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Issue # 6: Summer 1998 © 1998 Neil F. Neimark, M.D.


Look out Titanic!

In the last issue, we learned how to develop a rich inner life by seeking and following what is most precious to us. We learned how to weave our deeper desires and true longings into the daily fabric of our lives. By saying "yes" to our passion, we give our body a "live" message and reaffirm the value and worthiness of our lives. We begin to open up to our uniqueness and to live our very own lives.

In this issue, we will explore a model for health, called "The Iceberg Model" that was developed by John Travis, M.D. and Regina Ryan in The Wellness Workbook (© 1988 second edition, Ten Speed Press, Berkeley, California). This model teaches us that our state of physical health is only the visible tip of the iceberg. Hidden below the surface lie our lifestyle, psychological and spiritual choices, which form the foundation for our state of physical health or illness.

The Iceberg Model

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We often view our state of physical health as being determined solely by our genetics, our physiology and our chance exposure to toxins, viruses, infections and the like. The Iceberg Model shows us that our state of physical health or illness is only the visible "tip" of the iceberg. In order to completely understand our physical condition, we need to look beneath the surface to our choices of lifestyle (our eating habits, exercise level, addictions to alcohol, food, adrenaline, shopping, drugs, etc), psychological beliefs (the thoughts, feelings, attitudes and beliefs we hold) and spirituality (our inner life, our belief in a higher power and our degree of acceptance and love of self and others).

What we can see is that our lifestyles have the most immediate and direct influence on our physical health. Combined with genetic predisposition towards certain diseases, poor lifestyle choices can wreak havoc on our physical health. In contrast, healthy lifestyles lead to a state of optimal physical health and well being.

Overeating, overdrinking, under-exercising and over-stressing are all lifestyle CHOICES that directly effect our physical state of health. These unhealthy lifestyle choices contribute greatly to our increased risk for heart disease, stroke and cancer. As such, we call these big killers today, diseases of choice not chance.

What leads us to choose destructive lifestyles? Why would we knowingly choose a way of life that is harmful to us? The answer is, that in most cases, we do not "knowingly" choose them, we "unknowingly" choose them. We unconsciously choose them. They are choices, nonetheless, and they tend to be driven by some deeper driving force within us, some underlying compulsion.

WHERE DO OUR DEEPER COMPULSIONS COME FROM?

The deeper compulsions driving our lifestyle choices come from the psychological level, which reflects the thoughts, feelings, attitudes and beliefs we hold about ourselves, others and the world around us. In fact, our lifestyle choices become the level at which we "mood alter" our uncomfortable emotional feelings and our fearful thoughts. Overeating may be a way to avoid our pain, loneliness, sadness, conflict or sense of rejection. We may drown our sorrow by drinking too much, momentarily forgetting how afraid or alone we really feel. We may go shopping to "clothe" or cover up our boredom, our loneliness, our emptiness.

THE TIGER AND THE BREADCRUMBS

There is a wonderful story told by the great Sufi poet Nasrudin, of the tiger and the breadcrumbs. In this story, Nasrudin is seen in his suburban home spreading breadcrumbs outside of his house. A neighbor passing by inquires, "Nasrudin, what are you doing?" "Can't you see?" says Nasrudin, "I'm spreading breadcrumbs outside of my house in order to keep the tigers away." "But Nasrudin," replies the neighbor, "there are no tigers in this neighborhood." "See," says Nasrudin, "it works!"

ON SOME LEVEL, the lifestyles we choose work for us, even the apparently unhealthy ones. On some level, they help us to deal with our unwanted, uncomfortable feelings and thoughts. On some level, they help us avoid our pain, our sorrow, our fear, our conflict. They help us to "mood-alter". They keep us numb. They keep us from having to deal with our unresolved issues. They keep us from our loneliness, our uneasiness, our loss.

If we are feeling uneasy with ourselves, we may cover up our uneasiness by becoming "work-aholics", using our power in the company to avoid the painful powerlessness we feel in our personal or family life. We may choose a fast paced lifestyle in order to avoid deeper, more meaningful relationships, thus avoiding the even deeper fear that if someone really got to know us, they might "find out" how inadequate, alone or afraid we really feel sometimes.

SICKNESS WORKS

Here's a really scary thought. We may actually choose illness as a lifestyle. Let me say that again: "we may actually CHOOSE illness as a lifestyle." "How could that happen?" you might ask. If the only time we got love and attention was when we were sick, then on some level, the "payoff" for being ill, is getting the love and attention we don't know how to get appropriately.

After all, when we're sick, we get to feel as lousy as we really feel. John Bradshaw, the recovery expert, says, "Needs and feelings can be changed into bodily sickness. When one is sick, one is usually cared for. When one is sick, one can feel as bad as one really feels. Sickness works."

"IF YOU'RE DYING OF THIRST, YOU'LL DRINK MUDDY WATER."

So we see that things can get very tricky. Our psychological needs and wants can "act out" inappropriately in the lifestyles we unconsciously choose. So it becomes critical for us to become more conscious, more aware, to pay attention and be willing to explore the deeper levels of choice in our lives. We can so crave to be loved and stroked ("touched", cared for, paid attention to) that when we don't know how to ask for the love and attention we need, or when it is simply unavailable to us, we unconsciously choose illness or unhealthy lifestyles as a way to get it.

In pop psychology, we say that "bad strokes are better than no strokes at all". This is the power of our desire to feel loved and accepted for the very ones that we are. So the young boy brings home an "F" on his report card, and suddenly he has Mom and Dad's attention. Bad strokes are better than no strokes at all. Poetically, John Bradshaw says, "If you're dying of thirst, you'll drink muddy water."

At the lifestyle level, we can "behavior modify" our bad habits, without really breaking through to the deeper compulsions driving our behavior. That's why trying to "behavior modify" our unhealthy lifestyles can help, but often falls short, leading us into cycles of "over-controlling" our unhealthy behaviors (by extreme diets, complete abstinence, white knuckling it, etc) and then "losing control" and falling off the wagon again into our old bad habits.

For lasting change to occur, we must, in most cases, address the deeper psychological and spiritual levels of our lives. This is the subject of our next issue of Mind & Body.


Neil F. Neimark, M.D., 4870 Barranca Pkwy., Suite 330, Irvine, California 92604, (949) 451-6060
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