Meditation helps reduce the negative impact of stress & tension on the body

By Dr. Stephen E. Walker, PhD, CC-AASP

Have you ever wondered how your thinking might influence your physical health, performance or well-being? In the second quarter issue of 2005, research was presented by Dr. Alan Rozanski in the Journal of the American College of Cardiology focused on developments in the field of Behavioral Cardiology. This article reviewed research on the origins, physiology and impact of emotional social chronic stress risk factors on the development and course of heart disease and stroke.1

Rozanski offers a strong review of the literature that illustrates how depression, anger, anxiety, marital discord, occupational stress, and Type D personality traits are associated with those emotional catalysts that hurry us along toward a heart attack. We all have some kind of a genetic set point for heart disease that comes from our family history. As for stress and the role that emotions play, it is clear that emotions are among the culprits that trigger chemical shifts in our blood so it becomes toxic to the endothelium that lines the arterial walls. But how?

Readers seeking clarification as to how much of this disease is attributable to our poor choices in diet can take heart. Dr. William Roberts, editor-in-chief of the American Journal of Cardiology, is more inclined to focus on our poor choices in diet. He states, “Of the 6.5 billion people on this planet, 5 billion will never have to worry about heart disease because their diets contain no meat, and it matters little whether they exercise.” As such, he is a champion of cholesterol lowering medications in the Western world and EBCT heart scans which provide a coronary calcium score…”to date, the best measure of coronary vascular disease (CVD) in people without symptoms.”2

Cardiac Psychology does focus on the modification of diet, smoking, obesity and maladaptive behaviors that increase our risk of heart disease. But, for those who try to limit their intake of meat, exercise regularly and otherwise try to maintain a healthy lifestyle…stress is the X factor, and one that implores us to manage our emotions more conscientiously, especially since we can not alter our genetic imprint. It is the stress hormones that accompany the booms and crashes in our disposition. When these are added to the by-products of the food choices we make, metabolic disease ensues damaging the endothelium of our arterial walls. In a huge percentage of people this process also triggers inflammatory agents that surge through our blood producing pockets of plaque throughout the system. The process quietly evolves over many years until Inflammation, “sticky” platelets and an unstable piece of plaque ruptures. Then the party begins in the form of a “cardiac event or stroke” usually in an unsuspecting victim. Every 4 minutes someone dies experiencing their very 1st cardiac symptom. The truth of the matter is that the disease takes a long time to develop, and if we were more attuned to prevention and early diagnosis in the United States, we’d probably have prevented a lot of heart attacks.

Our Self-talk reveals the Mind/Body connection.

Having practiced psychotherapy for several years it is clear to me that no one is immune to “negative emotions.” Virtually all of us have a “bad day now and then.” However, the problem becomes more pronounced when you realize that many of us have “never had a good day” as emotions are concerned. There is sparse relief in our diversions too, as the most popular television shows in every market are the local news….followed by CSI, CSI Miami, CSI NY, NCIS, etc. Want to relax tonight and watch some television? Let’s see…we can hear about murder and mayhem that have actually become the news in our neighborhoods, or we can see dramatizations of it on every network.

Psychologist Dr. Johan Denollet, from Tilburg University in the Netherlands, has developed a psychological test called the DS14 that helps measure the nature and influence of the chatter in our own minds. The term chatter refers to the way in which we talk to ourselves, our self-talk. This internal dialogue is significant in that it is ongoing and characteristic of our emotional experience and affect. It is sensible for us to examine the quality and distinguishing features of that inner dialogue.

Do you often make a fuss about unimportant things?
Do you often feel unhappy?
Are you often irritated?
Do you take a gloomy view of things?
Are you often in a bad mood?
Do you often find yourself worrying about something?
Are you often down in the dumps?

While reviewing these questions we likely recognize patterns in our own self-talk. If our chatter is comprised of self-talk that favors these descriptors; making a fuss, unhappy, irritated, gloomy, bad mood, worrying, down in the dumps…our negative affect and corresponding behavior could be contributing to the production of the stress hormones we talked about earlier. Furthermore, additional items in the DS14 examine the extent to which certain people become socially isolated and what that might mean to our overall health. Denollet explores social patterns such as the tendency to keep to ourselves, avoid social supports, difficulty making social contact and/or communicating with others.

Negative thinking is clearly a problem, but there is another corresponding concern that complicates the situation even more so. Many of those who characteristically think negatively are prone to have few friends and rarely engage socially with others. Perhaps the negative thinking has pushed others away, or maybe their irritability and agitation unduly effected their ability to network amongst coworkers neighbors or teammates. Whatever the case, if someone is deprived of exposure to others who think differently, or they are stuck within their own little pessimistic world…their incidence of heart disease is increased significantly. So ask yourself, “Do I shy away from developing social relationships? Do I tend to stick to myself and avoid communicating with others? If so, much of the literature indicates that a prevalent experience of negative emotions and the tendency toward social isolation intensifies your risk of a heart attack. Denollet’s research has identified negative affect and social isolation as noteworthy risk factors for CVD.³

So, What Can We do About it?

