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2: Meditation; rupa jhana with modern applications
3: Adrenal Disorders
4: Food rotation and immune function
5: Causes and Treatments for Pain
6: Emotions and Psychology of Sympathetic and Parasympathetic systems
7: Mindfulness studies reports
Dysglycemia refers to any disorders in serum (blood) glucose stability. We will be covering hypoglycemia, insulin resistance, diabetes and some of the technical information related to glucose management. A study by J. Grimm in Public Health and Nutrition conservatively estimated that 30% of the population suffers from insulin resistance, an advanced state of dysglycemia. I have read that if current trends continue, projections hold that 60% of the population will be in this state or worse and that it will probably bankrupt our current medical system in the next ten years, caring for more than a hundred million people suffering from severe diseases related to blood sugar physiology.
Blood sugar disorders affect every aspect of our physiology. One of our body’s primary sources of energy is dependent on the ability to convert glucose into ATP, adenosine triphosphate. Glucose is also called dextrose and is comprised of 6 carbon atoms, 12 hydrogen atoms, and 6 oxygen atoms, and is split into ATP by the enzyme ribase. ATP is made of adenine and ribose with three phosphoric acid groups. Adenine and ribose are both forms of pentose, sugars with 5 carbon atoms. ATP is used by all cells of the body and particularly muscle cells for energy. The splitting of these groups of atoms is known as the citric acid cycle. A steady supply, storage of, and re-conversion of glucose back into the blood supply and the proper conversion of glucose into ATP are important for many reasons, as we will see.
First I will review basic components of glucose regulation.
Insulin is a protein hormone secreted by beta cells of the pancreas. Insulin allows glucose to enter the cells and begins the process of transforming glucose into energy that is used by all the cells in the body. Insulin is secreted when glucose levels are high. Insulin is also an anabolic hormone. This hormone promotes the production and growth of tissues. It signals the liver to produce and store glycogen, a stored form of glucose. Glucose is thus lowered in the blood stream by the utilization of the cells (forming ATP), and by the formation of glycogen in the liver called glycolysis.
Cortisol is secreted when glucose levels in the blood are low. It is a catabolic hormone secreted by the adrenal glands that breaks down glycogen into glucose, putting it back in the blood stream. This is called glycogenesis. This steroid hormone is also known as an adreno-cortico-tropic hormone, or ACTH. Cortisol should be highest in the morning after the body has been fasting. It should be low in the evening when glucose has been made available by feeding. When blood sugar levels are low, signals are sent to the hypothalamus to secrete cortisol releasing hormones. The hypothalamus thus becomes another critical link in stabilizing blood sugar.
Leptin is a hormone secreted by fat cells that signal the hypothalamus to stop feeding, by shutting down the production of hunger signals, altering the production of neuropeptides and neurotransmitters that stimulate feeding. The process of fat metabolism is closely related to sugar metabolism, as both are sources of energy. Fat metabolism is also called lipid metabolism. Lipolysis and Lipogenesis refer to the storage and synthesis of lipids. Lipids play many important roles in physiology such as regulating temperature, called thermogenesis. -Temperature is very important for enzyme processes and pH. The average number of enzyme reactions per cell is 35,000 per second. Lipids are also important for hormone production, prostaglandin production, regulating intercellular communication, transformation and transportation of micronutrients between cells. Lipids are closely related to phosphatides, cerebrocides, and sterols.
The liver is the main tissue that responds to signals indicating high or low blood sugar. High and low blood sugar trigger hormonal responses that induce pathways of restoring blood sugar. Signals like growth hormone released from the pituitary increase blood glucose by inhibiting uptake in the liver. Gluco-corticoids also leave more glucose in the blood stream to be used where it is most needed. Thus the pituitary/liver relationship is also important in blood sugar physiology. The liver performs glycolysis, glucogenesis, lipolysis, lipogenesis.
Now we will begin to explore various forms and effects of dysglycemia. Hypoglycemia refers to a lowered fasting glucose state. There are two types, hypoglycemia and reactive hypoglycemia. Reactive hypoglycemia has all the symptoms of hypoglycemia but may not be outside the laboratory range for glucose and may or may not have a lactic acid dehydrogenase, LDH below 140 U/L. The symptoms will include dizziness or light headedness if meals are missed or between meals, shaky, jittery, tremors, craving sweets during the day, craving coffee in the morning, eating relieves fatigue, easily agitated, poor memory, and blurred vision, and when severe can cause fainting blackouts and will eventually result in seizures. All proteins, fats and carbohydrates can and should be converted to glucose eventually. If a person only ate lean meats, they should still have a glucose level between 85-100 mg/dl.
Hyperglycemia refers to a state of excess glucose in the blood. This is a definite indication that glucose is not being managed properly. Hyperglycemia usually includes hyperinsulinemia. Hyperglycemia usually begins with hypoglycemia and progresses to insulin resistance or syndrome X, and then to diabetes. Insulin resistance is a state where the insulin receptors in the cells become desensitized to insulin. The cells are thus deconditioned to insulin stimuli and do not take up glucose as well. When people have insulin resistance they will display symptoms such as fatigue, especially after eating; difficulty with sleep patterns; usually difficulty falling asleep; digestive disturbances, such as gastric reflux, which may be proxysmal; other G.I. disturbances; cravings for sugar; inability to lose weight; constant hunger; eating sweets does not reduce cravings; increased thirst and appetite; migrating aches and pains. Lesser recognized but related dysfunctions may occur, such as leptin resistance and cortisol resistance. These display similar symptoms and will usually be accompanied by heightened stress and anxiety levels. Hypoglycemics can also have dysfunctions in cortisol that will manifest as stress. Hyperinsulinism is an independent risk factor for cardiovascular disease. It adversely affects the physiology of lipoproteins, coagulation protein synthesis, and blood pressure. Insulin upregulates the synthesis of cholesterol by stimulating the Hmb-coA reductase enzyme. This is why cholesterol goes up when glucose is not being managed properly. This is the same enzyme that statin drugs down regulate. We will see more examples of how some drugs only mask disease processes and do not address the underlying bio-chemical dysfunction. Insulin also negatively impacts the cholesterol ester transfer protein, CETP, the protein that is responsible for shifting cholesterols into HDL. The result is lower HDL. HDL is responsible for moving cholesterol out of the arteries. LDL transports cholesterol into arteries. HDL protects against arthrosclerosis by moving cholesterol to the liver where it can be removed from the body. Cholesterol is important for the formation of hormones. High cholesterol and the body’s inability to manage it properly negatively impacts hormone balance, as we will see.
When the insulin is not managed properly, males and females both have difficulty binding or synthesizing proper hormones and eliminating excess hormones. This leads to a variety of metabolic malfunctions. Hyperinsulinemia and its resultant hormone imbalance have different effects in males and females.
Females respond to a hyper insulin state with up-regulated hormone synthesis in the adrenal glands and ovaries of testosterone and cortisol. This is called an androgen shift. These hormones become abnormally increased and further promote insulin resistance, creating a vicious cycle. The increased androgen hormones increase free fatty acids in the liver, which decrease the liver’s ability to respond appropriately to the hormones. The androgen shift also affects the hypothalamus-pituitary feedback loop, resulting in changes in the leutinizing hormone, LH. This is an important signal that regulates menstruation and induces changes in the reproductive system. There are several other causes for disruption of LH. They are surges in estrogen at the end of the follicular phase and elevations of b-endorphin. Other causes of androgenism should be ruled out. These include ovary and adrenal hormone dysfunction in the absence of insulin disorders. The most common effect of the androgen shift in hormones is poly-cystic ovarian syndrome. Eighty percent of all women with this disorder have it as a result of the androgen shift due to hyperinsulinemia. The current model suggests using birth control to treat the androgen shift. This further dysregulates the hypothalamus-pituitary feedback loop creating post birth control syndrome, or an inability to regain a normal cycle after oral contraceptives. The current health care model suggests another way to treat the hormone imbalance is to prescribe drugs that directly suppress adrenal function such as prednisone, dexmethasone, or gluco-corticoids. These drugs have a long list of side effects and do not treat the underlying problems of hyperinsulinemia.
Hyperinsulinemia affects male hormone pathways differently. First progesterone may not be converted to testosterone and may be converted to cortisol instead. Excess cortisol again down-regulates insulin receptors creating a vicious cycle. Insulin resistance again disturbs proper fat metabolism. Progesterone is one of the hormones that protects and regulates the prostate function. Other factors that relate to prostate function are estrogen levels, and conversion of testosterone to dihydrotestosterone. Changes in insulin and adrenal hormones can impact the conversion of these hormones. When any or all of these processes occur, the prostate will undergo changes similar to the ovaries in women when LH is disturbed, swelling and abnormal growth. Progesterone also influences neurochemistry and osteoblastic activity.
