"How You Can Use the Principles of Holistic Medicine to Become Optimally Healthy in Body, Mind and Spirit"

by Larry Trivieri, Jr.

Chapter from the book The American Holistic Medical Association Guide to Holistic Health
by Larry Trivieri, Jr. (John Wiley & Sons, May, 2001)

Holistic medicine's primary emphasis is placed on achieving and maintaining optimum wellness. To a large degree, holistic practitioners accomplish this by teaching their patients principles of self-care and prevention. What follows are basic guidelines for creating and maintaining health from the perspective of the "whole person" -- body, mind, and spirit. While not intended as a substitute for professional care, the principles and exercises that follow can be used to begin creating improved levels of vitality and balance in all areas of your life.


Health of the body means being well both physically and environmentally. People who are healthy tend to bounce out of bed each day refreshed from a good night's sleep and eager to be about the challenges of the day ahead. Not only do they have high levels of energy, they also tend to be happier, more successful, and have fuller and deeper relationships with their spouses, partners, families, friends, and co-workers. They also enjoy and are in harmony with their environment, both at home and at work. From the perspective of holistic medicine, achieving this optimum state of physical health is largely due to an ongoing commitment to three factors: Diet and Nutrition, Exercise, and Environmental Awareness (safeguarding against toxins and allergenic substances at home and work, including hidden allergies that can sap energy). Becoming familiar with these factors and following the guidelines below will help you improve your health and increase your resistance to disease.

Diet and Nutrition
Diet: The importance of proper diet in relationship to health was stressed as long as 2,500 years ago, when Hippocrates, the father of Western medicine, proclaimed his famous dictum, "Let thy food be thy medicine and thy medicine be thy food". In the 12th century, famed physician Moses Maimonides echoed Hippocrates with the instruction, "No illness which can be treated by diet should be treated by any other means." This emphasis on diet is known in holistic medicine as Nutritional Medicine. Unfortunately, little training in diet and nutrition is provided in today's conventional medical schools and universities, meaning that many allopathic (conventional) physicians, unless they have studied nutrition on their own, are incapable of recommending a diet and nutritional program that meets the specific needs of each of their patients. Fortunately, this trend is beginning to change. But simply recognizing the importance of diet is not enough. What is also required is knowing what type of foods to eat according your unique biochemical needs. Despite the glut of books on the bestseller's list each year telling us otherwise, there is no such thing as an "ideal diet" that is suited to everyone. Despite how healthy a diet may be overall, invariably a certain percentage of people who try it will experience little or no benefit, while in some cases people will actually become less healthy because of it. Therefore, before beginning a specific dietary regimen, there are two things you should do to ensure that it will work for you: Determine your biochemical nutritional needs, and determine whether or not you are allergic to the foods you are eating.

As the research of Peter D'Adamo, N.D., author of Eat Right For Your Type, suggests, various genetic factors, including blood type, determine what kind of diet each of us is optimally suited for. Matching one's diet to one's genetic heritage and body type is also the basis of the dosha system of Ayurvedic medicine, which states that there are three primary body types, Vata, Pitta, and Kapha, and that for good health we should eat according to which dosha, or dosha combination, we belong to.

Knowing which type of diet you are suited for and following it can make a dramatic difference in your health. If you suspect your current diet is not serving you, seeking out a physician trained in nutrition, or a certified clinical nutritionist. Naturopathic physicians and many chiropractors can also offer dietary and nutritional guidance, as can practitioners of Ayurvedic and traditional Chinese medicine (TCM).

The concept of food allergy remains controversial among conventional physicians, but is recognized by holistic practitioners as an important aspect of proper diet. Nor is the concept new. Hippocrates, for instance, discerned that milk could trigger hives and gastrointestinal upset. Despite the fact that food allergies are becoming increasingly common, they remain one of the most misdiagnosed conditions. Ironically, people who suffer from food allergies often crave the very foods that are harmful for them. People who are allergic to wheat, for example, will often have pasta or bread throughout the week and feel deprived if they don't. Common food allergens are milk and dairy products, wheat, corn, tomato products, peanuts, chocolates, and shellfish, as well as food additives, dyes, and preservatives. If you suspect you suffer from food allergies, consult a practitioner of Environmental Medicine.

