Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx

MURMUR OF THE
HEART:
THE STORY IT TELLS IF WE LISTEN
MARTHA STARK, M.D.
marthastarkmd@hms.harvard.edu
JUNE 26, 2009

STRESSFUL STUFF HAPPENS
WHETHER THE PRIMARY TARGET IS THE MIND OR THE BODY,
THE CRITICAL ISSUE WILL BE THE ABILITY OF THE SYSTEM
(THE CARDIOVASCULAR SYSTEM IN THIS INSTANCE)
TO ADAPT TO THE IMPACT OF
THE ENVIRONMENTAL PERTURBATION
TOO MUCH STRESS – TRAUMATIC STRESS
WILL BE TOO OVERWHELMING FOR THE SYSTEM
TO PROCESS AND INTEGRATE,
PROMPTING INSTEAD DEFENSE, DISORDER, AND DISEASE
TOO LITTLE STRESS WILL PROVIDE
NO IMPETUS FOR TRANSFORMATION AND GROWTH,
SERVING INSTEAD SIMPLY TO REINFORCE
THE STATUS QUO OF THE SYSTEM
BUT JUST THE RIGHT AMOUNT OF STRESS – OPTIMAL STRESS
WILL PROVIDE THE CHALLENGE NEEDED
TO PROMPT ADAPTATION AND RECONSTITUTION
OF THE SYSTEM AT EVER HIGHER LEVELS
OF ORDER, COMPLEXITY, INTEGRATION, AND COHERENCE

STRESSFUL STUFF HAPPENS
… BUT IT’S HOW WELL WE ARE ABLE,
PSYCHOLOGICALLY, PHYSIOLOGICALLY, AND ENERGETICALLY,
TO PROCESS AND INTEGRATE ITS IMPACT THAT WILL MAKE OF IT
EITHER A GROWTH – DISRUPTING EVENT
OR A GROWTH – PROMOTING OPPORTUNITY
EITHER ONE THAT OVERWHELMS
OR ONE THAT PROMPTS TRANSFORMATION AND GROWTH
EITHER ONE THAT FURTHER UNDERMINES
AN ALREADY – COMPROMISED SYSTEM
OR ONE THAT FURTHER STRENGTHENS
AN ALREADY – RESILIENT SYSTEM
THE VILLAIN IN OUR PIECE – TRAUMATIC STRESS
STRESS THAT OVERWHELMS AND DISRUPTS
THE HEROINE IN OUR PIECE – OPTIMAL STRESS
STRESS THAT PROVIDES THE IMPETUS
FOR TRANSFORMATION AND GROWTH
IMPORTANTLY – NOT ONLY DOES OPTIMAL STRESS NOT OVERWHELM
BUT IT PROMPTS THE SYSTEM ADAPTIVELY TO RECONSTITUTE AT A HIGHER LEVEL

ENVIRONMENTAL CHALLENGE
TRAUMATIC STRESS – STRESS THAT THE SYSTEM
CANNOT PROCESS AND MUST THEREFORE DEFEND AGAINST
OPTIMAL STRESS – STRESS THAT THE SYSTEM
CAN PROCESS, INTEGRATE, AND ULTIMATELY ADAPT TO,
ALTHOUGH ALWAYS AT SOME COST TO THE SYSTEM
IT’S HOW WELL THE LIVING SYSTEM (THE MINDBODY MATRIX)
IS ABLE TO MANAGE THE CUMULATIVE IMPACT
OF THE MYRIAD OF ENVIRONMENTAL STRESSORS
TO WHICH IT IS BEING CONTINUOUSLY EXPOSED
THAT WILL MAKE OF THEM EITHER
TRAUMATIC EVENTS OR GROWTH OPPORTUNITIES
AND THAT ABILITY TO MANAGE STRESS IS A STORY ABOUT
THE SYSTEM’S ABILITY TO PROCESS, INTEGRATE, AND ADAPT TO
THE IMPACT OF ENVIRONMENTAL CHALLENGE,
INPUT FROM THE OUTSIDE THAT EITHER
THREATENS TO OVERWHELM THE SYSTEM OR
PROMPTS THE SYSTEM TO MOBILIZE ITS ABILITY TO HEAL ITSELF