The most important indicator of blood sugar management is how you feel after you eat a meal. If anything in your diet creates an insulin surge, you will feel tired after you eat. This indicates that glucose is not being converted to ATP. Food allergies and infections will also disturb the citric acid cycle and must be ruled out. Food allergies will induce inflammatory states, which stress the liver’s ability to respond to hormones, as well as adrenal stress affecting cortisol, disrupt intercellular communication between lypolysis and lipogenesis, decrease the activity and synthesis of thyroid hormones, upregulate the immune system and many other stressful and destructive effects. Infections will uncouple the citric acid cycle by disturbing phosphorylation. Gastro intestinal dysfunction may induce anemia, thus compromising the blood’s ability to carry oxygen, which is necessary in the production of ATP. Anemia must be treated before the blood sugar can return to normal. The lungs may also play a role in the failure to provide enough oxygen to the blood. When glucose is incompletely metabolized, the leftover glucose in the system will oxidize, lose electrons, and thus become tree radicals called g1ycolated end products. These compounds will cause inflammation and damage to sensitive tissues such as the retina, small nerves and blood vessels, and the kidneys.
When the glucose pathways are disturbed significantly enough, the body will begin to seek other sources of energy. When the glucose cannot be utilized directly for energy, it will be shifted into adipose or fat. The fat will then be converted to energy. This process is not very efficient for ATP production for several reasons. First, the breakdown of fats into ATP leaves a residue of ketones or ketone bodies. Ketone bodies deplete the cellular and extracellular acid buffers and the system becomes very acidic. When the system becomes acidic and loses its buffers, mineral and electrolyte reserves are damaged. Abnormal urination, kidney and adrenal dysfunction will ensue. This will further compromise the kidney/adrenal function already disturbed by glycolated end products. The body may try to reestablish ph by producing ammonia. Ammonia is very alkaline, but also very toxic. The body may try to restore mineral reserves in the blood by taking calcium from the bones. The second reason why utilizing fats for ATP is inefficient is that it requires more energy to break down the fats than is gained, resulting in low energy and weight gain. When the patient eats, they will put out more energy for the process of lipogenesis and lipolysis and have less potential for ATP from these cycles than they will be gaining.
Hyperinsulinemia has several other serious consequences for the human organism. Hyperinsulinism will down regulate the glucose-6-phosphate dehydrogenase (G6DP), which will then suppress the hexose monophosphate shunt (HMS). Reduced HMS activity will decrease NADP, which is the cofactor required to produce glutathione. Glutathione is the major nutrient for the oxidation/reduction axis. The net result is compromised phase I and phase II liver detoxification. Poor elimination of toxins will further compromise the liver’s ability to respond to managing blood sugar and other metabolic functions. The patient will also report heightened stress levels. In women menses may get heavier and more painful. Over exposure of insulin also has deleterious effects on fatty acid metabolism. It upregulates enzymes that convert DGLA into arachidonic acid. This is a precursor to prostaglandins and will shift the balance of prostaglandins, creating an inflammatory state and all of its detriments, as well as affecting prostaglandin function, which regulate lypolysis, platelet aggregation, gastro-intestinal activities, neuro-transmission; and many other functions. Prostaglandins are short-lived intracellular modulators of the biochemical activity of the tissues in which they were formed. They are called autocoids and are similar to hormones. Alterations of fatty acids affect many prostaglandin functions.
Diet is the MOST critical factor in treating dysglycemia. All forms of dysglycemics must eat a healthy breakfast, with lean meats, vegetables and legumes. A protein dominant diet will ensure a slow steady supply of glucose that avoids surges in hormones and glucose. A slow steady supply of glucose will reduce insulin surges. This is determined by how quickly a flood breaks down into glucose. The faster the food breaks down into glucose, the higher the insulin surge. The spike in insulin is what dis-regulates the entire hormonal system. A spike in insulin will cause all of the aforementioned alterations in physiology. All of the body systems will become stressed and challenged and concomitant shifts in chemistry take place. The more repeatedly this happens the more the system is likely to become compromised. The liver, the adrenal glands, the pituitary, the hypothalamus, the pancreas, the tyroid, the digestive system, and all of their mechanisms of regulation will begin to exhibit maladaptive responses that will create a viscous cycle of dysfunction and poor health, weight gain, insomnia, heartburn, menstrual irregularity, fatigue, pain, inflammation that will damage many other systems eventually, as mentioned in detail above. If a person exhibits fatigue after eating, they may have exceeded their carbohydrate limits or may be exhibiting food intolerance symptoms. This will be best managed by including high quality animal protein with every meal. The more blood sugar dysfunction there is, the more crucial this will be. Each person will have different tolerances and limits in both these areas.
It has also been found that the combinations of foods eaten will affect how carbohydrates and fats are absorbed. These factors make the glycemic index a poor predictor of how foods will affect someone. Therefore, when determining food intolerances, the most important initial indicator is the body's reaction to what is eaten. These reactions may include mental clarity or dullness, an increase or decrease in energy levels, a general feeling of well being or discomfort. It is up to each individual to begin to notice how they feel after eating specific foods, and note how their energy level reacts. Restricting diet to identify problem foods is of paramount importance. The most likely initial reason for tiredness after eating in hyperglycemics is an insulin surge, resultant from poor glucose metabolism. The important thing to do is not to exceed the carbohydrate limits for that individual. This will minimize the insulin surge, and all its concomitant hormone, lipid, inflammatory, toxicity reactions.
There are three critical guidelines for hypoglycemics. 1) They must eat a healthy breakfast, 2) they must not go long periods without eating, 3) they must not snack on sweets. This will stress the adrenals, which will result in cortisol excess and often manifest as insomnia. These patients may also complain that they experience nausea in the morning or at other times when they eat. This is due to the stressed adrenals putting the body into an excess sympathetic nervous system state. If they eat small meals and stabilize their blood sugar, this will take the body out of sympathetic stress, and they will have an easier time eating breakfast. They must not snack on fruit alone. However, if they want to eat a piece of fruit after a protein rich meal, they can.
Fat metabolism has not been studied as extensively as sugar metabolism, and there are many competing theories on what kinds of fats are better. Dr. Watson was probably the most groundbreaking theorist and researcher in this area. He found that hypoglycemics do better with meats high in adenine and saturated tats. Hyperglycemics have been found to do better with meats low in adenine and low in saturated fats. He also coined the terms glucogenic and ketogenic to describe different metabolic tendencies. He further developed specific amino acid and other micro nutrient supplementation for the different types. There have been extensive trials of this theory, and its practice has been found to be extremely beneficial for hypoglycemia and its severe consequence of seizure disorders, as well as benefiting hyperglycemics and their disease processes. The general guidelines for hypoglycemics, according to Dr. Watson, is to eat chicken organ meats, lamb, venison or beef protein at every meal, nut butters, sardines, salmon and tuna, vegetables, especially cauliflower. Hyperglycemics should eat fish or poultry protein at every meal and vegetables. Whole grains are neutral for both groups and both groups must avoid sweeteners of all kinds and fruit juices.
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Meditation; rupa jhana 1
The following is a meditation based on a classical Buddhist text with my commentary. After the meditation I have suggested applications to a contemporary psychological model for pleasure seeking, and then adapted all the aspects of the presentation into a brain functions model with some endocrine associations.
Here is a reference for the first four rupa jhanas from the Pali Cannon.
"There is the case where a monk — quite withdrawn from sensuality, withdrawn from unskillful qualities — enters and remains in the first jhana: rapture and pleasure born from withdrawal, accompanied by directed thought and evaluation. He permeates and pervades, suffuses and fills this very body with the rapture and pleasure born from withdrawal. There is nothing of his entire body unpervaded by rapture and pleasure born from withdrawal.
"Just as if a skilled bathman or bathman's apprentice would pour bath powder into a brass basin and knead it together, sprinkling it again and again with water, so that his ball of bath powder — saturated, moisture-laden, permeated within and without — would nevertheless not drip; even so, the monk permeates, suffuses and fills this very body with the rapture and pleasure born of withdrawal. There is nothing of his entire body unpervaded by rapture and pleasure born from withdrawal...
In this first jhanna, we have already deeply accessed a deep state of concentration and selectivity on rapture and pleasantness. These states are also commonly used synonymously with bliss and joy. I like the contemporary description of the background/foreground analogy wherein the hindrances and reactivity are moving further and further into the background. The text also mentions that this bliss is born of withdrawal. I would like to present withdrawal as a way of relating. This word has many interesting meanings, interpretations and connotations that I find fascinating in this context. For example; renunciation, solitude, surrender, have some obvious places in this context. By renunciation, I mean the renunciation of the conditioning by which we identify things and with things, not the renunciation of things. Closely related is cessation, abolition. In Buddhism this may refer to the cessation of name and form. A similar characterization of the letting go of the ways we identify things and with things. We may also derive the word eminence, which has connotations of pinnacle, summit, elevation, from which we may derive distinction, discrimination, discernment. I suggest these may all be applied to the usage of the word withdrawal in this context. We may also derive the word saki, a Persian word often used in Urdu poetry referring to “one who pours a drink.” This may be a bit of a stretch to consider, but may be interpreted as offering the perception of bliss to ourselves. In any case this initial stage is already characterized by a deep state of absorption. The state of absorption, which is one of the characteristics of concentration in Buddhism has some interesting etymological aspects. The word Dhyāna, from Proto-Indo-European root *√dheie-, "to see, to look," "to show” Developed into Sanskrit root √dhī and n. dhī, which in the earliest layer of text of the Vedas refers to "imaginative vision" and associated with goddess Saraswati with powers of knowledge, wisdom and poetic eloquence. This term developed into the variant √dhyā, "to contemplate, meditate, think", from which dhyāna is derived.
