from Dr. Stephen Cowan

There’s something missing from the information the CDC is offering right now that is more critical to our personal health than all the statistics.

During my many years of primary care practice whenever flu came through town, I would call those newly diagnosed every day to see how they were doing. This served two purposes. It let them know that I was caring for them and this helped them feel less alone, AND it also helped me know the story of the present illness, it’s natural evolution. This was critically important information that I could use to comfort other patients as they came down with the flu. And that’s exactly what’s missing right now. No stories!

Stories are facts! We should not deny this truth. Stories carry within them all the complexity of each individual life, the epigenetic truth of how we live our life, how we get sick and how we get better. When we lose the story we decontextualize the facts, and this depersonalizes our experience, creating great fear because it is not really about anyone. When it’s not about anyone, it’s about EVERYONE. Fear is an age-old way of motivating people. It’s been used in politics, medicine and education to coerce behavior. But mobilization with fear, as Stephen Porges has described in Polyvagal theory, can create more confusion and chaos by triggering fight-or-flight reactions in our mammalian brain, making it sound like it’s every person for themselves. Over time, this chronic state of threat creates a deep sense of social isolation and a deeper state of helplessness that disconnects us from the natural physiological rhythms and functions we’ve evolved to mount a healthy response to an infection.

Relationships matter in healing.

Chinese medicine has a long history of dealing with crises like the current one. During the 1600’s when new epidemics moved through the world, Chinese doctors recognized that new approaches were needed to address new problems so they changed their thinking. Such adaptability is why Chinese medicine remains the oldest continually practiced health care in the world. One of the basic tenets of Chinese medicine is called the Five Phases or Five elements of healing. There are five elemental rhythms and relationships that exist at every level of nature on planet earth. You don’t need a double blind randomized controlled study to know this is true. These five rhythms reflect the seasons, the time of day and the way all things grow. They are traditionally known as Water-Wood-Fire-Earth-Metal. This is how nature offers us a guide to self-care.

The Five Elements of Self-Care

Because we don’t yet know the particular stories of the people who have recovered from Corona virus, we are left without the basic information we need to understand the risks. But we do have the basic facts that nature offers us that can serve as a tool-box to promote resilience and improve our chances of survival in these extraordinary times. If we’re all going to help blunt the curve of this pandemic by limiting exposure here are some proactive things you can do to care for yourself while weathering the storm.

1. Water: Drink and Sleep

Drink: Try to drink 2-3 times more warm fluids than you would normally do. The immune system works best when it’s well hydrated. The lungs abhor dryness and can’t defend themselves well. As with the flu, people who end up hospitalized are typically under hydrated. And of course, Water means washing your hands. Here is a song I wrote for children to time their hand washing and at the same time chase away the fear that paralyzes our immune system. It goes to the tune of twinkle twinkle little star.

Fear kills my mind
I shall not fear

Fear makes my thoughts
become unclear

I face my fear
Wash it away

With these two hands
I face my day

And when my fear
Goes down the drain

I see that only
I remain.

Sleep: in Chinese medicine the night corresponds to the Water element, the time to cool down and detoxify. Inadequate sleep is one of the primary ways we run our immune defenses down. Create a new habit in these extraordinary times. Turn off the screens and lights and go to bed 1-2 hours earlier than you would normally do. Add some lavender oil to the room. Lavender oil can help clear the air of both infectious agents and stress. Download wave sounds to listen to before bed. This natural rhythm helps release the day’s anxieties.

2. Wood Power: Move and Nature

Move: Wood corresponds to the time of Spring when everything come alive. Movement promotes blood flow, which enables our immune cells to rally and circulate. This improves our resilience. Exercise should not be overly strenuous or excessive however, as it will deplete our reserves. Yoga, Taichi, dancing and walking are the best ways to promote mobilization without fear.

Nature: Unplug from your screens (at least part of the day)! It can deplete your defenses both by your lack of movement and because of the incessant fear being broadcast these days. Spend some time in nature. Even 10 minutes a day will help your body promote natural rhythms of defense and connect you back to Mother Earth.