The key to healthy eating can be summarized in two words: whole foods. Whole foods are foods that are unprocessed and unadulterated, and free of hydrogenated oils, sweeteners, additives, or preservatives. These include all fresh and organic fruits and vegetables, complex carbohydrates (such as whole grains, starchy vegetables, and legumes), seeds and nuts, free-range meats and poultry, fish, and dairy products such as milk, yogurt, and cheese (use sparingly and avoid altogether if you are lactose intolerant). Healthy fats and oils should also be included as a dietary staple. Good food sources include olives, avocados, wheat germ, seeds, nuts, and wheatgerm, while healthy oils include, olive, safflower, sesame, sunflower, canola, wheat germ, and flaxseed (do not use for cooking). Fiber is another important component of a healthy diet. Besides fruits and vegetables, good sources of fiber include brown rice, whole wheat, and rolled oats.

All of the above food types provide an abundant supply of the necessary vitamins, minerals, amino acids, and essential fatty acids necessary for good health. Eating at least 5 to 7 servings of fresh fruits and vegetables per day will also provide you with a rich source of enzymes, which help digestion and assimilation. You can easily accomplish this by making salads or steaming or sauteing a variety of vegetables, and by snacking on fruits between meals. Alkaline-rich fruits and vegetables also help to maintain the body's proper pH level, something that many researchers point to as playing a crucial role in resisting disease.

Also be sure to drink adequate amounts of filtered water throughout the day, in place of coffee, nonherbal tea, soda, and commercial fruit juices (which are usually laced with artificial sweeteners). Sufficient water intake is extremely important for good health, due to the fact that water is the medium through which all bodily functions occur. In place of the more common recommendation of eight 8-ounce glasses of water a day, many holistic physicians recommend that we drink half (healthy but sedentary individuals) to two-thirds (active individuals) of an ounce of water for every pound that we weigh. This means that a healthy, sedentary adult who weighs 160 pounds should drink about 80 ounces of water a day, while his more active counterpart should drink up to 112 ounces. People whose diets are already high in raw, fresh fruits and vegetables, may need less water intake, however, since such foods are 85 to 90 percent water. Herbal teas and natural fruits juices that are free of sugar are also acceptable water substitutes.

In addition to the recommendations above, none of the following ingredients belong in a healthy, whole foods diet: Sugar, salt, saturated (animal) fats and hydrogenated oils (found in margarine, cooking fats, packaged foods, commercial cereals, and many brands of peanut butter), and refined carbohydrates (white bread, biscuits, cakes white rice, pastas made from white flour, and other processed foods). Caffeine and alcohol can also have a negative impact on your health and should only be used in moderation (200 mg or less caffeine, and no more than one glass of wine or beer per day).

Remember that the quality of the foods you eat determines the quality of the "fuel" available to your body as it performs its countless functions. A healthy diet can dramatically increase your energy levels over time and is the primary preventive measure you can take to safeguard against disease. On the other hand, it is not necessary to become a fanatic about the foods you eat. For most people who are already in a reasonably good state of health, eating healthy 80 percent of the time, while satisfying a sweet tooth or craving for pizza the other 20 percent, is a good rule of thumb that most people can safely follow. Be aware, though, that if you are not used to eating whole foods, you may experience initial symptoms of headache, fatigue, and increased trips to the bathroom as you transition to a healthier diet. Such symptoms are simply signs that your body is finally feeling well enough to throw off toxins long stored in your tissues. Usually, they will pass within a few days as your improved eating habits start to take hold. If they persist or become too discomforting, it may mean that you are trying to do too much too soon. Increased water intake can often help during this time by flushing toxins out of the bloodstream. Be sure to get adequate rest, as well.

Nutritional Supplementation: Due to a variety of factors, including the stress of daily life, environmental pollution, and the diminished trace mineral content in the soil in which our foods are grown, for most people a healthy diet alone is not enough to ensure health. For this reason, holistic physicians often recommend nutritional supplements as part of a daily health regimen. Once again, biochemical individuality plays a role in determining the proper dosages.

Every person requires the same nutrients for proper physiological functioning. The amount of each nutrient needed by each of us varies greatly, however, due to such considerations as genetic predisposition, stress level, the environments in which we live and work, and our type of lifestyle (active or sedentary). People who smoke, drink alcohol, or suffer from illness or allergies all have higher nutritional needs, as well, as do pregnant women. Therefore, to get the best results from nutritional supplementation, it is advisable that you consult with a nutritionally-oriented health practitioner. In the meantime, the table below, created by Robert Ivker, D.O. past-president of the American Holistic Medical Association, and Robert Anderson, M.D., founding president of the American Board of Holistic Medicine, provides a suggested dosage range for the most common antioxidant vitamins and minerals that most people can use as part of their daily routine for maintaining their health.

