January 2009 Newsletter
A Newsletter for Integrative Treatments

Complementary treatments can be integrated with conventional medical practices to offer patients the best of both worlds. As clinician/researchers we seek new approaches to relieve emotional and physical problems while reducing medication side effects. The goal of this newsletter is to share with you Integrative Treatments we find to be safe and beneficial. We welcome your comments and contributions.

Home Run/Slam Dunk for SAMe

Those of you who received our Nov 2009 issue will recall our comment on an article in the October 2009 issue of Clinical Psychiatry News (Vol.37 No.10 pp. 1-2) discussed emerging evidence for the role of mitochondrial dysfunction in unipolar and bipolar depression and the potential benefit of medications such as mitochondrial-targeted antioxidants. We objected to the physician who discouraged the use of SAMe (S-adenosyl-L-methionine) because of concerns that SAMe could elevate homocysteine levels. While SAMe has been used to relieve depression and arthritis for 20 years and has been tested in more than 80 clinical trials involving over 24,000 people, there have been no case reports of homocysteine elevation. At last, a research team at the Mayo Clinic, Rochester, Minnesota led my Dr. Michael A. Thompson, completed a double-blind placebo-controlled randomized study of 62 adults given either SAMe (AdoMet) 800 mg/day or placebo. They found no significant difference in homocysteine levels or changes in homocysteine levels between the two groups after 4 weeks. In fact, the person with the highest homocysteine level at baseline actually showed a decrease in level after 4 weeks of SAMe. While someone might still argue that doses above 800 mg/day of SAMe might cause homocysteine elevations, they should provide credible evidence from clinical trials to support such a claim. Dr. Thompson’s article appears in THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Vol 15, No. 5, 2009, pp 523-529.

Dr. Patricia Gerbarg will be the guest of Harry Croft, MD on Healthy Place TV, Tuesday, January 12, 2010, from 6 pm to 7 pm EST at healthyplace.com/mental-health-tv-show. The show will focus on natural and integrative treatments for mental health conditions. Dr. Gerbarg will provide a glimpse into integrative treatments, combining herbs, nutrients, and mind-body practices with standard approaches to improve outcomes and minimize medication side effects. She will discuss best treatments for anxiety, PTSD, depression, brain function, fatigue, and post-Lyme recovery. Viewers will be able to ask questions by visiting: healthyplace.com/mental-health-tv-show. The show will be archived for those who cannot see it live.

Post-Doctoral Fellowship in Neurobiology of Yoga

Applications are now being accepted for a post-doctoral fellow to conduct research into the Neurobiology of Yoga at Massachusetts General Hospital (Harvard Medical School). The successful candidate will conduct research evaluating the neurobiological basis of yoga, and to assess the impact of yoga on changes in emotion and cognition. The study combines functional and structural MRI measures as well as behavioral and physiological assessments. Completed graduate training in psychology, neurobiology, or the equivalent is required, as well as experience with functional or structural MRI and a regular yoga practice. There is a competitive salary with excellent benefits. Send a statement of research interests, curriculum vitae, and the names and addresses of 3 references by Jan 30th to: Dr. Sara Lazar PhD, Massachusetts General Hospital, Charlestown, MA 02129
lazar@nmr.mgh.harvard.edu. www.nmr.mgh.harvard.edu/~lazar

Dr. Richard Brown Offers Space in His Manhattan Office

Looking to rent one comfortable, large, sunny psychotherapy office in a ground floor suite staffed by psychiatrists and psychologists at 30 East End Avenue (between 80th and 81st). Spacious waiting area with 2 bathrooms for clients. Utilities (A/C, electric, water), maintenance and cleaning included. Currently available all day Monday, Tuesday, Wed, Friday, Sat, Sun, and Thursday after 6 PM. Contact: Dr. James Spencer at 212-249-3160.

Current Projects & Workshops with Service Organizations
Highlighting the work of service organizations interested in providing
integrative treatments to those in need.