3. Fire Power: Massage and Laugh

Massage: Fire is associated with the coziness of connection. In Denmark there is an important quality of light within darkness called Hygge that has been shown to promote healthy physical, emotional and mental relationships with the world. Massage yourself and your loved ones. Massage will bring the immune cells to the surface of your skin where they are needed to defend you. Massage brings comfort, connection and a cozy feeling like “we’re all in this together.” This is mobilization without fear. There is an age-old massage of the hands called tuina that has been practiced in families for centuries in China to strengthen immune defenses.

Laugh: Playful humor has been shown to rally immune resilience, releasing the immobilization of fear. One of the best ways we can gain perspective and shift out of fight-or-flight is to laugh at the absurdity of our situation. Consider watching comedies or telling jokes with loved ones. Here’s how I teach laughing meditation to the children in my practice. Stand in front of the mirror and slowly curl your mouth into a smile. Eventually it will trigger a goofy grin because you see how ridiculous it is. This mobilizes the musculature and nervous system of your face, activating the social engagement network, preventing Corona virus from invading.

4. Earth Power: Eat and Converse

Eat: Food is more than just fuel. There is a way to eat that can mobilize your immune system without fear. Our digestive system is intimately connected to our immune system. When we take time to eat slowly, we avoid triggering fight-or-flight reactions that can lead to paralysis of immune resilience. Good eating habits send a message to our body to take care.

Prepare comfort food that contains diversity and complexity. The current epidemic is complex so we have to meet it with complexity. This is how you train your immune cells to remain vigilant. Foods that take time to prepare like soups and stews provide the kind of warmth that your immune system needs to care for you.

Converse: If you can, try not to eat alone. Loneliness is the epidemic of our age. Recent studies have shown how detrimental it is to our physical health leading to inflammation which can make you vulnerable to infection. Eating is about connecting with others, strengthening the bond we need to feel like we’re all in this together. Even if you are in quarantine because of exposure, try using FaceTime or some other digital mode of connecting with loved ones to share your eating experience, recipes and conversations with them and tell stories in real-time. Remember, stories are facts too!

5. Metal: Breathe and Poop

Breathe: Metal is associated with the Autumn season, the time to let go, to prepare for the winter months. Breathing exercises are one of the fundamental ways we can strengthen our lungs, clear out toxins, revitalize our respiratory immune defenses and calm ourselves. Make sure the air is clean and fresh and humidified to protect and invigorate the lungs. Remember, the lungs don’t like dryness.

The long exhale: Here’s how I teach “power breaths” to children. It’s like blowing out candles on a birthday cake. The timing is 3-4-5 (for adults 4-5-6). Make two fists and breath in and count to yourself 3 seconds. Hold breath (4 sec) and make a wish. Breath out slowly (~5-6 seconds) as if you’re blowing out candles on your birthday cake, while opening your fists. When you puff out your cheeks while exhaling, you are activating the facial muscles that trigger the social engagement network that brings a sense of calm. This is an important practice for relieving the panic attacks we’re all having right now around the threat of getting sick.

Poop: Have a good poop to have a good day. My grandfather always said that the secret to life was a good bowel movement. The United States is one of the most constipated countries in the world. Sales of Over-the-Counter laxatives in the US averages over a billion dollars. This is in part due to our dietary habits. But it’s also due to the chronic stress that elicits fight-or-flight responses in our body. A good BM helps us let go of all the toxic stress we’ve been carrying around all day. Diets rich in organic oils and fiber feed the “community garden” of organisms that live in our gut and help our immune system function effectively. Probiotics can help promote as much diversity to that garden as possible and will ensure that we can process the crazy information we are encountering and get rid of what we don’t need without it building up in our system. Until the stories start coming out about who is recovering from Coronavirus, practice these Five Elements of self-care seriously every day and you will be mobilizing the natural rhythms that have taken millions of years to evolve to ground you in the basic facts of life. Take care.

Stephen

Self-care in five phases

1. WATER: drink and sleep
2. WOOD: move and nature
3. FIRE: massage and laugh
4. EARTH: eat and converse
5. METAL: breathe and poop