During one of my on-call shifts as a chaplain, I encountered an 18-year-old female patient who was brought into the hospital due to a suicide attempt. She was in distress. I introduced myself as chaplain, and I told her that I could provide emotional support without making any judgments. I operated primarily through empathetic reflections and unconditional positive reinforcement. She expressed her fears, stressors, and why she wanted to die. She told me that when she was five years old, she was sexually abused by her biological father. She was traumatized and had been experiencing fear since she heard that he was released from jail. She said that this distress and fear led to her suicide attempt. I was able to provide emotional support through active listening, validation, and normalization of her feelings.

In reflection, this case drew my attention to the importance of awareness about adverse childhood experiences. It is very important for a peaceful society to have individuals who are spiritually and physically healthy. In 2019, research was published in the US by the Centers for Disease Control and Prevention (CDC), the national public health agency of the United States, regarding trauma exposure during childhood. According to the CDC, adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, as well as impacts on lifelong health and opportunity. ACEs are one of the major public health problems that result in long-term mental and physical health problems. 1 in 6 adults have experienced four or more types of ACEs. Females and certain racial/ethnic minority groups, such as African Americans and Hispanics, are at greater risk of experiencing 4 or more ACEs. At least 5 of the top 10 leading causes of death are associated with ACEs.

As we have seen in scientific studies on brain development, most human brains take about 23-25 years to develop, though these rates can vary between men and women and among individuals. However, the formative ages between 0 to 16 matter a lot for brain development. The amygdala, which is part of the medial temporal lobe, plays an outstanding role in mediating many aspects of emotional learning and behavior. It is responsible for the response and memory of emotions, especially fear. The effects of trauma, early life stress, or ACEs on the developing brain alter the amygdala and the structure of certain brain regions. If a human being is exposed to fearful activities or threats, the amygdala automatically responds to threatening or dangerous stimuli. It is a kind of defense and coping mechanism. These threats create toxic stress and affect the amygdala and other brain functions.

Stress is not always unhealthy. Stress can encourage healthy growth. However, exposure to childhood traumas included in the ACE study can result in stress that becomes chronic, and changes can occur in the developing brain and body [1]. Adverse childhood experiences such as neglect, abuse, household dysfunction, terror, and war create fear and toxic stress which are not good for the amygdala and other brain functions. 

A large proportion of adults (61%) reported trauma exposure during their childhood ages [2]. According to the CDC, 61% of adults had at least one ACE and 16% had 4 or more ACEs. Many people do not realize that exposure to ACEs is associated with an increased risk of health problems across one’s lifespan, including diabetes, cardiovascular disease, obstructive pulmonary disease, obesity, cancer, asthma, and depression.

Various studies have shown there are measured relationships between specific ACEs and diabetes. After combining data from four UK studies, it was found that, compared with adults with no ACEs, those with 2-3 ACEs had a 1.3 times greater risk of type 2 diabetes—and those with 4+ ACEs had a 2.1 times greater risk [3].

One major group of people that go through a specific trauma is immigrants, especially refugee children. Currently, there is an ongoing war between Ukraine and Russia, and there are still refugees fleeing Middle Eastern countries damaged by war and dictatorial regimes. Fearing arrest, torture, or even death, many people have fled the safety of their homes. In these conflicts, many people—including children—lost their loved ones or were physically injured. They were forced to migrate and flee their homes and their schools. These traumatic incidents are very vivid, and many victims struggle to cope with these tragic events. Integrating into new places, such as refugee camps or shelters, is not easy. Some children lost their family members while they were fleeing.

Zeynep, the daughter of one of my close friends, was just a baby when she spent 16 months in prison with her mother. When her mother was finally released under judicial control, her father got arrested. She could spend only 27 days with both parents. I still remember how, outside of a courthouse, she approached a dog and asked, “Hey, dog, where is my mom?” Unable to make her voice heard by people, she tried to be heard by a dog.

Such traumas irrevocably shape the way a child’s mind will form—and potentially lead to life-long health problems.

Many victims of war and human rights violations (HRVs) experience feelings of insecurity, fear, and grief, as well as intense resentment and anger. Their senses of identity, meaning, values, worldview, coping styles, and social functioning are often affected. When forced migration adds to the multiple pre-flight losses and traumatic experiences of many refugees, the challenges of acculturation, ongoing worries, and hardships in the post-migration phase may increase the severity of symptoms and suffering. The cumulative burden of pre-flight, flight, and post-flight experiences is reflected in the complex symptom patterns and comorbidities found among refugee patients in health care settings [4].

In light of these studies, intellectual people, journalists, civic and religious leaders, politicians, and NGOs must take immediate action to prevent adverse childhood experiences (ACEs) and trauma exposure such as war, terror, poverty, hunger, abuse, household dysfunction, and human rights violations. 

Clearly, the prevention of ACEs is a challenge, but clinicians, teachers, caseworkers, community leaders, and spiritual counselors also have an important role to play. There are actions clinicians can take in their practices that may help prevent ACEs and reduce the harms associated with exposure to ACEs. It is essential that professionals and volunteers become educated about and recognize ACEs and learn strategies for the prevention of ACEs—and caring for patients who have experienced ACEs. Community centers, social support groups, and government agencies also have an important role in providing spiritual, emotional, financial, and educational support to victims who have experienced ACEs. Mentoring programs, after-school programs, and high-quality childcare could be helpful for victimized children. Connecting youth to caring adults helps to ensure safe, stable, nurturing relationships as well as mitigating the immediate and long-term physical, mental, and behavioral consequences of ACEs.

References

1. Gail Hornor DNP, CPNP “Childhood Trauma Exposure and Toxic Stress: What the PNP Needs to Know.”
2. Rachel L. Loewy,a Sarah Corey,b Felix Amirfathi,a Sawsan Dabit,c Daniel Fulford,d Rahel Pearson,e Jessica P. Y. Hua,f Danielle Schlosser,a,g Barbara K. Stuart,h Daniel H. Mathalon,a,i and Sophia Vinogradovj “Childhood Trauma and Clinical High Risk for Psychosis.”
3. Hughes, Karen; Ford, Kat; Bellis, Mark “Adverse Childhood Experiences (ACEs) and Diabetes | A brief review.”
4. Opaas, Marianne Cand Psychol, CP^*; Varvin, Sverre Dr.Philos, MD “Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre-Flight Experiences of War and Human Rights Violations.”

“Free radicals” are a special type of atom that have been linked to many age-related diseases. They form as a result of a process called Oxidative Stress, which takes place when an oxygen molecule splits into single atoms with unpaired electrons. The nature of electrons is such that they like to be in pairs and as a result will “freely” and “radically” search throughout the body for another electron to pair with. They could almost be considered romantic if they were not so dangerous!

Their main danger comes from the damage that they cause to cells or cell membrane, proteins, and DNA. Cellular damage occurs when free radicals travel through cells and disrupt the structures of other molecules. The gradual accumulation of them, and the increased damage that builds as more and more of them collect, is what helps cause many of the aforementioned aging diseases. Our body is under constant assault from oxidative stress, and cells may function poorly or die if it occurs too frequently and without proper bodily maintenance.

Free radicals are a waste byproduct that form as a result of various chemical reactions that take place during our bodies’ normal metabolic processes. They are then “dumped,” and their eventual buildup will often harm our bodies much like how factory waste harms the environment However, they are not entirely useless; it is impossible for our bodies to turn air and food into chemical energy without a chain reaction of free radicals. Free radicals are also a critical part of the immune system, as they additionally move through our veins and can confront foreign invaders [1].

What are free radicals?

Understanding free radicals necessitates an elementary knowledge of chemistry.

Electrons orbit around atoms in levels called shells. Each shell is filled by a fixed number of electrons, and when the first shell is full then electrons will start to fill the next shell.

If there is an atom whose outer shell is not full then it may bond with another atom by using the electrons to fill its outer shell. These types of atoms are known as free radicals.

Atoms that have a full outer shell become stable, however free radicals are unstable. They are “desperate” to acquire the full number of electrons that are necessary to fill all of their shells and will therefore react quickly with other substances.

Take the example of oxygen molecules. If they split into single atoms that have unpaired electrons then they too will become unstable free radicals that seek other atoms or molecules to bond to. If this procedure continually occurs, then it will begin a process called oxidative stress.

Smoking, UV rays, air pollution, fast food, pesticides, ionizing radiation, drugs, and inflammation have all been linked to the formation of free radicals. We must be diligent when it comes to understanding how these influences can affect our bodily health, and then fight back with natural antioxidants.

Free radicals are heavily linked to aging

One of the effects of oxidative stress is that it can damage our body’s cells and thus promote many of the diseases and symptoms related to aging, such as wrinkles and gray hair. They will take electrons from other atoms in order to become more stable, a process that may cause diseases or signs of aging [2].              

In 1956, the “Free Radical Theory of Aging” was outlined as a way to understand how exactly our bodies age over time. Everybody ages, and as we age our body loses its ability to fight the effects of free radicals. Over time our bodies produce more free radicals and more oxidative stress, which increases the rate at which cells are damaged and thus can bring about degenerative processes.

Many age-related diseases such as muscular degeneration, certain cancers, atherosclerosis, cardiovascular disease, emphysema, Alzheimer’s disease, Parkinson’s disease, ulcers and all inflammatory diseases such as arthritis and lupus, and many others are linked to free radicals. Free radicals can be found in the food we eat such as fried foods, the medicines we take, the air we breathe, and the water we drink. Free radicals are also found in alcohol, tobacco smoke, pesticides, and air pollutants.

Several studies and theories have been linked to oxidative stress and the buildup of free radicals including: [3]

• Genetic degenerative diseases, such as Huntington’s disease or Parkinson’s
• Age-related changes in appearance, such as loss of skin elasticity, wrinkles, graying hair, hair loss, and changes in hair texture
• Cataracts and age-related vision decline
• Diabetes
• Cancer, which is associated with chromosomal effects and oncogene activation due to the reaction of free radicals [2]
• Central nervous system diseases, such as Alzheimer’s and various forms of dementia
• Cardiovascular diseases due to clogged arteries
• Autoimmune and inflammatory disorders, such as rheumatoid arthritis and cancer

The free radical theory of aging is comparatively new; however, several studies boost its credibility. Researchers focused on cell’s mitochondria, the “powerhouse” that process nutrients to power the entire cell. Experiments on rats, for example, showed a noteworthy increase in free radicals as the rats aged. These alterations coincided with age-related declines in their health. These experiments also showed that free radicals produced in the mitochondria harm the substances that the cells need in order to work properly. This damage causes mutations that produce more free radicals, thus accelerating the process of damage to the cell. This helps explain aging since aging quickens over time. The gradual, but increasingly rapid buildup of free radicals, offers one explanation for why even healthy bodies age and depreciate over time [2].

