Mental Health

ANXIETY AND THE BODY/MIND: A Chiropractic Approach

An interview granted Ms Wendy Fergusson, Public Education Director for ADAM given by Dr Henri Marcoux following an in-office conference on anxiety and chiropractic care in October 2006

Question: What do you understand about anxiety?

Answer: Dorland's Medical Dictionary states the following: A feeling of apprehension, uncertainty and fear." Webster's Unabridged Dictionary states that synonyms of anxiety are fear, foreboding, worry, distress, disquiet. Further, the word "fear" is defined as being "a distressing emotion aroused by impending pain, danger, evil, etc. whether real or imagined".

A definition of anxiety I favour can be stated as fear of impending doom. This could relate to situations real or unreal. Situations where the main anxiety is associated to nervousness in anticipation of an event or a performance, is often the fuel for success. However, this is not always the case.

Question: Are you saying that fear is the underlying factor in anxiety?

Answer: Fear is a strong and necessary emotion. It has to be expressed, be appropriate, and dissipated. If it is misplaced and continuous, the experience becomes debilitating and destructive. An emotion can be defined as an affective state of consciousness in which the feelings of joy, sorrow, fear, hate, or the like are experienced as opposed to thoughts or attitudes that constitute volitional states of consciousness.

Feelings can usually be identified by the mind, but they really exist in the body as patterns in the musculo-skeletal system that the cortex of the brain may identify as related to certain emotional states usually connected to situations. Certain emotions make us feel tense while others make us feel relaxed. When we feel anger or sadness, we know we are angry or sad by the way our body positions itself and by how our muscle system expresses its tension. The same applies to any and all emotions. Therefore, all feelings are physical. There are no feelings in "your head". The head can remember a feeling, but only the body can experience it.

If we do not fully express or experience the emotion in question, whatever it is, the unexpressed part of the experience stays locked in the body musculature. An example would be the expression of anger. If we fully express the emotion, that emotion disappears. We've all experienced that one! One minute you're angry and after having spoken your mind, you wonder what you were angry about. That's if the emotion was fully expressed and you feel much more relaxed.

Question: Are you saying that expressing emotions and our feelings gets rid of anxiety?

Answer: Absolutely. However, it is not usually that easy. Often, the fear associated to anxiety could come from a long way back and be well established. Fear is the first experience we face in our life during the birthing process, especially if the labour was prolonged and difficult. If we recover from the fear or birthing, we start a process of learning to deal with our fears as they present themselves in our early childhood. If we do not recover from these early fear experiences, we do not develop the skills necessary to handle fear, apprehension, nervousness and other indicators of stress.

Instead we develop survival strategies to avoid dealing directly with fear by repressing the emotional energy as muscle patterns held in the body, primarily the spine. Thus, we can unconsciously store previous experiences without the benefit of knowing where these came from and what they are about. And yet we can still feel anxiety without understanding where it comes from. We become stuck!

When we hold an emotional pattern in our muscle structure over long periods of time, our muscles pull our spine and body into a postural alignment that characterizing who we are. This phenomenon of held and repressed patterns is specific to our individuality. We recognize each other by posture, by the sound of voices, the rhythm of our footsteps and by the shape of our back, our facial expressions; these are all expressions of sustained muscular patterns. We literally sculpt ourselves as we age.

Fear has a characteristic posture, as do other emotions. Our postural patterns reflect different states of consciousness that we express or do not express.

It is difficult to feel happy and content when we are not able to relax our musculature to produce large expansive movements. We are tense when we are angry or upset and our movements are tight. We are on guard. In a state of joy and happiness, we are relaxed and our movements are loose and can easily stretch. We are more trusting and open to love.

Question: Can anxiety be healed?

Answer: There is an adage well known in natural and holistic healing circles that goes as follows: "If you can feel it, you can heal it."

In reality, any emotion we experience will disappear. If we experience the emotion fully, the emotion will evolve into a more positive basic emotion, usually the opposite side of the emotional spectrum. So anger could evolve into peace, fear could evolve into courage and strength.

Sometimes we have been so traumatized by our fears, real or imagined, we become afraid of fear. This creates constant anxiety also identified as chronic stress. We may be completely overwhelmed by fear or anxiety that we don't even want to go there! This guarantees that we will not allow ourselves to experience it, thus re-enforcing the feelings of anxiety.