Vitamin C (as polyascorbate) -- 1,000 to 2,000 mg 3 times per day
Beta-carotene -- 25,000 IU 1 to 2 times per day
Vitamin E -- 400 IU 1 to 2 times per day
B-complex vitamins -- 50 to 100 mg of each B vitamin per day
Folic acid -- 400 to 800 mcg per day
Selenium -- 100 to 200 mcg per day
Zinc picolinate -- 20 to 40 mg per day
Calcium citrate or apatite -- 1,000 mg per day
Magnesium citrate or aspartate -- 500 mg per day
Chromium polynicotinate (ChromeMate(R)) -- 200 mcg per day
Manganese -- 10 to 15 mg per day
Copper -- 2 mg per day
Iron -- 10 to 18 mg per day.

"People who are exposed to higher levels of stress and increased exposure to pollutants, or who are not feeling well or experiencing diminished sleep, should use the higher doses," Dr. Ivker advises. "Otherwise, take at least the minimum dose of each nutrient every day, preferably with your meals." A number of formulas on the market contain all of these ingredients, making it easier to adopt such a program. Dr. Ivker also recommends that people daily take one or two tablespoons of flaxseed oil, either on salads or mixed with an equal amount of low-fat cottage cheese, in order to receive a good supply of essential fatty acids, particularly omega-3 fatty acids.

According to Dr. Ivker, regular exercise can contribute more to optimal physical health than any other health practice, with the possible exception of diet. Adopting an exercise program at least three times a week can improve your energy level, aid in digestion, increase circulation, promote restful sleep, decrease stress, increase self esteem, raise HDL (good) cholesterol levels, increase longevity, enhance mental function, and decrease depression and anxiety. "Ideally, an exercise program should incorporate a mix of activities that increase your aerobic capacity, while at the same time enhancing strength and flexibility," Dr. Ivker says. "A routine geared solely towards strength conditioning, for instance, does little to increase aerobic capacity and can even diminish flexibility, so it's a good idea to add a stretching routine and an aerobic workout on alternate days to get the full benefits of an effective exercise practice."

Aerobic Exercise: Aerobic exercise refers to any form of exercise that requires increased oxygen intake in order to supply energy to the muscles via the mechanism of fat and carbohydrate metabolism. Such exercise over time produces many benefits to the cardiovascular system and delivers oxygen throughout the body, resulting in greater cardiac efficiency, lower blood pressure, and a slower heart rate, along with an overall feeling of well-being.

There are a variety of aerobic exercises to choose from. Among them are hiking, swimming, bicycling, and jumping rope. Jogging is another popular form of aerobic exercise, although care should be taken to stretch before and after you jog, to wear good running shoes to support your arches and ankles, and to avoid the heavy impact of hard surfaces. Many sports also provide a good aerobic workout, such as racquetball, handball, basketball, and tennis. You can also try treadmills, rowing machines, and stairmasters.

An increasingly popular aerobic exercise among health enthusiasts is rebounding, which can be performed at home on a mini-trampoline (available at most sports stores). Rebounding only takes 15 to 20 minutes a day, and as little as ten minutes of vigorous rebounding has been shown to offer the same benefits as an hour of jogging, without the accompanying joint and ligament strain. Rebounding is also considered the best single form of exercise for keeping the lymphatic system healthy, which in turn boosts immune function.

But far and away the safest and easiest form of aerobic exercise is brisk walking. Walking two miles at a brisk pace burns almost as many calories as jogging, as well as offering other similar health benefits. Swinging your arms when you walk will burn up to an additional ten percent more calories and can also provide an upper-body workout.

The key to a successful aerobic routine is to follow it consistently, which is easier to do if you select an activity that you enjoy. If you are not in the habit of exercising, consult your physician before beginning. You might also want to seek instruction from an aerobics instructor, who can help you determine and maintain you target heart rate (60 to 85 percent of your age subtracted from 220). If possible, exercise outdoors when convenient, since fresh air and sunshine provides greater health benefits than a workout indoors. Also make sure that you exercise at least half an hour before meals, or two and a half hours after you eat, to avoid indigestion. And never begin any aerobic activity in the midst of an emotional crisis, especially anger, as doing so can trigger a heart attack.

Strength Conditioning: There are three types of strength conditioning exercise: calisthenics, with aids, and in combination with aerobics. Calisthenics include sit-ups, push-ups, jumping jacks, and swimming. Free weights and weight machines are examples of strength conditioning with aids, and strengthening in combination with aerobics refers to various forms of interval training, which can be performed while running, bicycling, or jumping rope.

The most popular form of strength conditioning in America is weight training. If you have never trained with weights before, it is advisable to consult with a trainer, who can help design a weight training program that is tailored to your specific needs and abilities. A typical routine is to use weights two or three times a week, alternating with aerobics and stretching exercises.