Antioxidants can stave off free radicals

Antioxidants, molecules that prevent other molecules from oxidizing and thus undergoing oxidative stress, can help to avert the harmful effects of free radicals. They can also decrease or even nullify the effects of free radicals, as they can provide an electron to free radicals and thereby reduce their reactivity. The uniqueness of antioxidants is that they can donate an electron without becoming reactive free radicals themselves.

There is no single antioxidant that can combat the effects of every free radical. Free radicals have different effects in different areas of the body, and every antioxidant performs differently due to its chemical properties. Antioxidants such as vitamins C and E, beta-carotene, glutathione, and plant estrogens called phytoestrogens all scavenge the body and help remove free radicals. Honey can also function similar to antioxidants by removing free radicals. Additionally, selenium, a trace metal that is required for proper function of one of the body’s antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micronutrients so they must be supplied in the diet.

Foods that are rich in antioxidants include citrus fruits such as oranges and limes, berries, and many other fruits that are rich in vitamin C. Carrots are known for their high beta-carotene content, while the soy in soybeans, and some meat substitutes, are high in phytoestrogens. Apricots, spinach, mangoes, pumpkins, broccoli, and eggplants are all also helpful, along with a plethora of other fruits and vegetables [4].

More research needed

A 2010 study on antioxidant supplementation for the prevention of prostate cancer found no benefits. Furthermore, a 2012 study found that antioxidants did not lower the risk of lung cancer. On the other hand, the study found that people who were already at a heightened risk of cancer, such as smokers, actually had a slightly elevated risk of cancer due to antioxidants.

Some investigators have found that supplementation with antioxidants is injurious when people take more than the recommended daily allowance (RDA). A recent analysis found that high doses of beta-carotene, or vitamin E, appreciably increased the risk of dying. One study found that long-term use of beta-carotene could reasonably reduce the risk of age-related mental problems [4]. But perhaps one of the most important discoveries is that antioxidants are unable to “cure” the effects of free radicals completely [5].  

Additionally, we do not yet fully understand why free radicals form in the first place. They may result as an early sign of cells fighting diseases, or that free radical formation is simply a natural expectation that comes with aging. It is not possible to understand them completely without more conclusive research, which should be encouraged considering the significant impacts that free radicals can have upon our bodies.

References

1. https://www.rice.edu/~jenky/sports/antiox.html
2. https://www.medicalnewstoday.com/articles/318652#How-do-free-radicals-damage-the-body
3. http://www.mytruehealth.info/mytruehealth_antioxidants_freeradicals.html
4. https://www.medicalnewstoday.com/articles/318652#Antioxidants-and-free-radicals
5. https://www.medicalnewstoday.com/articles/318652#What-we-do-not-know

Most of us have taken, or at least interacted with, medicine at some point or another in our lives. This can range from more “simple” over-the-counter drugs to more complex medicines specifically designed for exact illnesses. Considering the Covid-19 era we are going through and as search for a vaccine is at the highest possible speed, it is important to have at least a general idea on how medicines are developed for our use. This article aims to explore how a complicated mix of chemical compounds in a laboratory end up as pills on a shelf in your local pharmacy. We will also explore a brief history of pharmacology, where drugs get their names, how drugs come into fruition, the various affects that drugs can have on our bodies, along with the discrepancies that exist between them in regard to when, how, and why they should be taken.

Pharmacology is the study of the interactions that occur between a living organism and the chemicals that affect normal or abnormal biochemical functions. It includes the study of how a drugs can affect our biological systems, such as individual organs or an entire part of the body, and how the body overall responds to the drug. The discipline encompasses the sources, chemical properties, biological effects and, therapeutic uses of drugs. Substances with medicinal properties are considered pharmaceuticals, whereas drugs given for therapeutic purposes are usually called medications. Drug therapy, which is also called pharmacotherapy, is the use of drugs to prevent, diagnose, and treat signs, symptoms, and disease processes. When prevention or cure is not a reasonable goal, relief of symptoms can greatly improve quality of life and the ability to function properly on a day-to-day basis. Developing an understanding of this craft can allow us to better appreciate how molecules interact to form the drugs and medicines that can change our lives, and perhaps even allow us to contemplate their complex creation and existence.

In its most simplistic definition, a medication is a substance that is ingested or placed onto the body in order to cure a disease or condition (antibiotics are given to cure an infection), treat a medical condition (anti-depressants are given to treat depression), relieve symptoms of an illness (pain relievers are given to reduce pain), given to prevent diseases (flu vaccine helps to prevent the person from complications of having the flu).

Source of drugs

Historically, drugs were mainly derived from plants, animals, and minerals. Morphine, insulin, and iron are all commonly used examples of their respective sources. Belief in the curative powers of plants and certain substances rested exclusively upon traditional knowledge. But empirical information was not subjected to critical examination. Until the end of the 19th century, medicines were made by natural organic or inorganic products including mostly dried or fresh plants and their parts. These compounds might contain substances that possess healing properties or reactions that exert a toxic effect. It is important to remember that many fruits, vegetables, and plants still possess great power despite not having a “modern” origin.

Most drugs used nowadays are synthetic chemical compounds manufactured in laboratories which are synthesized by altering the chemical structure of an existing drug. The first drug of a particular group of drugs are called prototypes. For example, morphine is the prototype of opioid analgesics, and penicillin is the prototype of antibacterial drugs. Drug classifications and prototypes are defined and most new drugs can be assigned to a group. We must be hopeful and continue to search far and wide for cures for all  diseases, whether they be organic or synthetic, since our world is full of an infinite amount of possibilities and discoveries.

Drug names

The systematic naming of pharmaceutical drugs is called “drug nomenclature.” Drugs primarily have three types of names: chemical names, generic names, and trade names. The chemical names are the scientific names that often sound complex and are based upon the molecular structure of a drug. During development, the company will apply for regulatory approval of the drug by the relevant national regulatory agency, such as the U.S. Food and Drug Administration (FDA), and will be granted a generic name for it. Generic names usually indicate, via their stems, what drug class the drug belongs to. For example, oseltamivir is an antiviral drug because its name ends in the -vir suffix.

After development, testing, and regulatory acceptance of a drug, the pharmaceutical company gives the drug a trade name, which is a standard term in the pharmaceutical industry for a brand name or trademark name. Many drugs have multiple trade names which can reflect separate marketing strategies in different countries, manufactured by different companies, or both.

Drug investigation

A new drug investigation is the beginning of the journey of a chemical compound to a drug that will be used in clinics. The testing process of a chemical compound begins with animal studies to determine potential beneficial uses and also potential toxic side effects of the candidate compound.  The results from these animal studies are reviewed, and if the results are satisfactory, the compound then undergoes clinical trials in humans that people can voluntarily sign up for. Most clinical trials use a randomized, controlled experimental design that involves selection of subjects according to established criteria, random assignment of subjects to experimental groups, and administration of the test drug to one group and a control substance to another group.

Patent protection

New drugs that are developed by pharmaceutical companies will be covered under patent protection. This means that only the pharmaceutical company that holds the patent is allowed to manufacture, market, and eventually profit from the drug. This is seen as a return on the company’s investment that it took to develop the drug, which may require years of work and millions of dollars, along with an incentive for developing other drugs. Other pharmaceutical companies cannot manufacture and market the drug during the patent period.

Usually, the drug patent is awarded for around twenty years in the United States, however the number of years varies across countries and drugs. Pharmaceutical companies apply for a patent long before the clinical trial period even begins. The effective patent period after the drug has finally received approval is often around seven to twelve years. After the patented period expires the drug can be manufactured and sold by other companies. The drug is referred to as a generic drug at this point, and they are required to be therapeutically equivalent and much less expensive than trade name drugs.

Pharmacoeconomics

Pharmacoeconomics involves all of the costs that are accrued due to drug therapy and experimentation including those related to purchasing supplies, dispensing the drug, storing it, administrative fees, laboratory and other tests that are used to monitor patient responses, and losses from expiration. The length of a patient’s illness or hospitalization is also considered. While the most important factor is the health of the patient the costs for treatment are increasingly being considered as a major factor when choosing medications, and research projects that compare costs have greatly increased in recent years. The goal is to make it easier for patients to choose the most cost-effective drugs that combine high quality treatment at an affordable price. For drugs or regimens of similar efficacy and toxicity, there is considerable pressure upon doctors and pharmacies to prescribe less costly drugs for shorter duration.

Prescription and non-prescription drugs

In many countries, consumers have two legal routes of access to therapeutic drugs. One route involves a prescription or order from a licensed health care provider, such as a physician, dentist, or nurse practitioner. The other route is by over-the-counter (OTC) purchase of drugs that do not require a prescription. Both of these routes are regulated by various drug laws that change from country to country. Acquiring and using prescription drugs for non-therapeutic purposes, by persons who are not authorized to have the drugs or for whom they are not prescribed, is illegal.

The rejection of drugs in modern society

Nowadays, there are some people who deny various kinds of treatments because of their religious beliefs. This category of people is only a minority, as the majority of religions advocate for people to be healthy and to take care of their health as much as they can. In almost all belief traditions, the human body is believed to be a trust, and in case of any disease, the most appropriate and fastest treatment methods should be used. Even substances that are not normally permitted are allowed by scholars to be used if the person’s safety is concerned. For believers, the most important goal in life is to worship God, and for this to be possible the body must be healthy.

One day, people asked Prophet Muhammad, peace be upon him:

“Should we make use of medical treatment?”

He replied: “Make use of medical treatment, for God has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.”

People are encouraged to seek out those remedies and to use them with skill and kindness. Let us also remember that Jesus, peace be upon him, too, was very active in his ministry of healing. He showed by God’s permission miracles like curing the blind and the deaf, and bringing the dead back to life. Thus, religions do not refuse treatment with any available methods, and they even strongly encourage treatment and prevention of diseases.

Religions are also well known to treat stress, which wreaks havoc on the mind and body. It is still not known exactly how stress harms our health, but researchers have found that chronic psychological stress is associated with body’s losing its ability to regulate the inflammatory response. It has been shown that the effects of psychological stress on the body’s ability to regulate inflammation can promote the development and progression of disease. We know that religions and beliefs give people hope and significantly decrease the stress.

Human beings are the most precious creation, and health is necessary for us to achieve the purpose of our existence. Using scientific medicine together with faith and religion can help people to protect their health. Being the science of drugs and by investigating new drug therapies, pharmacology helps us exactly with that.

History of Pharmacology

Claudius Galen (129–200 A.D.) was the first person who attempted to consider the theoretical background of pharmacology.

Ali al-Tabari (838 A.D.) Medieval Islamic physicians used natural substances such as Papaver somniferum Linnaeus, poppy, and Cannabis sativa Linnaeus, hemp as a source of medicinal drugs. Although poppy had medicinal benefits, Ali al-Tabari explained that the extract of poppy leaves was lethal, and the extracts and opium should be considered poisons (4).

