Even now, in an era in which medical chemistry can usher in everything from an improved mood to a healthier libido, Dr. James S. Gordon puts his faith in low-tech medicine.

These days, too many patients see a psychiatrist for 15 minutes and are handed a prescription, with no real dialogue about their condition, psychiatrist James Gordon says. But when people don't feel well, they want to know what they can do for themselves.

So Gordon, a Harvard-trained psychiatrist who runs the Center for Mind-Body Medicine in Washington, DC, gives the healing power back to the patients themselves. Using a combination of talk therapy, acupuncture, dietary changes, herbalism, and meditation -- but no chemical antidepressants -- Gordon has treated patients for everything from depression to attention deficit disorder to cancer.

And while some traditional psychiatrists have little patience for Gordon's unorthodox (and, some would hasten to add, scientifically unproven) procedures, his patients tell a different story. "I look better, I feel terrific," says one middle-aged woman who fought a losing battle with depression for nearly 30 years before Gordon weaned her from antidepressants. "It's like my entire essence changed."

Now that a growing array of scientific studies suggest that complementary mind/body therapies may be useful in treating cancer, asthma, diabetes, and other chronic conditions, the essence of medicine may be changing too. If so, it will be following a course Gordon first explored in the early '70s, when a chronic back injury led him first to an osteopath, and then a Chinese healer. Since then, Gordon has labored to find the common ground between modern and ancient traditions. Along with his private practice and his work at the Center for Mind-Body Medicine, Gordon serves as a clinical professor of medicine at the Georgetown University School of Medicine, and has written such books as Comprehensive Cancer Care: Integrating Alternative, Complementary and Conventional Therapies. He also has led groups of mind/body-oriented physicians to Kosovo, Israel, and Gaza, where they work with war victims, and also train local physicians to use mind/body techniques. It's a heavy schedule by any estimation, but Gordon rarely feels overwhelmed. "I always tell my patients [that] I'm not there to do it for them," he says. "I see my job as helping people help themselves. It's not quite so tiring, because that means they're doing the work."

Peter Carlin: Your prescription for holistic psychiatry strikes many mainstream psychiatrists as foolish, even irresponsible. After all, they say, modern antidepressants are more sophisticated and effective than ever before.

Dr. Jim Gordon: I'm not disputing that the drugs can offer significant relief to some people. But even if they work, often it's only for a short period of time. What's more, the drugs don't change the basic issues, and often create other significant physical problems. And don't forget that the drugs don't work for everyone. In some of the research on antidepressants, and in any of the studies in which the drugs are compared even to eight or 10 sessions of cognitive/behavioral therapy, the therapy does better than the drugs. So the whole science is a little shaky.

Most of the people who come to me have been on and off antidepressants for years, even decades. For me, the first step is always to find out why they're coming to see me. Almost always, it signals some desire to make a change. For instance, one woman came to me recently and said, "Well, these antidepressants are great. I'm not so depressed. But on the other hand I can't have orgasms and I don't care about anybody. I don't think I like that trade." Generally, they've gotten tired of taking antidepressants because they no longer work, or they're creating side-effects, or maybe the patient just doesn't want to be dependent on a drug.

Oh, absolutely not. What I really want is for them to take charge of their condition. Because the first thing I say is: I don't have a magic bullet. I may use dietary change, acupuncture, herbalism. But you're going to have to make the changes. You're going to have to help me. Are you interested in doing that? Hardly anyone says no, and I think that's crucial. This isn't about trying to force people to comply with some regimen. It's about helping them to grow, change, and help themselves.

I spend probably 90 minutes just talking, going over the patient's whole history: physical, mental, social, emotional, spiritual. I'll take a look at the structure of the body, then assess the person from the perspective of Chinese medicine. I look at the tongue, feel the belly, take the pulses, doing Chinese pulse diagnosis. Then I'll almost certainly do acupuncture, to balance the energy in the body.

Then after that, the person usually feels more relaxed and energized, and I sit down with them and try to talk about what's going to happen in terms of exercise, diet, herbs, and other attitude changes. A lot of people who come, for example, have serious problems with their work -- probably 60 or 70 percent of the people I see are very unhappy at work, or the kids are unhappy at school. So I talk to them about all these things, try to help them to become more self-aware, and teach them how to care for themselves.

Absolutely. People often have allergies they don't know about, and their everyday diets could be throwing their systems way out of balance. So I usually encourage patients to go on a fruit fast, then gradually reintroduce foods to see which ones may be hazardous to them. People tend to use a lot of caustic substances -- sugar, caffeine, tobacco -- and it can be amazing how much better they feel, physically and emotionally, when they get them out of their systems.

Yes. Cancer patients are very easy to work with, because they have tremendous motivation. But, as so many studies have made clear, changing your attitude can have a tremendous effect not only on the quality of a cancer patient's life, but also on their longterm prognosis. People who have connections live healthier lives.

So mostly I listen to people, and I talk to them. First of all, many of them feel like they're not getting better. But even more common, they feel no one is paying attention. And of course they feel that way! People with cancer often have eight to 10 minute visits with oncologists. And here they are with 40 questions about medications, herbs, anxiety, diarrhea, about being terrified, and so on. So to actually have someone who is interested in the person with the cancer, and not just the cancer has -- unfortunately -- become an alternative. Obviously it should be the basis of all care.

I don't know how emotions are connected to the onset of cancer. I think there is a certain subgroup of people who are genetically vulnerable, and if they go through long periods of overwhelming despair they're probably more likely to develop cancer. We still don't have the research on it.

But I think the crucial thing is if you have cancer, emotions can have a significant effect on the outcome. That doesn't mean you just need to have a smiley face. But if you deal with your anger and your sadness, it does seem to help. It certainly improves people's outlooks and how they deal with the world. And in some cases it seems to improve their likelihood of living longer, too. So it's complex. That doesn't mean you should look at it as a matter for blame: You were unhappy, and therefore you got cancer. That's not the calculus to use. But in a setting of chronic unhappiness, any kind of illness is somewhat more likely.

There's definitely been a shift, [which you can see by looking at our conference seminars]. There we're looking at complementary and alternative therapies, including mind/body therapies, and we have support from the National Cancer Institute as well as the National Institutes for Health alternative therapy division. We've got a former president of the American Cancer Society on our advisory committee, we've got the director of the American Cancer Institute, we've got people from all the major cancer centers in the world coming to take a look at these therapies. So yes, there is a shift. And there are certainly plenty of people who still aren't sure, and don't want to get involved. But I must say there are fewer and fewer of them. And when I go and talk at cancer centers, it's more like people have questions about specific issues: They don't like the claims made for herbal therapies, or that some people who promote alternative therapies try to keep people from using conventional therapies. Their problems are more specific. But I don't hear the kind of blanket condemnation: that this is all ridiculous and they're not paying attention.

I think of an oncologist here in Washington, DC, one of the most distinguished oncologists in the area, and five years ago I'm sure he wouldn't have sent people to me. I imagine he would have said I was reputable, that I had the right credentials and so forth, but he never would refer patients to someone like me. And now he sends LOTS of people to me. In fact, one of my patients told me that he recently went back to that doctor, and told him about the regimen I'd put him on -- herbs and so on -- and he said, "Well, that's great." Not, "that's crap," or even "do whatever you want to do," but "that's a terrific idea."

-- Peter Carlin, a staff writer for People, has written for Health, and Hippocrates magazines.

References

Last updated March 30, 2009
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