Self-Healing

Winning Strategies with Rheumatoid Arthritis

by Meir Schneider and Carol Gallup

Meet t\lz/o u1olnen who II~I\/P cievelopecf t I ? ~ i ir*e ~ ~ e f t ' ( ; c s Having rejected the drugs she was given,
Smart studied her own case and found her
of body, mind and spirit to live full, rich lives- own way to live with the disease. "My back-
ground in psychology-I have a master'-
clespite rhetrmatoid ;trit~rilis. gave me the confidence to look for other
solurions," she said. For years Smart experi-
rnented with self-suggestion, visualization,
and, most successfully, diet. "I never eat
hen Irene Smart was diagnosed cis arises not from intlarnmation alone but cheese; if I eat it at night, I can't move comor-

W with rheumatoid arthritis 13 years from a spiraling cornbination of problems. row. 1 can't ear bread, and the best bread,
ago at age 32, she was offered two Inflammation increases pressure in the joint home-baked with good yeast, is the worst-
very toxic drug therapies, which she refused, capsule; movement becomes unpleasant it cripples me! Cheap bread is safer-it has
and then was given nonsteroidal anti-inflam- because it intensifies the pressure further. The another rising agent, rather than yeast."
matory drugs (NSAIDs), the mildest drug joint becomes immobilized by a protective Some people wirh arthritis have gained
therapy
..
doctors have to offer. "They helped muscle spasm that fixes it in the position of ilnprove~nent from food rotation-avoiding
with the pain and stiffness for a few days,& least internal pressure, usually flexion. Muscle repeating the same food for a period of days
then I needed to increase the dose to get the atrophy develops quickly and limits the range so that toxins can't build up. Others have
same level of relief," Smart said. "I told the of movement. As inflammation spreads into found they need to avoid milk products,
doctor the drugs were making my stomach tissues around the joint-joint capsules, liga- along with members of the nightshade farn-
hurt now, and he prescribed new medicines ments, muscle fascia and tendons-fibrous ily (tomatoes, eggplants and potatoes), alco-
for my stomach. I wouldn't take them. I just connective tissue infiltrates and replaces these hol, caffeine, salt, sugar and smoking. Some
stopped the NSAID drugs abruptly. structures, resulting in permanent shortening find that stress and diet together trigger flare-
"That was a disaster," Smith continued. (contractures). Tendons may rupture, espe- ups; others, char it's mostly diet, or mostly
"The next morning, the stiffness arrived like cially in the hands. Immobility is an element stress. Studies have in~plicateda few foods,
a dead brick. I couldn't move. My husband in every one of these problems; to keep dam- including milk products, and have found
had to move me-he moved my legs, sat me age to the joints minimal, patients urgently that oral zinc and cold-water fish oil are
up, stood m e LIP,and then 1 could walk, need ro keep moving-to change position helpful.
sluggishly. I never took one of those drugs frequently and have regular exercise pro- Smart found it problc~naticto experiment
again." grams. Unfortunately, moving is the last thing will] exercise. "It was unclear whether exer-
In most cases, rheumatoid arthritis does- the patient wants to do, because it hurts too cise or rest was the best way forward," she
n't attack constantly and perpetually; it's much. said. "It wasn't a question of motivation or
interriiitrenr to begin with but becomes T h e strategy of doctors is to reduce pain enough courage to work rhrough rhe pain.
more sustained over time. More rarely, thel-c and inflammation immediately, and keep it Doctors, and my own research, gave me con-
is a nonstop progression that can end in reduced, at all cosrs. 7-his, in their opinion, flicting ;~dvicc;conscq~iently,I under-exer-
death. While the disease is attacking, the necessitates the use of drugs, all ofwhich are ciscd my ni~lscles,and 1 liave a lot of rnusclc
joints need to be protected from lasting, irre- toxic. T h e NSAIDs include aspirin, ibupro- atl-ophy that I needn't liave had."
versible damage, which rakes the forms of fen arid others, which are at the low end in Arthritis specialists roday believe that .I
deformity and destruction. terms of toxiciry, nnd i l ~ i r n ~ suppresso~-s
~ne :it good excrcisc regimcn will srrengthcn thc
According to The Arthritis Sozrrrrhook, co- the high end. Wirh every one of these drugs ri~ucclesa r o ~ ~ nthe d joints, C ~ L I Sreducing
authored by rhvi~rn;~tologist 0.1.Brewel- l r . , p ; ~ t i c n ~arcs ; ~ risk
t fol- damage to thc liver, sti-.rin o n joi~it tissucs . ~ n dpreventing sud-
~ in ~LII-!'. I IIC,.
. 7