According to Buddhaghosa (5th century CE Theravāda exegete), the term jhāna (Skt. dhyāna) is derived from the verb jhayati, "to think or meditate," while the verb jhapeti, "to burn up," explicates its function, namely burning up opposing states, burning up or destroying "the mental defilements, or hindrances, preventing the development of serenity and insight."[note 1]
Commonly translated as meditation, and often equated with "concentration," though meditation may refer to a wider scala of exercises for bhāvanā, development. Dhyāna can also mean "attention, thought, reflection."
The ability to maintain a high degree of selectivity on the experience of rapture and pleasantness develops and gets much stronger with practice. In the Buddhist suttas there is an analogy of a man who has been wandering in the desert and in the midst severe exhaustion and dehydration finds a pool of water. Rapture describes his feelings associated with drinking all the cool water he wants and bathing in the refreshment and restoration of the experience of the water. I have often felt that this really describes that relief of deep concentration and pleasantness free from the reactive states that can characterize our existence. At first it is often just a glimpse of the possibility of an inner state of pleasantness that is more independent, self-actualized, self-realized and in a sense, self-generated, and self-determined. But that glimpse can be the taste of freedom. A realization of a path to a deeper sense of wellness. The next state is a further refinement of this pleasure through concentration.
"Furthermore, with the stilling of directed thoughts & evaluations, he enters and remains in the second jhana: rapture and pleasure born of composure, unification of awareness free from directed thought and evaluation — internal assurance. He permeates and pervades, suffuses and fills this very body with the rapture and pleasure born of composure. There is nothing of his entire body unpervaded by rapture and pleasure born of composure.
"Just like a lake with spring-water welling up from within, having no inflow from east, west, north, or south, and with the skies periodically supplying abundant showers, so that the cool fount of water welling up from within the lake would permeate and pervade, suffuse and fill it with cool waters, there being no part of the lake unpervaded by the cool waters; even so, the monk permeates and pervades, suffuses and fills this very body with the rapture and pleasure born of composure. There is nothing of his entire body unpervaded by rapture and pleasure born of composure."
This state is characterized as born of composure and directed thought rather than withdrawal. Directed thought, vitaka, is often accompanied by, vichara, evaluation, as directed thought and evaluation. Here you are directing your thought to the experience, or object of your attention, pleasantness. As this is a feeling and feelings are associated with water in indigenous traditions, we might characterize this meditation as on the water element. An analogy for directed thought has been given in the Pali Cannon suttas as the sifting of sand. Directed thought and evaluation are a refined kind of attention that is sifting the experience into a finer construct and context. We have already been exploring the relationship between experience and the effect of the way we are relating to the experience changes the experience. In this meditation we are sifting and distilling the experience of pleasantness or the water element. The evaluation, vichara, is the sensitivity to the process. The feedback loop of the experience that tells us how it is going for us. Is this an appropriate efforting, right effort, or samma vidyana. It is also noticing if this is an appropriate object of attention at this time, or would some other meditative context be more conducive right now. I can tell you with practice you can access any kind of meditative construct at any time and we will be getting into the variations on that later as well. It is similarly telling us if there are places in the field where we are having trouble accessing. For example, the mixing of “bath powder into a brass basin and knead it together, sprinkling it again and again with water, so that his ball of bath powder — saturated, moisture-laden, permeated within and without” is telling us if there are some places that we are not able to mix, or perfuse, or enter the pleasantness into. That is, what parts can you work with and what parts are you not able to? How are you going to more fully actualize this process? This brings us back to some of the ideas on how to attend to experience. The teachings and the process are in a constant feedback loop, re-informing, and clarifying the process. We can recall the that the instructions included a withdrawal or a letting go of. This continues to be part of the process. There are many emphasized passages that state “ a thought, arises, is known and passes.” And this is one of the key teachings in Buddhism, impermanence. We may incorporate this into the directed through and evaluation in terms of letting go of some of our resistance to being able to access difficult areas of our perception. There are many ways to do this and we are exploring them systematically in a number of different meditation and contemplation practices. In this meditation, withdrawal and directed thought, and right effort, as well as right mindfulness “samapajanna’, or “damma vicaya,” or “satipattana” are also references for this practice. Sati is the usual reference for this word, mindfulness. This has been characterized in several interesting ways. As “one is endowed with sati,” “abides in sati,” and “the purity of sati.” These different uses give mindfulness interesting contexts in that it is not something someone does. We may look at this in terms of faith. One does not do faith. One is endowed with faith, abides in faith, or is endowed with or abides in the purity of faith. Through the practice we are making the transition from the reactive nature to states of rapture and bliss on a deep level. The reactive states are in some way much more removed from our consciousness. This suggests that we are moving into more refined states than those of good will/ill will or common reactive states. The reference that there is “no inflow from east, west, north, or south.” Is to me suggesting that we are moving beyond craving /aversion and liking/disliking. This is through directed thought. In the satibhatana sutta this is associated with the ability to “observe, understand, relax, clearly comprehend and review.”
"And furthermore, with the fading of rapture, he remains equanimous, mindful, & alert, and senses pleasure with the body. He enters & remains in the third jhana, of which the Noble Ones declare, 'Equanimous & mindful, he has a pleasant abiding.' He permeates and pervades, suffuses and fills this very body with the pleasure divested of rapture, so that there is nothing of his entire body unpervaded with pleasure divested of rapture.
"Just as in a blue-, white-, or red-lotus pond, there may be some of the blue, white, or red lotuses which, born and growing in the water, stay immersed in the water and flourish without standing up out of the water, so that they are permeated and pervaded, suffused and filled with cool water from their roots to their tips, and nothing of those blue, white, or red lotuses would be unpervaded with cool water; even so, the monk permeates and pervades, suffuses and fills this very body with the pleasure divested of rapture. There is nothing of his entire body unpervaded with pleasure divested of rapture...
In this state we are moving beyond the rapture into the pleasantness of the equanimity of the concentrated mind itself. This equanimity is not born of free from rapture and bliss that was born of the freedom from the hindrances, this equanimity is born of “abiding,” “vihirati,” “vihirana.” The translations include; to dwell in, spend time with, think, and then the interesting; “to sojourn, to set in motion.” I will take these up in my interpretation. To set in motion may be taken as to animate. In Carl Jung’s research on the psyche which includes much of known history, he chose the words animus and anima to describe the animating force of the unconscious that transcends the personal psyche. The animus is the unconscious masculine side of a woman, and the anima as the unconscious feminine side of a man. Each is characterized in terms of the development of the respective psyche. In men it is described as the progression from Eve, Helen of Troy, Virgin Mary, Sophia. In women it is described as Men of power; Tarzan, Men of romance, Clergy/professor/orator(diplomat,politician), Hermes. To me this is representing the respective genders relationship with the water element. How they perceive the water element. In males, in perception of and experience of the development of relationship with female traits of loveliness. In females, in perception of and experience of the development of relationship male traits of power. The etymological derivations of pleasantness reflect these two traits. In traditional cultures, the water element in males can refer to an increase in semen. The water element in females refers to the development of qualities of loveliness. In any case, the sutta is talking about a process of dwelling in or setting in motion the pleasantness. A third translation and derivation of “abiding,” is “a reliance on” or “a basis.” Consequently we can make the pleasantness as the basis of our perception. Hence a deep transition from relating to the pleasantness, to relating from the pleasantness may be achieved.
"And furthermore, with the abandoning of pleasure and stress — as with the earlier disappearance of elation and distress — he enters and remains in the fourth jhana: purity of equanimity and mindfulness, neither-pleasure-nor-pain. He sits, permeating the body with a pure, bright awareness, so that there is nothing of his entire body unpervaded by pure, bright awareness.
"Just as if a man were sitting wrapped from head to foot with a white cloth so that there would be no part of his body to which the white cloth did not extend; even so, the monk sits, permeating his body with a pure, bright awareness. There is nothing of his entire body unpervaded by pure, bright awareness."
— AN 5.28
In this fourth jhana the state is a more refined awareness than any kinds of comparisons with any other aspects of experience we have been working with including the pleasantness. It is described as the “purity of equanimity.” It is very deep and may even be described as beyond distraction/non-distraction.
I suggest that this equanimity is actualized as the experience and the knowing of the experience. The white cloth is a complete manifestation of this state of awareness
There is another related meditation with eight refined states I will detail in another meditation.
PRACTICE ADAPTATION AND APPLICATION
Beginning with physical sensations.
