Wednesday, September 14, 2011


Tried and True
Methods For Achieving
Mental and Emotional Well-being
(And none of them involve medications)
by Mark Foster, DO


1)     Daily exercise.  (If you do nothing else on this list, do this.)
a.      Get at least thirty minutes every day.  More is better.
b.     Get your heart beating faster than 110 beats per minute.  Break a sweat every time.
c.   Do cardio everyday, and do weight/ resistance training two to three times a week.
d.   Pick activities you enjoy, and make yourself do something vigorous everyday for two weeks.  Hiking, biking, jogging, climbing, swimming, tennis, soccer, basketball, aerobics, kickboxing, cross-country skiing, snowshoeing, home gyms with treadmills, elliptical, rowing machines, even golf--if you walk . . . or just a brisk walk in the evening is perfect.  Mix things up to maintain your interest.  By the end of two weeks, your mind and body will have become noticeably sharper and more fit, and it will not be an effort to sustain your new habit.  You will crave the exercise, and you will find ways to make it fit into your daily routine.
e.     Consider playing a competitive sport.  They can be great outlets for stresses, great for making social connections and a sense of teamwork, and also for helping you focus your exercise routines.
f.   Take satisfaction in knowing that while exercise improves your mental health, it is also improving every other aspect of your health:  weight loss, blood pressure, cholesterol, blood sugar, joint health, nerve tone, kidney function, digestive health, immune system, sexual health, skin health, respiratory health, and your overall constitutional health of strength, stamina, resilience, and energy.  You will sleep better and have an improved self-concept.  All of these benefits from doing something that's fun to do!  Get started today!

2)     Eat healthy food
a.     Don’t eat fast food, and don’t drink soda pop.  Seriously.  Don't do it.  Junk diets make you feel junky inside and out.
b.     Avoid excessive sweets.
c.      Eat five fresh fruits and vegetables a day.  Have something fresh at every meal.  Snack on grapes, carrots, apples, celery, etc.
d.   Eat savory foods.  Good food is one of life's great pleasures.  It is possible and enjoyable to prepare and eat delicious, healthy food.
e.   Frequently, even daily, eat meals as a family or in the company of others.  Eating has always been a social experience for humans.  It is likely that some of your best memories as involve a delicious family or social meal.
f.     Stay well-hydrated with crystal clear, refreshing water.

3)     Daily sunshine
a.     We live in Colorado.  Get outside and enjoy it!
b.     Interact with nature:  smell a flower, listen to creek, catch a sunset, watch geese fly, feel a summer breeze on your skin, catch snowflakes on your tongue—and do something like this outdoors, everyday.

4)    Celebrate life 
a.   Grow flowers.  Cultivate a vegetable garden.  Have houseplants.  Plant trees.
b.   Get a pet.  Dogs, cats, hamsters, fish, lizards, rabbits--there is some cute critter out there that will soften your heart and meet your lifestyle requirements.
c.    Ride and take care of horses if you can.  Being around horses has proven to be therapeutic for humans.
d.    Be around infants and children.  Nothing is quite as life-affirming as the sound of children laughing or playing in the park.
e.   Surround yourself with things that are alive, that give and receive love.

5)   Daily meditation
a.    Prayer
b.    Yoga
c.    Deep breathing / relaxation techniques
d.    “Spend less time as a human doing, and more time as a human being.”

6)     Daily journaling
a.     Reflect on your life, describe your successes and your struggles, dream about the future.  Write for your own benefit.  Blogging is great, but your journal is for the audience of you.
b.  Go back and read prior entries. See areas of progress, consider room for improvement, get a sense of your continuity of self.  In all great stories, the heroes must overcome great obstacles before achieving their greatest triumphs.  Be a hero on your journey through life!

7)  Daily supportive conversations with a trusted friend
a.     Seek out healthy, nurturing relationships.  Be around people who inspire you.
b.      Listen, and let yourself be listened to, if only for a few minutes.
c.      No one is an island.  We need each other, and others need us!
d.     Email and texting are great, but go for face-to-face conversation. 

8)     Get plenty of sleep
a.      Most people need at least eight hours of restful sleep each night
b.     Have a regular bedtime routine, don’t go to bed too late or get up too late
c.     Take a twenty minute power nap during the day if you can.  It will do wonders.
d.      Pay attention to your dreams, and what they are trying to tell you.  Write them down, and figure out what they mean for you.  You will be surprised.