M.11.. and nr[hri~ispatie111Kntliy Coclll-.)I) ltid~ic,y\.g:~srl-oinrcsrinalrracr ;rnti orlicr d c 1 1u\c, I ~ C C ~ I ~ ~ I I I!)0t11

C I I ~

Al~gcl.d;l~n;~gcto joints in rhCum,rroid:r~-rhl-i- org.iIi\. ;rnd li;~vcro I,c ~i~oliirorcd Ii-ccl~~c.~irls.

I > ~ \ ! . C I <,\<,I L I<,(, ivl1o11ic ~ - c ~ ~ i ~ l :pr0-lllc~'
 grams using Nautilusm, Cybexm,or similar
equipment, and aerobic exercise-walking,
jogging, treadmill, swimming, bicycling and
Stairmastersm.Their programs also include
warm-ups and cool-downs. When there's a
flare-up, some doctors advise cutting- down
on the number of repetitions but not stop-
ping; others caution patients not to move a
z
joint that's inflamed.
w
uZ Smart started working with Meir
Schneider and with advanced Self-Healing
t
m students near her home in England in 1995.
V)
P0 Schneider gave Smart an exercise program
2 based on gentle movement through many
planes. "It gives people with arthritis some-
thing they lack, a sense of the full movement
that is possible at any joint," Schneider said.
"You'll see misuse of a part of a joint from a
specificangle; for example,' there's a lot of hip
flexion and not enough hip extension.
Continual muscle imbalance around a joint
creates force patterns that eventually destroy
the cartilage. Movement exercises for arthri-
tis first and foremost need to rectify this
imbalance, but too many doctors are giving
programs of exercises in the sagittal plane
that only aggravate the imbalance, creating
additional wear and tear on the joints. And
I feel very strongly that people with arthritis
should not be advised to do power exercises
under any circumstances."
Schneider teaches his clients with arthritis
that their need for movement in an undam-
aging way is continual. "I do movement
exercises all day long for my pain and stiff-
ness," Smart said. "I'm a perpetual motion
machine."
Smart learned that she had to distinguish
between pain of the joints and of muscles. "I
used to get pain with movement and I did
not differentiate," she said. The pain in her
muscles came from spasm; to get her mov-
ing again, it had to be cleared up-a top pri-
ority in arthritis treatment, as Schneider sees
it. "I'll be very gentle with the joint, always,"
he said, "but I may do deep tissue massage
on the muscle to end the spasm and clear up
muscle pain-it's safe. Doctors think arthri-
tis causes muscle spasm, but I disagree; I
think muscle spasm stresses the joints and is
a cause of osteoarthritis, and worsen the
course ofrheumatoid arthritis. It's a mistake,
of course, to look at these things linearly-
muscle spasm and all the other contributing
factors, including an immune system that is
out of balance, aggravate each other."
Schneider's clients learn how to move dur-
ing flare-ups. "I was told by doctors not to
move a joint that's inflamed," Smart said. The
act of using it inflames
the joint [while the dis-
ease is attacking]- and it 1
becomes 'hot.' Meir
showed me how to cool
down an inflamed joint
with cold wet towels and
keep it cool as you move."
Schneider often sees a
"hot" joint next to a mus-
cle in spasm; he'll put a
cold compress on the
joint and a hot one on the
muscle-and the client
can get the movement he
or she badly needs.
Pain relief is available during flare-ups
through breathing/visualization exercises. "I
created the exercises for a state senator from
Alaska with rheumatoid arthritis, years ago,"
Schneider recalled. "I was telling him to
imagine that every joint expands as you
inhale and shrinks as you exhale; his swelling
disappeared for that day. It became our
Breath and Mobility of the Joints audiotape."
This kind of p i d e d meditation goes