FINDING QUALITIES TO FOCUS ON
In beginning with concentration on body sensations, I often notice that I am aware of a variety of physical sensations and emotional sensations together. These two aspects of feeling, along with empathy are closely related and can be processed in similar regions of the brain. The beginning of the practice of concentration is finding experiential qualities to focus on. These are basically sensations, and may consist of more coarse/ common or more refined/ subtle sensations. Often there is a progression from more common states to more subtle states.
In my presentations of, and examples of concentration I have used the word access to describe how concentration give us access to other aspects of our experience. That word does not appear as such in the classical Buddhist literature but it is used a lot in more contemporary literature as “access concentration.” I am not sure when the term gained popular usage. In the classical literature there is an analogy used to describe the development of concentration as compared to the transition of a baby learning to stand. When the legs get strong enough to support the body. I can remember when I was learning to meditate and my mind would just get so tired it seemed I could hardly stay awake. It used to happen a lot, but I knew there was something in meditation that was very beneficial for me and I just persisted. Then at some point my mind or my concentration or something developed to where I rarely encountered this state again.
In my earlier presentation, I also mentioned the arising of what I referred to as inherent wellness, or our natural basic wellness that is the beginning of the cultivation of positive or spiritual states. In Buddhism we refer to this as being free from the hindrances, or free from defilements. Those are ill will, sloth/torpor, restlessness/worry, and doubt. I like the way they frame the hindrances as that which hinders the natural disposition of our inherent nature. I find that a lovely depiction.
Using the present moment mindfulness techniques we may come into our basic wellness. Sometimes that can entail coming in touch with our reactivity as well, and I suggested some ways to work with that reactivity in the introductory present moment exercise.
When we begin to attend to our experience in a different way, a different context of our experience may arise, a different aspect of our experience may arise, different causes and conditions may arise. I think these may also represent the beginning of access concentration.
Jhanna as it is presented in the above classical Buddhist text begins with an experience of pleasant feelings. When you have worked with the present moment exercise a bit, and feel ready to move into working with the experience of well-being in some other ways, you can try the jhana exercises. I am presenting a number of variations of this jhana exercise, and another kind of jhana practice after that, and then some variations on that exercise.
The following description is an application of jhana practice, interpreted and adapted to the pleasure seeking model that characterizes so much of our modern society.
In the pleasure seeking model the drive is seen as generated by the norepinephrine, and cortisol based elements of the sympathetic aspect of our autonomic nervous system. It is often characterized by the adreno-hypothalamic axis of our hormone system involving cortisol, and the substantia nigra brain center which is norepinephrine based. In this model these are related to pleasure seeking which involves wanting and searching. It is also related to motivation and achievement.
This meditation is based on the practice of concentration. Selectivity, sustained concentration.
Allow yourself to focus on pleasantness in any form. Physical, emotional, mental, or all of the above. The classical literature does not really differentiate between them, as early experiences of life seem much more inter-related than our depictions or ways of describing experiences today.
While focusing on the pleasantness allow yourself to cultivate a wanting of the pleasantness, a drive for it, a searching and seeking for it. Allow the pleasantness to develop with your enjoyment of it, wanting of it, liking it, and we could even use the stronger term “grasping” of and onto the experience of pleasantness, and “craving” the pleasantness.
As the contemplation develops, allow the whole experience to build. I think of it as a resonance with my experience. I am developing a connectivity and drive to and with my experience in a way that reinforces it. Allow this to develop as much as you like. If you get distracted, just bring yourself back to seeking pleasure and pleasantness.
The next step is to notice the association with liking of the experience, and with the searching and seeking, in a way that allows that aspect to slowly fade into more the background, while slowly identifying more with the contentment aspect. This is a natural result of the pleasure seeking, searching, and wanting that initiated and drove the experience, which is slowly coming to more of a realization of an achievement of, a consummation of seeking/wanting/grasping/ searching. This is the natural cycle of the brain chemistry and the life experience in which we seek something and then achieve something.
This is the key transitional stage. It involves incorporating the aspects of allowing, receiving, accepting, acquiring, arriving, of the new state, as well as a letting go of dissolving of, dispersing of the previous state. It is a new arrangement of the experience in which we are trying to get closer to something pleasant we do want, which may also be the same as we are trying to get away from something unpleasant we don’t want, like hunger, or some other state. The transitional dynamic, of accepting and releasing, to and away, acquiring and letting go of, arising and passing, is a way to shift from pleasure seeking to pleasure attainment. It is the shift from control to acceptance/letting go. From our natural reactions with the eight worldly conditions to acceptance/letting go. While manifesting enjoyment, see if you can come to be less personally identified with the enjoyment. Less personal. Less reactive. Being less personally identified with the experience is not at all indifferent to the experience. In this practice, being less personal means a greater way of relating. As soon as we relax the parameters of self-grasping the transition to a more inter-related state takes place. We will continue to explore the parameters of self-grasping in a number of other contexts and mediums of perception and contexts of experience to get more familiar with this process. I believe that when it occurs in one context the signaling happens throughout the organism on all levels and it is just a matter of being able to realize and actualize this transition in greater and greater parameters. The greater aspect of ourselves, without the hindrance’s of our conditioned personal identities, roles, ways of relating, leaves a greater potential of interaction through a more relaxed and open mindedness. There are many famous examples of people solving problems when they are not focused on the problem. I’m sure you have had that experience of having an insight about something at a time other than when you were trying to understand something. Niels Bhor, the innovator of our basic physics model of the atomic structure, reported that the insight came to him in a dream. He states he was dreaming he was at a horse race and he had an insight that the horses positions around the track was like the orbits of electrons around the nucleus of an atom. At the time, that was a novel way of seeing the atomic structure. It gave way to quantum mechanics. He theorized that as a hydrogen atom moved from one orbit to another, one that had a lesser energy requirement, a quanta of energy was released. The idea landed him a Nobel Prize as well as completely revolutionized the world as we know it in every way. As it led to the atomic bomb and the technological advances behind much of our worlds instrumentation and apparati.
We are learning to access this greater mind through practices which can dependably, reliably, consistently produce this greater field of attention. We will be cultivating this mind and potential of this mind as our natural state of being the more we engage in these practices. This is being experienced with the many aspects of transitions from being focused on wanting/liking/controlling, to being focused on achievement/consummation/contentment/ and experiencing and knowing greater contexts of being.
The next stage is the realization of attainment, or achievement. This is the getting of the thing. Once we can realize that we have attained something, we may be able to slowly shift out of the pleasure seeking drive. It may be an experience of completion, which in many pleasure seeking and thrill seeking activities is never allowed to be fulfilled and leaves a huge gap in the neurological process. This ends up depleting the norepinephrine, dopamine, cortisol system leaving it in a state that can be characterize as hypokinetic. This is a little counter-intuitive. Parkinson’s disease, the severe tremors that become immobilizing and fatal, is characterized neurologically as hypokinetic. Not hyperkinetic as it may seem. This is because it is the tremors are due to a neurotransmitter insufficiency. Dopamine. A neurological hypo-activity. The result is a very agitated, restless, anxious, irritable state. In my application of the pleasure seeking model with brain functionality, this is compounded by the psychological and emotional effects of not achieving (satisfaction, contentment.) There are also other severe consequences in this state which entails pro-inflammatory chemistry and other neurological chemistry shifts that result in sleep deprivation and a variety of hormonal, gastro-intestinal, assimilation and elimination disorders, which are all found in states of a hyper sympathetic, hypo parasympathetic nature.
We are trying to focus on the result of the pleasure seeking as the attainment of pleasure. Through seeking pleasure, developing pleasure in our meditation/contemplation of pleasantness, we are slowly going to transition into the recognition of pleasure. The achievement of pleasure. The attainment of pleasure. There is no need to rush the process. It is a natural evolution of neurological, hormonal, and physiological chemistry. It will happen by itself. You just need to set up the proper conditions for it to take place as a meditation.
This stage, the realization of pleasure, is a conscious activity that is taking place in the cerebral cortex among other places. This area sends signals into the ponto-medullary reticular formation, PMRF, a parasympathetic structure in the brainstem that shuts down the sympathetic drives. This PMRF is 2/3 of the brainstem. Our brainstem is mostly parasympathetic tissue and it is well suited to calm down a strong sympathetic drive with all of its norepinephrine and dopamine. This stage also involves some opioid process. This also shuts down some of the pro-inflammatory aspects of the seeking, wanting state. The attainment of pleasure and especially the realization of pleasure is a state of contentment that can be enhanced by consciously engaging in the process which activates the cerebral cortex. This state can be characterized as equanimity. Equanimity is free from the push and pull, the wanting and avoiding. This depends on how one is relating to the push pull and how it this arises and is accomplished may require some further study and other examples and mediums through which equanimity can be revealed. In any case, one of the things that this entails is that we can actually have the felt sense experience of attainment, equanimity, arriving, acquiring, and accepting if you are interested in this type of meditative inquiry. This contentment, and especially its deeper stages and implications, may be somewhat of a learned process. It may involve a variety of neurological, psychological, emotional, and physiological processes that are dependent on some early developmental processes we may not have entirely developed as children or young adults. This may require some work, practice and study.