Theophrastus von Hohenheim (1493–1541), also known as “Paracelsus”, began to question doctrines from antiquity. He prescribed chemically defined substances with such success that professional enemies had him prosecuted as a poisoner. Against such accusations, he defended himself with the thesis that has become an axiom of pharmacology:

“If you want to explain any poison properly, what then isn‘t a poison? All things are poison, nothing is without poison; the dose alone causes a thing not to be poison.”

Johann Jakob Wepfer (1620–1695) was the first to use animal experimentation for pharmacological or toxicological actions.

Rudolf Buchheim (1820–1879) founded the first institute of pharmacology at the University of Dorpat (Tartu, Estonia) in 1847, which firstly made pharmacology as an independent scientific discipline. In addition to a description of effects, he strove to explain the chemical properties of drugs.

Oswald Schmiedeberg (1838–1921), together with his many disciples, helped to establish the high  reputation of pharmacology. He partnered with pathologist Bernhard Naunyn (1839–1925) to found the first journal of pharmacology, which has since been published without interruption.

After 1920, the pharmacological industry had their own pharmacology laboratories outside established university institutes. After 1960, departments of clinical pharmacology were set up at many universities and in industry.

References

1. Clinical Drug Therapy: Rationales for Nursing Practice – Seventh 7th Edition, Lippincott Williams &Wilkins.
2. Basic&Clinical Pharmacology, 12^th Edition, McGrawHill Lange.
3. Modern Pharmacology with Clinical Applications, Sixth Edition, Charles R. Craig and Robert E. Stitzel, Lippincott Williams &Wilkins.

Nooriye is a 39-year-old Iraqi female. She had a pretty normal life until a group of terrorists knocked on her door. Her two sons were killed in front of her. She was abused and tortured for days, as was her husband. Rebels eventually took her husband and left. Some neighbors helped her to bury her sons and provided her with shelter and food. She was about to kill herself when, miraculously, her husband came back 57 days later. He never told her what he went through during those 57 days. They were both in extreme pain but able to hold onto each other.

They immigrated to the U.S. a year later. Her husband found a job and is still working. They are safe now, but it has not been enough to heal them. Both still have nightmares and flashbacks. She spends all her time in her home. She stares at walls, feels numb and very fearful, and cries every day. Her speech is sparse, and she never smiles. She goes out with husband once a day but grabs his hand and won’t let him go when they are out. When faced with stress, she often passes out.

Her husband “has to be strong because she is the only thing he has,” although he also has extreme pain. He hides his tears from his wife, is unable to sleep at night, feels guilty, and misses his sons. He is afraid to make any Iraqi friends and stays away from mosques.

Obviously, providing a safe place, food, and a job is not enough to heal these people’s pain. Invisible wounds and problems are much harder to treat than visible ones.

In this article we will try to elucidate some elements of what Nooriye and thousands of other families have been exposed to all around the world.

Mass trauma

When a group of people, regardless of size, experience psychological effects after a trauma that was suffered collectively, this is called a mass trauma. Sometimes an entire society witnesses the same trauma, and this may cause a collective sentiment, often resulting in a shift in that society’s culture and mass actions.^1,2

Wars, political violence, natural disasters, exile, torture, and terrorism are examples of mass trauma. The Holocaust, the Atomic bombing of Hiroshima and Nagasaki, slavery in the United States, and the 9/11 attacks are well-known collective traumas.

Collective traumas have been shown to play a key role in group identity formation. Having the same problems, suffering from the same pain, and being under the same pressures bring individuals together. This togetherness eventually helps to build a community, a group, and sometimes a nation. Almost every nation has traumatic events in their history. Even the concept of “nation” is extensively affected by these events.

Nevertheless, despite its role in building group identity, mass trauma is still individually painful. In fact, the effects of mass trauma can be very deep and transferred through the generations. In 1966, clinicians observed that large numbers of children of Holocaust survivors were seeking treatment in psychiatric clinics in Canada. Moreover, when compared to the general population, the grandchildren of Holocaust survivors were three times more likely to seek clinical psychiatric help.³

Post-Traumatic Stress Disorder

According to the National Center for Posttraumatic Stress Disorder, the most common stress reactions in the wake of disaster may include the following:

Emotional reactions, including shock, fear, grief, anger, guilt, shame, feeling helpless, feeling numb, and sadness.

Cognitive reactions, including confusion, indecisiveness, worrying, shortened attention span, and trouble concentrating.

Physical reactions, including tension, fatigue, edginess, insomnia, bodily aches and pains, startling easily, racing heartbeat, nausea, change in appetite, and changes in other bodily desires.

Interpersonal reactions, including distrust, conflict, withdrawal, work or school problems, irritability, loss of intimacy, and feeling rejected or abandoned.⁴

Several factors present in the acute-phase recovery environment of a disaster have been found to aggravate stress reactions and therefore increase survivors’ risk of developing negative outcomes. These include:

• Lack of emotional and social support
• Presence of other stressors such as fatigue, cold, hunger, fear, uncertainty, loss, dislocation, and other psychologically stressful experiences
• Difficulties at the scene
• Lack of information about the nature and reasons for the event
• Lack of, or interference with, self-determination and self-management
• Treatment [given] in an authoritarian or impersonal manner
• Lack of follow-up support in the weeks following the exposure

Protective factors that may mitigate negative effects include:

• Social support
• Higher income and education
• Successful mastery of past disasters and traumatic events
• Limitation or reduction of exposure to any of the aggravating factors listed above
• Provision of information about expectations and availability of recovery services
• Care, concern and understanding on the part of the recovery services personnel
• Provision of regular and appropriate information concerning the emergency and reasons for action.⁵

In most cases, the symptoms of trauma eventually disappear, but unfortunately, some of the survivors of the mass trauma will eventually develop Post-Traumatic Stress Disorder (PTSD). PTSD is a mental disorder resulting from exposure to an extreme traumatic stressor.

The National Comorbidity Survey Replication (NCS-R), conducted between February 2001 and April 2003 in the U.S., estimated the lifetime prevalence of PTSD among adult Americans to be 6.8%.⁶ The lifetime prevalence of PTSD among men was found to be 3.6% and among women 9.7%. ⁷

PTSD is described in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM 5) which is published by the American Psychiatric Association, as:

Criterion A (at least one required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

• Direct exposure
• Witnessing the trauma
• Learning that a relative or close friend was exposed to a trauma
• Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B (at least one required): The traumatic event is persistently re-experienced, in the following way(s):

• Intrusive thoughts
• Nightmares
• Flashbacks
• Emotional distress after exposure to traumatic reminders
• Physical reactivity after exposure to traumatic reminders

Criterion C (at least one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

• Trauma-related thoughts or feelings
• Trauma-related reminders

Criterion D (at least two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

• Inability to recall key features of the trauma
• Overly negative thoughts and assumptions about oneself or the world
• Exaggerated blame of self or others for causing the trauma
• Negative affect
• Decreased interest in activities
• Feeling isolated
• Difficulty experiencing positive affect

Criterion E (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

• Irritability or aggression
• Risky or destructive behavior
• Hypervigilance
• Heightened startle reaction
• Difficulty concentrating
• Difficulty sleeping

Criterion F (required): Symptoms last for more than 1 month.

Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required): Symptoms are not due to medication, substance use, or other illness.⁸

Treatment for mass trauma:

Treatment for mass trauma should be delivered at two different levels: the community level and the individual level.

1. Community level:

Dr. Frantz Omar Fanon gives the recipe for mass trauma treatment at the community level: “Mass trauma can be alleviated through cohesive and collective efforts such as recognition, remembrance, solidarity, communal therapy and massive cooperation.”

The statement above can be a topic for a separate article. Here, we would like to express the importance of the remembrance days. People comes together on remembrance days and remind the victims that they are not alone and not forgotten. This can be therapeutic for the victims and alleviate their pain.

2. Individual level

PTSD treatment includes pharmacotherapy (medical treatment) and psychotherapy. Some of the medications which have been helpful combatting depression are selective serotonin reuptake inhibitors (SSRIs), such as Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Venlafaxine (Effexor) and Duloxetine (Cymbalta).

There are several therapy types that have been shown to be effective at treating PTSD. Trauma-focused psychotherapies are the most highly recommended psychotherapies for PTSD. In these therapy types the treatment focuses on the memory of the traumatic event or its meaning. These treatments use different techniques to help a victim process their traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. Prolonged exposure therapy, Cognitive Processing Therapy, Eye-Movement Desensitization and Reprocessing, Brief Eclectic Psychotherapy, and Narrative Exposure Therapy are the some of the therapies that have been found to be helpful for PTSD patients.

Additionally, spirituality might help treat PTSD, too. A study of Bosnia-Herzegovina war veterans suggested that veterans who prayed had significantly higher levels of incorporation, self-protection, and reactive formation and significantly lower levels of regression, compensation, transferring, lack of control, and aggressiveness than their peers who did not pray. ⁹

In brief, providing shelter, food, and a safe environment are mandatory for trauma patients, but they aren’t nearly enough. Psychological traumas are very hard to treat, and treatment may take years. It has been shown that soldiers who have somebody to share their war experience/trauma with, have a lower risk for PTSD when compared with the ones who can’t talk to anybody. Victims need professional help along with community support. Trauma can be alleviated through cohesive and collective efforts and cooperation. Praying for the trauma victims, as politicians suggested for recent hurricane victims, definitely has some social impact. It has also been shown that medication/prayers decrease PTSD symptoms ¹⁰; however, showing support and empathy, listening to victims, and acts of remembrance are the other key elements of community support.

References

1. Lisa Gale Garrigues, “Slave and Slave Holders Break Free of History’s Trauma“, Yes Magazine, August 2, 2013
2. Updegraff, Silvler, Holman, “Searching for and Finding Meaning in Collective Trauma, Journal of Personal and Social Psychology, September 2008
3. Coffey, R. (1998). Unspeakable truths and happy endings. Sidran Press. ISBN1-886968-05-5
4. https://www.ptsd.va.gov/professional/pages/handouts-pdf/Reactions.pdf
5. NSW Institute of Psychiatry and Centre for Mental Health. (2000). Disaster Mental Health Response Handbook.North Sydney: NSW Health.
6. Kessler, R.C., Berglund, P., Delmer, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6): 593-602.
7. National Comorbidity Survey. (2005). NCS-R appendix tables: Table 1. Lifetime prevalence of DSM-IV/WMH-CIDI disorders by sex and cohort. Table 2. Twelve-month prevalence of DSM-IV/WMH-CIDI disorders by sex and cohort. Accessed at: http://www.hcp.med.harvard.edu/ncs/publications.php
8. American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC.
9. Pajević I, Sinanović O, Hasanović M. Association of Islamic Prayer with Psychological Stability in Bosnian War Veterans. J Relig Health. 2017 Dec;56(6):2317-2329. doi: 10.1007/s10943-017-0431-z.
10. Gallegos AM, Crean HF, Pigeon WR, Heffner KL. Meditationand yoga for posttraumatic stress disorder: A meta-analytic review of randomized controlled trials. Clin Psychol Rev. 2017 Dec; 58:115-124. doi: 10.1016/j.cpr.2017.10.004.

