Chronic Stress, Anxiety? You Are Your Best Doctor: Dr. Bal Pawa (Transcript)

Full text of Physician Dr. Bal Pawa’s talk titled “Chronic Stress, Anxiety? – You Are Your Best Doctor” at TEDxSFU conference.

Listen to the MP3 Audio here:


Dr. Bal Pawa – Physician

Let’s pretend that I’m Oprah, and all of you are getting a brand-new car, a BMW. Whoa! You’re excited, you rev up the engine, and you hit the road; you’re enjoying the ride, and suddenly a little white poodle jumps right in front of you. You panic, the dog panics. You’re going right, left right.

And just when you think you’re going to hit the dog or crash into the ditch, you slam on your brakes, swerve, and shoo! The dog scampers off but you’re left shaking.

What just happened? You just experienced an acute, short-lived stress called ‘fight-or-flight.’ sound familiar?

Now, imagine if your body lived in this state all the time. Chronic excessive stress leads to distress – heartburn, headache, muscle tension, hypertension, gut problems, sleep problems, high anxiety, low sex drive. Sound familiar?

As I can tell you, the American Medical Association also reports that an astonishing 75% of all the symptoms that doctors treat can be traced right back to excessive stress.

As a researcher and as a physician, I see these symptoms. And eventually, these symptoms lead to serious life-threatening diseases – diabetes, depression, heart attacks, and even cancer.

There is an undeniable mind-body connection when it comes to stress and disease. But today, I’m going to show you how to use your mind to stress proof your body by becoming your own best doctor.

But first, a little Anatomy 101, like a car, your brain has a little engine and it’s called the autonomic nervous system; and this autonomic nervous system revs up when there’s stress. And that’s great when we had to run away from external dangers like saber-toothed tigers, that fight-flight reaction was important.

But nowadays, those prehistoric tigers are replaced by tigers that roam in our mind: Fears; fear of failure, fear of rejection, loneliness, a toxic boss, busy to-do list. You can’t run away from those fears in their mind; they’re with you all the time.

So what happens, your body goes into fight-or-flight all the time; becomes your new norm, your default option. Your engine is revving up all the time and your gas pedal is stuck.

So what happens? You’re bombarded with stress hormones, cortisol, adrenaline, and they wreak havoc with your body. The more stress, the more you get sick – cause and effect.

But wait, the autonomic nervous system has a brake. It’s called the Vagus nerve. But unlike that other Vagus, what happens in this Vagus doesn’t stay there. This Vagus runs from your brain all the way, and it wanders, this nerve collection wanders to all the different organs in your body, and it does the opposite of fight-or-flight; it’s called rest and digest. It slows everything down.

So, it’s taking you out of that survival brain into your calm, cool, rational brain. Much better for your health, but the problem is we don’t apply the brakes consistently. And I know this too well, both as a doctor and as a patient.

At age 32, I wasn’t perfect but my life sure was. I’m married to an adoring man, an optometrist, whose eyes is only for me. We’ve moved into our brand-new home; we have two beautiful children, and one more on the way. And I’m doing something I love – delivering babies and keeping families healthy. Life is good.

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One rainy Vancouver evening, I’ve just finished delivering a baby, I’m heading home. The baby is a nine pound beautiful future wrestler, big boy. You should have seen the mother: tears of joy streaming down her face, and it’s the best part of my job; I get to share that joy.

And I couldn’t wait to get home and hug my two children when I walked through the door. They say that your life can turn on a dime, and mine turned in my prime. Out of nowhere, a speeding truck rams into my little white sedan. The impact catapults me and my car into oncoming traffic in the other lane: screeching tires, crunching metal, smashing glass, and sirens screaming, and lights flashing.

And the paramedic is asking me questions, how old are you? What’s your name? And then, total blackout. When I wake up, I’m now a patient in the neck brace, in the same hospital that I just left as a physician a few hours ago. But this time, I’m the one who’s getting poked and prodded, x-rayed and examined. That role-reversal, very scary and sobering.

That accident ruined seven years of the prime of my life. I was left with debilitating injuries to my neck, shoulder; fractured ribs, collapsed lung, my chronic pain, exhaustion; I couldn’t sleep. I lost my baby. I was sad, depressed.

And on top of that, I was woken up with nightmares because my autonomic nervous system was revving up all the time; I was reliving the accident over and over and over again. I couldn’t look after myself; how could I look after my children or my patients?

My medicine cabinet was overflowing with drugs. You name it, I had it; but I was not healing physically or emotionally.

At age 39, I felt like I was 59, and my dreams and careers were washing away. If you’ve ever had a serious setback and you’ve been down in that dark place, you know how it feels, hopelessness and despair.

But I had to do something. My crushed shoulder meant I couldn’t deliver babies anymore. So, as a career transition, I signed up for a mind-body course at the Harvard Medical School, and Dr. Benson was a leading researcher there.

So, one day, after class, I approached him and I said; “Dr. Benson, I’ve been suffering for seven years after an accident. I’ve had multiple surgeries, I’ve seen so many different specialists; I’ve tried every kind of medication but I’m still not getting better. Could your research help me?”

He said; “Definitely, Bal. Chronic pain and chronic stress triggered the autonomic nervous system. You are living in constant fight-or-flight; you can’t heal in that state. You have to turn on your Vagus nerve, rest and digest.”

But how?

He said; “Look, stress is automatic but relaxation is not. You have to relax your diaphragm; relax your muscles in your body and repeat a word. Put the three together. Try it. What have you got to lose?”