Equinity sounds nice. I think in terms of the pleasure seeking model of seeking and contentment, we can’t have one without the other. It is a natural cycle like yin and yang. Like day and night. This may be where some concentration practices fail in being able to realize and actualize the states in more comprehensive way . They may be seeking equanimity, or peace, or harmony or balance, in a way that does not include the understanding of the processes that precedes such practices and entail the development of those states. The whole cycle involves a complete brain involvement and balance. I would even say self-actualization. The ability to recognize satisfaction shifts us out of the pleasure seeking drives, it may be useful to include more of the aspects of this cycle, before and after. As humans we may be able to enhance several aspects of this whole cycle. We may be able to significantly alter any aspect of the cycle. With the respective positive and negative results. If we can learn to dwell more deeply in the recognition of satisfaction we may be able to achieve deeper states of contentedness. The movement into equanimity may thus be understood in a broader context than the ending of seeking. This may be experienced in terms of greater and greater freedoms I will revisit later after presenting some more contextual perspectives. This shift represents the transition from control/ managing experience through craving and aversion, to acceptance. I suggest considering the conscious dwelling in the contentment/achievement/acquiring/arriving state as a type of self-actualization itself. I suggest this is actualizing your own pleasantness, and contentment. Or perhaps the potential of self-actualization as the classical form has one more step.
The final state suggested in the traditional literature for this particular practice I am basing this on is where the consciously developed equanimity of the mind itself, becomes a source of pleasure. However it is characterized simply as the purity of equanimity, not pleasure.
Within this application of jhana exercise we are exploring a number of different qualities. I would like you consider the experience of wanting, searching and liking. I have included all these together and for the purposes of further exploration of qualities and meditations, I would like you to consider that these are experiential aspects that can be of a felt sense order. Can you experience liking and wanting as a felt sense?
How about equanimity? Can you experience equanimity as a felt sense order of experience? How about isolation? Is isolation available as a felt sense? How about connection? How about freedom? This then brings some more aspects into what we may consider for concentration practice. I will be giving a variety of possible examples we may adapt into this practice. As I mentioned, I think we are always a bit engaged in concentration and contemplation. They are just different aspects of our experience like thoughts and feelings. So, in this practice we are exploring what may be available to us through the capacity we have called concentration. Just as there are certain experiences available through thoughts, and other kinds of experiences available through feelings, there are certain experiences available through enhancing the faculty of concentration. I see contemplation and concentration as slightly different processes and may entail different mediums through which we may experience equanimity. The different practices within those mediums also consist of different methods and mediums by which we may experience equanimity. I will be presenting a number of different practices in which to experience equanimity. If you could only play one song on the piano, that would not necessarily entail that you were adept at playing the piano. Or that you understood music theory, or were even a musician. I liken that to being able to experience the nature of equanimity in many, if not all contexts and mediums.
In this application of the pleasure seeking model I would like to point out another feature, that of identification and releasing of identification. I suggest that the releasing of identification in this process could be seen as the experience of equanimity. This is the greater context of equanimity, the state of being free from the reactions created through the process of worldly experience. As such, this whole meditation could be seen as a cycle of the process of identification and releasing of identification. When I say identification and releasing of identification I am speaking in terms of a continuum. I am not referring to the complete release of identification. If you experience it that way, if you experience yourself as completely released from any kind of identification with experience, great, I personally could not really say I know what that is. Thus I just think in terms of more identification and less identification and place the experience of equanimity as lesser identification. To use some other terms I have been presenting, to me it seems equanimity is a less unidirectional state. That means it is more multidirectional. I also suggest that this is akin to the first person order of experience, a less conditioned one. These ideas and characterizations are explored in many areas of this book
This transition from seeking to contentment could also be seen/ observed as an insight, that is, from a contemplative aspect of mind, rather than through an experientially perceived process such as in a concentration practice. In traditional Buddhist contemplative insight terms this would simply be noted as impermanence.
In summary, concentration practices, have a few essential components. An ability to selectively attend to aspects of experience, the ability to maintain and sustain that aspect of experience in your attention. This implicitly means that you are isolating an aspect of your attention as an experiential quality, such as pleasantness and contentment. I am also suggesting In this meditation that there may be several other qualities that we may be able to recognize in a similar way, that is, as felt sense, experiential qualities, those are wanting/liking/searching and towards and away from, carving/aversion.
Note; I see much in modern societies structure that supports the incompletion of the pleasure seeking phenomena. Social media of all kinds for example, presents small triggers in the form of “alerts” from email, or facebook, or twitter, or news reporting, that gives a stimuli for a seeking of information or pleasure that results in an experience that leaves the recipient with an unfulfilled data entry. i.e. Inaccurate and or insufficient, or not really satisfying in terms of a first person experience, which in partly or perhaps mostly the responsibility of the recipient. My point is that much of the experiences of modern society are based on a pleasure seeking model that keeps us looking for more, the next piece of information or experience that will supposedly bring satisfaction. I address this in some other contexts in the “Conclusions on Thoughts and Feelings” section.
The adrenal glands are triangular shaped glands that attach to the caudal aspect of the kidneys. “Ad” refers to above, and “renal” refers to the kidneys. The gland is made up of an outer adrenal cortex which produces the steroid hormones; cortisol, aldosterone, progesterone, and DHEA. The inner adrenal medulla produces catecholamines such as epinephrine and norepinephrine, described below. Steroid hormones (sterones) are fat soluble compounds which means they can pass through cell membranes easily. They travel through the blood attached to globulin, (a protein) and once inside a cell will interact with the corresponding receptors to initiate a variety of effects depend on the sterone. These effects are described below.
Mineral corticoids primarily affect sodium potassium balance.
Glucocorticoids influence carbohydrate, fat and protein metabolism. Cortisol is the main glucocorticoid produced by the adrenal cortex. It regulates blood glucose in two ways.
Increase hepatic glucogenesis. Cortisol also allows other glycolytic hormones, such as epinephrine and glucagon to mobilise glucose between meals.
The catecholamines, epinephrine and norepinephrine are release when a threat is perceived and increase heart rate, breathing rate, constricts blood vessels, relaxes bronchioles. They stimulate the release of free fatty acids from stored fat, and the release of glucose from stored sources, (glycogen.)
The adrenal cortex response is modulated by the hypothalamus-pituitary-adrenal axis. The hypothalamus responds to stress by releasing corticotropin releasing factor, the hormone signals the pituitary to replace adrenocorticotropic hormone which stimulates the adrenals to secrete cortisol.
The circadian rhythm of cortisol. Cortisol levels should follow a natural rhythm based on dietary intake, the body’s energy demands, and sleep cycle. Alterations in this rhythm indicate adrenal dysfunction. Cortisol should be high in the morning after the body has been fasting all night. This level should slowly decrease during the day as food supplies more glucose and cortisol is not needed to release stored glucose. The level should be lowest before bed. When cortisol cycles are disturbed due to stress and other factors, described below, sleep will often be one of the first disturbances to manifest.
The stages of Adrenal Stress.
The first stage is called the alarm stage. Demands of stress and increased activity will cause the adrenals to accelerate their secretion of hormones.
If this state goes on for a prolonged time the adrenals and the pituitary will go into what is called the resistance stage. This stage is also called the pregnenolone steal phase, as the body will convert pregnenolone into cortisol instead of DHEA. Thus cortisol may be high and DHEA may be low.
The final stage is referred to as the exhaustion stage. This reflects the adrenal glands inability to maintain the levels required to meet the demands of the stress or activity and associated metabolic functions. This will be reflected by low DHEA and cortisol levels. If this pattern continues the body may convert pregnenolone to DHEA. The cortisol levels will thus be low and DHEA will be normal.
Dysglycemia and Adrenal Disorders
Elevated cortisol will down regulate insulin receptors and create insulin receptor desensitivity. AS the receptors do not respond to insulin the pancreas will respond by secreting more insulin. This will result in elevated insulin and all the associated adverse impacts associated with it. (See my article on Dysglycemia.)
Decreased cortisol associated with adrenal exhaustion will impact the signals to the liver to induce glycogenesis and glycolysis. This will result in Hypoglycemia.
Thyroid dysfunction and Adrenal Disorders.
Adrenal stress adversely impacts many of thyroid hormone functions. Elevated cortisol suppresses the enzymes 5’diodinase which converts T4 to T3. There has been a lot of research into the mechanisms of maladaptive Thyroid hormone conversion and elevated cortisol. Lopresti and Nicoloff have demonstrated how much of the T4 can get converted into the inactive rT3 which does not have the metabolic stimulating properties of T3.
Anterior Pituitary Hypofunction
Elevated Steroid hormones can suppress TSH by a similar action described above, the receptors of the pituitary will become blunted and thus effect associated endocrine function especially the thyroid.
One of the livers functions is detoxification. It does this by making fat soluble substances into water soluble substances. The body can only eliminate water soluble compounds. Hormones are fat soluble and can accumulate into unhealthy levels causing pathology if not conjugated by the liver. Elevated hormone levels, cortisol and others, will place an added load on the liver and compromise its detoxification functions.
Intestinal Dysbiosis, Leaky gut and Adrenal disorders.