National Veterans Foundation
9841 Airport Blvd Suite 512, Los Angeles, CA 90045 www.nvf.org or 888-777-4443 (help line)

Among the many services it provides, NVF is developing pilot projects using mind-body practices to help veterans and their families recover from the emotional scars of their war experiences.

The mission of the NVF:

To Serve the crisis management, information and referral needs of all U.S. Veterans and their families through: Management and operation of the nation’s only toll-free helpline for all veterans and their families.

Public awareness programs that shine a consistent spotlight on the needs of America’s veterans. Outreach services that provide veterans and families in need with food, clothing, transportation, employment, and other essential resources.

The founder of the National Veterans Foundation, Floyd ‘Shad’ Meshad has been working with Veterans since 1970. Meshad was a Medical Service Officer during the Vietnam War, where he counseled soldiers in the field who were suffering from a psychological and emotional problems resulting from their experiences in combat.

In 1985, Shad founded The Vietnam Veterans Aid Foundation (VVAF), a non-profit, 501- c (3) human service organization to help veterans and families. The VVAF established the first toll-free helpline in 1987 offering nationwide benefits information, resource referral, and crisis counseling. In 1992, the VVAF formally became the National Veterans Foundation.
Staffed by veterans (from Vietnam, the Cold War, Desert Storm, Bosnia, Iraq, and Afghanistan) who are specially trained in the delivery of crisis information and referral services, as well as licensed volunteer counselors to whom all crisis calls are routed, the NVF has served more than 275,000 veterans in need of medical treatment, substance abuse or PTSD Counseling, VA benefits advocacy, food, shelter, employment training, legal aid, or suicide intervention. NVF has provided financial assistance, training, and donations of food, clothing, and other goods to other non-profits serving the veterans’ including New Directions (CA), The Marine Corps Scholarship Foundation (NJ), LA County Department of Military and Veterans Affairs (CA), Desert Storm Justice Foundation (OK), Point Man of Northern California (CA), Veterans Coalition of the Hudson Valley (NY), Westside Stand Down (CA), Stamford Homeless Project (CT), US VETS (CA), and Swords to Plowshares (CA), among many others. The U.S. Government sought Shad Meshad’s expertise in PTSD to provide training to counselors at Ground Zero after the terrorist attacks of September 11, 2001. The NVF is committed to developing the most effective means to help those who have served our country and their families. The NVF is open to all who seek emotional support and other assistance.

Serving Those Who Serve

Serving Those Who Serve (STWS) is a non-profit group providing services to people who are still suffering from physical and emotional illnesses related to the NY September 11th World Trade Center Attacks. The 9/11 Community includes First Responders, Ground Zero workers, WTC workers, and area residents. STWS sponsors our new Breath~Body~Mind™ program for relief of physical and emotional distress as well as for personal development. Workshops are open to the public and a portion of the profits are donated to STWS. In addition to positive feedback from participants, our preliminary research data indicate significant improvement in measures of anxiety, depression and post-traumatic stress symptoms (Martin Katzman and Monica Vermani, in process). See www.stws.org.

STWS also provides Drs. Pankaj and Smita Naram’s Ayurvedic herbs (at cost) to help detoxify people exposed to chemical fumes from the WTC attacks and from working at Ground Zero. James J. Dahl, Ph.D., Research Director, Phoenix House Foundation, and Dr. Katherine Falk reported on a web-based survey of 50 people affected by the WTC attacks who were treated with these Ayurvedic herbs. All 50 respondents reported significant improvements in long standing, intractable respiratory symptoms, fatigue, and depression that had not responded to standard treatments. This article appeared in Alternative Therapies in Health and Medicine. Jan/Feb 2008; 14(1):24-48. Correspondence: jdahl@phoenixhouse.org For Dr. Naram see: (www.ayushakti-usa.com).

Breath~Body~Mind Courses with Dr. Richard Brown

Dr. Brown teaches a fusion of modern and ancient practices to rapidly balance the stress response system, relieve stress and anxiety, and enhance physical and mental health. Training includes QiGong breathing and movement, Christian monk breath moving techniques, Coherent Breathing, and Open Focus Meditation. Proceeds from these courses will be used to benefit the 9/11 Community.