Pretty much all of us have been on a job interview. We tailor our resume and take the time to craft a good cover letter. Realizing the importance of a good first impression, we dress well, think positive thoughts, rehearse answering questions, focus on the positive attributes we can bring to the job…and we probably deemphasize those things that won’t help us much. We have to work at it but like any other life skill, practice helps us groove the thinking pattern. Remember when you first learned to drive a car and how uncoordinated it felt in the beginning? How much focused attention did it take? Now, it is likely that the basic driving skills are so well integrated by pattern and routine that they hardly require deliberate concentration. These things are guaranteed…if we emphasize a positive outlook and practice a good attitude, we are inclined to develop one. Our genetic predisposition may not make us an optimist, but the development of skill sets and consistent practices will engender in us a positive attitude and the ability to make conscious choices.

Dr. Karen Mathews was recently honored with the American Psychological Association’s award for distinguished scientific applications in the literature on this topic and offers us substantive data to suggest that “optimists are less likely than are pessimists to exhibit the common progression of this disease over time.”4 Other research linking patience, discipline, and close friendships…in addition to…emotional competence (the ability to regulate emotions across a range of situations) have been encouraging to say the least. Studies of professional, marital, interpersonal, and life enrichment activities that require effort but that also promote joy, engage people’s curiosity and provide meaning in life serve to enhance vitality and flexibility.5 The protective effects of these positive coping skills, impulse control, and strong social support are beginning to emerge in the literature of psychosomatic medicine, positive psychology and the writings of mainstream health advocates.6 Harvard psychologist, Daniel Gilbert, who is a leader in this field responds to those who question this kind of research with, “Why on earth would one want to study anything else?”7

Want to give it a try? Take an inventory of who you currently spend the most time with. Think about the nature of your exchanges and the degree to which you are able to think positively after each conversation. If they are important to you, share this article with them and see if they might be willing to “experiment” along with you. Put a chart together of those you consider the most positive and encouraging influences in your world and make it a point to get together more often. Notice people who are kind, loving, competent leaders, avid students of something, those who show persistence, creativity, are fair-minded, or likely to savor a beautiful scene or have a blessing to share. They are in your world for a reason so take the time to discover what good can come from their contribution to your life…and remember to practice, practice, practice.

The top 10 list of things you can do right now, to begin shifting the “emotional” momentum in your life:
1. Take the time to meditate for 20 minutes everyday on your life’s blessings and those things for which you are thankful.
2. Monitor carefully what you watch on TV and notice how you feel afterward.
3. Go to a comedy club, or a funny movie and laugh out loud.
4. Find a comic strip that you like to read, and follow it everyday.
5. Listen to music that is relaxing and yet inspiring (Chopin, Schubert, Springsteen)
6. Make a list of the most “important” things in your life.
7. Make a list of the most “important” people in your life…..tell them so.
8. Think about the last time you were so captivated while doing something, you lost your sense of time completely. Do it again.
9. Intentionally gravitate toward folks who are curious, have a zest for life, are thankful, hopeful, optimistic, & loving.
10. Practice modeling these same virtues for yourself, your coworkers, and your children.
Special bonus suggestion: Log on to Dr. Martin Seligman’s Positive Psychology website: www.authentichappiness.org and take 2-3 inventories that measure your signature strengths & current level of happiness.

References:

1) Rozanski, A, Blumenthal, J, Davidson, K, Saab P, Kubzansky L, “The Epidemiology, Pathophysiology, and Management of Psychosocial Risk Factors in Cardiac Practice”, J Am Coll Cardiol 2005;45:5:637-651.
2) Roberts, W, “Aggressive Testing for and Treatment of Heart Disease and Stroke”, Seminar Proceedings, Denver, Colorado, Nov.19, 2005.
3) Denollet, J, DS14: “Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality”, Psychosom Med 2005; 67:89-97.
4) Mathews, K, “Psychological Perspectives on the Development of Coronary Heart Disease”, Am Psycholgst 2005; 60:8:783-796.
5) Bonanno, GA, Papa, A, O’Neil, K, Westphal, M, Coifman, K, “The Importance of Being Flexible; The Ability to Enhance and Suppress Emotional Expression Predicts Long-term Adjustment.” Psychol Sci 2004;15:482-7.
6) Gross JJ, “Antecedent and Response-focused Emotion Regulation: Divergent Consequences for Experience, Expression, and Physiology.” J Pers Social Psychol 1998; 74;224-3
7) Gilbert, D, Stumbling on Happiness, Knopf A, NY, 2005

At 6′ 2″, 240 pounds, Dan Cox is certainly on the larger end of the triathlete scale. It’s just hard to imagine upon meeting him that less than five years ago he tipped the scales at a very non athletic 400+ pounds.