Elevated cortisol hormones will suppress secretory IgA. IgA is the main immunocyte cell in the digestive tract. Suppressing this function will lead to a diminished intestinal barrier, as well as other mucosal linings that can lead to recurring ulcers and dysbiosis.
Suppressed Immune function and Adrenal disorders.
Chronic hypercortisolemia will also suppress white blood cells, inhibiting the patients’ ability to fight infections. This will cause a diminished function and atrophy of the thymus gland and interleukin-2 production.
Bone density and Adrenal disorders.
Elevated cortisol will have negative impacts on bone metabolism. It appears that either endogenous or exogenous cortisol will disrupt normal calcium absorption. One of the most common side effects of patients on cortisol replacement therapy is increased risk of fractures.
Depression and Adrenal Disorders.
The changes in metabolism that occur as a result from chronic stress are causative factors in depression. Over active HPA activity has been linked to depression, Alterations in catecholiamine activity have also been reolated to depression. The neurotransmitter norepinephrine plays a signifuicant contributing role in neurochemistry associated with depression. Over stimulated norepinephrine will cause a sililar down regulated neural receptors as noted above. Adrenal exhaustion will lead to depleted supply of norepinephrine which will result in the same symptoms.
Insomnia and Adrenal Disorders.
This disorder is very common today and involves several components addressed above. The circadian rhythm of cortisol, and the stimulation of epinephrine and norepinephrine.
The hypo functioning patient will present with hypoglycemia symptoms. This person depends on sweets and stimulants to keep them going. They have low energy and miss meals. (also see my article on dysglycemia for more information.) This diet contributes to the body’s natural ability to store and replenish (glycolysis and glycogenesis) appropriate levels of glucose. As a result they will not be able to maintain healthy levels at night and sleep. Their glucose levels will drop and the body will respond by releasing cortisol, epinephrine and norepinephrine to break down stored glucose. This will have an excitatory effect on the body and nervous system causing the person to wake up.
The other pattern is people who can not fall asleep. These patients will present as over stimulated during the day. The nature of their chronic stress will not allow their cortisol levels to drop during the day as they accumulate glucose from food. The cortisol will remain high at night when it should be declining. The reason for this (also above) is that he alarm pattern of their nervous system places an added demand on the HPA axis. These stresses may also come from endogenous sources such as food sensitivities, which will activate gut associated lymphoid tissue and place the body in an alarm pattern. Other gastro intestinal disturbances will have a similar effect.
Neurodegenerative Disease and Adrenal Disorders
There have been many recent studies that demonstrate how the HPA axis contributes to and causes a number of neurological disorders. Neurology published a study in 1999 that linked HPA hyperactivity with MS. Alzheimer’s disease has been linked to lowered DHEA levels associated with the pregnenolone steal phase. Elevated cortisol and its’ proinflammatory reactions (elevated cytokines,) have been shown to destruct hippocampal cells, and trigger glial cells in the brain to produce a variety of neurotoxic agents that cause neuronal apoptosis. Gliosis has been identified in Alzheimer’s, Huntington’s. MS, ischemia, oedema, and seizures.
The Effects and Cycle of Chronic Stress
The H-P-A axis-Hippocampus cycle.
The hypothalamus releases corticotrophin releasing factor, CRF, when cortisol levels are low. This is carried to the anterior pituitary gland where it induces ACTH. ACTH then stimulates the production of hormones in the adrenal glands. When cortisol levels are high the hypothalamus sends out signals to reduce hormone production. When hormone levels are increased for a prolonged period of time, the HPA becomes desensitized and can no longer respond to the levels of cortisol. This occurs due to the sensitivity of the hippocampus to cortisol, prolonged exposure directly causing desensitivity, and destruction of its’ cells by inflammatory cytokines, nitric oxide, and other oxides, and gluco-corticoid down regulation.
Elevated Cortisol and Insulin resistance and Leptin resistance.
Elevated cortisol has been shown to lead to insulin resistance. Insulin resistance is a similar mechanism as above, only that insulin receptors become desensitized to insulin and thus can dysregulate the feedback mechanism involved with blood sugar levels.
( See my article on Dyglycemia.) Insulin resistance is also associated with hyper cortisolemia. Both of these co occurring states will induce Leptin resistance. Leptin is a hormone that regulates fat storage. Leptin is also associated with hunger signals. Leptin also acts as an intercellular messenger in the brain to regulate hunger signals. Leptin receptors in the brain become down regulated and do not respond to the feedback mechanism of cortisol, insulin and leptin. Leptin also promotes the inflammatory cycle by its transcription on cytokine receptors. Thus higher levels of leptin will promote cytokine activity. The loss of feedback in the insulin, cortisol cycle will starve cells of glucose since the insulin receptors have become desensitized. The message is that the body is lacking glucose and so will increase even more cortisol productivity.
Vitamin D and Steroid Hormones
The term Vitamin D refers to several different kinds of molecules. They are also known as secosteroids as they have several different chemical characteristics than steroid hormones. Vitamin D receptors are found in most if not all cells in the body. These receptors function as gene expression modulators. This means Vit. D affects the growth, differentiation and expression of many different kinds of cells. The far reaching impacts of Vitamin D are only just beginning to be understood.
Food rotation and immunology
The importance of the rotation diet.
Rotating your foods, known as the rotation diet, is a crucial aspect of mediating your immune responses. Immune responses lead to inflammation. Some of the immune related pro inflammatory chemistry include IL-6, IL-1, and related interleukins, lipoxygenase, leukotrienes, TNF-a, PG-E2, NF-kappaB, nitric oxide synthase, cyclooxygenase-2, Prostaglandins, and Thromboxanes. While these compounds and enzymes play an important role in fighting disease, they can also become very destructive to many physiological processes and tissues. They result in pain, inflammation, poor health. They can be brought on by many factors such as stress, radiation, oxidation, injury, bacteria and related compounds such as lipopolysaccharides inherent with leaky gut, foods, viral infections, dietary mismanagement of carbohydrates, lipids, proteins and their resulting metabolites, vitamin D deficiency, diets insufficient in, or mal absorption of phytonutrients, antioxidants, ALA, EPA, DHA, GLA.
Minimizing your immune reactions is crucial to minimizing these destructive pro inflammatory cascades. One element that must not be overlooked is rotating your foods.
Food rotation mediates your immune responses by strengthening your immune system. This may seem a little contra intuitive at first.
I will explain. When you eat the same foods every day your immune system must work harder to identify the different macro nutritional compounds of proteins, fats and carbohydrates. When your immune system is working harder it is known as being upregulated. This means it is more hyper reactive. When you eat different foods every day, your immune system has an easier time recognizing the macro components, and it is more at ease or downregulated. When your immune system is downregulated, it is less reactive. This means it is actually functioning more efficiently because it is identifying compounds more easily. It is thus is less likely to react to foreign substances.
Many new studies in immunology reveal the destructive effects of immune related compounds. This is an excerpt from a study from the website selfhacked.com
Feeding rats diets high in glycine (5%) totally prevented death after exposure to an injection of an toxin (E Coli) by blunting TNF-alpha. Whereas 50% of the control group died within 24hrs
TNF-alpha, mentioned above, is an immune mediated compound. As you can see, 50% of the rats did not die from exposure to E. coli. They died from the inflammation response. Glycine does not reduce E. coli, it reduces the inflammation response. That is what prevented their death. Many such studies and information conclude that exposure to toxins, bacteria, viruses, and many other elements, are not as huge risk factors as they were once thought of. The new immunological research shows that the inflammation produced by an over active immune system can be just as detrimental as the exposure, if not more. Thus regulating the immune system is crucial to health. The rotation diet is a proven method that cannot be ignored. There are many other dietary factors being discovered all the time. Food is now seen as one of the leading factors of health.
Auto immune disease is sky rocketing. Two years ago, there were approximately 10 million cases of cardio-vascular disease, 15 million cases of cancer, and 30 million cases of auto-immune disease. Auto immune disease can affect any and all tissues of the body, but most significantly the brain. For every one neuron, there are twenty lymphocytes. An upregulated immune system will have a significant impact on the brain. It is now possible to test most of the bodies tissues for antibody destruction.
The holistic treatment of pain: western and eastern views of pain, etiology, and treatment.
Through out the ages, there have been many different ways people have identified and treated the sufferings of humankind. This is true of existential, and well as physiological suffering. These discoveries have many commonalities. I will give a brief presentation of some of the ways western science and eastern science have developed their approaches to understanding and treating pain in the physical body.