beyond pain relief; with rheumatoid arthri-
tis the immune system is attacking the
joints, and you need stress reduction tools-
breathing, imagery and relaxation-to make
immune function more homeostatic.
In acute stages, clients need the full pro-
gram: a meditation like the Breath and
Mobility tape, alternating hot and cold
showers (a few minutes at each temperature
setting), cold compresses on the joints and
heat on muscles that are in spasm. Give the
client pelvic floor exercises, during which the
client exhales, holds the breath and maxi-
mally tightens one sphincter at a time for a
count of 15 before inhaling. (For a complete
description of this exercise, see Issue #62,
JulylAug. 1996). Such exercises are a won-
derful stress reduction tool, since they work
directly on the autonomic nervous system.
Give them gentle, slow movement and pas-
sive movement within pain-free limits or
with very little pain, although when they're
not in a flare-up, it's okay to provoke some
pain. They need isolation exercises (exercises
to isolate the use of just one muscle group.
See Issue #60, MarchlApril 1996, or, for a
fuller treatment, The Handbook of Self-
Healing) and walking barefoot, backward
and forward.
Above all, clients need massage while the
disease is attacking, for stress reduction and
more direct effects. If many joints are at risk,
you'll have to prioritize. Start with joints
Fingertips-only
@urage:
thefingertips are
more sensitive
'
I than the whole
hand thus, very
gentle work with
arthritis is done
with thejngertips.
where mobility is at least 20 percent of nor-
mal, as you're more likely to be able to
increase range of motion there.
"Sometimes your target joint is too ten-
der to be touched," Schneider said. "I've
had students massage [the joint], with a
feather with good results. Usually we loosen
it up first by working on an adjacent joint.
Irene had poor use ofher right elbow in our
first session-the joint was under attack and
deteriorating fast. I started doing massage
and rotations with the shoulder, then the
wrist, then the fingers, and finally the elbow.
We got it back.
"Soon after she went home from this visit,
she found her mother on her deathbed-
and it was up to her to take care of her,"
Schneider said. "What we could do was
retain our improvements, help her through
it, and plan to find new life for her joints
later, when she recovered from her hard
work and gief." Smart feels that "it's been a
long struggle. Self-Healing is helping me
work through it; it's given me a route rather
than a solution." She has continued to take
charge of her own case, enrolling in the Self-
Healing PractitionerlEducator training.
Don't run away from what you feel
When rheumatoid arthritis struck in
1977, Darlene Cohen was a 35-year-old sin-
gle mother of a small child. Almost
overnight her lifestyle changed from "crazed
and overcommitted to "bedridden, unable
to dress myself, lift a telephone receiver or
get up from a toilet seat without help." As in
Smart's case, doctors ~ r o ~ o s drugs
e d to con-
trol the pain and stiffness, warning her that
they were toxic. "I knew that I'd be taking
them for the rest of my life, and I thought I
was too young to begin a regimen that could
destroy my internal organs." Instead, she
chose to work with Schneider.
 Osteoarthritis and Other Arthritises
by Meir Schneuhr and Cdrol Gallup

T he major threat that is common to all of the more than 100

kinds of arthritis is the destruction of joint cartilage. Cartilage
is a shock absorber between bones; when it is destroyed, bone can
der when touched. There is morning or inactivity stiffness, fatigue
and fever.