Building and maintaining muscle strength is an essential part of good overall physical health, and strength conditioning is an excellent way of doing so. It isn't necessary to lift a lot of weight to get results, however. In fact, to tone muscle you will get better results using less weight and performing more repetitions. But if you want to bulk up, you will need to increase the amount of weight you use and do fewer reps. Wear a weight belt during weight training to keep the spine aligned, and exhale as you exert effort. Working with a spotter when using free weights is also advisable, in order to avoid injury.

Flexibility Exercises: Maintaining a limber, flexible body is another essential component of optimal physical health. Flexibility enhances overall physical performance by allowing the various muscle groups to operate at peak efficiency, maintains good posture, and decreases the chance of injury. Improved circulation and increased tendon and ligament health are other benefits of muscles that are strong and flexible.

The most common method of promoting flexibility is to stretch. Stretching exercises are best performed before and after other types of exercise, after five minutes or more of movement, which improves circulation and makes stretching easier. As you stretch, you should feel tension in the muscle or muscle group you are stretching, but not to the point of pain. Breathe into the stretch as you perform it. This both elongates the muscle further, and relaxes it, enabling you to hold the stretch for thirty seconds. Repeat each stretch two or more times, which will increase your range. Over time, a few minutes of daily stretching will result in a noticeable improvement in how you feel.

Yoga is another popular form of stretching, which both improves flexibility and increases muscle strength. Proper breathing is essential to all forms of yoga and, in addition to enhancing flexibility, also results in improved concentration and mental and emotional well-being. There are many forms of yoga, with hatha yoga being the most popular form in the West. Yoga is increasingly being recognized by researchers as an optimum form of overall exercise, since it combines aerobics and strength conditioning with stretching to provide a total body workout. Ideally, it is best to spend a few months receiving instruction from a qualified yoga teacher in order to learn the proper way of performing each yoga pose, or asana.

A variety of bodywork techniques, such as Rolfing and The Feldenkrais Method, also promote increased flexibility and greater body awareness and physiological function.

As a complement to proper exercise, be sure to also get adequate amounts of sleep, which, according to Joseph Pizzorno, N.D., a leading holistic physician and founding president of Bastyr University, one of the most important aspects of ensuring optimal health. "It's while we are sleeping that the body's regenerative processes are at work," Dr. Pizzorno explains. "But in our society today, adequate sleep is becoming lost. We are averaging almost two hours less sleep a night than we got one hundred years ago. And even when we are getting the sleep, we aren't sleeping as deeply. We're sleeping later at night and bypassing the normal circadian rhythm that's created by nature."

Dr. Pizzorno's claims are borne out by the fact that 60 million Americans suffer from insomnia, costing the U.S. economy over $107 billion annually. Lack of sleep results in depressed immune function, increased susceptibility to disease, stress, diminished mental acuity, depression and anxiety, poor job performance, and increased risk of accidents. While commonly prescribed sleeping pills can provide benefit in cases of insomnia and other sleep problems, they can also be fraught with side effects and possibly lead to dependency. A more holistic approach to promoting proper sleep is to establish a regular bedtime each night in order to reattune yourself to nature's circadian rhythms, which research shows has a definite counterpart in the human body, both neurologically and within the endocrine system. To improve your sleeping habits, consider retiring no later than 10 P.M. and establishing an early wake-up time of 6 to 7 A.M. every day, regardless of when you go to bed. If additional help is needed, consult with a holistic physician, who can help you determine and alleviate whatever other factors may be interfering with your ability to get a good night's rest.

Environmental Awareness
Living in an environment that is free of environmental toxins and pollutants, breathing good quality air, and drinking pure, clean water, is essential for good health. Unfortunately, doing so is becoming an increasingly difficult task in today's modern world. Yet a variety of self-care measures are available that you can employ preventively and therapeutically to safeguard yourself from harmful chemicals and pollutants.

According to Dr. Ivker, an internationally recognized specialist in the holistic treatment of respiratory conditions, one of the most important aspects of environmental health is clean, fresh air. "Sixty percent of all Americans live in areas where the air quality is unhealthy, according to EPA standards," he points out. "In addition, many new, air-conditioned buildings suffer from 'sick building syndrome,' and are breeding grounds for airborne bacteria and fungi." To mitigate against such factors, Dr. Ivker recommends supplementing with antioxidants (see above), following a healthy, whole foods diet, and drinking plenty of pure, filtered water to flush out toxins in your system. "It's also helpful to create a setting of indoor plants in your home and at work," he says. "Plants oxygenate the air, create more moisture, which makes for healthier breathing, and some plants also filter out carbon monoxide and organic chemicals. Plus, they add beauty and can increase feelings of well-being." More importantly, Dr. Ivker also recommends using a humidifier and especially a negative ion generator, which functions as an extremely efficient air cleaner.