In terms of western physiology, physical pain has been described in the following ways. A German physician, in 1843, named Robert Friedrich Froriep, coined the term " muskelschiele " translated as muscle callus. We commonly think of a callus as developing on a bone, or the skin. Dr. Frorieps' description entailed a hardening of nodules of bands in muscles that offered relief of pain patterns, when treated by pressing, or massaging. These nodules were named "trigger points" by Janet Travel in 1942, in her books Myofascial Pain and dysfunction, the trigger point manual, Volumes 1 and 2. Dr Travel and Dr. Simmons, who co authored the books, also describe these nodules as existing in ligaments, tendons, musculo-tendonous junctions, periosteum tissue, ( bone associated tissue ) and cutaneous tissue, ( skin related tissue. ) The description of, and development of, or etiology of this phenomena, that the authors suggest is known as the trigger point hypothesis, and has been reviewed, further studied and developed, and their findings published in journals and books by many scientists in all disciplines of physical medicine. The authors description can be found in volume 1 of the trigger point manual on pages 45-74. The Journal of the American Osteopathic Association presents another similar description of this phenomena in their June 2004, Vol. 104, pgs 244-249, which includes some findings from modern genetic studies that contribute to this pathology.
The hypothesis of this dysfunction is called "motor endplate depolarization. " This is where nerve endings innervate or connect to the muscle fibers by the synapse junction. This region becomes depolarized by inflammation, or other chemical dysfunction, including those caused by genetic SNP's, and/or muscle strain. Some of the chemicals involved in this dysfunction include bradykinins, cytokines, serotonin, histamine, potassium, calcium, prostaglandins, leukotrienes, somatostatin, adenosine triphosphate, acetylcholine, oxygen, and substance P. These factors disrupt the release of neurotransmitters and ions within the endplate region. The basic mechanism is seen as caused by the excess release of Acetylcholine from the nerve end plate. Acetylcholine is a substantial neurotransmitter to regulate many functions through out the brain and nervous system. The release of Ach stimulates the release of calcium from the sarcoplasmic reticulum, which causes the actin and myosin heads to move closer together resulting in a tiny shortening within a muscle fibril. Millions of these processes result in a muscle contraction. An excess of which then depletes the synapse of ATP, adenosine triphosphate. ATP regulates the release of Ach, which is now dysregulated and a perpetual upregulation occurs. The ATP also, along with oxygen, returns Ca ions back to the sarcoplasm. The muscle is now in a chronic state of contracture. With a depletion of the chemistry that would cause it to release. Oxygen is deprived by the contracted muscle having less blood supply. This creates a chronic, self perpetuating condition where the muscle can not perform it's normal functions of tightening and releasing. Please see the above references for a more detailed descriptions and diagrams of how this process works.
The proper chemical balance of this region must be restored in order for the muscle to regain normal function. This can be accomplished by improving circulation, which disperses the accumulation of the above chemistry. The restoration of proper circulation detoxifies the region, removing the excess ions, inflammatory chemistry, and replenishing the depleted supply of other chemistry. This can be accomplished in many ways such as stretching, exercise, massage, acupuncture, and trigger point injections. The result is dependent on how well the perpetuating factors have been identified, and the understanding of the muscles and associated systems condition will lead to the correct employment of the correct technique. None of these techniques will restore the system completely with out a correct evaluation, diagnosis, and correct application of the appropriate technique, for that particular stage of dysfunction.
Dr. Travel and Dr. Simmons pioneered the injection of substances to inject into the trigger points to rebalance the muscle chemistry. This can employ the direct restoration of some important chemistry, and the flushing out of some pathological chemistry.
Acupuncture can directly reduce nerve inflammation, reducing the release of Ach. Acupuncture can also reduce inflammatory factors from different immune dysfunctions, if they are correctly identified. Acupuncture can also detoxify other chemistry, if performed accurately. Acupuncture can reduce inflammation from other sources, such as cortisol, insulin reactions, and other pathologies, if performed correctly.
Some of the other perpetuating factors include pathological inflammation due to food irritants and sensitivities, infectious pathogens, hormonal imbalances including cortisol, glucagon, insulin, and sex hormones, medications, stress, injury and strain related inflammation. These may also need to be identified and treated, especially in cases of chronic pain, but also perhaps in other conditions too.
Muscular imbalances can cause parts of the muscle to contract and lose range of motion, which can profoundly alter the health of joints and proper joint function, including the spine, pelvis, knees and any and all other associated joints. Compromised joints will be painfully affected and, after prolonged dysfunction, can undergo degeneration, arthritis, bursitis, and other common ailments. The compromised muscle may also become weakened and/or trap nerves, which will also create pain and compromise musculoskeletal actions and integrity.
Effective treatment depends upon proper identification of precipitating and perpetuating factors, meaning accidents, injuries, illnesses, daily activities, diet, and other information. Dr. Ruther conducts an intake to gather subjective information and patient history, as well as objective information about range of motion, orthopedic testing, postural analysis, and strength testing. Often blood chemistry testing is requested to identify excesses and deficiencies of many components mentioned above. A complete picture of the patient’s health is then determined, Dr. Ruther can employ the correct treatment that addresses each patient’s individual needs.
I have always thought that acupuncture was pretty safe for everyone. That is because most peoples bodies do a pretty good job of regulating themselves, and they would probably get better anyway. Acupuncture generally works for most people, almost regardless of the skill of those performing it, because it works with the bodies own self regulating system. Some people do require very specialized techniques, as their body does not regulate itself very well. I have seen some incidences of people getting worse from seeing some acupuncturists, and even hospitalized. People often site the release of endorphins to be an effect of acupuncture to relieve pain and create other states of well being. I think the release of endorphins is a minor player in the treatment of pain and effect of acupuncture. There was actually a whole book written by a western medical doctor asserting that this was the entire mechanism of acupuncture's healing. The book went on to state that it does not even matter where you put in the needles. First of all, you might expect of trained western medical doctor to have some fairly detailed knowledge of basic physiology of the body, and perhaps the nervous system. In my experience of talking with medical doctors and nurses, some of them do not possess such understanding. I have, of course, come across some more knowledgeable people than others. The other assertion of the book is also completely erroneous and unfounded. Myself, and all my patients can tell you that the placement of the needles does indeed make a very significant difference. A small change in the location can alter the entire therapeutic principal, or treatment stratagy of the treatment. It can make the difference between treating someone for blood stasis problems in the head, or gall bladder problems in the abdomen. Just by changing the location of the needle less than 1/2 inch. The result will follow accordingly. I can prove this to you over and over again, and you will feel the different effects of proper needle placement. My patients have often seen many other acupuncturists, with relatively small improvements.
Chinese medicine and the etiology, evaluation and treatment of pain.
Chinese medicine identifies twelve causes that perpetuate pain symptoms, which are summed up by descriptions of excess and deficiency. Excess describes accumulations of some kind of pathological substance which should not be present, such as inflammatory toxic chemistry. The excess may also be energetic accumulations of protons or ions that disturb proper musculoskeletal function. Deficiency describes not enough supportive nutritive chemistry, or energy.
These treatment are classically described as Warming exterior resolving methods, Cooling exterior resolving methods, Heat clearing and depression resolving methods, Coursing the liver and rectify the qi methods, Heat clearing and dampness disinhibiting methods, Heat clearing and draining repletion methods, Warming the center and dissipate cold methods, Free the network vessels and quicken the blood methods, Abduct, disperse and harmonize the stomach methods, Supplement the kidneys methods, Dispel wind, dissipate cold, and dry dampness methods, and expel worms and abduct stagnation methods. ( From Blue Poppy Press research reports. )
These methods also require a detailed knowledge of the subjective signs and symptoms of Chinese Medicine, as well as objective signs and symptoms, a detailed patient history, and an ability to synthesize all the different parts of the patterns, which are often a combination of two, or three or more patterns, and put this together into an effective strategy. Furthermore, the correct strategy must be tailored to the correct region of the body. There are never any textbook cases to be found in either eastern or western medicine, and that is where the years and years of experience begin to form understanding. It should never be assumed that any treatments are safe and without possible side effects. It should be clear that if the improper method is used, the condition will get worse.
Dr. Ruther has been studying and practicing in all these perspectives and treatments of eastern and western medicine for more than 28 years.
Emotions, Psychology, Sympathetic and Parasympathetic states, a brief overview
The autonomic nervous system is comprised of two components. The sympathetic and parasympathetic. This part of the nervous system is located in the brainstem. Known as the MRF, medullary reticular formation, or sympathetic, and PMRF, Ponto medullary formation, or parasympathetic.
Sympathetic is known as fight or flight and characterized by survival. Mating, primitive emotions, aggression, fear, I would add control, wanting, aggression in many forms, passive aggression, interpersonal non acceptance, social discrimination, sexual discrimination, objectification,
Parasympathetic is known as rest and digest. This state is often related to being, peace, contentment, slowing down. A contemporary innovative meditation teacher, Shinzen Young, advocates focusing on a state he calls “rest” for which he has some specific teachings and applications.
In terms of digestion, the parasympathetic system regulates digestion by sensing where food is at in the digestive tract, to secrete the proper enzymes and other gastric secretions, ensure proper blood flow through the abdomen, and proper gut motility. This is all coordinated by proper communication with the brain through the release of neuropeptides. If these neuropeptides are altered, this is another way that gastro intestinal function is disrupted. These neuro peptides are easily affected by inflammation. This can be associated with inflammatory responses from a hyper active sympathetic system through cortisol and up regulation of other hormones such as insulin, and a cascade of other inflammatory responses related to stress that can also affect the immune system. The immune mediated inflammatory chemistry can also disrupt the G.I. system as well as the brain and many other physiologies.
