.

When he is done, life comes to appear as a well-designed project, carefully conceived in the beginning, reviewed and adjusted along the way and brought toward a well-rounded fruition.

The second way of thinking about your life might be called the Summoned Life. This mode of thinking starts from an entirely different perspective. Life isn’t a project to be completed; it is an unknowable landscape to be explored. A 24-year-old can’t sit down and define the purpose of life in the manner of a school exercise because she is not yet deep enough into the landscape to know herself or her purpose. That young person — or any person — can’t see into the future to know what wars, loves, diseases and chances may loom. She may know concepts, like parenthood or old age, but she doesn’t really understand their meanings until she is engaged in them.

Moreover, people who think in this mode are skeptical that business models can be applied to other realms of life. Business is about making choices that maximize utility. But the most important features of the human landscape are commitments that precede choice — commitments to family, nation, faith or some cause. These commitments defy the logic of cost and benefit, investment and return.

The person leading the Well-Planned Life emphasizes individual agency, and asks, “What should I do?” The person leading the Summoned Life emphasizes the context, and asks, “What are my circumstances asking me to do?”

The person leading the Summoned Life starts with a very concrete situation: I’m living in a specific year in a specific place facing specific problems and needs. At this moment in my life, I am confronted with specific job opportunities and specific options. The important questions are: What are these circumstances summoning me to do? What is needed in this place? What is the most useful social role before me?

These are questions answered primarily by sensitive observation and situational awareness, not calculation and long-range planning.

In America, we have been taught to admire the lone free agent who creates new worlds. But for the person leading the Summoned Life, the individual is small and the context is large. Life comes to a point not when the individual project is complete but when the self dissolves into a larger purpose and cause.

The first vision is more American. The second vision is more common elsewhere. But they are both probably useful for a person trying to live a well-considered life.