Manhattan, NY. Save the Dates: May 1 and May 2

Location and details to be announced. This will be the first Breath~Body~Mind Workshop open to the public, health practitioners, and members of the 9/11 community to be given in NYC in 2010. Proceeds will benefit Serving Those Who Serve. Watch for registration information in April at www.stws.org.

Professional Lectures and Conferences

Integrative Healthcare Symposium
February 25, 2010 at the Hilton New York
9:00 – 10:30 am Plenary Session Brain and Mind Health: Roberta Lee, MD (mod), David Perlmutter, MD, Richard Brown, MD, Jay Lombard, DO
4:30 – 5:45 pm Richard P Brown, MD CAM Practice Movement and Breathing Information & Registration: http://www.ihsymposium.com/

March 6 2010, Anxiety Disorders Association of America
Baltimore Marriott Waterfront, Baltimore, MD.

Session #150 Title: Breath-Body-Mind™ Practices for Treatment of Anxiety Disorders
Richard Brown, Patricia Gerbarg, Martin Katzman, Monica Vermani
3/6/2010 10:30:00 AM - 12:00:00 PM

Integrative treatments are needed to improve outcomes for anxiety disorders and to reduce the burden of medication side effects. By combining specific mind-body practices with standard treatments (psychotherapy, CBT, and medication) it is possible to obtain more rapid and more complete resolution of symptoms. Mental health practitioners are subject to caregiver stress and burn-out. Mind-body practices can help protect caregivers from the effects of professional stress. The goals of this symposium are to present the theoretical background, research evidence, and clinical applications of powerful self-regulation strategies to enable participants to improve their own well-being and the mental health of patients suffering from anxiety disorders including Generalized Anxiety Disorder and Post Traumatic Stress Disorder due to childhood abuse, military service, and mass disasters. How to build upon this knowledge and use it in clinical practice will be discussed.

Session# 195 Experiential Training in Breath-Body-Mind™ Practices for Stress Reduction
Richard Brown, Patricia Gerbarg
3/6/2010 4:00:00 PM - 5:30:00 PM
Information & Registration: www.adaa.org

March 17-19, 2010 Integrative College of Integrative Medicine
Nashville Airport Marriott, Nashville, TN
March 19 11:00am – 12:15pm Movement and Breathing: Keys to Health
Richard Brown & Patricia Gerbarg
Information & Registration: www.IntegrativeMedicineConference.com

March 26-27 Psychotherapy Networker Symposium: The Power of the Breath Neurophysiological Tools for Self-Regulation
Omni Shoreham Hotel, Washington, DC
March 28 All-Day Workshop 10:30am–12:30pm and 1:30–3:30pm: Breath-Body-Mind Practices for Caregivers and Clients to Enhance Empathy and Relieve Stress, Anxiety, and PTSD
Richard Brown MD and Patricia Gerbarg MD

There may be no clinical strategy as simple, effective, and useful as teaching clients soothing and healing breathing techniques. In fact, there’s now a large body of research demonstrating that a few easily learned breathing practices have powerful self-regulating effects that often quickly alleviate the symptoms of stress, insomnia, pain syndromes, anxiety disorders, and treatment-resistant PTSD without medication. In this workshop, we’ll review the neurophysiological research demonstrating the effectiveness of breathing techniques and their impact on cardiopulmonary function and the parasympathetic nervous system. You’ll learn a range of experiential breath-body-mind techniques, including “coherent” or “slowing down” breathing, Breath Moving, “ocean breathing”—a Yoga-based practice—and Open-Focus meditation. We’ll then explore a variety of strategies for integrating these tools into work with anxious and traumatized clients.