Using natural products that emit no pollutants is another important step anyone can take to reduce indoor environmental pollution. Such products include wood, cotton, and metals, in place of synthetic particle board, plastics, and polyester. Other environmental self-care measures include avoiding second-hand smoke (if you smoke, get help to quit), using efficient furnace filters at home, reducing the use of coal- and wood-burning fireplaces and stoves, replacing commercial cleaning agents with nontoxic products (available in most health food stores), regularly cleaning carpets and rugs to prevent mold and bacteria build-up, keeping the bedroom window open during sleep to ensure a stream of fresh air, maintaining proper ventilation at home and at work, taking regular breaks away from your computer, and spending regular periods of time outdoors in a natural, unpolluted setting.


Holistic physicians view mental health as a condition of peace of mind, contentment, and positive beliefs and attitudes. These mental and emotional aspects are interrelated and fall under the province of Mind/Body medicine. While competent professional care may be required for people suffering from depression, bipolar disorder (manic depression), or chronic, unresolved grief, sorrow, or anger, a variety of self-care measures are available for creating a more positive mental and emotional outlook. Among them are affirmations, breathwork, journaling, and conscious laughter. Working with one or more of these methods will help you become more aware of your thoughts, emotions, and beliefs in a way that will better enable you to meet your personal and professional goals, and experience improved levels of energy and greater well-being.

Affirmations. Most people's predominant beliefs are handed down to them when they are children by their parents, teachers, and other influential adults. The thoughts and ideas they heard expressed helped to shape their own world view, and for the most part remained with them as they grew into adulthood. Usually this process occurs unconsciously, and often with limiting consequences during adulthood, if the beliefs remain unexamined. By becoming conscious of our beliefs, we gain the power to change or eliminate those that no longer serve us, replacing them with those that do. Working with affirmations is one way of accomplishing this.

Affirmations are positive messages that you repeat to yourself either verbally or in writing in order to produce a specific outcome. Over time, they affect the unconscious by "reprogramming" it with the thought patterns you consciously select to influence your behavior. In the process, they can unleash and stimulate healing energies in all areas of your life.

Because of their simple nature, the greatest challenge in working with affirmations is to suspend judgment long enough to allow them to produce the results you desire. In addition, it helps to feel your affirmations as you recite or write them, since this brings more energy to the experience. Make the process as vivid and real as possible.

The following guidelines are recommended for anyone interested in beginning an affirmation program:

Always state your affirmation in the present tense and keep it positive.
Keep your affirmations short and simple, no longer than two brief sentences.
Write or verbalize each affirmation ten to twenty times each day.
Whenever you experience yourself thinking or hearing a habitual negative message, counteract it by focusing on your affirmation.
Schedule a regular time each day to do your affirmations to add momentum to what you are trying to achieve until it becomes a positive, effortless habit.
Repeat your affirmations in the first, second, and third person, using your name in each variation. First person affirmations address any mental conditioning you have given yourself, while affirmations in the second and third person help to release the conditioning you may have accepted from others. In each case, write out or repeat the affirmation ten times.
Make a commitment to practice your affirmations for at least 60 days or well beyond the time you begin experiencing the results you desire.
Visualize your affirmations by closing your eyes and imagining what the affirmation looks and feels like as you say or write it. Try to engage as many of your senses as possible.

An additional affirmation technique, developed by Leonard Orr, the founder of Rebirthing (see below) makes use of a "response column." According to Orr, who has worked with affirmations for over four decades, this technique will help you become more aware of unconscious limiting thoughts and beliefs. The exercise is performed as follows: Draw a line down the middle of a piece of paper. On the left hand column, write out the affirmation you are working with. On the right hand column, immediately write the response that occurs to you without judging it. For example, if you desire more energy, your affirmation might be, "I have abundant energy throughout the day," while your initial response might be, "It's all I can do to get out of bed in the morning!" Note your response, then write your affirmation again, followed by your next response. Do this at least ten times, twice a day, until your response becomes neutral or you truly feel in agreement with your affirmation. In this way, over time, you will be drudging up and releasing the various limiting, negative beliefs you've unconsciously been holding onto, and replacing them with thoughts and images that better serve you.