rub against bone and be eroded. Joint destruction is called
osteoarthritis (OA); another name for it is degenerativejoint disease.
Forty million Americans have OA. It can begin in the 20s; by our
50s, 90 percent of us have some apparent cartilage changes and 20
percent of us are diagnosable with OA. Doctors believe that carti-
lage inevitably frays and wears out with aging; OA, they say, is an
exageration of this "normal" process. Secondary OA can result from
an injury, perhaps many years in the past; a metabolic arthritis like
gout; an infection; a congenital joint defect; or one of the inflarn-
matory arthritises (the major ones are listed below).
Joints are not affected symmetrically. Risk factors for joints
include hypermobility, obesity (OA of the knees), heavy lifting (hips
and knees), and weaving (OA of the dominant hand). OA can cause
bone spurs, sometimes in the spine, where they may impinge on
nerves. With OA, joints ache after exercise and feel better after rest;
stiffness lasts for minutes, and the joints are not usually inflamed
(warm and swollen). The disease can progress until minimal exer-
cise causes pain; at the point where joint pain wakes you and pre-
vents sleep, it's serious. When cartilage has worn away, the result can
be pain, tenderness to the touch, limited range ofmotion, and crepi-
tus, the crunching, grating sound of bone crunching on bone. OA
can become inflammatory in late stages.
One kind of OA in the lumbar spine is degenerative disk disease.
- intervertebral disks in the spinal column are believed
Like cartilage,
by doctors to degenerate inevitably, beginning at early adulthood.
As a complication, the disk may herniate or rupture (herniated disk,
also known as disk prolapse or slipped disk). A strong ligament keeps
it from bulging directly backward, so it moves posterolaterally, where
it may compress or stretch a spinal nenre root. The radiating pain,
muscle weakness and sensory losses that result (always along the dis-
tribution of the spinal nerve) constitute a form of sciatica. The dis-
ease is most prevalent in young men and rare after middle age,
because the disk has lost some of its mass.
While OA is localized and specific, the arthritises described below
are systemic, and may attack other organs of the body. The causes
of these autoimmune disorders (immune cells attack the body's own
tissues) are thought to be genetic predisposition coupled with some
kind ofenvironmental trigger-stress,
-- a virus, diet, and others. With
inflammatory arthritises like rheumatoid arthritis and juvenile
rheumatoid arthritis, joints are painful, red, swollen, warm and ten-
Rheumatoid arthritis
Up to three million Americans, most of them women, have
rheumatoid arthritis (RA).
The joints most often affected, usually symmetrically, are those of
the hands, wrists, knees, elbows, feet, shoulders and hips. As the dis-
ease attacks the synovial membrane, it swells and discharges fluid,
causing the joint to feel "boggy" and "squishy."
Juvenile rheumatoid arthritis
Up to 200,000 American children have one of about 100 kinds
of arthritis; half of them, predominantly girls, have juvenile rheuma-
toid arthritis (JRA). Like rheumatoid arthritis, the disease predom-
inantly attacks the legs and arms, especially the wrists and fingers.
In general, the outlook is brighter 'For JRA than for rheumatoid
arthritis. Severityvaries among the three kinds of JRA; the least com-
mon varlety can be fatal.
Ankylosing spondylitis
Unlike rheumatoid arthritis and juvenile rheumatoid arthritis,
ankylosing spondylitis (AS) does not attack the synovial membrane;
instead it attacks the insertions of joint capsules, ligaments, tendons
and fascia. Inflammation of these tissues leads to fibrous replacement
and then bony replacement. As AS spreads upwards along the spine,
the soh tissues of joint structures ossify, until the entire spine may
be fused into flexion. Other joints may be affected, most commonly
the hips. About two million Americans, more than 75 percent of
them men, have the disease. Some loss of breathing capacity usually
occurs.
These patients need spinal extension and breathing exercises. The
disease is active for about 10 years.
Systemic lupus erythematosus
About 100,000 Americans, 90 percent of them women, have sys-
temic lupus erythematosus (SLE); the disease usually strikes during
the childbearing years. There is a characteristic red butterfly rash
across the cheeks. SLE causes joint pain, and can damage and
deform joints. The damage to other organs is more dangerous and
may even be fatal--especially kidneys, heart and blood vessels, lungs,
digestive organs and brain (causing depression and psychosis and a
wide range of serious neurological problems).