Question: Does this mean that we are stuck with our fears forever?

Answer: As we mature, we develop strategies to conquer, eliminate or repress our fears. If we learn to face our fears and consequently experience them, our anxiety disappears and is replaced by more positive emotions. This work is not easy. The key is to become aware of what we are feeling. This is the work necessary to deal with anxiety.

Fear and apprehension associated to daily living causes stress reactions in the body. If we do not have strategies to handle stressful situations, the stress reaction, which is a body reaction, may become permanent or chronic. Some situations can be so traumatic that we establish a permanent fear/stress pattern within minutes. Chronic stress manifests itself as anxiety.

In examining anxious and stressed patients in my practice I have found that certain muscles are hyper-contracted in holding patterns typical of unresolved stress. The most common postural pattern seen when stress levels are high can be described as a fight or flight posture. This posture is also present when a patient is lying face down on the chiropractic table. The thoracic/dorsal curve is often exaggerated in both standing and face lying positions. There is also a postural hump where the neck meets the dorsal spine, projecting the neck forward. These are classical signs of stress, which is always connected to a fear reaction.

The thoracic or dorsal spine is usually very tense and inflexible, a finding consistent with chronic anxiety syndromes.

Whenever there is a softening or decrease of the spinal tension, the person starts to feel better overall. The spine and body become more flexible and the person becomes better at handling stress, anxiety and other negative emotions.

Question: What do you find when you examine a patient who is stressed or anxious?

Answer: Other than what I just described, the individual muscles that are the most hyper-contracted are found in the upper shoulders (Trapezius), neck, upper back, lower back, jaw (TMJ) shoulders and arms, and calves. When seen as muscle groupings, a stress or fear pattern becomes apparent. The spine, which is the central holding element to the entire musculo-skeletal system, shows many segmental misalignments. These misalignments, called subluxations in chiropractic terms, are more often present in the neck (C1-C2, C5-C6), show as a "hump" where the lower neck meets the dorsal spine, increased curvature in middle dorsal vertebrae, lower back and pelvis, and in the feet, usually as dropped arches and pronated ankles. The front of the chest may be showing signs of "collapsing". ("I have had enough!") In humans, these are the areas where most symptoms occur and manifest as head and neck aches, tense shoulders, chest tightness and discomfort, lower back pain, and foot problems.

It is rare indeed, that symptoms to the neck and lower back are not associated to an emotional trauma or a major stress shortly before the onset of the symptoms. Sometimes those symptoms finally manifest after a prolonged period of emotional stress.

Question: How do you handle patients who are stressed and perhaps have anxiety?

Answer: Dealing with stress and anxiety is challenging. There are many therapeutic interventions that can be helpful. However, many of these do not address the root causes and serve only to hide the symptoms of anxiety. Many times, these remedies and drugs will help to reduce the intensity of the experience thereby allowing a person the space or relief to deal with the situation. And using antidepressants may make you feel better, but any drug does not address the root causes. The body is not deficient in Prozac!

While there are many ways that can help to deal with anxiety, one of the most progressive ways, in my experience, has been through the application of appropriate chiropractic care. My clinical experience in dealing with patients who are plagued by anxiety has been very positive. This is especially true when the patient follows through on the necessary care. Over the years and after trying many different treatment protocols, I found that some chiropractic techniques were more effective than others in helping patients with anxiety.

Another aspect of effective care for anxiety states has to do with learning to breathe properly. This means having a full breath that includes the upper, middle and abdomen. Deep breathing usually dispels fear, especially if the fear is a residue of unresolved experiences. This may not necessarily resolve the problem, but it can serve to take the heat off.

Question: Is there any research that validates what you have stated about helping patients with anxiety?

Answer: A research paper published in the peer reviewed publication "Nature", under the heading of Molecular Psychiatry, authored by Dr Jay Holder DC, founder of the American College of Addictionolgy and Compulsive Disorders and developer Torque Release Technique, showed conclusively that subluxation based chiropractic care had a profound effect on reducing anxiety.