And you know, he was right. I had nothing left to lose at that point; I had everything to gain. So, I returned to Vancouver with renewed hope and determination, but my science-based training, evidence-based medicine made me very skeptical, so I had to do my own research.

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Study after study confirmed that relaxation techniques definitely slowed down this automatic, autonomic nervous system, but more compelling was the neuroscience that showed when you do mind-body medicine and connect this, you get remarkable dramatic improvements in your emotional and physical health.

I was convinced. I’ve got to take this, so I combined the research that I did with the relaxation techniques I learned from Dr. Benson, and I made it very simple. I said three steps that I could do: breath, mind and wordBMW meditation. So, that was going to be easy.

I started. I got up in the morning and I started a routine; found a quiet, small, comfortable space, started with deep diaphragmatic breath. Then two minutes in, I would relax my muscles. And I remembered what the research said; “Relaxed muscles slow down your autonomic nervous system and very tensed diaphragm, tensed muscles do the opposite, fight-or-flight.”

The second thing, the mind; that was more challenging, especially when you have chronic stress and you have chronic pain. It’s going thought, thought, thought, thought. I had to slow the mind down. I had to go and be within that moment, and just be present.

I realized what a powerful force the mind has over the body, because the mind is inextricably linked to your autonomic nervous system; state of mind equals state of body.

So, when I went quiet, went in the moment, that meant being mindful; not letting my past thoughts, my future thoughts hijacked me; had to stay there, and it helped when I focused on my breath.

Third thing, I had to repeat a word. He said; “Repeat a word.” So, I chose the word ‘Om’ because it rhymes with ‘home.’ And I was so desperate to come back to my pre-accident body and reclaim my home. So, I would start breathing, putting the mind into it, putting the breath into it, focusing.

And every morning, I created a routine; ten minutes in the morning, ten minutes in the evening. And soon, I was able to get to one minute little mini meditations throughout the day.

And then, I started to feel a shift; my body was changing, my brain was producing endorphins, natural painkillers, melatonin – a sleeping pill that is just natural, and serotonin – a natural antidepressant.

Within a few months, the skeptic scientist had her proof. I was off all my medications. I felt whole. I felt healed. I felt I had a new mindset and a new outlook. What was supposed to be a career transition course at Harvard turned out to be the most radical transformation of my life.

Today, I’m closer to 59 but I feel like I’m 39. It was this BMW meditation, and not medication, that transformed my life and then helped me to transform the lives of thousands of my patients since then. I completely changed the way I practice medicine; co-founded a clinic where we look at mind and body, integrating the whole person, empowering patients with tools like this, so that you’re a part of the solution, the health solution.

I was so inspired I wrote a book called ‘the mind-body cure’ because I truly believe that every single one of us has an innate ability to heal ourselves, cure ourselves when we provide the right environment for the body; breath, mind and word works. This meditation works.

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A few years ago, a young lady, I’ll call her Michelle, came to my office. She was in serious distress. She said; “Dr. Pawa, I flunked my medical school qualifying exam. I’m a straight A student, and I panicked. And now my dreams of becoming a doctor are crushed.” And she had a huge meltdown, size of Manhattan, right there in my office.

Her autonomic nervous system was so revved up. I calmed her down, we breathed through it, and I said; “Michelle, meditation is the thoughtful act of creating order in your body. You need to get your mind to control your autonomic nervous system.”

She went home. She soon started following the BMW meditation steps, reset her nervous system, and came back after few months; “Guess what? I got 95 percent of my exam.” Wow! That was fantastic.

But the best part, Michelle is now an integrative physician, and she is using BMW meditation for her patients. Now, does this mean that if you meditate and I meditate, we don’t need to see our doctors? Absolutely not. You, me, we all need to see our doctors for essential treatments, but let’s face it.

If many of your symptoms are due to stress, then the responsibility falls on you to take charge, to become your own doctor. Right? You know your mind the best, you know what your stressors are, and you know how your body reacts to them.

So, soon as you wake up in the morning, and before you touch that phone, start. If you’re already doing some mindful meditation, great! But if you’re not, please start now, because just ten minutes a day will have profound and huge benefits for the rest of your life.

So, when you get up, get into your BMW. Start with your breath, deep inhales and exhales. Then, just focus your mind. Then start a word, repeat a word, ‘peace, Om, amen’ whatever resonates. And ten minutes in, you will feel more calm, more energized, and more refreshed.

The best part is when you live like that, and rest and digest, your brain is more calm, cool and rational. And the biggest thing, when you learn to master your mind, to control your autonomic nervous system, you have ultimately become your own best doctor. Right?

And you start seeing the difference; you feel better, you heal better, because your stress hormones are not wreaking havoc with your tissues. You start feeling more creative, more resilient, more focused. And when your mind and body are connected, you connect better with others, especially your significant other.

And let’s face it; stress is not going away. All of us are affected. No one is immune to stress, not even Oprah, but you don’t have to let chronic stress and anxiety and setbacks cause you distress.

So, go ahead. Use your BMW to bring you back home, to health and vitality and joy, and enjoy the rest of your ride.

Resources for Further Reading:

How Stress is Killing Us & How You Can Stop It: Thijs Launspach (Transcript)

From Stress to Resilience: Raphael Rose at TEDxManhattanBeach (Transcript)

How to Make Stress Your Friend by Kelly McGonigal (Transcript)

Billy Graham: Who is Jesus, Really? (Full Transcript)