We eat, sleep, and go to the bathroom. Yet, we never think about how all these physical needs are processed in the systems of our body when they are functioning normally.

Yes, our bodies are created with perfect systems by which our all kinds of needs are met. The digestive system is one of them. Our intestines are key elements of this system, so much so that asking someone “How are your intestines?” would be as comprehensive as asking “How are you?”

Digestive system

Food is critical to life. A human being can bear hunger for one month at most and can only endure a few days of drought. Thus, eating and drinking is crucial.

Foods as we eat them are not convenient for use by the cells. Food must be broken down into smaller pieces. This process begins in the mouth and ends at the anus, and it is called digestion.

The main task of our stomach and intestines is digestion. The teeth, salivary glands, the tongue, and the gullet – as well as swallowing – are essential secondary elements. Additionally, if the pancreas or liver fall ill, it can paralyze the whole system. While also working with the circulatory system, kidneys have the task of reabsorbing useful substances like glucose, amino acids, and water.

Our digestive system works together with the urinary system and the digestive organs like a factory. How these parts work together is still not fully understood, but more detailed research has been performed and revealed more secrets of the digestive system. By means of every discovery, it is realized that this perfect creation has a more intricate structure than is known.

The brain in the intestine

There are more neurons in our intestines than in our spinal cord and the intestines are created in a way that can move independently from the central nervous system. They have their own nervous system, known as enteric nervous system (ENS), which is also called the “second brain. “Within those yards of tubing lies a complex web of microcircuitry driven by more neurotransmitters and neuromodulators than can be found anywhere else in the peripheral nervous system. These allow the ENS to perform many of its tasks in the absence of central nervous system (CNS) control…” [1]. Thus, “… isolated segments of intestine can independently coordinate propulsive movements and propel content without any neural connections to the brain or spinal cord [2].

The intestines take action when food comes into the stomach. This movement is known as colonic migrating motor complexes (CMMC), and it moves the substances that cannot be digested, like bone and fiber. According to neurophysiologist Nick Spencer et al, “The gut wall contains a complete network of intrinsic nerves capable of propelling contents along the bowel, without any requirement of nerves originating in the brain or spinal cord” [3].

Eat different types of food

70% of our immune system cells are in our intestines. A big part of the approximately 38 trillion bacteria in our body are in our intestines, and they are useful; they have a big role in digesting food. Different groups of bacteria feed on different types of food; so for intestinal flora it is very important to have a variety of food on our table. For the ideal day on a plate Dr. Megan Rossi recommends people should “aim for at least 30 different plant species per week.” “The reason for this is that each plant contains different types of fibres and phytochemicals (the super healthy components of plants) that feed different good bacteria. The more plant variety, the more variety of gut bacteria – which is associated with health and happiness” [4].

Pets in our body

For Dr. Megan Rossi, “microbes are like our pets, so you have to take care of them and feed them” [5].

Of course, germ flora in our body is not just limited to the ones in the intestines. Bacteria, viruses, and fungi in our body are nearly scattered throughout the whole body. These living things produce pellicle on our head skin, irritate the gaps between our toes, live on our skin, are on duty among our teeth, and have ecosystems and assigned positions convenient to them. According to the situation, they keep their living spaces healthy or unhealthy. Although they number 50 trillion, they are approximately 200 grams of our body weight.  

Useful microbes

An average size human adult houses about 10¹² bacteria on the skin, 10¹⁰ in the mouth, and 10¹⁴ in the gastrointestinal tract [6].

These microorganisms are useful microbes with duties in our body. The harmless flora of microbes is generally present on the skin, mouth, teeth, nose, throat, and bowel and genital areas. There isn’t normal flora in internal organs except the large bowel. Internal organs have no microbes. If we look closely, flora is inserted in every part of our body which is dirty and has contact with the outer environment. If it was not for the useful flora, microorganisms causing illness would settle instead. Only intestinal bacteria are permanent microbes which are useful. For example, vitamin K plays a part in a crucial event like blood clotting and is produced in the intestine.

Control your stress

Research has revealed that mental and psychological stress affects the health of the intestines. Serotonin is produced automatically in case of need, and 85% of it is produced in the digestive tract. Stress suppresses the level of serotonin produced. Psychological illnesses are associated with low levels of serotonin.

Studies have shown that relaxing practices like meditation for 15-20 minutes can be good for health and reduce stress. At this point, daily prayers are a kind of therapy. Other ways to stay healthy include: avoiding things like alcohol and caffeine, and sleeping well.

Our body has ways of telling us when it’s not healthy. For instance, we can learn the digestive tract isn’t healthy if we have to use the toilet more than three times a day and fewer than three times a week.

References

1. Gershon, Michael D. “The Enteric Nervous System: A Second Brain.” Pdfs.semanticscholar.org.
2. Spencer et al. 2018. “Identification of a Rhythmic Firing Pattern in the Enteric Nervous System That Generates Rhythmic Electrical Activity in Smooth Muscle.” http://www.jneurosci.org/content/38/24/5507
3. http://www.flinders.edu.au/neuroscience/lab_visceral.html
4. https://www.dailymail.co.uk/femail/article-5543159/Doctor-debunks-myths-surrounding-gut-health-say-surprise-you.html
5. https://navva.org/brazil/health/why-the-bowel-is-considered-our-39-2nd-brain-39-and-other-5-amazing-facts-about-the-organ-news/
6. http://www.textbookofbacteriology.net/normalflora_3.html

Original Article: Cranford, S.W. et al., Nature 482, 72 (2012).

Spider silk has been a symbol of durability and strength, but the role the design of a web plays or contributes to the strength was unknown. Researchers from Massachusetts Institute of Technology discovered that the impressive design of web and the feature of silk allow spiders to build a super-strong web under different levels of stress. The response of spider silk subjected to load was studied. They studied webs of a variety of species, including European garden spiders and orb weavers, and combined their experiments with correlated web models. At low stress, silk threads soften and extend that result in retaining web structure. At high stress, the silk threads extend and the most stretched ones break. The strength of the silk and the geometry of the web allow only one or two threads being broken under strain. Therefore, the break in the web is minimized and prevents destruction of the whole web. The localized web damage can be repaired by the spider and therefore a requirement for rebuilding the web completely is eliminated. This study shows that spider silk web is very stable even under hurricane winds. This research gives an idea to engineers to build a system that will fail only at small parts of the system under certain stress. Therefore, the system will continue to work just after repairing the destroyed parts of the system. Otherwise, the whole system may be destroyed under potential load and will have to be rebuilt. For example, when a building is exposed to large mechanical stress such as an earthquake, it may be destroyed as a whole and become dysfunctional. Applications on such systems require further research in engineering to achieve structures as stable as a spider’s web.

2- Benefits of Exercise Through a Protein

Original article: Bostrom, P. et al., Nature 481, 463 (2012).

Exercise has a number of beneficial effects in human health such as increasing cardiovascular, respiratory and metabolic capacity. Scientists at Harvard Medical School have discovered a muscle hormone, Irisin, which may be responsible for the many beneficial effects of exercise. Irisin secreted from muscle after exercise and act on white adipose tissue that stores energy. Excessive amounts of white fat cells contribute to many pathologic effects of obesity and diabetes. Irisin, however, converts white fat into the more beneficial and metabolically active brown fat, which burns more calories and produce heat instead of energy. It helps to prevent excessive glucose and fatty acid accumulation in the body. The researchers demonstrated that mildly increased Irisin levels in the blood cause an increase in energy expenditure in mice with no changes in movement or food intake. It also reduces body weight and improves glucose tolerance and obesity induced insulin resistance. This research suggests that Irisin can be a new therapeutic target in human metabolic diseases treatment. Also it could help people lose weight and fight against obesity induced problems such as diabetes and hypertension.

3- New Generation Vaccines with High Efficacy

Original Article: Avci F.Y. et al., Nature Medicine 17, 1602 (December 2011).

Most pathogenic bacteria contain complex carbohydrate structures on their surfaces. These carbohydrates are called capsular polysaccharides. “Glycoconjugate” vaccines are prepared by chemical conjugation of capsular polysaccharides with proteins. This method is the standard design for many vaccines that protect us against common diseases such as pneumonia and meningitis. One drawback with these vaccines is their limited efficacy in populations such as the elderly, children and patients with compromised immune systems. Researchers at Harvard Medical School and Rockefeller University have designed and synthesized a vaccine that is about 100 times more potent than traditional vaccines available today. Until now, the scientific community believed that the body’s professional immune cells, called T-cells, were only able to recognize vaccine’s protein molecules to generate an immune response. However, after studying how glycoconjugate vaccines stimulate immune response, the researchers found that T-cells are also able to recognize the carbohydrate molecules. In a series of elegant experiments, they demonstrated that there is a repertoire of T-cells that can recognize the carbohydrate portion of a glycoconjugate vaccine, and that these T-cells stimulate antibody producing B-cells to generate high affinity antibodies against the carbohydrates. Based on the knowledge obtained from this mechanistic study, researchers have designed a new-generation glycoconjugate vaccine and showed that this new vaccine was about 100 times more immunogenic than a vaccine made by traditional methods.

4- Producing Fuel from Waste with Bacteria

Original Article: Bokinsky, G. et al., PNAS 108, 19949 (December 2011).

It turns out, the secret for alternative source for oil might be hidden in a very common bacterium and plant, E coli and switch grass. As the world’s natural resources are quickly exhausted by humans, new energy sources or alternative energy production methods are needed. One popular way for addressing this question is promoting biofuels. Most of the biofuel source is in ethanol form, often produced from sugar that is extracted from sugarcane and corn. However the consuming of main food sources for energy sources begs a question: What if one day feeding the machines with our food sources makes food scarce? Another concern is that many countries are not using ethanol as an energy source. All these led researchers to pursue another idea: Instead of using food sources as precursor for ethanol, non-food biomass or bio-waste can be converted to precursors for biofuels by utilizing the cellulose or hemicellulose as a starting material. Human body cannot digest cellulose. Hence, cellulose is a bio-waste, which can be broken down into sugar using a mixture of enzymes and subsequently can be used for gasoline production. The enzymes for this procedure can be produced by bacteria in massive amounts. To this end, researchers genetically engineered Ecoli bacteria to consume large amount of cellulose from switch grass and convert it to sugar. Scientists achieved to produce different precursors for different fuels, including gasoline, diesel or jet fuel with bacteria. These are big steps in turning bio-waste into fuels. Imagine one day your plane will be powered with a hay of switch grass and a bottle of bacteria. Next time when you fly over a field of switch grass, you might actually be seeing the next oil well.