OPTIMAL STRESS
MILD AGGRAVATIONS STIMULATE THE BODY’S ABILITY TO SELF – HEAL
INTERMITTENT EXPOSURES PROMPT THE BODY TO ADAPT
EVERY – OTHER – DAY WORKOUTS / MODERATE AEROBIC EXERCISE
(MICROTEARS THAT THE BODY REPAIRS ON THOSE DAYS WHEN THE BODY IS AT REST)
VACCINATION / IMMUNOTHERAPY / DESENSITIZATION THERAPY
TO PROMOTE RESISTANCE TO SUBSEQUENT EXPOSURES
HOMEOPATHIC REMEDIES TO ACTIVATE THE BODY’S ABILITY TO HEAL ITSELF
LIKE CURES LIKE – PRINCIPLE OF SIMILITUDE
(TREATMENT OF A RATTLESNAKE BITE WITH A DILUTED SOLUTION OF SNAKE VENOM)
“PIN FIRING” PARTIALLY HEALED TENDONS OF INJURED RACE HORSES
(INSERTION OF SMALL, RED – HOT PINS INTO THE 80% HEALED TENDON TO CAUSE
AGGRAVATIONS THAT WILL TRIGGER THE HORSE’S SELF – HEALING MECHANISMS)
DEFIBRILLATION TO RESTORE NORMAL SINUS RHYTHM / ELECTROSHOCK THERAPY
MILD SLEEP DEPRIVATION FOR TEMPORARY RELIEF OF DEPRESSION
TOUGH LOVE TO CHALLENGE / SUPPORT A STRUGGLING TEEN TO GET BACK ON TRACK
ANXIETY – PROVOKING INTERPRETATIONS TO CHALLENGE OLD DEFENSIVE PATTERNS
FRAXEL LASER TREATMENTS TO STIMULATE REGENERATION OF FACIAL COLLAGEN
DEEP TISSUE MASSAGE TO PROMOTE RELEASE AND FLOW
DEBRIDEMENT OF WOUNDS TO ACCELERATE HEALING
PICKING OF PARTIALLY HEALED SCABS TO PROMOTE WOUND REPAIR

RESILIENCE
WE ARE SPEAKING TO THE RESILIENCE OF THE MINDBODY MATRIX,
ITS ABILITY TO RECOVER, ADAPTIVELY TO RECONSTITUTE,
IN THE AFTERMATH OF DISRUPTION
OCCASIONED BY ENVIRONMENTAL CHALLENGE
IN FACT, THE HALLMARK OF A SYSTEM’S RESILIENCE
IS ITS CAPACITY TO RECONSTITUTE, TO SELF – ORGANIZE
IN RESPONSE TO REGULATORY INPUT FROM THE OUTSIDE,
ITS CAPACITY TO ADAPT, TO SELF – REGULATE,
TO RESTORE ITS HOMEOSTATIC BALANCE IN THE FACE OF CHALLENGE
IN SUM – ENVIRONMENTAL STRESSORS
IN THE FORM OF BOTH TOXICITIES AND DEFICIENCIES
WILL PROVE ULTIMATELY TO BE EITHER
TOXIC OR THERAPEUTIC, OVERWHELMING OR TRANSFORMATIVE,
DEPENDING UPON THE SYSTEM’S RESILIENCE,
THAT IS, THE SYSTEM’S ABILITY, AFTER THE INITIAL DISRUPTION,
TO PROCESS, INTEGRATE, AND ADAPT TO
THE IMPACT OF THE ENVIRONMENTAL PERTURBATION
AND TO RECONSTITUTE AT A HIGHER LEVEL

CARDIOVASCULAR
DISEASE
THE LEADING CAUSE OF DEATH IN THE UNITED STATES
KILLS ONE PERSON EVERY 34 SECONDS
ACCOUNTS FOR 30% OF DEATHS WORLDWIDE
TAKES MORE LIVES THAN DOES CANCER
HIGH BLOOD PRESSURE
CORONARY HEART DISEASE
MYOCARDIAL INFARCTION
ANGINA PECTORIS
ATHEROSCLEROSIS
CONGESTIVE HEART FAILURE
PERIPHERAL VASCULAR DISEASE
CARDIOMYOPATHY

NOURISHING THE HEART
CARDIAC MUSCLE IS SUPPLIED WITH OXYGEN AND NUTRIENTS
BY BLOOD DELIVERED TO IT BY THE CORONARY CIRCULATION,
NOT BY BLOOD WITHIN THE HEART CHAMBERS
MOST CORONARY BLOOD FLOW OCCURS DURING DIASTOLE,
BECAUSE THE CORONARY VESSELS ARE COMPRESSED
BY THE CONTRACTING HEART MUSCLE DURING SYSTOLE
CORONARY BLOOD FLOW IS NORMALLY VARIED
TO KEEP PACE WITH CARDIAC OXYGEN NEEDS
CORONARY BLOOD FLOW MAY BE COMPROMISED
BY THE DEVELOPMENT OF ATHEROSCLEROTIC PLAQUES,
WHICH CAN LEAD TO ISCHEMIC HEART DISEASE
RANGING IN SEVERITY FROM MILD CHEST PAIN UPON EXERTION
TO FATAL HEART ATTACKS

