Contributor: Andrea Yeh
Work and Life is a radio program hosted by Stew Friedman, director of the Wharton Work/Life Integration Project, on Sirius XM’s Channel 111, Business Radio Powered by Wharton. Every Tuesday at 7 pm EST, Stew speaks with everyday people and the world’s leading experts about creating harmony among work, home, community, and the private self (mind, body, and spirit).
On Work and Life, Stew Friedman spoke with Robert Hedaya, psychiatrist, founder of National Center of Whole Psychiatry. The following are edited excerpts of their conversation.
Stew Friedman: How did you come to look at your patients as whole people not just a picture of symptoms, but people trying to create harmony and integration in their lives and health? What is it that shaped your thinking?
Robert Hedaya: The short answer is that back in about 1983 or so when I first went into practice, I had a patient who was a 50-year-old woman. She had one child and a marriage that wasn’t so good, and her child was going off to college. She started having panic attacks, and I thought she was anxious about having to live with her husband or leaving her husband. I went through a series of standard treatments over the course of a year. Nothing worked – not therapy, not various medications, not cognitive behavioral therapy. I went back to the drawing board. I looked at her labs and saw that the size of her red blood cell count was a little bit larger than the upper limit of normal. I did a little research and found out that it could be a B12 deficiency. I gave her a B12 injection, and her panic attacks cleared up overnight. I was blown away. And I thought, “Gee, this is important. I wonder what else I’m missing. What else wasn’t I taught, and what didn’t my teachers know?” I eventually figured out that it is essential to remember that the head is connected to the body by the neck. I learned all the different interactions between the body and the mind and ultimately how the mind is really influenced by every level of our environment.
SF: As you know, on this show we focus on work and the rest of life, including our minds and our bodies and our spiritual lives, as well as family and communities. We’re looking at how the four domains of work, home, community, and self interact; how they affect each other in both positive and negative ways; and what can be done to maximize the former. In the National Center for Whole Psychiatry, what is your primary mission, and how do you go about serving it?
RH: l I’ve shifted my focus recently, and I’ve decided to look closely at inflammation because inflammation really is the key factor for all of our chronic illnesses. Inflammation is affected by psychiatric conditions. Just take an example in the workplace: If you have a boss who is abusive, if you’re having trouble with your colleagues, or if you’re frustrated and you’re having continual difficulties, these all cause changes in your immune system, which leads to changes in your gut. Most of your immune system is around your gut, so then you get these immunological changes, which will bring out various illnesses over time.
SF: Inflammation – can you define what that is for our listeners?
RH: When you get a cut and you see redness and increased blood flow and heat, that’s a localized inflammation. We have more and more difficulty as we age in controlling inflammation, so we might have more aches, more pains, more joint problems. We may have inflammation in our cardiovascular system, for example. And inflammation is at the root of atherosclerosis, the hardening of the arteries. Inflammation is also at the root of dementia, osteoporosis, diabetes, etc.
SF: What are some of the most important aspects of the work environment that can cause problems like the ones you’re studying now with inflammation in various body systems?
RH: A useful metaphor is to think of concentric rings. On the outermost ring might be something like the stability, innovation, or financial condition of the organization that you’re a part of. Then you move to a ring that’s closer into you, and you might have management issues, which might be having an even closer and more direct effect on you. Of course if these are good situations, your health improves and wellbeing improve. If there is an opportunity provided by the organization and management to grow – challenges, learning, stimulation, supportive relationships with you, your colleagues, etc. – that also supports your health. Then if you move even a little bit closer in, it might have to do with your immediate work environment, say the floor you’re on, the office you’re in. Maybe the lighting is affecting you in a positive way or negative way. Maybe there’s a moldy environment. Then you can move more intimately towards yourself to look at the relationships that you’re involved in on the day-to-day and the hour-to-hour basis at work and examine how those are affecting you. Ultimately if you come in even closer, it’s worth asking how your skill set fits with the kind of work you do. Does it provide you the opportunities that you as a person need to feel fulfilled, to find meaning in your life, and to be challenged?
SF: Let’s dig a little further into that if we can. From a whole psychiatry perspective, there’s just so much you could look at, in terms of identifying the sources of physical and mental strain. How do you know where to start? Especially if the source of the problem is at work, how do you find that in your intake and diagnostic?
RH: I spend a lot of time with people. I’ll usually spend four hours on intake. I’ll do a medical history and a physical, and I’ll talk with family members. That’s something that’s not accessible to everybody. I wrote a book about ten years ago that’s still available called The Antidepressant Survival Program. The content of the book gives an analysis of different aspects of a person’s life. Going through that might help you identify areas of vulnerability.
SF: So the book takes you through a kind of diagnostic checklist to look at things that might be affecting your health?
RH: That’s right. I think that’s one way of doing it. Another way is to think about where you feel best at work, and where you feel worst. What are the stresses at work, and what are the strengths? What is it you wished you had more of? When were you happiest in your work life?
SF: I wonder if you could share an example of someone who you’ve treated where there was a work element to both the diagnostic and the treatment that helped.
RH: I have a good story about a woman who was in her fifties working for the government. She started to become ill, and we went through the whole checklist of situations in her life, but nothing had really changed. It turned out that an important factor was that she had recently advanced in her career and moved to a different building. Many government buildings are old, and she moved into a building that was full of mold – it was a sick building.
SF: Sick building?
RH: Yes, it’s called “sick building syndrome.” There was a lot of mold and toxins in the air. It turns out many of the people that she was working with would become ill. There was just a lot of subtle illness. So when we got her to work at home, she just really cleared up.
SF: Amazing. Bob, is there one piece of advice you’d like to leave our listeners with in terms of how to think intelligently about their mental and physical health and how their work affects it?
RH: I think the key comes down to finding meaning in your work; that is the most important thing.
You can find meaning in work by the nature of your work, by the nature of the relationships you have, by helping people around you, and by being of service to the people around you. Hedaya’s work underscores the importance of evaluating our lives holistically. Given that mental, social, and physical problems may all be interrelated, finding a resolution to an issue we face may require a multi-dimensional analysis. As Hedaya suggests, we can ask ourselves, when we have personally found our work and life most rewarding, and what were the circumstances surrounding that satisfaction? Have you experienced instances where your physical and mental well-being affected one another in a positive and synergistic way? Share your experiences and thoughts in the comments section below.
To learn more about Dr. Hedaya, the Founder of the National Center of Whole Psychiatry and his work, read his book, or visit the National Center of Whole Psychiatry on Facebook.
ABOUT THE AUTHOR Andrea Yeh is an undergraduate junior majoring in Operation and Information Management and in International Relations.