At the beginning, I really did not pay much attention to him. He was very small, almost invisible and harmless-looking. However, he started to reproduce all of a sudden. Now, there were billions of his copies on one of my leaves. Everything was happening so quickly. They were taking me over. Something had to be done urgently.

As plants, we cope with such environmental stresses everyday. If the stress factors affecting us are living organisms, such as bacteria, harmful insects, and weeds, we call those as biotic stresses (1). On the other hand, if we are exposed to drought, salinity, heat, cold, and deficiency or excess of a chemical in soil, those are abiotic stresses for us. Both biotic and abiotic stresses impair our growth and even lead to our death sometimes. Therefore, stress response mechanisms are very important for us. Unfortunately in the United States alone, crop losses due to plant pathogens amount to billions of dollars (2). As we are the main food resource for the humans and assigned for so many other important functions on earth by God, our health and productivity is taken very seriously by scientists. So, it is of great interest to them to find out how our defense responses against microbes work. If scientists learn what is going on when a plant is infected by pathogens thoroughly, they can introduce better resistance mechanisms into economically important crop plants via genetic engineering.

Oh “NO,” I am stressed!

Unlike animals, we are firmly attached to the ground so we can not escape from stress factors. However, thanks to God, we have fascinating defense mechanisms against environmental challenges. First of all, I need to know who this infectious agent (pathogen) is so that I can trigger a stress response mechanism against it. The interactions between me and these microbes are controlled by my receptor proteins and Pathogen-associated molecular patterns, or PAMPs, delivered by the pathogen. PAMPs help pathogen growth by suppressing my defenses and manipulating my metabolism (3).When I recognize a PAMP by my receptors, I activate a set of defense mechanisms known as the hypersensitive response (HR) to arrest and terminate pathogen growth before it terminates me (4). Just before or in conjunction with HR, I increase synthesis of several families of pathogenesis-related (PR) proteins in my infected part (5).

Do you want to know what I do after I identify a pathogen? I bet you do, so I am going to tell you about the other components of my signal transduction cascade that is activated upon brutal attack of microbes (Fig. 1). One of the early steps in this signaling cascade is the elevation of cellular calcium (Ca (2+)) levels mediated by my plasma membrane and channels such as cyclic nucleotide gated channels (CNGCs). After the initial Ca(2+) increase, I activate some of my calcium-binding proteins (calmodulin or CaM) and protein kinases, which modify other proteins by chemically adding phosphate groups to them, and ultimately I generate nitric oxide (NO) and reactive oxygen species (ROS) (6). ROS function as signaling molecules that coordinate a wide range of diverse plant processes, such as growth, development, stress adaptation, and cell self-destruction (programmed cell death) (7). However, the real reason I produce ROS under attack is to use them as local toxins to form unfavorable conditions for pathogen growth and reproduction. NO plays a key role in our immunity in synergy with ROS regulating responses that include defense gene expression and programmed cell death (8). As a result, I utilize both ROS and NO to say “NO” to the pathogens. Other important signaling molecules I utilize are salicylic acid and jasmonic acid. These essential plant hormones are chemical messengers that enable me to respond to my environment. Salicylic acid, SA, which is chemically similar to but not identical to the active component of aspirin (acetylsalicylic acid), is involved in the defense against pathogens that feed and reproduce on live host cells and activates signaling processes providing systemic acquired resistance, protecting the plant from further infection after an initial pathogen attack (9) (Fig. 2). On the other hand, jasmonic acid (JA) induces defense against pathogens that kill host cells for nutrition and reproduction (10). Another hormone in the complex cross talk of signaling pathways regulating my defense responses to microbial attack is ethylene, ET (11).

Although, I have not even told you all the details, I bet you have started to think that all these signaling cascades, regulators, hormones, molecular patterns, and receptors are highly complicated. Do not worry; I am not planning to tell you all the molecular mechanism(s) and relevant pathways I execute during biotic stress responses. If I do, then what will the plant scientists who are interested in plant pathogen interactions do for the rest of their lives? Instead I am going to briefly describe to you what strategies I use to prevent the spread of infection that the small microbe started.

Initially, I build physical barriers around the infection by increasing my cuticle, a protective waxy covering, and cell wall thickness, and then I release antimicrobial compounds, such as phenolics and phytoalexins to the sites of invasion (11). However, this effort is usually not enough to stop the microbes. Therefore, most of the time, the cells in the local region surrounding the infection decide to commit suicide to limit the growth of the pathogen through programmed cell death, which is a highly coordinated and sophisticated phenomenon. This resembles to the firefighters’ strategy to put down a forest fire. Firefighters control flames by cutting down trees, clearing brush away from the existing edge of the fire. This way they can form borders to mitigate the forest fire.

While I am fighting the infection, I also try to confer a long-lasting protection against this pathogen. I send mobile signals like salicylic acid to activate defense responses in distal tissues in case a secondary pathogen attack might occur there (12). Salicylic acid also induces numerous genes that encode PR proteins with antimicrobial properties (13).

I have done all those things I have told you here and a lot more that are still undisclosed to humans in a really short time because it was a matter of “to be, or not to be.” After all that stress, I have won the battle against the microbe at least for now. I have gained a life experience and will defend myself better in the future. I am recovering, but unfortunately my leaf, where all that fighting happened, has a big lesion, an abnormal tissue, which was formed when my poor cells died during the attack (Figure3).

As you can tell from my story, plants get stressed out too. However, we are not stressed due to problems at home, school, or work or spending time stuck in traffic. We deal with salinity, heavy metals, temperature, drought, lack of nutrition, herbivores (insects, mammals, etc.), and pathogens. Thanks to God that He gave us astonishingly complicated response mechanisms to resist all sorts of stresses to some extent, especially biotic stress. Otherwise, we might have become extinct. Can you imagine a world without us? You would have no more oxygen in the air, no more food for animals and humans, no more papers or books, no more clothes, no more furniture, no more blooming beautiful gardens, no more roses for your loved ones, and no more trees, which hold the soil in place so that wind and rain don’t cause severe erosion and destruction of homes for so many species. In addition, there will be fewer resources for drugs and dyes. Oh my God, you are the Most Gracious and the Most Merciful. Thank you that You created us, shaped us and gave us smell, taste, color, and resistance to stresses.

Safiye Arslan is a research fellow in the area of biological chemistry and lives in Nevada.

References

1. Holopainen JK, Gershenzon J. 2010. “Multiple stress factors and the emission of plant VOCs.” Trends Plant Sci. 15,176–184.

2. http://www.apsnet.org/online/feature/biotechnology/

3. Wulff BB, Chakrabarti A, Jones DA. 2009. “Recognitional specificity and evolution in the tomato-Cladosporium fulvum pathosystem.” Mol Plant Microbe Interact. 22, 1191–202.

4. Genger RK, Jurkowski GI, McDowell JM, Lu H, Jung HW, Greenberg JT, Bent AF. 2008. “Signaling pathways that regulate the enhanced disease resistance of Arabidopsis ‘defense, no death’ mutants.” Mol Plant Microbe Interact. 21, 1285–96.

5. Klessig DF, Durner J, Noad R, Navarre DA, Wendehenne D, Kumar D, Zhou JM, Shah J, Zhang S, Kachroo P, Trifa Y, Pontier D, Lam E, Silva H. 2000. “Nitric oxide and salicylic acid signaling in plant defense.” Proc Natl Acad Sci USA. 97, 8849–8855.

6. Ma W, Berkowitz GA. 2007. “The grateful dead: calcium and cell death in plant innate immunity.” Cell Microbiol. 9, 2571–85.

7. Gechev TS, Van Breusegem F, Stone JM, Denev I, Laloi C. 2006. “Reactive oxygen species as signals that modulate plant stress responses and programmed cell death.” Bioessays. 28, 1091–101.

8. Asai S, Yoshioka H. 2009. “Nitric oxide as a partner of reactive oxygen species participates in disease resistance to nectrotophic pathogen Botryis cinerea in Nicotiana benthamiana.” Mol Plant Microbe Interact. 22, 619–29.

9. Beckers GJ, Spoel SH. 2006. “Fine-Tuning Plant Defence Signalling: Salicylate versus Jasmonate.” Plant Biol (Stuttg). 8, 1–10.

10. Spoel SH, Johnson JS, Dong X. 2007. “Regulation of tradeoffs between plant defenses against pathogens with different lifestyles.” Proc Natl Acad Sci USA. 104, 18842–7.

11. Bouchez O, Huard C, Lorrain S, Roby D, Balagué C. 2007. “Ethylene is one of the key elements for cell death and defense response control in the Arabidopsis lesion mimic mutant vad1.” Plant Physiol. 145, 465–77.

12. Ficke A, Gadoury DM, Seem RC, Godfrey D, Dry IB. 2004. “Host Barriers and Responses to Uncinula necator in Developing Grape Berries.” Phytopathology. 94, 438–45.

13. Liu PP, Bhattacharjee S, Klessig DF, Moffett P. 2010. “Systemic acquired resistance is induced by R gene-mediated responses independent of cell death.” Mol Plant Pathol. 11, 155–60.

14. Durrant WE, Dong X. 2004. “Systemic acquired resistance.” Annu Rev Phytopathol. 42, 185–209.

We invite you to embark on a journey with us to explore some fascinating perspectives that shed a light on our relationship with sound and music.

Dr. Jeffrey Thompson, the Founder and Director of the Center for Neuroacoustic Research in California (www.neuroacoustic.com), is recognized as a worldwide expert in the field of acoustic pacing frequencies that are incorporated into musical sound tracks. A consummate musician and composer in his own right, he has established a method for using modulated sound-pulses that change states of consciousness for optimal “Mind-Body” healing. Dr. Thompson believes that the sounds in nature resonate with us because they take us back to the beginning of our journey and our primary senses.

Matter&Beyond: Why are sound and music so central for us, both culturally and personally?

I don’t think I’ve found a single culture on earth which at some point hasn’t used sound as a prominent technique in healing, in religious rites, or as a means of attaining a change of consciousness in one way or another. I think the tradition probably dates back to the first use of sound as a soothing or healing means for mothers; that is lullabies for babies.

M&B: Is this our earliest experience with sound? Is this what you call primordial sounds?

If you go back to before the lullabies, we’re talking about womb experiences and it’s one of the primal things we all share; this is what I call primordial sounds. Certain type of sounds have the same influence on anyone who hears it, no matter what age you are, what sex you are, what culture you were brought up in, what language you speak; womb sounds fit that criteria.