MURMUR OF THE HEART
BLOOD NORMALLY FLOWS IN A LAMINAR FASHION,
LAYERS OF THE FLUID SLIDING SMOOTHLY OVER ONE ANOTHER
LAMINAR FLOW DOES NOT CREATE ANY SOUND
WHEN BLOOD FLOW BECOMES TURBULENT, HOWEVER,
A SOUND CAN BE HEARD
THESE SOUNDS ARE THE RESULT OF VIBRATIONS CREATED
IN THE SURROUNDING STRUCTURES BY THE TURBULENT FLOW
LUB – WHISTLE – DUP
SYSTOLIC – STENOTIC SEMILUNAR VALVE
LUB – DUP – WHISTLE
DIASTOLIC –STENOTIC AV VALVE
LUB – SWISH – DUP
SYSTOLIC – INSUFFICIENT AV VALVE
LUB – DUP – SWISH
DIASTOLIC – INSUFFICIENT SEMILUNAR VALVE

MYOCARDIAL ISCHEMIA
CARDIAC ISCHEMIA IS A SITUATION IN WHICH
THE FLOW OF OXYGEN – RICH BLOOD TO THE HEART MUSCLE
BY WAY OF THE CORONARY ARTERIES IS IMPEDED,
RESULTING IN INADEQUATE OXYGENATION OF THE HEART
THREE UNDERLYING MECHANISMS –
PROFOUND VASCULAR SPASM OF THE CORONARY ARTERIES
THE FORMATION OF ATHEROSCLEROTIC PLAQUES
THROMBOEMBOLISM
THE MOST COMMON CAUSE OF CARDIAC ISCHEMIA
IS PLAQUE BUILDUP IN THE ARTERIES AS A RESULT
OF THE LONG – TERM EFFECTS OF CORONARY ARTERY DISEASE
THIS BUILDUP OF PLAQUE CONSTRICTS THE ARTERIES TO THE POINT
WHERE THE AMOUNT OF BLOOD FLOWING THROUGH THE ARTERIES
IS NOT ENOUGH TO SUPPLY OXYGEN – RICH BLOOD TO THE HEART,
PARTICULARLY DURING TIMES OF PHYSICAL EXERTION
OR EMOTIONAL STRESS

VASOSPASM
VASCULAR SPASM – AN ABNORMAL SPASTIC CONSTRICTION
THAT TRANSIENTLY NARROWS THE CORONARY VESSELS
REDUCED OXYGEN AVAILABILITY IN THE CORONARY VESSELS
CAUSES THE RELEASE OF PLATELET – ACTIVATING FACTOR (PAF)
FROM THE ENDOTHELIAL LINING OF THE BLOOD VESSELS
ONCE RELEASED, PAF DIFFUSES TO THE
UNDERLYING VASCULAR SMOOTH MUSCLE
AND CAUSES IT TO CONTRACT,
BRINGING ABOUT VASCULAR SPASM
ENVIRONMENTAL TOXINS ARE COMMONLY IMPLICATED
IN THE INITIATION OF LOCALIZED VASOSPASM

ATHEROSCLEROSIS
A PROGRESSIVE, DEGENERATIVE ARTERIAL DISEASE
THAT LEADS TO OCCLUSION OF AFFECTED VESSELS
THE INITIAL STAGE IS CHARACTERIZED BY THE ACCUMULATION
BENEATH THE ENDOTHELIUM OF EXCESSIVE AMOUNTS
OF CHOLESTEROL – RICH LIPID DERIVED FROM THE BLOOD
THE DISESASE PROGRESSES AS SMOOTH MUSCLE CELLS
WITHIN THE BLOOD VESSEL WALL MIGRATE FROM
THE MUSCULAR LAYER OF THE BLOOD VESSEL
TO A POSITION ON TOP OF THE LIPID ACCUMULATION
JUST BENEATH THE ENDOTHELIUM
THE LIPID – RICH CORE AND OVERLYING SMOOTH MUSCLE
FORM A PLAQUE, WHICH PROGRESSIVELY ENLARGES,
THEREBY INTERFERING WITH NUTRIENT EXCHANGE
AND LEADING TO DEGENERATION OF THE BLOOD VESSEL WALL
CALCIUM OFTEN PRECIPITATES INTO THE COLLAGEN – RICH
CONNECTIVE TISSUE CAP THAT FORMS OVER THE PLAQUE,
LEADING TO “HARDENING OF THE ARTERIES” OR ATHEROSCLEROSIS