Cox has always been an athlete. Born and raised in the “two stop light” town of Ansonia, OH, in the middle of the Ohio/Indiana farm belt, Cox, like most of the boys he grew up with, passed his days in the classroom, spending long hours doing his farm chores, and when time allowed, playing football.

“Ansonia was the archetypal Midwest farm town,” said Cox. “Everyone I knew was a farmer or farmer’s son, and there was a long tradition of staying on the farm, maintaining the family business. Many of my friends decided to stay put, because there wasn’t a lot available with respect to business or career opportunities. For those who wanted the opportunity to try something else, sports were the ticket to get you there.”

Self admittedly, Cox was a better athlete than a student. “I had a lot of teachers who were surprised that I was actually accepted at a number of colleges.” The fact that he was 6’2″, and just a hair under 300 pounds didn’t hurt either. “I was a decent enough athlete and football player,” he notes, “and my size certainly helped me land where I did.”

That landing spot was Division III Wilmington College, in Wilmington, OH. Cox enjoyed a solid career as an offensive lineman, earning a degree in education along the way. Upon graduating in 1982, he began teaching, and it wasn’t long before he caught the coaching bug. “I missed the competition and the intensity of the game,” said Cox. “It was also an opportunity to spend more time with my students and help them outside of the classroom.”

Working his way up through the extremely competitive Ohio coaching ranks, Cox landed at Mississinawa Valley High School in Union City, Ohio. He took over a program that had been less than stellar, and in just a few years had developed it into one of the state’s powerhouses.

“We weren’t the biggest classification,” said Cox, “but in a state where high school football is king, we became highly competitive and respected. It was a great feeling for me and my staff to take the program from basically nothing and develop it into one of the best in the state.” Things continued to go well for Cox, both in the classroom and on the football field. In 1993, after a 9-1 season, he was selected as High School Football Coach of the Year by the Associated Press. He had coached two players who would later play in the NFL, one being tailback Curtis Enis, who was a first round draft pick after an All-America career at Penn State.

Despite the success, Cox and his family were eager for change, for a number of reasons. “My wife (Deborah) and I had never really left Ohio except to go on vacation, so we were eager to see another part of the country. I had also been experiencing some health problems, and I thought a move would motivate me to tackle them.”

His health problems were directly related to his weight, which had gone uncontrolled since his days as a college lineman. “I was always a big guy, so remaining big really didn’t bother me, in part because I was never real sure how big I was,” said Cox. What he did know was that he was having trouble walking, and at more than 350 pounds, a regular exercise program was out of the picture. “I tried every fad diet known to man,” he laughs. “I had success in getting my weight down close to 300, but once there, I inevitably put the weight back on. It was an ongoing cycle that became impossible for me to control.”

Upon making the decision to move, the Cox family hopped on I-75 and went as far south as the highway allowed them, finally settling in Naples. Upon their arrival, Cox and his wife found teaching jobs, with Dan beginning a new stage in his career at Barron Collier High School. He enjoyed the new job, but became increasingly dissatisfied with his uncontrolled weight, which led to problems with his confidence and self-esteem. “One of my career goals was to be a high school principal, but I began to realize that the odds were pretty slim that a school district was going to hire someone who weighed 400 pounds.”

It got to the point where Cox could no longer manage the thirteen steps that led to his young daughter’s upstairs bedroom to kiss them goodnight. Rock bottom was near, but it took a comment from his daughters to realize that he had to do something drastic. “One morning at breakfast my daughters asked me why I didn’t come up stairs anymore. I welled up, knowing full well that I couldn’t tell them the truth – that I was too fat. It was then that I made the decision to get rid of the weight for good and get healthy.”

In 2000, Cox began to research his weigh loss options, including the relatively new procedure of gastric bypass or “stomach stapling.” He had seen a TV special that documented singer Carney Wilson’s battle with weight, and her subsequent success in keeping the weight off after the risky surgery. He enlisted the help of Dr. Carlos Carrasquilla, a highly respected surgeon in Ft. Lauderdale to see if gastric bypass was an option for him.

“After an initial exam, Dr. Carrasquilla asked me how much I thought I weighed. I said over 350, but I really wasn’t sure. His response was ‘come on Dan, you’ve got to be honest about this.’ He took me to another room that housed a cattle scale. I got on, he moved the scale mechanisms, and soon I realized that yes, I was over 350. The scale did not move at 400, or even 425. At 450, the mechanism began to move, finally settling at 446. It was the most crushing blow I had ever been dealt.”