9)     Seek service opportunities
a.      Volunteer at schools, churches, community organizations, international missions.
b.     Forget about your own problems, and make a difference in somebody else’s life.

10)     Fill your mind with positive messages
a.      Read good books, watch inspiring movies, listen to uplifting music.
b.   Try a "news fast" for a week.  Turn off the news.  Don't read the newspaper.  Stay away from the hysterics of the blogosphere.  Allow yourself the luxury of living only within your own sphere of influence for a week.  So much of our anxiety comes from internalizing news events that are beyond our influence.

11)  Be creative
a.     Try painting or sculpture.  Try crocheting or cooking.  Write music or poetry.  Even if you think it's no good, even if your only audience if yourself, express yourself!
b.   Transform your inner world into a unique creation, express things for which there are no words, no text books, no guidelines, no defined feelings.
c.     Release the artist within.  Leave your unique mark on the world.  You have something to say that can only be said by you, because you are totally unique.  

12) Keep a positive attitude
a.      Hope for a better world and a better life.  Never give up!
b.     When things seem overwhelming, take one step at a time. 
c.      Things will get better.  The sun will rise tomorrow, and you will find a way to cope.  We hurt and then we heal.  We suffer and then we recover.  The pull is towards wellness and wholeness.
d.     Take responsibility for your moods, your actions, and your reactions.  In the end, we create and control our own inner weather.
e.      Be gentle and kind with yourself.  Give yourself permission to feel down, to hurt, to be human, but then expect yourself to get right back up.  We are resilient beings, and our brains and souls can heal. 
f.      The expert in anything was once a beginner.  Life is a journey, not a destination.  Be patient with your progress.

13)   Integrate your feelings and thought patterns.
a.      To be human is to feel emotions, both positive and negative.  You don't want to be numb to life.  Be fully alive and responsive to your emotional state.
b.    Relish moments of joy and peace.  These are the exquisite moments of aliveness that frame all of our memories and expectations.
c.    Give yourself permission to feel depressed, anxious, scared, confused.  That's okay.  
d.    Work through your negative feelings.  Within the turmoil of the moment, there is something valuable for you to learn about yourself.  Harness the intensity of the emotions, and make changes where needed.
e.    Remember the Prayer of Serenity, printed below.  Even if you are an atheist, then consider how you could apply the sentiment of this prayer to your own value system.  One some level, we need to surrender our problems to a greater power, be it to your personal vision of God or to your own conception of the creative power that binds the universe together and creates life and consciousness.  May the Force be with you!
f.    Maintain perspective.  Emotions are powerful and necessary, but you are more than the sum of your emotions.  You are a soul traveling through time, and your emotions are the changing weather patterns you will encounter.  There will be both sunny and rainy days, summer vacations and winter blues.  Accept the inevitable changes in your internal weather as temporary, meaningful, cyclical and essential to being fully human.
g.   Read "Man's Search For Meaning" by Viktor Frankl, the account of a Jewish psychiatrist who survived the Nazi concentration camps.  In this one short book, which is at times horrifying and at times sublimely beautiful, you will gain an intense appreciation for the preciousness and uniqueness of your own life, and how you may derive meaning from even your most difficult trials.

14)   Work with a trusted professional counselor, therapist or pastor. 
a.   Sometimes we all need a coach to help us achieve our fullest potential, to help us recognize our faulty thought-patterns, and to point the way forward when things seem dark and uncertain.  
b.    There is no "one best way" to do therapy that fits all people.  In fact, there are dozens of specific disciplines, and within each discipline the therapy is as individualized as the therapist.  Find something and someone that works for you, that matches with your life experiences, values, and expectations.  Get recommendations from friends and family, and interview potential therapists until you find one that seems a good fit.
c.   The most important ingredients in successful therapy are trust, empathy, and flexibility.  If you have engaged in a therapeutic relationship that is not working for you, then don't feel bad in seeking another approach from another therapist.
d.   Your counselor, therapist or pastor is a human, too.  They come to your sessions with their own ingrained habits, preconceptions, and personal feelings.  Plus, they are silently dealing with their own issues.  Sometimes, they will have a bad day, too.  Accept their shared humanity and their flaws, and find a way to make the relationship mutually beneficial.





The Prayer of Serenity

Lord, grant me the serenity
to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference.

Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.
Amen.