THROMBOEMBOLISM
THE ENLARGING ATHEROSCLEROTIC PLAQUE
CAN BREAK THROUGH THE WEAKENED ENDOTHELIAL LINING
THAT COVERS IT, EXPOSING BLOOD TO THE
UNDERLYING COLLAGEN IN THE COLLAGEN – RICH
CONNECTIVE TISSUE CAP OF THE PLAQUE
WHEN PLATELETS COME INTO CONTACT WITH COLLAGEN
AT THE SITE OF VESSEL DAMAGE,
THEY STICK TO THE SITE AND CONTRIBUTE TO THE FORMATION
OF A BLOOD CLOT, FORMING A THROMBUS
THE THROMBUS MAY ENLARGE GRADUALLY
UNTIL IT COMPLETELY BLOCKS THE VESSEL
OR THE CONTINUED FLOW OF BLOOD PAST THE THROMBUS
MAY BREAK IT LOOSE FROM ITS ATTACHMENT
SUCH A FREELY FLOATING CLOT, OR EMBOLUS, MAY
COMPLETELY PLUG A SMALLER VESSEL AS IT FLOWS DOWNSTREAM
BECAUSE OF THROMBOEMBOLISM, ATHEROSCLEROSIS
CAN RESULT IN THE GRADUAL OR SUDDEN OCCLUSION OF A VESSEL

COLLATERAL CIRCULATION
WHEN A CORONARY VESSEL IS COMPLETELY PLUGGED,
THE CARDIAC TISSUE SERVED BY THE VESSEL SOON DIES FROM
OXYGEN DEPRIVATION AND A HEART ATTACK OCCURS, UNLESS
THE AREA IS BEING SUPPLIED WITH BLOOD FROM NEARBY VESSELS
SOMETIMES AN AREA DEPRIVED OF BLOOD FLOW IS FORTUNATE
ENOUGH TO RECEIVE BLOOD FROM MORE THAN ONE PATHWAY
A SYSTEM THAT IS RESILIENT WILL HAVE BEEN ABLE TO ADAPT TO
THE STRESS OF DECREASING BLOOD FLOW AND DECREASING
SUPPLIES OF OXYGEN BY DEVELOPING COLLATERAL BLOOD VESSELS
THESE ACCESSORY VESSELS CANNOT DEVELOP SUDDENLY
FOLLOWING AN ABRUPT BLOCKAGE
BUT MAY BE LIFESAVING IF ALREADY DEVELOPED
SUCH ALTERNATE VASCULAR PATHWAYS OFTEN DEVELOP
OVER A PERIOD OF TIME WHEN AN ATHEROSCLEROTIC
CONSTRICTION HAS PROGRESSED SLOWLY
OR THEY MAY BE INDUCED BY SUSTAINED DEMANDS ON A
HEALTHY HEART THROUGH A REGULAR AEROBIC EXERCISE PROGRAM

HOMEOSTASIS
WALTER B. CANNON – The Wisdom of the Body (1932)
HANS SELYE – The Stress of Life (1956)
THE WISDOM OF THE BODY SPEAKS TO
THE BODY’S INNATE ABILITY TO ADAPT
IN ORDER TO PRESERVE THE CONSTANCY OF ITS INTERNAL ENVIRONMENT
OR, IF THAT CONSTANCY IS DISRUPTED, TO RESTORE IT
THE CAPACITY OF THE BODY TO MANAGE THE IMPACT
OF ENVIORNMENTAL CHALLENGE IS ULTIMATELY A STORY
ABOUT THE BODY’S ADAPTIVE (HOMEOSTATIC) MECHANISMS
THE LIVING SYSTEM’S EVOLUTIONARILY ANCIENT ABILITY TO
MAINTAIN ITS BALANCE IN THE FACE OF ONGOING ENVIRONMENTAL CHALLENGE
BALANCE ACHIEVED BY WAY OF CONTINUOUS
PROCESSING, INTEGRATION, AND ADAPTATION
ENVIRONMENTAL CHALLENGES THAT CANNOT BE MANAGED
CONSTITUTE TRAUMATIC STRESS
THOSE CHALLENGES THAT CAN BE MANAGED
CONSTITUTE OPTIMAL STRESS AND ARE THE OCCASION
FOR THE EVOLUTION OF THE MINDBODY MATRIX
TO EVER HIGHER LEVELS OF ORDER, COMPLEXITY, AND INTEGRATION