Information & Registration: www.psychotherapynetworker.org

April 16 Ackerman Institute, New York
10:00 am – 4: 00 pm Richard Brown, MD
Information & Registration: www.ackerman.org

May 7, 2010 Neuropsychoanalytic Study Group, New York
Sponsored by The National Psychological Association for Psychoanalysis
1:45-3:00 pm Neuro-psychoanalysis and Yoga for Treatment of PTSD
Patricia Gerbarg, MD
Information : Neruro.NPAP@gmail.com or 212-288-0760

May 22-235, 2010 American Psychiatric Association Annual Meeting
New Orleans
Information & Registration: www.psych.org

Full Day Course #CO07 Saturday, May 22 9am-4pm: Complementary and Integrative Treatments for Stress, Depression, Anxiety PTSD, Mass Trauma, Cognitive Function, ADD, and Schizophrenia

Participants will learn how to integrate complementary treatments with standard treatments in psychiatry practice. The course focuses on research and clinical applications of complementary treatments for which there is sufficient evidence of safety and efficacy. The authors have selected those treatments that are the most useful for clinicians to integrate into their practices from the following categories: herbs, adaptogens, nutrients, nootropics, hormones, mind-body practices, cranial electrotherapy stimulation, and neurotherapy. Evidence for efficacy and clinical practice guidelines for integrative approaches will include the following diagnostic categories: Anxiety Disorders, PTSD, Depression, Bipolar Disorder, Cognitive Enhancement, Brain Injury, ADD, and Schizophrenia.Participants will have an introduction to the experience breath techniques that rapidly relieve stress and anxiety.

Full Day Course #CO28 Sunday, May 23 2010, 9am-4pm: Yoga of the East and West: Integrating Breath Work and Meditation into Clinical Practice: Participants will learn the theoretical background and applications of two powerful self-regulation strategies to improve their own well-being and the mental health of their patients. A program of non-religious practices will enable participants to experience “Coherent Breathing,” Victorious Breath, Bellows Breath, and “Open Focus” meditation. Through a sequence of repeated rounds of breathing and meditation with gentle movements and interactive processes, participants will discover the benefits of mind/body practices. How to build upon this knowledge and use it in clinical practice will be discussed. An in-depth case of a patient with posttraumatic stress disorder who benefited from the addition of yoga breathing to her ongoing therapy will be explored from the perspective of neuro-psychoanalytic theory. This will also highlight clinical issues to consider when introducing mind/body practices in treatment. This course builds upon introductory material presented in the Course “Complementary and Integrative Treatments for Stress, Anxiety, Post-traumatic Stress Disorder, Depression, Bipolar, Cognitive Enhancement, Brain Injury, Attention Deficit Disorder, and Schizophrenia.” This course is suitable for novices as well as experienced practitioners.

How to Use Herbs, Nutrients, and Yoga in Mental Health Care, by Richard P Brown, Patricia L Gerbarg, & Phiulip R. Muskin (WW Norton, 2009) available at www.wwnorton.com or amazon.com.

Effects of a Yoga-Breath Intervention Alone and in Combination with an Exposure Therapy for PTSD and Depression in Survivors of the 2004 Southeast Asia Tsunami. Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BNG, Damodaran B, Adelson B, Braslow LH, Marcus M, Brown RP. Acta Psyciatr Scand 2009 [in press].

Richard P Brown and Patricia L Gerbarg. Part I. Longevity and Aging Advancements. Yoga Breathing, Meditation, and Longevity. Annals of the New York Academy of Sciences. 2009, 1172:54-62.

"Yoga for Anxiety and Depression" Harvard Mental Health Letter April 2009 https://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/

Review of How to Use Herbs, Nutrients, and Yoga in Mental Health Care, by Cathy Durga, LA Yoga magazine, June 2009.

About the Authors

Richard P. Brown, MD, Associate Professor in Clinical Psychiatry, Columbia University Medical Center, NY is a psychopharmacologist and a certified teacher of Aikido (4th Dan), Yoga, Qi Gong, and meditation.

Patricia L. Gerbarg, MD, Assistant Professor in Clinical Psychiatry, New York Medical College, has a clinical practice in psychiatry and provides consultation for research on mind-body practices.