"I was surprised whclt h4cir encournged
nle to feel, rather t h a n deny, my pain 2nd
restrictio~is.He said that only by starting
with this much awareness could I get access
to the information that would alter my suf-
fering." Coheii showed eno~-~nous talent in
finding small, painfrre movements and
enlarging them through 111-eacha n d visu;~l-
ization; within a few r n o ~ i r h sshc w:~s n o
longer bedridden. <:l-c;tring hcl- own csc.1.-
cises>"I \\,;IS :tI>leto rc<.l,ti111r i l o r c .111cirllorc
activities of my life as my body loosened and tion and pain management in her own right,
strengthened. Meir refused to heal me; he offering lectures, workshops, materials and
insisted I heal myself." Schneider urged her client sessions. Cohen offers her clients xnd
to take LIP his work. "He ~~nderstood,"audiences with arthritis and chronic pain n
Cohen said, "what a storehouse of informa- program she calls "the relentless pursuit of
tion a h o ~ al-thritis ~t my body had bcconle pleasure." There at-e five major emphases:
and how useful it might be to othel-s." 1 ) Gcr tllc deeply satisfjing feeling of
Shc became a student, then a therapist in heing in contl-ol of your o\vn life: Bc a n
SelI-Hc;lIing.AI~-cndy cl-edenrialcdwirh 3 mas- acti\,c lx~rticipnnri n .III the important dcci-
ter's in l>llysioloSicall~sycholoL~, she I~ecarnc. ;I \ions, i n c l t ~ d i nhc;~ltl~
~ care. Activel!l enS;lg-
r I l c i . . ~ ~ ) i h ccI~~c;~ror
~. ,111d.tu[1101- i l l rcll;~Oilit;t- ins l ) ~ - o l ~ l cr G
~ ~
~ t l
~ , c~, i\~
. I ~ ; I I ,,~\.oicii~ls
tIic111
 changes your body's hiocl~emistryand raises Tyyes of Massage Recommended for Those with Arthritis
your energy.
2) Relax. Cohen specifically defines this as by Meir Schneider and Carol Gallup
relinquishing control of the body, to the
body itself-eat, sleep or play when the body
wants to d o exactly that activity.
3) Invite ecstasy-river rafting, painting,
anything that shuts down the part of your
mind that's always worrying, planning and
making value judgments. Cohen's classes dis-
cover ecstasy for themselves with long walk- it. This massage reduces swelling.
;
>
ing meditations in a garden.
W
0
4) Transform everyday activities like
5
z
toothbrushing, dressing and undressing, and
& chopping vegetables into exercises thar nur- rnetacarp~phakzn~eal
jo
m
ture joints and lift your spirits (see sidebar,
E "Dancing with the Vacuum Cleaner"). You
have to take the time for these chores any-
how; if you work them into an exercise
sequence, your joints will improve, your
muscles will become stronger, and you'll suf-
fer fewer of the small defeats; for example,
when your motel room meets disability stan-
dards but you can'r turn on the faucets, flush
the toilet or turn the doorknob. Loosening with passive movement:
T h e key is long-term careful observation, Tap directly on the joint, then d o gentle
so that the brain creates its own strategies to passive movement of the limb.
reduce pain and improve function. If going
up stairs is hurting your knee, pause on a 4t lej?:
stair and d o some sidestepping, or put the Looseniw with fent/e passiue movement.
foot o n the next stair and rotate the knee on
it with your hand.
5 ) Cultivate relationships that nourish
and support you, and gradually discourage
the relationships thar drain your energy.
Nurturing someone who has bouts of
extreme pain takes creativity, exemplified in Mobilization of the jointi
this story of Cohen's family: Years ago, Passively rotate a n adjacent joint, distal or proximate to the affected one. Apply gentle
Cohen would groan words of ventinglcurs- effleurage o n and around the affected joint as tolerated and intersperse with the following:
ingtpraying o n her way to the bathroom in ask the client to actively rotate the affected joint; follow with passive rotation, then visual-
the morning because she was in such pain- ization ofthe movement, then active rotation again. Rotations are always directions.
with arthritis, the first hour of the day is the
worst. Her husband and young son said they
couldn't stand having such a start to their
day. Cohen replied that she needed this self- ese areas makes an important difference.
expression. ~ e husband r proposed that he
and their son ventilate their feelings too. T h e
next morning, she heard an answering cho- Self-Healing bone-tapping massage:
rus ofcries and moans, including, - "Oh God, If your client with arthritis has had lim-
help niy mommy. She hurts too much and 1 ited movement for any appreciable time,
can't help her." "I felt like I was floating to he or she has ~ r o b a bsuffered
l~ bone loss.
the bathroom on their support," she recalls. Tap. -
lightly, steadily, rapidly, with alternat-
Many years ago Schneider urged Cohen ing hands, using all fingertips, keeping
to "move more than you want but less than your wrists loose and fluid. Feel a tram-
will destroy your joints. Feel what you feel, ~ o l i n eeffect and visualize deep penetra-
and don't run away from it." I n another col- tion. This massage regenerates bone.
umn, we presented a client who looked at his
extrcmc pain ;IS soul-dc\troying: "\'ou c;in At right:
rakc i t f i ~ ;tr d.ty ;lrid it'\ ok;~y.l i v o d . l y , ; I I ~ Bone-tcrpping massnge.
Dancing with the Vacuum Cleaner
by Darlene Cohen