GROUND REGULATION SYSTEM
ALBERT SZENT – GYORGYI, HARTMUT HEINE, ALFRED PISCHINGER,
ROBERT BECKER, FRITZ – ALBERT POPP, AND JAMES OSCHMAN
RESEARCH SCIENTISTS DEDICATED TO UNDERSTANDING,
ON BOTH A MOLECULAR AND A SUBMOLECULAR LEVEL,
THE COMPLEX WORKINGS OF THE HIGH – SPEED, BODY – WIDE
INFORMATION AND ENERGY DISSEMINATION SYSTEM
RESPONSIBLE FOR THE MAINTENANCE OF HOMEOSTASIS
VARIOUSLY DESCRIBED AS THE GROUND REGULATION SYSTEM,
THE EXTRACELLULAR MATRIX, THE CONNECTIVE TISSUE MATRIX, AND THE LIVING MATRIX
A VAST INTERCONNECTED NETWORK OF MOLECULES WITHIN WHICH
ALL THE BODY’S CELLS, TISSUES, AND ORGANS ARE EMBEDDED
AND THROUGH WHICH THE FLOW OF LIFE TAKES PLACE
COMPRISED OF A CONTINUOUS MESHWORK OF COLLAGEN FIBRILS
AND AN AMORPHOUS COLLOIDAL GROUND SUBSTANCE
(CONTAINING LARGE SUGAR – PROTEIN COMPLEXES – PG / GAGs)
IN PRECISE AND INTIMATE RELATIONSHIP
WITH ORGANIZED LAYERS OF ELECTRICALLY CHARGED WATER
THIS LIVING MATRIX CONSTITUTES A BODY CONSCIOUSNESS
WORKING IN TANDEM WITH THE BRAIN CONSCIOUSNESS
OF THE NERVOUS SYSTEM

GROUND REGULATION SYSTEM
HOMEOSTASIS WAS THOUGHT BY CANNON AND SELYE
TO INVOLVE REGULATORY ORGAN SYSTEMS
(ESPECIALLY THE NERVOUS AND ENDOCRINE SYSTEMS)
BUT ALFRED PISCHINGER WAS ABLE TO DEMONSTRATE THAT
NERVE ENDINGS AND CAPILLARY BEDS NEVER ACTUALLY HAVE
DIRECT CONTACT WITH FUNCTIONING (PARENCHYMAL) CELLS,
THAT THE NERVOUS AND ENDOCRINE SYSTEMS COMMUNICATE WITH
THESE CELLS ONLY BY WAY OF THE GROUND REGULATION SYSTEM
THE HEALTHIER THE MATRIX,
THE MORE EFFECTIVE THE RELAYING
OF NEURAL AND HORMONAL MESSAGES BETWEEN
THE REGULATORY ORGAN SYSTEMS AND THE PARENCHYMAL CELLS
THE PRESERVATION OF HOMEOSTASIS IS ULTIMATELY A STORY ABOUT
THE GROUND REGULATION SYSTEM / THE LIVING MATRIX
ALFRED PISCHINGER – Matrix and Matrix Regulation: Basis for a Holistic Theory in Medicine (1991)
FURTHERMORE, MOST LOWER ANIMALS (e.g., SEA SPONGES AND CORALS),
ALTHOUGH LACKING NERVOUS SYSTEMS, ARE NONETHELESS ABLE TO PRESERVE
THEIR HOMEOSTATIC BALANCE BY ADAPTING TO CHANGING ENVIRONMENTAL CONDITIONS –
PERHAPS BECAUSE OF THEIR SELF – REGULATORY GROUND REGULATION SYSTEMS?

ORDEREDNESS AND EASE
OF FLOW WITHIN THE MATRIX
THE THERAPEUTIC ACTION INVOLVES FACILITATING
THE FLOW OF INFORMATION AND ENERGY
THROUGHOUT THE ENTIRE FABRIC OF THE BODY
IN ORDER TO FACILITATE THE SYSTEM’S
PROCESSING AND INTEGRATION OF ENVIRONMENTAL CHALLENGE
AND THE PRESERVATION OF HOMEOSTATIC BALANCE
THE MORE ORDERED THE CRYSTALLINE MATRIX
THE MORE FLUID WILL BE ITS FLOW
THE MORE COHERENT WILL BE ITS ENERGETIC SIGNALS
THE MORE OPTIMAL WILL BE ITS FUNCTIONALITY
THE MORE BALANCED AND HARMONIOUS WILL BE
ITS OVERALL HEALTH AND VITALITY
GOOD HEALTH IS A STORY ABOUT ORDEREDNESS AND EASE OF FLOW
BAD HEALTH IS A STORY ABOUT DIS – ORDER AND DIS – EASE
(DISRUPTED ORDER AND DISRUPTED EASE OF FLOW)