M&B: Why is it sound, but not the vision?

Because at 16 weeks, when the fetus is very small, the nervous system is developed enough that all the senses are functioning; however it is dark, so the eyes aren’t working, no information is being received and the nose and the mouth are filled with fluids, so there is no tasting or smelling, but sound travels through water five times better than it does through air; therefore the ears are working but amplified by five times, and the largest sense organ we have, the skin, is a huge sense organ for vibrations. Thus, we’re experiencing vibration and sound for nine months in the womb and that sound environment is a very specific type of environment; the amniotic fluid sounds, the watery bubbly sounds, the mother’s heartbeat through the placental artery, respiratory sounds from the diaphragm, noises of the internal organ; it’s a rich complex, three-dimensional sound environment that is exactly the same for everyone of us; we all experienced this in the same way.

M&B: How does the fetus perceive this sound?

Remember the fetus is small and the ear is small; the eardrum is extremely small. If the eardrum was blown up to the size of my eardrum and the mother’s heart was blown up in proportion it would fill this room. So what kind of sound would such a heart make? It wouldn’t be the sound that you would expect it to be listening to the adult’s heart with a stethoscope from the outside; it would be a very large, slow sound, a large thumping sound.

M&B: How is this related to the use of sound in therapy or for relaxation?

Most of us who have gone on vacations and have explored nature feel a peaceful, beautiful return to nature; why?

Because if you take the sounds of the amniotic fluid and you slow those sounds down, they sound a lot like the ocean. The size of the sound waves compared to the eardrum would make these watery sounds sound like they have also slowed down. So many of the watery sounds in the womb sound like other sounds that we can hear later in nature. This can spark a similar kind of primordial recognition which is beyond the control of the rational thinking mind.

So when we build up these kinds of sounds on a soundtrack you can then push the button and the body will automatically go back to what it felt like to have a natural experience; when we combine the sounds of nature with music this makes a relaxation tape. So I would say that the sounds of nature provide secondary primordial sounds, as not all of us would have heard the same natural sounds in our lives.

The idea is to extend the power of the primordial recognizable components of sound in order to create a physical response. The technique is to connect with a primal recognition at a subconscious level; this will tap into experiences that you have had in the womb and at other times.

M&B: You not only use sound for relaxation, but also in order to combat stress. Could you please talk about this?

When a person has a fight-or-flight response, a stress response, we know very precisely what happens physiologically. The very first thing, the most sensitive organ, to respond to stress is the heart and thus when we look at the heart waves we can gain important information.

M&B: Why the heart and not the brain?

The reason for this is that the heart is the perfect system in the nervous system; it is called the autonomic nervous system or the automatic functioning nervous system; it knows how to organize and control my organs and glands and body chemistry and perform biomechanics that I’m not aware of and can’t control.

My rational-thinking brain can control physical body movements and thinking processes, but there’s another section that controls the automatic functioning of how my body runs. There is another control of this autonomic nervous system, which has two large branches of nerves that innervate all the organs and glands; these two branches of the nerves are the sympathetic and the parasympathetic nervous system.

While the sympathetic nervous system switches on, the parasympathetic switches off and mobilizes energy from the higher brain centers, from my digestive system, from my elimination system and from my immune system, it pulls that energy into my muscles to fight for my life.

This is when the brain freezes when you take an exam. You’re frightened about the exam; it is your final exam and you’re frightened that you’re not going to pass it or that you’re not going to do well. That fright causes the sympathetic system to switch on and drain the energy out of your brain; this is a self-fulfilling prophecy. You don’t have a brain left, because all the energy has gone to your muscles. At the moment the sympathetic system switches on, it mobilizes the pituitary which signals the adrenal glands; these fires adrenaline, the adrenaline starts the heart and the respiration and a number of other things. At the same time it suppresses the pancreas and lets loose extra glucose so you can fight for your life more and so what you end up with is the very first thing that happens.

M&B: What is the normal stress response and how do we return to a normal state?

When a person is required to carry out special tasks, like running or fighting for one’s life, then the sympathetic nervous system has to switch on, mobilize the energy from various places and send it to my muscles. If I am injured, but I survive and win, then the parasympathetic system is going to switch on and build up; that energy will be sent to my immune system, healing centers and recuperation areas for my muscles; when this is finished these are basically switched off, because we don’t need this energy anymore. This is certainly the normal way of functioning.

Thus, there are certain normal ways in which the body should function when a person is okay and normal. When the patient comes in and lies down on their back we hook them up and look at what’s happening in the autonomic nervous system. Normally when you lay down for three to five minutes your system should relax. Gravity isn’t affecting you, your heart doesn’t have to do extra work to pump the blood up to your brain; as a result the muscles relax and the sympathetic system and parasympathetic nervous systems should be at a level playing field. Now they can conserve their energy and this state of balance in the autonomic nervous system is known as homeostasis. The best state of health you can have is in homeostasis, where you’re not using energy in an unnecessary way. Homeo means unity, one, within my body, while stasis is a perfect state of rest.

M&B: What are the results of your studies to date? How many of us return back to homeostasis in three to five minutes?

Clinically what I see is maybe two patients with a normal response; I’ve been checking every patient with the real time heart rate variability system now for 7 years. This means thousands of patients; in all of that time I have seen one, maybe two patients with a normal response. I hook the patient up, and see what the response is. Most people’s response is abnormal; what this abnormality says is that after five minutes they have not attained a balance, and they have a good strong, healthy, dominant sympathetic stress response which never stops.

M&B: What do you think is the reason for this?

This state is constant because of the artificial, extremely stressful world that we have artificially created for ourselves. It wasn’t supposed to be like this; you are supposed to wake up in the morning and grab your spear and go catch a rabbit and that’s your workday; when you get there and you see that rabbit the sympathetic system turns on and the heart rates increase, the same thing happens with the rabbit, and it’s all going to be over in a couple of minutes. You’re going to catch the rabbit or he’s going to get away and then everything goes back, the clutch pushes in. Let’s say you get the rabbit, and the clutch pushes in; everything is fine and you are going to go home. Now you hear a growl behind you and there’s a saber tooth tiger looking at you, thinking about dinner; now the sympathetic system switches on, the heart rate is up, and you are running and he is running. It is all going to be over in a couple of minutes and either you are going to get away or you’re not.

But what I’m talking about here is that the nervous system, at its core, and its stress response are both designed for a sprint and not a marathon; but what we have had in the twenty-first century and throughout the twentieth century is a marathon of stress; but these are the kind of stresses that we can’t see, i.e. invisible stresses. They’re electromagnetic frequencies; the walls in this room, television channel frequencies, military frequencies, microwave frequencies, air pollution, food pollution and traffic jams when going to work to a job that doesn’t pay enough money for a boss who has the emotional development of a three-year old are all problems for us. The stress goes and then it’s back again; it’s time to get dinner for the kids and watching 7:00 news. This doesn’t stop; the nervous system’s solution to surviving this is to invent a mechanism of merely stepping on the gas, switching on the emergency sympathetic system on and bulldozing your way through the stress for the rest of your life with great momentum; but at nighttime, when it’s time to go to bed the nervous system doesn’t want to let go of this momentum that it has built up to get through the day.

M&B: And this has devastating effects on our health?

You can’t keep running in high gear for the rest of your life without some horrible consequences; the body’s not designed for it. You can only do this for a few decades before your heart or your brain blows up, the two biggest killers in Western society are heart attacks and strokes – there is also high blood pressure and diabetes. But what can we expect if our sympathetic nervous system is all the time working, which means by definition that our heart pressure is up and the pancreas is suppressed, so there is extra glucose being sent out? So people who don’t have the constitution to handle the stress blow a fuse; they have no way to handle the stress and as a result they have immune system problems, digestive problems, and problems that come from that colon cancer, irritable bowel syndrome, autoimmune diseases, allergies.

M&B: You are using sound in order to help people return to their normal healthy state. How does this work?

I’ve come up with a way to use sound to force the autonomic nervous system to push in the clutch, removing us from a place of high stress from which you can leave by using sound; we do this by using the heart-rate variability to see how bad the heart rate is and then explore various precisely tuned sound frequencies which will actually force the nervous system to push in the clutch. There will be a very specific tone for every person; this is like a glass vibrating if I sing the right note. An opera singer can sing the right note to make the glass vibrate. Well, now let’s imagine that your autonomic nervous system is the glass and we’re going to explore various sound frequencies that are very precisely tuned to find out which one affects your autonomic nervous system function; when we find it the response will be like pushing in the clutch and sending it into a state of relaxation. So we hit the right note and we get the response; this is what I’ve been looking for. Now we can see this phenomenon clinically. Once we’ve got the tone that’s associated with the pushing in of the clutch of the autonomic nervous system we can use that therapeutically through a specially designed sound table that I have made; this consists of low-frequency sound components which drive the low frequencies right into your cells via headphones. This relaxation mode is introduced to your nervous system over an extended period of time. We can burn this sound onto a CD and you can take it home and work with it at home on your stereo; it is like an internal training program. Every time your nervous system pushes in the clutch, the ability to push in the clutch grows, just like working a muscle in a gym.

This is a kind of high-tech stress reduction training program for the nervous system with sound. This is one of the three components I mentioned earlier; there are three parallel processes using sound for healing. This one is the idea of using the physical resonance to cause an effect on the nervous system to relax people.

M&B: This is what is called a sound table, right?

Yes, the sound table I needed had to have specific requirements, which is why I had to make my own to attain the exact clinical results I wanted. The power in the table actually delivered more power to your body than I wanted to be delivered. Therefore, I had to be able to have the sound that was coming from the table split into the right and left speakers, but none of those that were available on the market could do that. So I had to have it specially designed. As a composer, musician and audio engineer I was able to design the sounding board of that table and the transducers so that a lot of free sound could be delivered and spread out, therefore it is much more effective and delivers the sound to your body via headphones. Thus there is a lot going on in that table that you cannot see and this is what makes it work properly.

Interview conducted by Mustafa Tabanli for Ebru TV for the Emmy Award winning television series Matter and Beyond.

God burdens no soul except within its capacity… (Al-Baqarah, 2:286)

This verse is not strange to any Muslim. God has promised that He will never burden a person with difficulties beyond his or her capacity. This is supported by other verses in Surah Al-Inshirah (94:5–6), where it is said that with every hardship, comes relief and this divine statement is repeated twice in the same chapter. This clearly shows how God knows the limits of the human being’s capacity to endure challenges in life.

However, despite these beautiful statements God has made in the Qur’an, we still hear many people complaining about how tough life is, about how they cannot bear their problems anymore and asking why God gives them certain challenges other people do not have to bear. The worst thing is when suicide is contemplated as a reaction to what God has given to His servant.