Vacuuming and sweeping are basically to raise your arms so that

whole-body activities in which the lower they will meet, palms
body supports the upper body while the together, over your head.
upper body maneuvers the vacuum cleaner Do this extremely slowly
or broom. It is very important to distribute so that you can feel each
your weight evenly over your lower body as muscle d o its part to lift
you move, to stay balanced, to feel the sup- your arms over your head.
port of your feet and legs, rather than suain- When your palms meet
ing your back by lugging your vacuum over your head, hold the
cleaner from too far a distance across the position for a breath or two
room. Develop the habit of moving your to rest. Lower your arms
vacuum cleaner only a short distance, so that equally slowly until your
your back and shoulders remain comfort- hands are back down
able. In fact, it is a good idea to
weight vacuum cleaner that you
about easily. Most upright machine
heavy and require you to push
from your mid- and lower back, which is port with one hand, while
very stressful. My vacuum cleaner is a tiny standing perpendicular to
floor model that weighs about five pounds the chair (the chair is at
and is easy for me to pull around as I move your side while you hold
from room to room. on to it with one hand).
Begin to swing your inside
Exercises to limber up leg, the one closest to the
Because vacuuming and sweeping are chair, forward and back-
such whole-body workouts, it is advisable to ward. This should be a
do a few exercises before beginning. loose, easy motion, led by Darlene Cohen vacuums ajoor
your foot. Your foot swings )om the point of view ofher hips.
Shoulder curl: Stand with your feet your leg out from your
slightly apart, for astable base. Let your arms torso, back and forth. Your straight leg your inside leg across your body and then
hang loosely at your sides. Your knees are swings out in front of you and out behind out to the side, then back across your body,
loose, not locked. Feel the crown of your you. This swing should not be so vigorous instead of swinging your legs forward and
head incline toward the sky. Stretch your that it affects the straightness of your upper back. Let your hips be loose while your foot
arms out straight from your sides, your fin- body at all. Let your upper body relax; your swings your leg well within your range of
gers pointing out straight at the ends of your legs do all the work. motion. \When your leg gets tired of swing-
arms. Relax your shoulders onto your mid- When your leg is tired of swinging or your ing or your other leg gets tired of support-
back muscles. supporting leg is tired of supporting, switch ing, switch legs and repeat the movement.
Don't hold your arms up with your shoul- sides. Turn around, hold on to the back of
der and neck muscles; relax them and feel the chair with the other hand, and swing the Working from your body's point of view
the support of the muscles in your midback, other leg. If your hip joint is very loose and When you are ready to begin vacuuming
around your shoulder blades. Next, curl the pain-free, your swings will be wide. If your or sweeping, take the vacuum cleaner or
backs of your shoulders up toward your ears, hip joint is tight, your leg won't swing as broom loosely in your hands. Let the instru-
and then curl them back down. Twist your high. It is important to keep within your ment move in your hands as you work.
wrists as you curl your shoulders. Feel the own range of motion to loosen the joint. Because vacuuming is largely a one-sided
effects of this motion in your shoulders and If this exercise hurts you at all, you might activity, it is a good idea to change your lead-
back and all along your arms. If you are stiff be better off not to swing your leg but to ing hand occasionally, so that both sides of
in your elbows and shoulders, this is an stand on a phone book and let the leg next your body are used.
excellent stretch for you. You will feel more to the chair just hang from your hip joint. This helps break the common habit of
comfortable maneuvering a vacuum cleaner Use your hands to shake the flesh over your building up one side of the body while the
or a broom after loosening your shoulders hip joint as your leg dangles from it. Breathe orher remains weak and constricted.
and arms this way. and release your leg, so that it feels as if it is As you work, move from your body's
falling out of your hip. point of view. Feel your lower body joi~lts
Arm lift over head: Stand with your feet support the Inovcrr,ent of your upper body
slightly apart, for a stable base. Let your arms Leg swing to side: Hold on to the chair as you m.~nipulntcthe vacuum cleaner o r
hang loosely at your sides. Very slowly, begin for support, as you drd above, and swing broom. Focus on drst~ihutingyour lower
you start getting tired of it, but on the third cartilage is the least regenerative of all the
day, you don't have anything left. You're not body's tissues. Regeneration occurs much
you anymore." Cohen has been there, and more readily in tissues with a good blood