THERAPEUTIC INTERVENTIONS
TO RESTORE HOMEOSTASIS
PRESENCE OF BAD MUST BE DETOXIFIED
(e.g., CHELATION, DETOX FOOT PADS, IONIC FOOT BATHS, COLONICS)
TO LIGHTEN THE TOTAL BODY LOAD AND RESTORE THE FLOW
ABSENCE OF GOOD MUST BE SUPPLEMENTED
(e.g., OXYGEN THERAPY, LOVE, SUPPORT, PROBIOTICS, ORGANIC FOOD, ANTIOXIDANTS,
NUTRITIONAL SUPPLEMENTATION, PHYTONUTRIENTS, ADAPTOGENS, ALKALINE WATER,
RESTFUL SLEEP, LIGHT BOX, EARTHING, NEODYMIUM MAGNETS)
TO REPLENISH THE TOTAL BODY RESERVES AND RESTORE THE FLOW
SOME INTERVENTIONS DO BOTH – GET BAD OUT AND GET GOOD IN
(e.g., SENSORIMOTOR PSYCHOTHERAPY, EMDR, PSYCHOMOTOR PSYCHOTHERAPY,
SOMATIC EXPERIENCING, PSYCHOANALYSIS, YOGA, AEROBIC EXERCISE,
FAR INFRARED SAUNAS, DEEP TISSUE MASSAGE, LYMPHATIC DRAINAGE, CHI MACHINE,
CRANIOSACRAL THERAPY, REIKI, SHIATSU, FREQUENCY SPECIFIC MICROCURRENT,
TRADITIONAL CHINESE MEDICINE ACUPUNCTURE, THERAPEUTIC TOUCH, CHIROPRACTIC)
ALL WITH AN EYE TO RESTORING THE EASE OF FLOW OF
REGULATORY INFORMATION AND VIBRATORY ENERGY
AND TO BOLSTERING THE SYSTEM’S CAPACITY
TO PROCESS AND INTEGRATE THE IMPACT OF ENVIRONMENTAL IMPINGEMENT,
THEREBY AVOIDING TRAUMATIZATION AND PROMOTING OPTIMIZATION
LIGHTENING THE BODY LOAD AND REPLENISHING THE BODY RESERVES
WILL REINFORCE THE SYSTEM’S RESILIENCE
AND CAPACITY TO TOLERATE THE STRESS(ORS) OF LIFE

THE CAPACITY TO
COPE WITH STRESS
A REFLECTION OF UNDERLYING HEALTH
THE CAPACITY TO TOLERATE STRESS IS ULTIMATELY A STORY ABOUT
THE ABILITY OF THE MINDBODY MATRIX TO PROCESS AND INTEGRATE
THE IMPACT OF ENVIRONMENTAL PERTURBATION,
WHICH IN TURN WILL BE A REFLECTION OF THE UNDERLYING
ORDEREDNESS AND FLUIDITY OF THE LIVING SYSTEM
AND THE EASE WITH WHICH
REGULATORY INFORMATION AND VIBRATORY ENERGY
CAN BE PROPAGATED THROUGHOUT ITS EXPANSE
LACK OF ORDER AND DISRUPTED EASE OF FLOW
MANIFESTING AS “DIS – ORDER” AND “DIS – EASE”

HOW DOES COHERENCE EMERGE FROM CHAOS?
THE EVOLUTION OF A SELF – ORGANIZING SYSTEM FROM CHAOS
TO COHERENCE IS NOT SIMPLY A MONOTONIC PROGRESSION
(THE ORDEREDNESS OF THE SYSTEM CONSISTENTLY INCREASING AND NEVER DECREASING),
THE SYSTEM ADVANCING IN A FAIRLY STRAIGHTFORWARD FASHION
BY WAY OF DIRECT INPUT FROM THE ENVIRONMENT
IT IS NOT ALWAYS TRUE THAT THE GREATER THE INPUT, THE MORE DRAMATIC THE RESULT;
THAT THE HIGHER THE DOSE OF PROZAC, THE BETTER THE ANTIDEPRESSANT EFFECT; OR
THAT THE HIGHER THE DOSE OF OMEGA – 3 EFAs, THE MORE ROBUST THE RESPONSE
RATHER, THE EMERGENCE OF COHERENCE FROM CHAOS
IN A SELF – ORGANIZING SYSTEM IS LESS PREDICTABLE THAN THAT,
MORE ERRATIC, UNEXPECTED, UNPREDICTABLE,
THE SYSTEM, IN RESPONSE TO ENVIRONMENTAL INPUT,
ADVANCING IN A NONLINEAR FASHION
BY WAY OF ONGOING CYCLES OF DISRUPTION AND REPAIR,
DISORGANIZATION AND ADAPTIVE RECONSTITUTION
AT EVER HIGHER LEVELS
NOT JUST IN SPITE OF THE IMPACT OF ENVIRONMENTAL STRESSORS
BUT BY WAY OF THAT IMPACT …