People often view parasympathetic states as passive. And acceptance is often seen as weak, or people often enquire with such questions and references to the effect of they are afraid of being a “doormat” for their experience and for those around them. The mental states associated with the parasympathetic system and the sensing aspect of this system is actually a state of discernment. This non-reactive quality and its related parasympathetic states have been shown to be very conducive to problem solving, cooperation, social acceptance, and self-acceptance, wellbeing, sentience, contemplativeness, and thoughtfulness.
I would contrast this with current trends of brain enhancement methods, such as problem solving, math, chess, bridge, crossword puzzles, and Sudoku. These methods do not enhance the overall ability to relate to others, and solve day to day problems, that enable them to live a more satisfying life, fulfilled, contented life. I would say from a clinical and casual observance of these methods, that they do not enhance their practitioner’s lives in any significant way, other than they can solve such puzzles faster, which may not be a strong indication of the wellbeing of the brain or nervous system.
Seeing, mindfulness and simply seeing and knowing things as they are, is a special kind of application of the power of observation, and can also be very results oriented. In fact, that is the purpose of this inner work; to live a more sustainable, enjoyable, workable, life. This clear mindedness supports our ability to create a better life for ourselves, which includes the ability to make choices about the quality and quantity of our assertiveness. Mindfulness capitalizes on the capacity of the brain to concentrate on particular phenomena. With practice this exercise can be refined to enable the person to direct their attention and secondarily there experience, to varying degrees, to any state they wish, also allowing them a wider range of potential experiences.
Sympathetic dominance supports an emotional pattern that represents survival. This pattern has physiological components, as well as psychological and emotional. Stages of adrenal stress, Cortisol resistance, pro inflammatory, INL 6, pathological gastrointestinal responses, are representative of the vicious cycle of wanting and doing, having to do to get, to consume to be content, processes of contentment conditioning, dis content arises out of this kind of wanting, and then that wanting becomes conditioned to outside stimuli and causes. The hippocampus has many receptors to cortisol and is easily disrupted by chronic stress. This is the main cause for the alterations in sleep cycles so common with stress related disorders. This stress also affects the vascular system. Blood vessels physiology is in part mediated by the inner linings of blood vessels, known as the tunica intima. This tissue helps produce and regulate hormone and nitric oxide processes. When these become altered circulation is disturbed, as well as inflammatory damage can occur in blood vessels and many other tissues including the brain.
Parasympathetic, infused with mindfulness, simply knowing, is often cited as a nonjudgmental quality of being in the present moment. I would emphasize that this quality is also non interfering. The intention is not to eliminate aspects of ourselves, but simply make them conscious. This is sometimes called “choice less” awareness and implies’ that we are impartially aware. This is required to enable one to clearly observe the building up of reactions and especially of their motives. This allows one to become an unbiased observer of one’s subjective involvement in a situation. One then becomes more clearly able to discern the nature of the situation outside of our own agenda. Ones actions become better suited to a larger frame of reference that can embrace wider range of solutions.
The survival pattern requires a deep usage of the transference of perception, and a strong re conditioning of our feelings and interpersonal lives. It is repressing one’s own feelings, to survive. Concomitantly acting out behaviors for the sake of one’s own survival as well as the family or caretaking system. Taking on other behaviors to survive in family, social, sexual, cultural, taking on other identities. All these behaviors support a survival instinct and perception that includes sympathetic dominance. They can be social forms in terms of needs or isolation. They also include conditionings of discriminations, all that may be considered right or wrong, acceptable or unacceptable, views on sexuality, food, drugs, and all kinds of conditioning of the psyche. The danger and addiction lies in the sympathetic drive behind them.
We develop numb bodies, vs. feeling bodies, which employ empathy and other ways to evolve our capacity to experience and express our essential goodness.
Behind the personas and distortions is our true self. Spiritual literature often talks about our true nature, our essential goodness, alluding to a deeper self, a more expansive self, consistent with a more para sympathetic state. A more real, expanded self, an expanded sense of aliveness, and more of what is truly great about life. I find it interesting to note that it is the transcendent nature of the self that is altered/used to live out this survival perception. It is he vulnerable self that could transmute itself, and adapt itself in order to survive.
- Krishnamurti and Ramanamaharshi, two renowned East Indian spiritual teachers implore us to see for ourselves. To understand for ourselves. Buddhism asks also to see for ourselves. To clearly seeing what is inspiring us in any given moment.
It is also very apparent and has been demonstrated by many studies in many disciplines how these states affect our relationships with others. Mentioned above was enhancing co operation, and acknowledgement, which require stepping outside of our ego based experience. As well as an increased capacity for being with ourselves, the way we relate to our experience, and then extending that generosity to others.
I would like to introduce some more neurological concepts to show how these mechanisms function in our bodies and nervous systems. Addictive behaviors, stress and triggers and other psychological states are often explained and treated in terms of the neurochemistry of neurotransmitters, and rightly so as they are an important component of our nervous system. Equally large and being given a lot of attention is factors of glucose and related inulin, and especially cortisol. I would like to introduce factors that are less often talked about. That is the concept of neuronal tone. This model has four main components. The “afferent” system, the “efferent “system, the brain, and motor endplates. Simply put, the afferent system senses, and sends information up the spinal tract system via the posterior horns of the spinal cord. The signals pass through the cerebellum to the neocortex. The information is processed there with the help of the thalamus. The neocortex then projects information through the Ponto medullary reticular formation down the spinal tract by the anterior horns of the spinal cord. I am eliminating a few details to give an overview of the process. The more the afferent system if activated, the less neuronal tone. The more the efferent system is activated, the less neuronal tone. This tone manifests in the motor endplates. The motor endplates are where muscles are innervated by the nervous system. The afferent system senses the pull or stretch on the muscles. The efferent system fires more to increase this tone or fires less to decrease this tone. This firing is controlled by the overall firing frequency of the brain. This is mediated by the activity in the medullary reticular formation. The MRF can be hyper reactive and very little input will result in a lot of firing. Meditation can intervene in several ways on this model. Mindfulness can increase the afferent system by focusing on sensation. The practice of mindfulness can also slow down the overall firing rate of the brain reducing the output into the MRF. There are also nutritional protocols to help with all these processes and their feedback loops as well. If you are interested, please consider making an appointment for a nutritional consultation.
In conclusion would like to add, that meditation can help us reconcile some deep issues that seem paradoxical. Through the focus of present moment awareness we are able to be less caught by our painful sympathetic triggers. We begin to see them more clearly. We can then be able to access our parasympathetic states as an alternative. With practice we develop the capacity to embrace all our experiences in and through wellness. We are less likely to react out of patterns that may disrupt our relationships, physiology, and psychology. We can embrace diversity of experience, cultural differences, sex differences, age differences, racial differences, etc. Through practicing being aware of judgment and non judgement, aversion and non-aversion, we use our frontal lobes to make decisions which directly influence the more primitive centers of the brain.
Studies of mindfulness showed it prevented depression relapse, reduced self injury, alleviated obsessive compulsive disorder, and managed the stress of chronic illness of self, and loved ones. Studies also show mindfulness makes people more open minded, and this allows them to experience more positive states as well as try new things and experiences. Mindfulness studies show the technique enhances peoples ability to respond to what’s happening now, not what if’s. They don’t overgeneralize or over react. Studies found that mindfulness allows people to attend more deeply to their environment and self in deeper and more enriching ways. They become more accepting of themselves and others and forge deeper and more trusting relationships and feel more support from others. They find more purpose in life. They are healthier, with less stress hormones, more growth hormones, dopamine and opioids. This resulted in lower blood pressure, less stomach problems, less back pain, better immune function, less sore throats, less colds, better sleep and much more. Studies also showed faster recovery from stress in orbito frontal lobes and insula. This means people are less likely to get triggered by cravings and stresses. One study of mindfulness reported that 30 minutes of mindfulness practice could reduce cortisol by 20%
Common Conditions Treatable With Acupuncture
Some common symptoms that can often be successfully treated with acupuncture and or herbs, nutation, massage: Joint swelling, Joint stiffness, Joint pain, Muscle spasms, Muscle pain, Muscle stiffness, Muscle Swelling, Radiating pain, Diabetic neuropathy, Radiculopathy, Chills, Fever, Fatigue, Runny nose, Nosebleed, Sudden loss of hearing, Ear pain, Throat pain, Difficulty swallowing, Eye pain, Chest pain, Palpitations, Irregular heart beat, Shortness of breath, Cough, Wheezing, Nausea, Vomiting, Acid reflux, Bowel dysfunction, Bowel pain, Constipation, Diarrhea, Abdominal pain, Loss of urine control, Blood in urine, Painful urination, Sinus pain, Recurrent infections, Rash, Loss of hair, Itching, Ulcers, Wound infection, Headache, Tingling/numbness, Dizziness, Anxiety, Depression, Anger, Thirst and sweating, Cold intolerance, Bruising problems, Bleeding problems, Swollen glands.