Using Beck's Depression Inventory and the Spielberger State Anxiety Test, highly accepted methods of determining levels of anxiety, found the following: The Beck's Depression Inventory revealed that chiropractic care got depression levels below a score of 5 in 4 weeks, something which usually took one year of medication and psychotherapy to achieve the same results. The Spielberger State Anxiety Test revealed that chiropractic care got anxiety levels below a score of 35 in 3 weeks. Normally it took 6 months of medication and psychotherapy to achieve the same results.

The chiropractic technique used in this research was a subluxation or neurologically based chiropractic technique known as Torque Release. Other research by the Association of Network Chiropractors published in the peer reviewed Journal of the Vertebral Subluxation revealed that subluxation or neurologically based chiropractic care produced an 80% improvement in overall quality of life in 2800 subjects polled for nearly two years. The improvements noted included feelings of well-being, more relaxation, handling stress more effectively, better symptomatic outcomes, dietary improvements and a more positive outlook. The technique used in this research was Network Chiropractic.

Because these chiropractic technologies were subluxation or neurologically based suggests that other subluxation-based techniques would have similar outcomes.

Question: How do you find a chiropractor who can help someone with anxiety syndromes?

Answer: There are at least 100 different chiropractic techniques or ways of assessing the spine and its relationship to the nervous system. Many of these techniques are oriented towards the relief of symptoms to the lower back or other joints of the body. Many more are oriented towards changing the nervous system as it manifests through the spine. The research described above was based on subluxation-based or neurologically based chiropractic care. This does not mean that symptom based DC's cannot help in alleviating anxiety. The available research and my clinical experience strongly suggest that some methods will be more effective than others.

Question: Why do some techniques work better than others?

Answer: The reason that some methodologies seem to work better than others is because these subluxation based techniques address those spinal segments that change the postural patterns associated to stress and anxiety patterns. Generally these methodologies analyze the whole spine and nervous system in its relationship to the spine, as opposed to one set of symptomatic joints. These techniques go beyond symptom relief care and focus on changing the dynamic tension in the spinal cord membranes that influence the way we hold emotional patterns in the spine and body.

Question: How do you explain why these techniques work?

Answer: Any thought that originates in the brain has to be organized by the spinal cord in order to become an action. Anything that changes the biomechanical dynamics of the spinal cord will influence the function of the nervous system. Only certain vertebrae can effect the tension in the spinal cord and only certain techniques can positively influence these important spinal bones.

Any system that reduces the amount of spinal cord tension will create more "ease" or a state of relaxation in the body. More relaxation or "ease" means more flexibility, better body function and a greater sense of well-being. Stress and fear makes us lose that "ease" causing what is called "dis-ease" or loss of ease. Loss of ease also means loss of normal function and a decreased sense of well-being.

If the loss of normal function stays long enough, this will create a permanent change in structure in the body in keeping with the laws associated to how function and structure inter-relate. Hence joints that do not function well develop degenerations known as osteoarthrosis commonly called osteoarthritis.

Subluxation based chiropractic systems of spinal analysis identify areas commonly called "subluxations" by assessing the nervous system seen in spinal biomechanics. These are specialized procedures that generally go beyond the evaluation of symptomatic joints and focus on identifying vertebral segments that have a negative effect on the nervous system. In other words, the subluxation based spinal examination would look at the whole spine not just the area of complaint. Looking at the whole spine means looking at the whole person. Anxiety involves the whole person.

Question: How does correction of subluxations help to reduce anxiety?

Answer: The correction of these spinal "subluxations" or signs of abnormal function in the nervous system creates "ease" and a restoration of normal function into the spine and nervous system. In the relaxation and sense of well-being that follows, patients not only feel better, but also end up being able to become more aware of themselves and how they feel. This means being more in control of body reactions, body functions and better able to experience life more positively. In this new context a person can deal with stress more effectively and be more able to handle situations that cause stress. When the nervous system and its musculo-skeletal expression are more flexible, the body's healing forces work more efficiently.

Managing life more efficiently opens many new possibilities for more health and wellness. This might mean being eager to start an exercise program, having massages, changing one's diet, indulging in meditation or prayer, discovering new ways of responding positively to the challenges life has a habit of providing for our growth. This is wellness.