PARADOXICAL IMPACT OF STRESS
LONG FASCINATING TO CHAOS THEORISTS HAS BEEN THE SANDPILE MODEL,
THE EVOLUTION OF WHICH IS GOVERNED BY SOME COMPLEX MATHEMATICAL FORMULAS
BUT THE MODEL, THOUGH WELL – KNOWN IN MANY ACADEMIC CIRCLES,
HAS BEEN RARELY APPPLIED TO THE LIVING SYSTEM
THE SANDPILE MODEL IS
A WONDERFUL VISUAL METAPHOR FOR THE ABILITY OF A
SELF – ORGANIZING SYSTEM TO RECONSTITUTE AGAIN AND AGAIN
AT EVER HIGHER LEVELS OF ORDER AND COMPLEXITY
NOT JUST IN SPITE OF INPUT FROM THE OUTSIDE
BUT BY WAY OF THAT INPUT
THE GRAINS OF SAND BEING ADDED ONE AT A TIME
TO THE GRADUALLY EVOLVING SANDPILE
ARE THE OCCASION FOR BOTH PARTIAL COLLAPSE AND
ADAPTIVE RE – EQUILIBRATION AT A NEW SET POINT
IN ESSENCE, STRESS PROMPTS BOTH DISRUPTION AND REPAIR
NOT ONLY WILL ENVIRONMENTAL STRESSORS
PRECIPITATE BREAKDOWN OF THE SYSTEM
BUT THEY WILL BE THE MEANS BY WHICH THE SYSTEM
WILL BE ABLE TO BUILD ITSELF BACK UP
THIS TIME AT A HIGHER LEVEL !

EVOLUTIONARY PROCESSES
FROM CHAOS TO COHERENCE
THE EMERGENCE OF EVER MORE COHERENT STRUCTURES, PROPERTIES, PATTERNS, THEMES,
CONFIGURATIONS, REPETITIONS, THAT REFLECT THE INTEGRATED WHOLENESS OF A SYSTEM
THE DEVELOPMENTAL PROCESS / THE HEALING PROCESS
THE THERAPEUTIC PROCESS / THE WORKING – THROUGH PROCESS / THE GRIEVING PROCESS
THE LEARNING PROCESS / THE THOUGHT PROCESS
THE CREATIVE PROCESS / THE WRITING PROCESS
COME TO THE EDGE by CHRISTOPHER LOGUE (2004)
COME TO THE EDGE – WE MIGHT FALL
COME TO THE EDGE – IT’S TOO HIGH!
COME TO THE EDGE! – AND THEY CAME, AND HE PUSHED, AND THEY FLEW.
ALL SUCH TRANSFORMATIVE PROCESSES INVOLVE
GRADUAL EVOLUTION OF A SELF – ORGANIZING SYSTEM
TO EVER MORE COMPLEX AND NOVEL STRUCTURAL CONFIGURATIONS
THE EVOLUTION OF THESE COMPLEX ADAPTIVE SYSTEMS
INVOLVES WORKING THROUGH RECURSIVE CYCLES
OF DISORGANIZATION AND REORGANIZATION,
DISRUPTION AND REPAIR, CHALLENGE AND RECOVERY,
EVERY ITERATION ACCOMPANIED BY ADAPTIVE RECONSTITUTION
AT EVER NEWER BALANCE POINTS AND EVER HIGHER LEVELS

CHALLENGE AND SUPPORT
THE WORKING THROUGH OF TRAUMA INVOLVES
A DELICATE BALANCE BETWEEN CHALLENGE AND SUPPORT
THE THERAPIST, EVER ATTUNED TO THE PATIENT’S
CAPACITY TO TOLERATE STRESS, WILL ALTERNATELY
CHALLENGE (WHEN POSSIBLE) AND SUPPORT (WHEN NECESSARY)
CHALLENGE WITH ANXIETY – PROVOKING INTERPRETATIONS
THAT DIRECT THE PATIENT’S ATTENTION TO WHERE SHE ISN’T
SUPPORT WITH ANXIETY – ASSUAGING EMPATHIC INTERVENTIONS
THAT RESONATE WITH WHERE THE PATIENT IS
CHALLENGE WITH INTERPRETATIONS IN AN EFFORT TO TRIGGER
SELF – REGULATORY, COMPENSATORY, HOMEOSTATIC MECHANISMS
THAT WILL PROMPT THE BODY ADAPTIVELY TO RECONSTITUTE
AT A HIGHER LEVEL OF PSYCHOLOGICAL SOPHISTICATION,
EMOTIONAL MATURITY, AND INSIGHT
SUPPORT WITH INTERVENTIONS THAT WILL EASE THE PATIENT’S
ANXIETY AND RESTORE HER CAPACITY TO ADAPT TO
THE IMPACT OF THERAPEUTIC INPUT