--Reinhold Niebuhr









-- by Max Ehrmann


Go placidly amid the noise and the haste,
and remember what peace there may be in silence.
As far as possible, without surrender,
be on good terms with all persons.
Speak your truth quietly and clearly;
and listen to others,
even to the dull and the ignorant;
they too have their story.
Avoid loud and aggressive persons;
they are vexatious to the spirit.
If you compare yourself with others,
you may become vain or bitter,
for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans.
Keep interested in your own career, however humble;
it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs,
for the world is full of trickery.
But let this not blind you to what virtue there is;
many persons strive for high ideals,
and everywhere life is full of heroism.
Be yourself. Especially do not feign affection.
Neither be cynical about love,
for in the face of all aridity and disenchantment,
it is as perennial as the grass.
Take kindly the counsel of the years,
gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline,
be gentle with yourself.
You are a child of the universe
no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you,
no doubt the universe is unfolding as it should.
Therefore be at peace with God,
whatever you conceive Him to be.
And whatever your labors and aspirations,
in the noisy confusion of life,
keep peace in your soul.
With all its sham, drudgery, and broken dreams,
it is still a beautiful world.
Be cheerful. Strive to be happy.

Wednesday, April 13, 2011

Empathic Therapy

I recently returned from Peter Breggin's Empathic Therapy Conference in Syracuse, NY.  It was a phenomenal event, attended by nearly 200 physicians, psychologists, recovered mental health consumers, authors and advocates.  It was inspiring to be surrounded by so many people who are dedicated to a humane and hopeful approach to help those who struggle with mental and emotional distress.

Dr. Breggin and me in Syracuse, NY
Dr. Breggin, MD is a pioneer, and one of the real founders of the modern mental health reform movement.  He is an accomplished author of several related books, including Toxic Psychiatry, and Your Drug May Be Your Problem.  This latter book I highly recommend to anyone looking for practical advice on how and why to withdraw from unwarranted and potentially harmful psychiatric medications. 

I was honored to be able to present a short message at the conference describing my evolving views on mental health, and my efforts to help patients withdraw from drugs and find alternatives. I'm also honored to accept an invitation to be on the Advisory Council for the Center for the Study of Empathic Therapy, Education, and Living.

Below is Dr. Breggin's definition of Empathic Therapy, and here is a link to his website's Founding Guidelines of Empathic Therapy.  In our Western health care system that grows ever more inefficient, cynical, dehumanizing, and blindly faithful in technology, it is my belief that we must return to these principles in order to guide patients towards healing and wellness, and to live up to our oath to Do No Harm.


What Is “Empathic Therapy”?

Empathy recognizes, welcomes and treasures the individuality, personhood, identity, spirit or soul of the other human being in all its shared and unique aspects. 

Empathic therapies offer a caring, understanding and empowering attitude toward the individual’s emotional struggles, aspirations and personal growth.  They promote the individual’s inherent human rights to life, liberty and the pursuit of happiness.  They respect the autonomy, personal responsibility and freedom of the person. They encourage the individual to grow in self-appreciation as well as in the ability to respect, love and empathize with others. 

A broad spectrum of therapeutic and educational approaches can draw upon and express empathy; but conventional psychiatric diagnosis, psychiatric medication, electroshock and involuntary treatment suppress the individuality and the empathic potential of both the provider and the recipient.  Empathy lies at the heart of the best therapeutic and educational approaches.

Sunday, April 3, 2011

Towards Mental Wellness

Many of my patients have received from me the following handout, which is a summary of non-drug therapies that can improve mental and physical wellness.   I hope you find them useful.

