Image by Nico H. from Pixabay

September 16, 2019

Why do we need to learn to be still? We always hear about the virtues of being still. Our parents yell at us to "sit still". Pink Floyd extolled the lyrics, "You! Yes you! Stand still, laddy". Hyperactive kids get labeled and find their way into trouble for not being still. I suffered from this label for years in elementary school and beyond as I loved to squirm in my seat and talk far too much to my neighbors to the utter displeasure of Mrs. Smalley, my third grade teacher. It reached its peak that year when a friend of mine and I were labeled the chatterbox twins and were routinely sent out into the hall so as to not disrupt the class.

Not the most effective punishment I will have to admit.

 Ask the crowd at a Philadelphia Eagles game or the Flushing Meadows US Open final played last week between Rafael Nadal and Daniil Medvedev (awesome by the way) to be still and you will have a riot on your hands. You get the idea that stillness is not a common event for many of us. As a kid growing up, the sum total of my stillness events occurred while asleep and in church although I still struggled mightily with the latter.

 For most of my life, I never fully understood the need nor felt the desire to be still for any length of time as it went counter to my sense of self and sense of natural inclination to move and talk. However, as with everything in life, the science has caught up to my unscientific beliefs.

 The real issue with stillness is wrapped up in the benefits of randomly being in a state of relaxation. This is well known for sleep as we discussed a few weeks ago with Matthew Walker's work. Sleep is life giving and cellularly rejuvenating. My thoughts around stillness used to be that when I sleep, I got the chill moments that I needed. Unfortunately, it turns out that in our high paced and high stress world, this is likely not enough for most of us.

 When we are stressed chronically, we are suffering from damaging inflammation across the cellular board. Dr. Koontz and I often debate the power of the mind versus the power of nutrition to maintain a healthy body. For the better part of 20 years, I have put most of my eggs in the nutrition and movement basket while he has filled his more into the mind side. Over the last 5 years, I have realized that I think that he is onto something. Stress may be the most important issue that is being brushed under the rug and stagnating our growth and ruining health.

 Storytime: A young teenage girl had chronic stomach and gut complaints coupled with headaches that would not resolve despite a very thorough functional medicine plan that she was following by report. Her issues should have resolved if it was of this nature. At follow up, when asked about stress, the patient minimally and mostly the family (red flag) all in unison vigorously denied it. My gut feeling was the opposite, but there was nothing to do in a denial state. Fast forward to the resolution. The young girl admitted later that she was stressed out by her families restricted goal oriented desires. Her symptoms abated and have not returned to my knowledge after she started to live for herself, authentically.

This has been a repeated pattern in clinic: parental stress directed behaviors driving dysfunction in the child who is living for them and not self.

 To heal the human body we need to be balanced with movement, nutrition, chemical exposure and mental stress. The stress side of the equation is more about the function of a calm and controlled neuroendocrine inflammatory system, in specific, the autonomic nervous system. When we are calm the system is balanced and allows for the brain, the gut, the hormones and the immune system to have robust crosstalk. This crosstalk is the point at which: the immune system recognizes friend from foe, the hormonal/gut systems sense the need to run or digest, the brain decides to think and learn versus fight or run and much more.

Let us take for example a discussion we had a few months ago: Mental stress acutely is good for you as it causes cortisol to down regulate the powerful inflammatory gene regulator known as NFkB through another protein called IkBa to make sure that all energy is pointed toward running away from or fighting the acute mentally stressful event. However, in a chronic stress based situation, these cortisol related events lose sensitivity and shift toward a pro inflammatory response from NFkB which we see as all types of disease symptoms.

The relaxing part of the autonomic nervous system from the brain called the parasympathetic nervous system communicates with gut/endocrine axis via the vagus nerve which travels from the brain all the way down to the gut and innervates a large percentage of tissue there. The signals that are sent down this nerve complex are involved in many relaxing events:

1) decreasing inflammation post resolution of the inciting event
2) promotes GI motility and digestion
3) mediates heart rate
4) mediates breathing
5) reverses the effects of the overactive sympathetic system when unregulated
6) helps the brain talk directly to the gut microbiome
7) moves the swallowing muscles
8) helps move blood around the body

These events are all involuntary making them uncontrollable by us. However, we can change the outcome of these events by working specifically on relaxation. Thus the return full circle to beginning with stillness and meditation. When we take the time to learn how to be still, meditate, pray and be present moment in our lives, we start to send signals via the vagus nerve that are primarily promoting all of the vagally relaxing events.

The relaxation methods that have been shown to be beneficial are yoga, prayer, meditation, stillness, vagal nerve stimulation, breath work, walks in nature, hug your pet, get a massage, tai chi, and other mind body techniques.

Spend some time this week with your children practicing the art of being still.


Dr. M

Cleveland Clinic Article