[hschubiner]

Very amazing article, Aleks.
Here are some excerpts:

More recently, a relatively large epigenetic study of the Dutch hunger cohort (422 exposed and 463 sibling controls) identified alterations in DNA methylation specifically associated with in utero exposure to maternal famine152. Among those exposed early in gestation, additional CpG mediators were identified. Interestingly, exposure to famine during pregnancy had biological and behavioral effects on grandchildren, such as on adiposity153. This transgenerational effect has been attributed to the fact that prenatal exposure directly impacts both the fetus and the fetal germ cells, thus directly exposing the third generation. In a recent study, grandmaternal stress during pregnancy was associated with genome‐wide methylation changes in offspring and grandchildren154.

In one study, male mice were fear conditioned with an odorant at two months of age (post‐puberty but not yet adults)175. The odorant acetophenone paired with an electric shock resulted in behavioral sensitivity in the fear conditioned mice, with an accompanying change in DNA methylation in brain and sperm of the M71 receptor, which is involved in sensing acetophenone. An increased size in the M71 specific glomeruli in the olfactory epithelium and bulb was also observed175. The offspring (F1) of odor conditioned F0 males mated with naïve females also showed similar changes in brain and sperm. When the F1 males were themselves mated, changes in brain persisted in the F2 male offspring, demonstrating conservation of the effect through two generations.

These guidelines should be kept in mind as studies on effects of trauma on offspring in the next and subsequent generations are pursued. The concept of intergenerational transmission has resonated among offspring who feel affected by their parents’ experience. The concept has also been embraced by communities that are affected by significant traumatic experiences through several generations. That there may be a biological or molecular representation of an intergenerational effect appears to validate the experience of offspring who may feel that they bear effects of their parents’ hardship, even if the concept may also carry an implication that they are damaged, impaired, or permanently disadvantaged. It is also important to underscore the lack of permanence of effects once environmental conditions are altered.

[hschubiner]

Hi Aleks. I don’t think this forum allows for file sharing, but if you want to send it to me, I can email out to the class.
Thanks!! Howard

[hschubiner]

Excellent points, Becca.
I learned much of this from Allan Abbass and Mark Lumley; and you have learned it well too!!
Howard

[hschubiner]

Great work, Aaron.
The fact that he was able to express that something made him angry is a great sign. I would explore what about your relationship led to that feeling and allow him to express directly to you anything that he can and is important about that. It will model for him that he can allow anger and express it in a safe and healthy way (with you).
Then you can also explore what might be underlying this; what in his life has led to him being angry. He may have been told that he was safe when he really wasn’t by people who had power over him. There was probably something like that that triggered his reaction. Then you can do emotional processing work (EAET) with him on that situation from the past.
It’s also great that you helped him to tolerate being anxious without fearing it. That is the PRT approach to anxiety (and pain).
Excellent stuff!!
Howard

[hschubiner]

Excellent points, Alicia.

There are folks who have been dismissed and invalidated for a long time, by friends, family and doctors. They need validation, first and foremost. Often they have found that validation in an online support group of others who are also suffering. Those groups can be very helpful, but they also can act to imprint the ideas that their suffering will never end, that they have a disease that is completely incurable, and that they can only cope with it as best as they can and wait for a miracle medical treatment to emerge.

Rocking that boat can be met with a lot of anger, understandably. We need to tread softly with these folks and recognize that they may never see things from our point of view.

[hschubiner]

These are important questions, Becca. But ones that only you can figure out over time with your patients and your schedule. I found that my schedule dictated how much I could do, how many new patients I scheduled, and how often I saw them. You have to protect yourself and your schedule. If you get too overloaded, you may get back pain! 🙂 Keep your balance in your life to make sure that you stay able to help as many people as you can, but not more people than you can! 🙂
Best, Howard

[hschubiner]

Great article, Jonathan!! This is a really important perspective and one that I take in my Anxiety and Depression book. The two influential books on this are from Robert Whitaker in Anatomy of an Epidemic and Irving Kirsch in The Emperor’s New Drugs. Both should be required reading for all physicians, especially psychiatrists!

[hschubiner]

I have worked with teens for 30 years now; and you can never be effective with parents in the room like that. I would suggest that you state that it is important for you to see him alone for most of all of the visit. You can get input from the parents at the beginning; and give them some feedback at the end. But if that’s not possible, I would ask them to find a different doctor.