Tried and True Methods of
Promoting Mental and Emotional Well-being
(And none of them involve medications)
by Mark Foster, DO
1)     Daily exercise.  (If you do nothing else on this list, do this.)
a.      At least 30 minutes every day.
b.     Get your heart beating faster than 110 beats per minute.
c.      Break a sweat.  A brisk walk is perfect.
d.     Play a competitive sport.  They can be a great outlet for stresses, great for making social connections and a sense of teamwork, and also help you focus your exercise routines.
2)     Eat healthy food
a.     Don’t eat fast food, and don’t drink soda pop.
b.     Avoid excessive sweets.
c.      Eat five fresh fruits and vegetables a day.
d.     Stay well hydrated with water.
3)     Daily sunshine
a.     We live in Colorado.  Get outside and enjoy it!
b.     Interact with nature:  smell a flower, listen to creek, catch a sunset—and do this everyday!
4)     Daily meditation
a.     Prayer
b.     Yoga
c.      Deep breathing / relaxation techniques
d.     “Spend less time as a human doing, and more time as a human being.”
5)     Daily journaling
a.     Reflect on your life
b.     Describe your struggles and your successes
c.     Dream about the future
6)  Daily supportive conversations with a trusted friend
d.     Seek out healthy, nurturing relationships
e.      Listen, and let yourself be listened to, if only for a few minutes.
f.      No one is an island.  We need each other, and others need us!
g.     Email and texting are great, but go for face-to-face conversation. 
7)      Get plenty of sleep
a.      Most people need at least 8 hours of restful sleep each night
b.     Have a regular bedtime routine
c.      Don’t go to bed too late or get up too late
d.     Take a twenty minute nap during the day if you can.  It will do wonders.
e.      Pay attention to your dreams, and what they are trying to tell you.  Write them down, and figure out what they mean for you.  You will be surprised.
8)     Seek service opportunities
a.      Volunteer at schools, churches, community organizations
b.     Forget about your own problems, and make a difference in somebody else’s life.
9)     Fill your mind with positive messages
a.      Read good books
b.     Watch inspiring movies
c.      Listen to uplifting music
10) Be creative
a.      Try painting or sculpture.  Try crocheting or cooking.  Write music or poetry.  Transform your inner world into a unique creation, and let it express things for which there are no words, no defined feelings. 
b.     Release the artist within.  Leave your unique mark on the world.
11) Keep a positive attitude
a.      Hope for a better world and a better life.  Never give up!
b.     When things seem overwhelming, take one step at a time. 
c.      Things will get better.  The sun will rise tomorrow, and you will find a way to cope.  We hurt and then we heal.  We suffer and then we recover.
d.     Take responsibility for your moods, your actions, and your reactions.  In the end, we create and control our own inner weather.
e.      Be gentle and kind with yourself.  Give yourself permission to feel down, to hurt, to be human, but then expect yourself to get right back up.  We are resilient beings, and our brain can heal.  “Get right back on that horse.”
f.      The expert in anything was once a beginner.  Life is a journey, not a destination.
12) Work with a trusted professional counselor or pastor. 
a.      Sometimes, we all need a coach to help us achieve our potential, to help us recognize our faulty thought-patterns, and to point the way forward when things seem dark and uncertain.

Friday, March 25, 2011

New Beginnings: The Rest of the Story

Beware the Ides of March.

On March 15th, I was visited by three administrators from my employer, Littleton Adventist Hospital and Centura Health, and was "terminated without cause," effective immediately.  There was no disciplinary action taken, no concerns about the quality of my practice or my professional conduct, no time allowed for me to notify my patients or make arrangements for their transition in care.  The hospital administration simply said that they felt our interests had diverged and it would be better if we parted ways immediately.  I asked if they would allow me to work another month to help patients adjust, but they said I needed to see my patients scheduled for that day, and then pack up my office and leave.

As they own the clinic, I respect their right to make this decision, but that doesn't mean I have to like it.  I have done nothing wrong, and it has been a humiliating experience for me personally, as I've never been fired from any job for any reason.  Mostly though, I deeply regret the inconvenience and disruption in care that this sudden change is having on my patients, whom I care for greatly and who have looked to me for guidance and support.  I appreciate the outpouring of support that has been offered to me.  Unfortunately, the messages communicated through the clinic about the reasons for my sudden departure were varied and inaccurate.  Patients have been prevented from having access to my contact information.  I have worked with the hospital to try to establish reasonable measures to provided accurate contact information to my patients, but they have declined my requests.  This entry is my attempt to set the record straight, and this blog has been established so that patients can stay in contact with me.

First, I want to say that, while these events are unfortunate and unwarranted, I maintain respect for Littleton Adventist Hospital, and I will always appreciate the opportunity given to me to open such a fine clinic in such a wonderful location.  Dr. Lisa Walker, MD is an excellent physician and friend, and she will continue to provide care for my patients at CFM.  For those of my patients who are currently in a transition period in their health, Dr. Walker will do her best to follow the treatment plans we had previously laid out.