Breathwork. We can live for weeks without food, and days without water, but if we stop breathing for more than few minutes, we die. Yet most people breathe inefficiently and unconsciously, breathing shallowly through the chest and depriving themselves of the many benefits proper breathing can provide. These benefits are not only physical. Proper breathing also relieves stress, enhances feelings of well-being, and promotes clearer thinking. According to Leonard Orr, who has taught a breathwork technique known as Rebirthing to thousands of people for the last four decades, learning to breathe fully and consciously can also heal the parts of ourselves that are wounded, rejected, or disowned, restoring them to wholeness.

Rebirthing, or "conscious connected breathing," is perhaps the most popular form of modern breathwork techniques, all of which focus on breathing in a manner that moves energy through the body and connects you with suppressed emotions and limiting beliefs in order to heal them. Most forms of breathwork employ connected breathing, meaning that each inhalation and exhalation is connected and occurs without pausing, unlike unconscious breathing, in which there is typically a gap between the inhale and the exhale. The rate of respiration varies; sometimes it is rapid; sometimes it is deep, slow, and full. Because of the emotional release that can result from such techniques, it is advisable to learn them under the direction of a skilled breath therapist. The following exercise, however, can be safely performed by anyone to relieve stress and increase energy.

Sit straight and in a relaxed manner, placing your palms on your chest and belly. Now breathe as you normally do. Most likely when you inhaled your hand covering your chest moved, while your other hand did not. In this exercise, you are going to reverse this pattern by breathing in through your stomach area. Keeping your hands in the same position, once more inhale, this time directing your breath in and out through your belly. Don't strain and remember to breathe fully, without pausing between the inhale and exhale. At first, this exercise may feel odd and even difficult, but with practice it will become easier. The goal is to breathe freely and deeply only through the belly, so that your chest does not rise. (Keeping your hands in position will help you monitor your progress.)

Breathing in this manner on a regular basis is a very effective way to relieve stress, improve energy, curtail anxiety and depression, and enhance digestion. Try to breathe in this manner for at least twenty minutes each day, and whenever you feel tired, tense, or irritable.

Journaling. Also known as "expressive writing," journaling is an easy yet powerful way to keep track of your personal experiences, while also allowing you to develop new insights and solutions to your problems, discover unconscious beliefs that may be limiting your growth, and appreciate all for which you currently can be grateful. People who make a daily habit of writing entries in their journals report a deeper understanding of themselves, and often become better able to achieve their goals, including health. For many people, journaling becomes a productive form of therapy which can lead to a new understanding of how and why they act the way they do. In the process, they often become better aware of their beliefs, and discover how to change those that don't serve them. Journaling is also valuable for people who have difficulty expressing their emotions. In their journals they have the opportunity to write out and resolve what they are feeling, without having to worry about others judging them.

The most common form of journaling is keeping a diary. What follow are three other forms of journaling you can use to create more vitality and personal satisfaction in your life.

The Gratitude Journal: This type of journaling is best performed at the end of the day, prior to going to bed. Its purpose is to help you better appreciate all that you have to be grateful for each and every day of your life. No matter how misfortunate you may feel at any given time, if you truthfully investigate your life you can always find reasons to be grateful, even when you are sick. By focusing on these positive factors, you can stimulate your immune system to operate more efficiently.

To keep a gratitude journal, write down each night all the events of the day that caused you to feel happy, even those you may not have noticed when they happened. Don't rush this exercise. Take time to really examine your day and make a list of all the people and events that made you happy, allowing yourself to reexperience that happiness as you write about it. Over time, this exercise can substantially improve your mood, self-esteem, and confidence levels, boosting your physical well-being in the process.

The Stream-Of-Consciousness Morning Journal: This method of journaling was popularized by Julia Cameron, author of The Artist's Way. She suggests that upon arising each morning, you fill up three pages of paper, writing down whatever thoughts come into your head. Don't edit yourself, just write all the thoughts that occur to you. Cameron and other proponents of this method claim that this exercise helps people rid themselves of "mental debris," allowing them to become better able to then focus on and accomplish their goals during the rest of the day.

A variation of this technique is to write for 15 minutes and then read over what you wrote, underlining any thoughts that you find negative. Then rewrite each of them as a positive affirmation (see above). For example, if you wrote, "I'm feeling tired and I wish I didn't have to get up and go to work," your rewrite might read, "I am naturally energetic and enjoy my job." Do this for each sentence you underlined. At first, you may feel resistance during this process, yet over time you will discover how performing it helps you create the reality you prefer for yourself.

The Illness Dialogue: Illness often has a mental or emotional component that isn't readily apparent. This form of journaling helps to uncover the "hidden" meaning or message of your illness so that you can better understand the causes behind your symptoms. Often, once these psychological causes are understood and accepted, the illness itself also resolves.