Not sure if there is any other way, really. If you don’t do that, you will just be trying to dance around the issues and not really addressing the causes and not really connecting to him.

Sorry, Howard

[hschubiner]

Thanks very much, David.
You’re doing a fantastic job! I would simply add that looking carefully for the FIT criteria and doing provocative/neural circuit testing can be very helpful in
helping people with the actual clinical evidence that these are mind-body conditions. We will be covering those in upcoming months in the live class; and they are part of the OVID mobile app as well.
Best, Howard

[hschubiner]

Thanks Beatrice.
We have seen this “spreading” phenomenon for many years, and it happens more commonly than not! It’s the result of positive feedback loops that are triggered by the pain/fear/pain cycle. The more of what I call the “six Fs” (fear of pain, focus on it, fighting it, frustration with it, trying to figure it out, and trying to fix it), then the more severe the pain, the more it spreads, and the more other symptoms begin as well. This positive feedback loop can also occur with stress and emotional distress in people’s lives. These reactions feed back to the danger/alarm mechanism in the brain, which activates more danger.

I explain it to my patients by saying: If you’re talking to someone and they don’t hear you, what do you do? Talk louder, right? So, your brain is sending you messages of dangers and you’re not hearing them as such. You’re not calming the danger signal but reacting in ways that make it need to “speak louder.”

Does that help?
best, Howard

[hschubiner]

Thanks Becca and Alicia. I just happened to speak to Paul Garner today and he told me about his story of getting long haul COVID and then recovering from it. He’s a great guy, now totally immersed in the mind-body connection and predictive processing world. There was an article that just came out in a local paper in Liverpool about him, detailing that he even got death threats a few people in the CFS activist community who were unhappy with him publicizing his recovery.
Best, Howard

[hschubiner]

Thanks for writing, Carol. There are many ways to work with patients with stress and trauma. In particular, many people talk about “top down” versus “bottom up” interventions. We tend to focus on the “top down” ones, of helping people to turn down the danger signal in the brain. When people do that, their peripheral nervous system will tamp down as well, since the peripheral nervous system (and autonomic nervous system) are controlled by the brain.

That being said, ways of working in the “bottom up” fashion can be very helpful, when the patient and practitioner are on board with them. I would think that tapping is one of those methods. Clearly, you’ve found it helpful and I’m sure your patients are benefitting from that. Many people in our world use lots of bottom up interventions, including breath work, therapeutic touch, body focused meditations, and others.

When one considers how tapping works, there can be a difference of opinion: does it work by directly affecting the peripheral and autonomic nervous system or does it work by calming the brain, which then lowers sympathetic/fight or flight activity? It’s impossible to say for sure as we can’t study people without brains! In this course, we emphasize that the brain is the generator of all our experiences, i.e., predictive processing, and I’ve found that organizing principle invaluable. In practice, there are many ways to get the brain to feel “safe.” Body work is clearly one of those.

So, thanks for the input and the benefits of a way to help people as we do this work together.
Best, Howard

[hschubiner]

Thanks so much for your own eloquent words, Murray. I agree with you wholeheartedly!
I can’t reference that article as it hasn’t come out yet, so sorry about that.
Sometimes, it takes time for people to realize that they actually have a mind-body condition. It can help to just wait and see; and observe the symptoms closely as they often will vary, change, shift, or become triggered by innocuous stimuli. Usually, the truth will emerge over time! 🙂
Best, Howard

[hschubiner]

I find that the provocative testing “works” about 70% of the time; and a recent research study appears to corroborate that! But I have also found that it is much less likely to “work” when the person is not buying into the mind-body concepts, interestingly!! 🙂
Best, Howard

[hschubiner]

Hi everyone and thanks for being in the class!!
I’ve just sent my intake forms to Grace and she will email them to you.

Here is a link to a video by Mark Wolynn about healing his vision by changing his relationship to his parents:
http://www.youtube.com/watch?v=YqBhAgqZGSU

Here is the youtube channel from my patient with mast call activation syndrome:
https://www.youtube.com/@thehistaminedeception5378

The article I was involved with is in the Journal of General Internal Medicine, “Racism as a source of pain”
Racism as a Source of Pain https://doi.org/10.1007/s11606-022-08015-0

Thanks again, Howard

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