These complaints, at first glance, appear to contradict these verses, since surely the people so afflicted should know their own capacity to endure tough problems. At second glance, however, it becomes clear that this is not so. Does God really test someone beyond his capacity?

In talking about the endurance of an individual, we cannot avoid the subject of coping skills. Generally, coping skills are divided into two categories, namely avoidance coping skills and approach coping skills (Soderstorm, et.al., 2000).

Avoidance coping skills are basically unhealthy ways of dealing with problems. These coping skills delay the process of recovery and emotional stability. An example of a coping skill of this type is substance abuse, where many people turn to coffee, drugs, cigarettes and other substances when they are in distress.

Another avoidance coping skill is denial, where the person refuses to believe what has happened. In some really bad cases, people go on with their lives, refusing to believe the problem they face and allowing the situation to deteriorate. Some other examples are self-harming, minimization and cognitive avoidance. These mechanisms of coping do not just delay the process of recovery, but also exacerbate the situation.

On the other hand, approach coping mechanisms promote the mental and physical well being of an individual. These mechanisms foster positive thinking and motivate problem-solving behaviors. One of the skills in this category is action taking. Rather than sitting and waiting for something to happen, a person who adopts approach coping mechanisms will plan the strategies and actions required to solve or ease the problem.

Another approach coping skill is acceptance. However, acceptance here means to admit that there is a problem and not resent to the occurrence of the problem. Acceptance which means giving up is not the same as acceptance as an approach coping skills. Positive acceptance is the opposite of denial. Therefore, acceptance is an important beginning of acting to solve or ease a problem.

Humor can also be an approach coping mechanism. By making appropriate fun of the problem, distress can be reduced, and thus more mental stability can be achieved. For example, a mother who has just experienced the loss of her child might say to herself, “At least he is enjoying as much candy as he wants in paradise.” By using appropriate humor like this, the mother can broaden her perspective, allowing her to see the brighter side of the loss she has experienced.

Religious coping is another strategy among approach coping skills. In psychological research, more and more studies suggest ways that spirituality and religiosity help in dealing with life’s problems. One of these studies (Meisenhelder and Chandler 2002) stressed that faith as the concept of spirituality was more applicable than religiosity. One of the variables investigated by these researchers, which was religious coping, correlated positively with mental health. This study is only one out of many to show a strong relation between spirituality and mental and physical well being.

Soderstorm et.al. (2000) also suggested some gender differences in coping strategies. They asserted that men tend to adopt task-oriented coping strategies or approach type and women tend to use the contrary, avoidance coping strategies. However, some other studies have suggested that women are more likely to use task-oriented coping strategies or that there are no gender differences (Holahan & Moos, 1985 as cited in Soderstorm et.al. 2000). Nevertheless, more and more researchers have found a tendency for men to focus on a problem and start taking action to overcome it.

The relation between the verse in Surah al-Baqarah at the beginning of this discussion and coping skills is clear. The question then arises: if it is true that God would never burden a soul beyond its capacity, why do some people complain of being unable to deal with a certain problem they face? If they think that God is unfair, or that they are now unable to cope, or are thinking of committing suicide, it is simply that they have adopted the wrong kind of coping strategy for their individual circumstances, or they may have adopted unhealthy avoidance coping strategies in dealing with problems.

Abi-Hashem (2007) describes how unhealthy coping skills can have negative impacts on people who live in a country with ongoing war, as in the Middle East. Such circumstances, where violence, cruelty, and harshness are an unavoidable part of life make things seem hopeless, and nothing can be done to break away from the situation. The author suggests that at this point, the best coping strategy to be employed is action taking, because worsening mental paralysis can happen to an individual in a country with war who takes no positive action. So, if a person feels as if the challenge God has given them is beyond what they can bear, they should ponder any action they have taken to adjust to the problem. They may have missed some points where, if action is taken, a great deal of worry and stress can be reduced or allayed.

Another way of looking at this is that religious coping skill correlates with mental well being. But sadly not many people realize the importance of religious coping skills in managing life’s problems. In many verses in the Qur’an (e.g. Al-An’am 6:102; Hud 11:123), God reminds us to depend on Him in all affairs, to put our trust in Him and make Him the basis of our decision making. This reflects all research findings, which tell us repeatedly of the advantages and positive outcomes of religious coping. Perhaps this is because we know that there is something we can rely on in hard times, which makes it easier for us to deal with life’s problems. Some practical ways to cope religiously are the performance of greater numbers of recommended prayers, more frequent remembrance of God, and contemplating the creation of the universe.

Sometimes we believe too much in the power of our own selves, feeling too confident that it is we who make the changes, who solve the problems. But we all know the power of togetherness. Support from other people can significantly increase the effectiveness of our coping style. We can reduce our stress by sharing what is bothering us and perhaps getting wiser advice from another person on handling the problems we are facing.

It is important to reflect on ourselves in times of stress. Do we just listen to ourselves? Do we turn to substances when we are distressed by something? Are we brave enough to accept the problem which is afflicting us? Most importantly, do we trust God enough to help us with our problems? These questions can only be answered by each individual for himself or herself.

Taufik Mohammad, PhD, is a senior lecturer in Universiti Sains Malaysia.

References

• Abi-Hashem, N. (2007). The agony, silent grief, and deep frustration of many communities in the Middle East: Challenges for coping and survival. In P. T. P. Wong and C. J. Wong (Eds.), Handbook of Multicultural Perspectives on Stress and Coping, US: Springer US, pp. 457–486.
• Meisenhelder, J. B. & Chandler, E. N. (2002). Spirituality and health outcomes in the elderly. Journal of Religion and Health, 41, 243–252.
• Soderstrom, M., Dolbier, C., Leiferman, J. & Seinhardt, M. (2000). The relationship of hardiness, coping strategies, and perceived stress to symptoms of illness. Journal of Behavioral Medicine, 23, 321–328.

Currently, some religious scholars in the Islamic world denounce music. This paper analyzes the Islamic perspective on music and singing, and concludes that using music as a therapeutic agent in medicine is not forbidden.

Documented evidence shows the power of music can be tapped to heal the body, strengthen the mind, and unlock the creative spirit. Published papers and journal articles offer dramatic accounts of how doctors, musicians, and healthcare professionals use music to deal with everything from anxiety to cancer, high blood pressure, chronic pain, dyslexia, and even mental illness. During childbirth, music can relieve expectant mothers’ anxiety and help release endorphins, the body’s natural painkillers, and thereby dramatically decrease the need for anesthesia.

Exposure to sound, music, and other acoustical vibrations can have a lifelong effect on health, learning, and behavior, for such exposure stimulates learning and memory and strengthens one’s listening abilities. Music has been used as a treatment or cure from migraines to substance abuse.

One thousand years ago, Muslim physicians were in the forefront of medicine and used innovations and therapeutic techniques that are now considered modern. They treated mental illnesses by confining patients in asylums with twenty-first-century techniques of music therapy. In Fez, Morocco, an asylum for the mentally ill was built early in the eighth century, and asylums for the insane were built in Baghdad (705), Cairo (800), and Damascus and Aleppo (1270). In addition to baths and drugs, the mentally ill received kind and benevolent treatment, and were exposed to highly developed music-based therapy and occupational therapy. Special choirs and live bands were brought daily to present singing, musical, and comical performances to patients.

Malik al-Mansur Sayf al-Din Qalawun built the al-Mansuri hospital in Cairo (1284). Its most outstanding characteristic was that, just like today’s advanced hospitals, provisions were made to entertain patients with light music. Professional storytellers were appointed to narrate stories and jokes (radio, TV, and computers perform these functions today). People who called the faithful to prayer would sing religious songs in their melodious voices before the morning call to prayer; so that afflicted patients might forget their suffering. This hospital still renders such services today.

Medical benefits

Music therapy has been lost for more than 1,000 years in the Muslim world and in the West. In the last three decades or so, the West has shown tremendous interest in using music therapy to treat several diseases and ailments. No one knows exactly how music heals, but it looks like our brains are wired to respond to it.

Dr. Clive Robbins, a co-founder of the Nordoff-Robbins Center for Music Therapy at New York University in New York City, says: “There is something intrinsically musical about the brain’s neurological structure and the muscular function of the human organism. At a nonverbal level, music activates our minds, integrates our attention, and seems to help regulate some body functions.”(2) He has treated a child afflicted with cerebral palsy with music therapy in order to teach the child how to balance his body, coordinate his limbs’ movement, and communicate. It has made him motivated and intent.

The right song seems to work in more than one way-distracting us from pain, boosting one’s mood, reviving old memories, and even prompting the body to match its rhythms. Music has long been appreciated for its calming effects, but new research shows it also may have the power to restore and keep us healthy. Soothing sounds, from Tibetan chants to Beethoven symphonies, are being given scientific credit for preventing colds, easing labor pains, and even boosting anti-aging hormones. One study found that surgery patients who listened to comforting music recovered more quickly and felt less pain than those who did not. The International Journal of Arts Medicine reports that infants in intensive care units go home three days earlier, eat better, and gain more weight if the staff talks and sings to them.

Clinical studies and anecdotal evidence from music therapists suggest that the sound of music is soothing and comfortable. For example, music is credited with lowering cortisol, a stress hormone, as much as 25 percent; boosting endorphins, the body’s natural opiates or feel-good drugs; reducing pain after surgery and reducing the need for sedatives and pain relievers; making patients recover from surgery faster and with less pain; possibly preventing colds; raising blood levels of Immunoglobin A (immune system fighter) to a whopping 14.1 percent; and easing labor without drugs. It also seems to help premature infants in intensive care; stimulate the brain’s neural connections and promote children’s spatial ability and memory; lower blood pressure as much as 5 points, reduce heart rate, improve cardiac output, and relax muscle tension; and manage non-pharmacological pain and discomfort.

But these are not all of its benefits, for research shows that music also improves the mood and mobility of people with Parkinson’s, decreases nausea during chemotherapy, helps patients participate in medical treatment, decreases length of hospital stay, relieves anxiety and reduces stress, eases depression, enhances concentration and creativity, brings positive changes in mood and emotional states, increases awareness of self and environment, gives a sense of control over life through successful experiences, provides an outlet for expressing feelings, improves memory recall and thereby contributes to reminiscence and satisfaction with life. In addition, music therapy may allow for emotional intimacy with families and caregivers, relaxation for the entire family, and meaningful time spent together in a positive, creative way.