Perform this exercise by asking yourself the following question: "If this illness (or pain) could speak, what would it say?" Then write down the first impression that comes to you. Once again, don't edit yourself. Write down whatever occurs to you, even if it seems ludicrous or upsetting. Then read your response and ask yourself the first question that presents itself. Then write down your next response. Repeat the process until no further questions occur to you or you feel that you have the answer that can help you. Most likely you will need to repeat this exercise for a few days or more before your questions are resolved, but the rewards of doing so can be well worth it.

Conscious laughter. Modern science is now beginning to verify the adage, "Laughter is the best medicine." One of the most famous examples illustrating this point is that of Norman Cousins, who wrote of recovering from a potentially crippling arthritic condition after spending hours watching Marx Brothers movies and reruns of Candid Camera while taking megadoses of vitamin C. Laughing regularly caused his pain to lessen, until eventually his illness disappeared altogther. More recently, the work of Patch Adams, M.D., founder of the Gesundheit Institute in Arlington, Virginia, has spurred increased interest in laughter's therapeutic effects, so much so that Dr. Adams' life was the subject of a hit movie starring Robin Williams.

Hearty laughter offers many of the same benfits as gentle exercise. Laughing exercises the facial muscles, shoulders, diaphragm, and abdomen. Laughter also decreases anxiety and stress and can improve our outlook on life, which is very useful when we get sick. Research shows that laughter may also boost endorphin levels, increase circulation, and enhance immune activity.

All of us laugh at certain times throughout each day, but we can increase laughter's benefits by consciously choosing to laugh more often. Doing so requires commitment and a willingness to cultivate a sense of optimism and humor, however. Like any skill, learning to become a conscious laugher takes practice, but when you find yourself laughing throughout the day, you can be sure that you are increasingly becoming healthier in every area of your life.


Spiritual health, while often the most overlooked aspect of healing, is actually the ultimate goal of holistic medicine, and leads to a heightened awareness of the Divine Spirit referred to by all religions. "It isn't important what name you give it," Dr. Ivker points out. "What matters is that you come to know and attune yourself to its guidance in all areas of your daily life. Doing so will reduce your feelings of fear, and provide you with a greater capacity for loving yourself and others unconditionally. It will also help you reconnect to your special talents and gifts and use them to fulfill your life's purpose."

In addition to being consciously aware of the role Spirit plays in your life, being spiritually healthy also means being intimately connected to your spouse, partner, family, friends, and community, resulting in social health, as well. "Spiritual and social health are interconnected, since it is through our committed relationships that we find the greatest opportunities for spiritual growth and for learning how to receive and impart unconditional love," Dr. Ivker says.

In addition to the observance of spiritual and religious traditions, working with spiritual counselors and support groups are common methods of creating spiritual and social health, as are the opportunites afforded us through our friendships, marriage, intimate relationships, and parenting. A variety of self-care approaches, including prayer, meditation, gratitude, and spending time within nature, can further deepen your awareness of yourself as a spiritual, socially-connected being, and are increasingly being recommended by conventional and holistic physicians alike.

Prayer is the most common form of spiritual practice performed by most Americans, and the majority of people who pray report a greater sense of well-being than those who don't. Harvard researcher and mind/body medicine expert Herbert Benson, M.D., author of The Relaxation Response, has found that regular prayer or the repetition of spiritual phrases such as "Shalom," or "Hail Mary," triggers relaxation and reduces stress.

There are many effective ways to pray, both for yourself and for others. Many people find great benefit using the prayers from their religious upbringing. Others make prayer a time of personal conversation with God, stating their need or concern and asking for divine intervention. Others find talking a walk in a place of natural beauty to be a form of prayerful worship. Simply taking the time to acknowledge all you have to be grateful for and giving thanks can be effective as well. Choose the form of prayer that feels most comfortable for you, then establish a regular routine of repeating your prayers daily.

Meditation has been scientifically researched and proven to have physiological benefits for decades. Besides its physical benefits, which include stress-relief, improved immune and cardiovascular function, relaxation, and decreased pain, the regular practice of meditation can lead to new insights about life issues (often resulting in the healing of past emotional trauma), heightened creativity, inspiration, greater compassion for others, and a greater connection to one's own inner guidance.

There are a wide variety of meditative techniques to choose from and, as with prayer, choosing the one that you are most comfortable with will provide the greatest benefit. Meditation can be performed while sitting, lying down, or while walking or jogging. Some people also prefer singing or chanting a word or phrase that has spiritual significance to them. What all meditative techniques have in common is conscious breathing (see above) and a focus on what is happening in each present moment, until the mind becomes empty of thoughts, judgments, and past and future concerns.