A DELICATE BALANCE
BETWEEN CHALLENGE AND SUPPORT
CHALLENGE (WHEN POSSIBLE) AND SUPPORT (WHEN NECESSARY)
INTERVENTIONS TO WHICH THE PATIENT WILL RESPOND BY EITHER
BECOMING DEFENSIVE OR ADAPTING AT A HIGHER LEVEL
CHALLENGE – DISRUPT – SUPPORT – RECONSTITUTE
CHALLENGE – DEFEND – SUPPORT – ADAPT
AGAIN, WHAT PROMPTS TRANSFORMATION AND GROWTH?
THE EXPERIENCE OF GRATIFICATION?
OR THE OPPORTUNITY TO WORK THROUGH (OPTIMAL) FRUSTRATION?
IS IT SIMPLY REGULATORY INPUT FROM THE OUTSIDE
THAT PROMOTES GROWTH AND HEALING?
OR IS IT THE WORKING THROUGH OF DISRUPTIONS
OCCASIONED BY THAT REGULATORY INPUT
THAT PROMOTES GROWTH AND HEALING?
THE THERAPIST ATTEMPTS TO DO THE BEST THAT SHE CAN,
BUT EVEN MORE THERAPEUTIC
MAY BE THE “MISTAKES” THAT SHE MAKES …

REGULATORY INPUT FROM THE OUTSIDE
WHAT MAKES IT “GOOD”?
WHAT MAKES IT “BAD”?
“THE DIFFERENCE BETWEEN A MEDICATION AND A POISON IS THE DOSAGE THEREOF.”
PARACELSUS
WHAT MAKES AN INTERVENTION THERAPEUTIC? WHAT MAKES IT TOXIC?
WE MUST CONSIDER BOTH THE PRIMARY ACTION OF THE AGENT
AND THE SECONDARY REACTION OF THE SYSTEM
AN AGENT IS INHERENTLY NEITHER “GOOD” NOR “BAD”
RATHER, IT’S HOW THE AGENT ULTIMATELY IMPACTS THE SYSTEM
(i.e., THE SYSTEM’S ABILITY TO PROCESS AND INTEGRATE THAT IMPACT)
THAT WILL MAKE THE DIFFERENCE BETWEEN
A THERAPEUTIC OUTCOME AND A TOXIC OUTCOME
AND MAKE OF THE AGENT EITHER A MEDICATION OR A POISON
PROZAC CAN BE MEDICATION OR POISON
ARSENIC CAN BE MEDICATION OR POISON

REGULATORY INPUT FROM THE OUTSIDE
WHAT MAKES IT GOOD?
WHAT MAKES IT BAD?
ALL REGULATORY INPUT FROM THE OUTSIDE
(BE IT ULTIMATELY GOOD OR BAD)
PROMPTS INITIAL DISRUPTION OF THE STATUS QUO
(BE THAT EXISTING STATE CHAOTIC OR COHERENT)
AND, AT EACH BIFURCATION POINT
AS THE SYSTEM BEGINS ITS DECLINE,
EITHER ADAPTIVE REORGANIZATION
OR FURTHER DISORGANIZATION AND DECLINE
A COMPLEX INTERPLAY OF FACTORS,
INCLUDING THE DOSAGE OF THE AGENT
AND THE UNDERLYING RESILIENCE OF THE SYSTEM,
WILL DETERMINE THE FINAL OUTCOME,
THAT IS, WHETHER THE SYSTEM
WILL BE ABLE TO BENEFIT FROM THE INTERVENTION
OR WHETHER THE INTERVENTION
WILL PROMPT FURTHER DECLINE

“AND NOW HERE’S MY SECRET, A VERY SIMPLE SECRET:
IT IS ONLY WITH THE HEART THAT ONE CAN SEE RIGHTLY;
WHAT IS ESSENTIAL IS INVISIBLE TO THE EYE.”
THE LITTLE PRINCE
ANTOINE DE SAINT - EXUPERY

Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx

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Martha Stark MD – 26 Jun 2009 – Murmur of the Heart.pptx