gone beyond it; most of us, in our culture of supply, and blood vessels do not extend into
shallow successes and denial, try to stay well normal joint cartilage. This avascularity
away from this kind of experience. keeps normal cartilage from ever experienc-
"At best, it's been an adventure," she said. ing inflammation; somehow, in arthritis,
"At worst, it's demoralizing-bitter pain and capillaries get into joint cartilage and inflam-
suffering. I've come to see the benefit of the mation can ensue. Nevertheless, regenera-
shadow. Pain, despair and suicidal thoughts tion of cartilage is possible-up to the point
can be quite nourishing in terms of energy. where the collagen microskeleton of the car-
If you stop using your vital energy to shut tilage is lost.
out those scary thoughts and feelings and let In his book Self-Healing: My Life and
yourself sink into them, all that energy is E o n , Schneider reported that in the early
released-you have access to it. Normal peo- 1970s he saw X-rays of some of his arthritis
ple tie up a lot of energy in fear of this spaceclients showing joint space that had been
and then can't access it. It's a wheel that you absent in earlier films-indirect evidence of
turn, or it turns you." regeneration of joint cartilage. He never
Ironically, Cohen was living in a medita- bothered to ask for copies of the documen-
tion community when the disease stxuck; tation, and wishes he had. When Cohen had
"the big broad pattern ofoverachievement in hip replacement surgery in 1991, X-rays
our culture doesn't spare spiritual communi- showed the joint was virtually fused, but she
ties. I had to get off the fast train, because Idemonstrated full active range of motion in
got hit by it." Now, she does only what is the joint and could even touch her toes.
deeply meaningful to her-she serves on Amazed, her surgeon remarked, "There is
two boards of directors, teaches, sees clients, more happening here than medical science
creates materials for use with arthritis and can explain." Doctors had begun to urge her
chronic pain, plays with her new grand- to have the surgery in 1977, and Cohen
son-and moves through her days with a managed to avoid it for 14 years by leading
pleasant, powerful serenity. a very active life, including bicycling across
Cohen's strategy for having a full, rich lifetown every day to her massage therapy job.
with arthritis was demonstrated in the As psychologists, both Cohen and Smart
preparation of this article. At the end of the are aware of psychoneuroimmunology
allotted time for an interview with Carol (PNI), the study of how the nervous,
Gallup, Cohen rose to her feet and began to endocrine and immune systems continually
head for the door, talking with an unhurried exchange chemical messengers in a fine-
air, but obviously leaving- on schedule. tuned interplay (gonads and intestines also
Gallup attempted to work in a few more appear to have such capabilities). In all this
questions, squeezing a little more into a tight delicate machinery, stress is the loose cannon
time frame out ofhabit, and found that "you on deck (see Issue #GI, MayIJune 1996),
could as soon perturb her schedule with one having enormous, cascading, destructive
more question as divert an ocean liner. It was effects. Disease is a stressor that amplifies
wonderful and a little unnerving; you need every other stressor in a patient's life, and
a lot of self-command, a lot of presence, to stress greatly worsens the physiological effect
bring it off. She was positively regal." of any disease.
Later Cohen explained that she wouldn't Early PNI studies showed that the immune
have minded staying, "but my body said, system can be classically conditioned, explain-
'Let's get out of here.' I had to go home and ing the mechanism of the placebo effect.
see a client, and my energy started to drain Placebo was once merely something to con-
away. The price for not listening to my body trol for in research; now it is looked at as a use-
has been swift and terrible. I think the gift ful and powerful nonspecific effect that may
everyone in our society needs is validation of account for much of what is accomplished in
our slowing down and doing what the body complementary medicine-and is certainly a
wants to do. I do have a very pleasant life. " factor in orthodox medicine too. Mediated
autonomically and in other ways, nonspecific
What kind of miracle is it? effects are particularly important in reducing
Schneider has often been asked by arthri- stress and pain.
tis sufferers whether he believes cartilage can Studies have shown that a lot of the
regenerate. According to medical science, improvcnlcnr brought about by comple-
mentary medicine is linked to patients' self-
perceived health status, and that patients
normally give up the traditional sick role on
that basis, not because of medical criteria.
Although Smart and Cohen have achieved
major accomplishments -finding a way to
get the movement they need without drugs,
reducing and coping with pain, increasing
strength and flexibility, and improving func-
tion, perhaps their greatest gain has been a
change of state, on every level of being, from
patient to healer. clM'