A simple way to meditate is to sit comfortably erect with your eyes closed, while paying attention to your breathing. Observe yourself inhaling and exhaling, allowing whatever thoughts you have to pass you by. In the beginning of your practice, you will find your mind wandering. Each time this occurs, gently refocus on your breath. To improve your concentration, you can also silently repeat a word, or mantra, such as love, peace, or Jesus. Eventually, you will experience longer periods of silence between each thought, although it may take months before this occurs. Be patient and don't force matters. Try to sit for 10 to 20 minutes once or twice a day, but if you find yourself too distracted or pressed for time, end your session, instead of sitting restlessly. With commitment and consist practice, the benefits of meditation will become apparent to you, and you'll realize your efforts are well worth it.

Gratitude. Dr. Robert Anderson describes gratitude as the Great Attitude. "Gratitude produces feelings of joy and self-acceptance, and is an attitude that anyone can choose to have, just as we can choose to see the glass half full or half empty" Dr. Anderson says. "Being grateful for what you have, instead of worrying about what you lack, enables you to let go of negative thoughts and attitudes more easily. This can be difficult at times, especially if you are feeling a great deal of fear or anger, but if you make the effort to release these painful emotions and choose to be grateful, instead, positive benefits can be achieved."

One method of cultivating feelings of gratitude is keeping a gratitude journal, as outlined above. A variation of this technique is to close your eyes before bed and mentally review your day, taking an inventory of all the things that happened for which they feel grateful, silently giving thanks for them. "By making gratitude a regular part of your daily experience, you set the stage for living more deeply connected to spirit, "Dr. Anderson says. "In the process, your life will be transformed into an increasingly joyous adventure."

Spending time in nature. The most visible manifestation of spirit is nature, where we most fully encounter and interact with life's primal energies in the forms of earth, water, fire, and air. Taking a walk in a park or hiking through the woods are easy and practical ways of reconnecting with nature, as are gardening, bike riding in the country, and camping and boating trips. By making it a habit to spend regular amounts of time outdoors within a natural setting, you enable yourself to better appreciate the rhythms of life, including your own. As Dr. Ivker points out, "We need to recognize that cities and other industrialized areas can prevent us from living a life of balance. Spending time in nature helps restore that balance, while also deepening our connection with Spirit."

Spending time near the water can also be a spiritually healthy experience, due to water's higher concentration of negative ions, which can contribute to feelings of well-being. Swimming in the ocean, lakes, or rivers is a great way to benefit from this life-enhancing energy. Soaking in a mineral hot spring can provide therapeutic benefits for a variety of ailments, as well.

Exposure to fire around a campground or before a fireplace can also have health benefits, according to Leonard Orr, who has found that fire cleanses the bioenergy field of negative energies, and can be a powerful aid in curing physical disease. Orr recommends spending a few hours each day before fire for people who want to experience such benefits. Fire is also an important component of the vision quests undertaken by Native Americans to connect with the Great Spirit and discover their life purpose.

Of all nature's elements, perhaps the closest expression of Spirit is the air. Clean, fresh air is essential to health on all levels, and practicing conscious breathing as outlined above is a potent self-care method for restoring energy and making you more aware of the power of Spirit as it flows through you.

Regularly exposure to each of these four elements can help you become more conscious of how Spirit's loving intelligence sustains the world, while more deeply recognizing your place within it.

All of the principles and practices outlined above can lead to a significant improvement in your physical, mental and Spiritual well-being once you make them part of your regular health routine. Rather than try to adopt them all at once, it is best if you choose one or two areas to work on until you feel comfortable enough to incorporate more. Doing so will help you create momentum and lessen the chance of failure and discouragment. At times, however, self-care alone will not be enough to meet the challenges of disease or other life challenges. During such times, the services of a skilled health practitioner should be sought. Within the field of holistic medicine a variety of therapies are available to assist you on your healing journey.

Larry Trivieri, Jr. is a leading lay expert in the field of holistic healing methods and personal transformation, which he has been exploring for the past 25 years. In addition to serving as senior editor of Alternative Medicine: The Definitive Guide, he is the co-author of The Complete Self-Care Guide to Holistic Medicine, contributing editor to Alternative Medicine magazine, and a frequent lecturer on the principles of holistic health. His most recent work, The American Holistic Medical Association Guide to Holistic Health, provides in-depth overviews of more than 25 of the most common professional care holistic therapies. Currently, Mr. Trivieri is writing his next book, Health on the Edge: Visionary Views of Healing in the 21st Century, which is scheduled for publication in 2002. Readers can contact him by e-mail at larrytriv@yahoo.com.

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