On Dec. 10 I interviewed Sandra Scheinbaum, Ph.D. on functional medicine. She is a psychologist, and has been in a practice with other therapists, medical doctors, and a psychiatrist. Her core argument is that psychotherapy has been too narrow to help as many people as it should.

For her, the missing element is a rigorous lifestyle analysis.

She focuses on the issue of inflammation, the term that means the body is at war with something.

If you sprain your ankle or get the flu, that inflammation helps you to get better.

But imagine that there is no injury, no illness. Then your inflammation should be low, right?

Not so fast.

Our lifestyle choices these days are inflammogenic, that is, those choices generate an excess of body inflammation. Our body goes to war against itself. We feel sore and achy, we feel tired, we just don’t feel good.

Here is my own take. If you have a tendency toward anxiety or depression (ruminating on themes of avoidance or futility), that physical stress will trigger a full-on set of symptoms. And while cognitive therapy does clearly help, that alone would leave the person vulnerable to future symptoms. When inflammation rises, state-dependent-learning dictates a very likely return of the depression or anxiety. And while we can treat anxiety and depression effectively with psychotherapy, Sandra argues why not look to the root of the problem, lifestyle problems? I would say it is one root. Cognitions play a role. But the surprise is we can often treat mental illnesses just with addressing the inflammation issue.

She mentioned that C-rp, the C-reactive protein blood test, is a useful way to assess and track body inflammation. An ideal practice might be working with a group of physicians who refer patients for lifestyle coaching.

We can take powerful anti-inflammatory drugs to reduce the inflammation, but that just suppresses the symptoms without addressing the deeper issues. Habits of eating poorly, avoiding activity and exercise, living an isolated life, feeling little purpose and meaning, all of these raise chronic inflammation.

Being overweight automatically puts us into a state of chronic inflammation.

Here are a link to the Wall Street Journal article about exercise and mental health.


They focus on physical health. Sandra argues that emotional issues will disappear when we improve our lifestyles. Take a look at my interview with Dr. Scheinbaum here: :

As you all know, my technical skills rank up there with those of a groundhog. About half the way through, she disappears, and after that, when she links back in, you see only my mug and you can’t see her. But you hear her very well.

And she has some provocative things to say about the future of our profession.

Here are a couple of links, one to a major association for lifestyle medicine, and the second one is to Sandra’s own website.



So look at the replay and leave comments below.

And feel free to share with your colleagues.