This is the last installment of the 'Self-

Healing" column.

Meir Schneider, Ph. D., L.M. T., an inter-

nationally known therapist and educator, is the
creator of the Meir Schneider Self-Healing
Method, the author of two books, Self-Healing:
My Life and Vision and The Handbook of
Self-Healing, and thefounder/a'irector of the
Center and School for Self-Healing in San
Francisco. As a teenager, he overcame bli?zdrless
caused by congenital cataracts and other seri-
ous vision problems and today has an unre-
stricted driver j license. For @rther informa-
tion call the Centerfor Self-Healing at (415)
665-9574.

Carol Gallup is an aduancedstudent ofSeIf-

Healing, Registrar of the School for Self-
Healing, staf writer of the Self-Healing
Research Foundation, and the author of
numerous magazine articles. She studiedphys-
ical therapy at the Mayo Clinic and is now a
master; degee candidzte in research psychol-
o g at San Francisco State Uniuersiq.

Resources
1. Cohen. Darlene. Arthritis. Stop Suffering, Start
.
Moving, Walker & Co New York. New York, 1995.
2. Schnelder. Melr. The Handbook o f Self-Healing.
Penguin Arkana, London, England, 1994.
3 Schneider. M e ~ r Breath
. and Mob~lityof the Jolnts,
The Center for Self-Heallng. San Franclsco,
Cal~forn~a,
1994

An arthritis workout video and self-help aud~otapes

[theory, meditation and gu~dedimagery) on paln man-
agement are avatlable from Hlpbone Producttons at
(415) 552-5695.