446 pounds. That’s where things had gone for a former college football player who had always been “big,” but in good shape. After shedding a few more tears upon seeing the scale needle stop at just under 450, Cox received some major words of motivation from his doctor.

“He told me that if I had the surgery, followed post-op protocol, stuck to the required diet and began to exercise, I would weigh 230 pounds at this time next year.” For Cox, the decision was made. He was going to do this not only for himself, but more importantly for his family.

The gastric bypass surgery was performed in June, 2000. And as Dr. Carrasquilla had promised, in the time of one year, Dan Cox had lost more than 200 pounds!

According to Cox, the road to his weight loss was “beyond difficult, the toughest thing I had ever or will ever do.” With his stomach now the size of his thumb, the diet restrictions were tremendous. “I went from being a guy who could polish off an extra-large pizza and pitcher of beer and still be hungry, to a situation where I couldn’t even finish one piece, due to the size of my stomach.” Any more than that, Cox chuckles, and the food had a propensity for “coming right back up.”

It was a drastic lifestyle change, but one well worth it for a guy who had thought of driving his car into a ditch just a year before. That 200 pound weight loss led to other tangible results that helped bring back his confidence and self-esteem. Cox went from a size 60 pant to a 38. The XXXXXL shirts he once wore were now replaced a XL’s. It was time to smile again.

“My success really hit me one day while shopping,” said Cox. “For years I had to go to big and tall stores to get clothes because I couldn’t come close to fitting in anything off the rack from a regular department store. I had inadvertently gone to a big and tall outlet one day, and asked the salesman who I knew very well where the XL shirts were. He looked at me and smiled, telling me that the smallest they had was XXL. I would have to go to a ‘regular’ store to get what I was looking for.”

Despite the drastic change, Cox had the sense to realize that the surgery would not be the end-all cure. “My doctors stressed the fact that the surgery was only a tool to losing the weight and keeping it off. I would have to remain faithful to my diet and incorporate an intensive exercise plan if I wanted to remain healthy. That’s how I found the sport of triathlon.”

To be honest, Dan Cox found the sport by mistake. He hadn’t been on a bike in 20 years, had done zero open water swimming, and only became reinterested in running after he was able to run a mile on the beach without stopping. After seeing a triathlon highlight show on cable television, and learning that the sport was not just about Ironman distances, he realized that with a some coaching and training, even he would be able to handle a sprint distance race. With the help of a local bike shop owner, he purchased a bike, began to spend time in the pool, and ran as much as he could. The man who once could not make it up a flight of thirteen stairs was becoming a triathlete.

“My wife Deborah and daughters Emilie and Maddie have been my biggest inspiration, but I owe a great deal of thanks to Clint Kronenberger, owner of Clint’s Bicycle Shop in Naples. His willingness to work with me, patience and support provided a lot of the motivation I needed to dive into and stay with the sport. Clint’s a great friend, not only to me, but to many triathletes in the Naples area.”

Cox’ day of reckoning came in June of 2003 at the first Central Florida Spring Tri of the season. The first timer swam, biked and ran his way to a finishing time of 2:11:59 in the men’s novice division. He finished more than an hour behind the novice winner and an hour and a half behind the overall winner, but that hardly mattered. Crossing the finish line to the applause of his wife and daughters, Dan Cox had become a triathlete.

“The feeling I had coming across the finish line with my family there to greet me is one I’ll never forget,” said Cox. In the last 100 yards it seemed like I relived the last four or five years of my life. The depression, the surgery, the struggle to lose all the weight were all so vivid. I was humbled beyond belief, and so thankful at the same time.”

On a lighter note, additional humbling came in the form of one of the athletes who finished ahead of Cox. “I remember the PA announcer introducing and talking about an 81-year old gentlemen who was competing. I figured there’s no way I can lose to someone almost forty years my senior. Next thing I know he’s swimming by me like Mark Spitz. I never saw him again, but it was clear he was going to finish well ahead of me. After the race, I found out that athlete was the nationally ranked John Taylor, so I didn’t fell that bad. It was still humbling to realize, however, that I got beat by a guy who had probably voted for FDR.”

His transformation from a 446 pound heart attack waiting to happen to competitive triathlete also inspired Cox to tackle some other goals. At present, he is an Assistant Principal at Golden Gate High School in Naples, and is closer to reaching his goal of becoming a full principal. He has continued his education, and is currently enrolled in the doctoral program at Nova Southeastern University, with just a few classes to go before he receives a Ph. D. in International Leadership. Most importantly, he has become a happy and healthy husband and father to his wife and children.

“I owe so much to Deborah, Emilie and Maddie. They have been by my side since day one, and never once gave up on me. The fact that I have conquered what I once thought was an insurmountable obstacle has made me stronger than I ever was as a football player. Knowing that I am healthy and will be there for them is the greatest thing I ever could have hoped for.”

By T.J. Cesarz