Exciting new research suggests that our brains respond to music almost as if it were medicine. Music may regulate some body functions, synchronize motor skills, stimulate mind and even make us smarter. According to Suzanne Hanser, D. Ed., a lecturer at Harvard Medical School’s Department of Social Medicine: “There is no set prescription or a particular piece of music that will make everyone feel better or more relax. What counts is musical taste, kinds of memories, feelings and associations a piece of music brings to mind. Some people relax to classical music, others like the Moody Blues. The key is to individualize your musical selections.”(3)

Depression

Research conducted at the Stanford University School of Medicine provides some interesting results. For one group of 20 people aged between 61 and 86, moods rose and depression fell when they listened to familiar music they selected, on their own or with the help of a music therapist, while practicing various stress-reduction techniques. A control group who missed out on the music and the exercises saw no improvement during the 8-week study period. It helps to perform gentle exercises, depending on one’s fitness level, while the music plays. Movements should be light and flowing. Breathe to the music, and gently come to rest when the music ends.

Insomnia

A study from the University of Louisville School of Nursing Research indicates that 24 out of 25 people with sleeping problems nod off more quickly, sleep longer, or get back to sleep more easily after listening to classical and New Age music. The music must be quiet and melodic, have a slow beat and few, if any, rhythmic accents. To be effective, one should skip the after-dinner coffee or tea and avoid telephone calls and TV after 9 p.m. Softer and quieter music should be played as bedtime approaches. Listen to the music in bed with a tape recorder or a CD player equipped with a silent on/off switch. One should lie quietly and take even, deep breaths.

Stress

Many studies have found that soothing melodies can ease anxiety and quiet both blood pressure and heart rate even under very stressful conditions. Everyday stress also responds to music. Select music that grabs your attention and, at the same time, relax your body so that all of your worries slip away. Slow music, like a love song sung by an accomplished singer or a calm instrumental piece may be perfect. If a slow tune gives your mind time to fret or obsess, switch to something livelier. Sit or lie down in a comfortable position and where you will not be disturbed. After a few minutes, perform a relaxation exercise.

Pain

One Yale University School of Medicine study found that people who listened to their favorite music while awake during a surgical procedure needed smaller amounts of sedatives and pain medication than those who did not. Music therapists and researchers say that physical discomfort from post-operative pain to chronic aches can be eased with flowing melodies and distracting rhythms. Dr. Alicia A. Clair, a board-certified music therapist and professor and director of music therapy at the University of Kansas in Lawrence, says that music can bring transitory relief from short-term and long-term pain and discomfort, such as arthritis and osteoporosis. Gentle and soothing stress-reducing music, which can relax and distract the mind, is helpful. Martha Burke, a board-certified music therapist in Durham, North Carolina, says: “Gently flowing music or music with a slow, steady pulse can help promote relaxation, which can then alter a patient’s perception of pain. Soothing music can lower the heart rate and breathing rate, leading to further relaxation, and reduces tension that comes with the pain. We know music is so incredibly complex–it has tempo, rhythm, melody, and harmony. And so it stimulates the brain in many ways at once.”(4)

Brain damage

Samuel Wong, a Harvard-trained physician based in New York City, plays musical instruments to help patients with brain damage (from strokes) and Alzheimer’s reconnect to the world. He is also music director of the Hong Kong Philharmonic and the Honolulu Symphony. “When brain damage (from stroke, Alzheimer’s, etc.) leaves a devastated mental landscape, music ‘builds a bridge’ that allows patients to reconnect with the outside world. The study of medicine has informed my performance of music, and my learning of music has deepened my role in healing,”(5) he says. In 1996, researchers at Colorado State University tried giving 10 stroke victims 30 minutes of rhythmic stimulation each day for three weeks. Compared with untreated patients, they showed significant improvements in their ability to walk steadily. People with Parkinson’s enjoyed similar benefits. Stroke victims and patients with Parkinson’s walked more steadily and with better balance and speed if they practiced while hearing a balanced metrical beat or a piece of music with a powerful, even beat. A musical beat from any genre seemed to provide a rhythmic cue, which has a powerful, organizing effect on the brain’s motor skills—it helps harmonize movement almost at once, according to researchers. Scottish researchers have found that a daily dose of music significantly brightens the moods of institutionalized stroke victims. When daily music therapy was administered for 12 weeks, the patients were less depressed and anxious, and more stable and sociable than other patients in the same building. Music therapy also has proved useful in managing Alzheimer’s and other neurological diseases.

Sounds of healing

Mitchell L. Gaynor, MD, director of medical oncology and integrative medicine at New York’s Strang Cancer Prevention Center (affiliated with the Cornell Medical Center), says: “More doctors are seeing a connection between harmonious sound and health. If we are around very harmonious people and harmonious vibrations and harmonious sounds, we begin to feel better. I have never found anything more powerful than sound and voice and music to begin to heal and transform every aspect of people’s lives. It can really change people’s lives.”(6) “We know that music is capable of enhancing the body’s immune function, lowering heart rate, lowering stress-related hormones like cortisol that raise our blood pressure and depress our immune systems. It also trims complications after heart attack, calms anxiety, slows breathing and increases production of endorphins, the body’s natural painkillers. Eighty percent of the stimuli that reach our brains come through our ears.” (7) “Even before birth, music makes a difference. Hearing is the first sense to develop, when the fetus is only 18 weeks old (Qur’an 32:9). We know that the unborn child hears for literally half the pregnancy and is affected profoundly by what it hears. Studies show that music by Mozart and Vivaldi actually can bring down fetal heart rate, calm brain waves, and reduce the baby’s kicking. Rock music, on the other hand, appeared to drive fetuses to distraction, greatly increasing kicking.”(8) “Our bodies are 70 percent water, and thus excellent conductors for sound and vibration. We do not hear just with our ears, but literally feel vibration’s sound with every cell in our body. Disharmony and noise, whether from traffic, the boss yelling at us about a deadline, or a jackhammer on the street can make us stressed, depressed, and pessimistic–all of which depress our immune systems. That is why disharmony can eventually lead to disease.”(9) “Our own voices are very underutilized healing tools. Singing is a great way to tap music’s healing power. If you are self-conscious, try chanting. Anyone can do it, and you can’t do it wrong. We are just seeing the tip of the iceberg as far as the incredible power of sound to affect every cell and every organ system in our bodies.”(10) The Qur’an says: He fashioned him in due proportion and breathed into him something of His spirit. And He gave you (the faculties of) hearing and sight and feeling (and understanding). Little thanks do you give! (32:9, 16:78, 67:23). Dr. Keith Moore, professor and chairman of the Department of Anatomy at the University of Toronto’s School of Medicine, writes in his most popular textbook on human embryology that the human embryo first gets the ears (hearing), then the eyes (sight), and next the brain (feeling and understanding or mental faculties) in that order, as mentioned in the above Qur’anic verses. On the other hand, very loud music with sounds louder than 90 decibels cause stress and ear damage. Pierce J. Howard, Ph.D., director of the Center for Applied Cognitive Studies in Charlotte, NC, says: “Very loud music creates an altered state of consciousness akin to an alcoholic or drug-induced stupor that can become addictive.”(11)

The Mozart effect

Don Campbell, a composer, music researcher and teacher, healer and the author of The Mozart Effect, learned that he had a potentially fatal blood clot in an artery just below his brain. He shrunk the blood clot from more than 1.5-inch length to one-eighth of an inch by humming quietly for three to four minutes at a time, up to seven times a day. He did this for three weeks before he went back for a second brain scan. In The Mozart Effect, he writes: “You know music can affect your mood: it can make you feel happy, enchanted, inspired, wistful, excited, empowered, comforted, and heroic. Particular sounds, tones and rhythms can strengthen the mind, unlock the creative spirit, and miraculously, even heal the body. Exposure to sound, music, and other forms of vibration, beginning in-utero, can have a life long effect on health, learning and behavior.”(12) In conclusion, one should listen to a piece of music that one finds inspirational and uplifting. Dr. Ahmed al-Kadi of Florida’s Akbar Clinic conducted research on the healing power of listening to Qur’anic recitations. There is an urgent need for conducting more research on music therapy by Muslim physicians in the West and in the Muslim world.

Footnotes

1. Cayce, Edgar, “Readings on Music: Healing.” 1944. A free handout distributed by ARE (Association for Research and Enlightenment, 215, 67th St., Virginia Beach, VA 23451)
2. Nordoff, Paul and Clive Robbins, Therapy in Music for Handicapped Children, London, Gollancz, 1992
3. Cromie, William J., “Treating ills with music, from Anxiety to Alzheimer’s from Pain to Parkinson’s.” Harvard University Gazette, 22 August 2002
4. Burke, M. & Thomas, K., “Use of Physioacoustic Therapy to Reduce Pain During Physical Therapy for Total Knee Replacement Patients Over Age 55,” in Music Vibration and Health, Wigram, T. & Dileo, Ch. (Ed.), Jeffrey Books, Cherry Hill, NJ, USA, 1997
5. Noonan, Peggy. “Take two tunes and call me in the morning” USA Weekend Magazine-Health. Dec. 19, 1999
6. Gaynor, M. L., Sounds of Healing: A Physician Reveals the Therapeutic Power of Sound, Voice, and Music. Broadway Books, 1999
7. Gaynor, quoted by Peggy Noonan, Ibid 8 Gaynor, quoted by Peggy Noonan, Ibid
8. Gaynor, Ibid
9. Gaynor, Ibid
10. Howard, P. J. The Owner’s Manual for the Brain: Everyday Applications from Mind-Brain Research. Bard Press, 1999
11. Campbell, D., The Mozart Effect: Tapping the Power of Music to Heal the Body, Strengthen the Mind, and Unlock the Creative Spirit. New York: Avon Books, 1997

References

• Alvin, J., Music Therapy. Basic Books, Inc. Publishers, New York. 1975.
• Campbell, D., The Mozart Effect: Tapping the Power of Music to Heal the Body, Strengthen the Mind, and Unlock the Creative Spirit. New York: Avon Books, 1997.
• Coleman, J. M. et al. “The Effects of the Male and Female Singing and Speaking Voices on Selected Physiological and Behavioral Measures on Premature Infants in the Intensive Care Unit.” Int. J. Arts Med. 5, no. 2 (1997): 4-11.
• Gaynor, M. L., Sounds of Healing: A Physician Reveals the Therapeutic Power of Sound, Voice, and Music. Broadway Books: 1999.
• Gerber, S., “The Sound of Healing. Every Culture in the World Has Used Sound and Music To Heal. Finally We Are Catching Up.” Vegetarian Times, 247 (March 1998): 68-74. Harrar, S., “Got Pain? Got the Blues? Try the MUSIC CURE.” Prevention 51, no. 18 (1995): 100.
• Howard, P. J. The Owner’s Manual for the Brain: Everyday Applications from Mind-Brain Research. Bard Press: 1999,
• Moore, K. L. and Persaud, T. V. N. The Developing Human: Clinically Oriented Embryology. Philadelphia: Saunders W. B. Co., 1998.
• Syed, I. B. “Medicine and Medical Education.” In Islamic Perspectives in Medicine, edited by S. Athar. Indianapolis: American Trust Publications, 1993, 45-56.