Many of my patients are aware of my alternative views and writing activities in regards to mental health reform, about the serious problems created by our society's over-reliance on prescription drugs to treat mild mood and thought disturbances.  I contribute a blog on the website of Robert Whitaker, author of the highly acclaimed book "Anatomy of an Epidemic:  Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness."  The website is www.madinamerica.com.  When I started writing for Robert, I realized that my views and activities in this area would place me outside of the mainstream medical thought, and that expressing such views would potentially open me up to repercussions.

I am currently working on a important book that relates to these issues.  It is the biography of an amazing person that I have met, a woman who has overcome years of mistreatment in the mental health system to become one of the leading advocates for reform in Colorado.  To give you the brief version:  she had been labeled as schizophrenic during her college years while abusing various substances.  This diagnosis eventually led to her being placed on twelve (Twelve!  Can you believe that?) powerful psychiatric drugs,but instead of getting better, she got worse.  Much worse.  She became homeless, violent, and hopeless.  One day, she developed a toothache, and that led to her being unable to swallow her pills for four days.  On day five, she says she awoke as if from a coma, like Lazurus from the dead, newly in possession of her mind and faculties.  That was ten years ago, and that awakening was the start of her remarkable transformation into the warm, intelligent, funny, ambitious woman that she is today.  She recently told me, "I feel like I'm getting smarter everyday! How many women can say that at my age?"

It is a powerful human interest story, and a perfect example of how a person's humanity can be reclaimed when they are removed from the toxic effects of unwarranted prescription drugs and dehumanizing labels.  Her story is one that needs to be told, and I am fortunate that she has asked me to write it.  In order to do so, I needed create some time in my schedule to devote to the project.  My plan was to work two days a week from June through August, allowing me to continue to provide care for my patients.   I went to my employer at Littleton Adventist Hospital in early February, and asked if they could support me in these plans.  They said yes.  A meeting was scheduled for March 15th.

In the intervening weeks, I got a call from a different administrator saying that the corporation had received an unspecified complaint regarding my alternative views.  He said, “We have become aware of your blog and are concerned that your methods fall outside of the standard of care and that they may adversely affect patient safety.  We need to make sure that our physicians are representing the hospital well.”

I responded by saying, “I am not promoting any new or unproven therapies, procedures, or drugs. I am not forcing med withdrawal on anybody. I am merely communicating to patients the potential harm of long-term drug therapy, and if they so desire, I am helping them to wean off.  If I am able to prescribe the medications, then I should be able to take them away, right?" Then I continued, and said, "But this question begs a follow-up question: you are questioning the safety of my methods, but what are the known risks of continuing patients on long-term psychiatric drugs, especially patients on multiple medications? What research could we bring to bear on the question of the safety and efficacy of long-term psych med treatment?”

At the end of this conversation, I agreed to submit to an Investigational Review Board through the hospital where I would be given a chance to explain and defend my methods.  I was excited about this prospect, because I knew that the evidence would support my position.
I heard nothing more about the blog over the next four weeks, although I heard more evidence that administrators at the highest level of the corporation were continuing to raise questions about it.  I had some other confrontations with administrators about the management of our clinic.  I was concerned with the business side of things, including problems with computer systems and serious billing errors.  It was impeding our ability to provide a satisfactory experience for patients and their families, and I felt it reflected poorly on me as a doctor.  

I believe that it is because of these confrontations and mostly because of my "non-standard" practices and high profile writing that the hospital decided to abruptly give me "termination without cause" on March 15th.  My spidey sense was up the day before the meeting, and so asked for clarification about the agenda.  This is what I was told by hospital administrators less than 24 hours before I was terminated:  "We will be discussing how a new contract would work, any expectations you have, as well as ours."  This was clearly deceitful, as they must have known at that moment that I was to be terminated the next day.  Why they chose to lie to me and treat me so disparagingly, I will never know.
But that is in the past now.  I am getting my feet under me, and I hope to establish a practice again soon.  I have an important book to write.  Mental health reform is a cause that I believe deeply in, and to take a bullet for it is an honor.  I hope that this entry provides some clarity for patients wondering what happened and why.

Please stay tuned to this blog over the following months for updates on my future practice plans.  Future entries on this site will be forward-looking, focusing on healthy lifestyle habits and wellness.


Friday, March 18, 2011

A Message To My Patients and Friends

I have resigned my position with Chatfield Family Medicine in order to pursue other health care and writing opportunities.

I realize this was sudden, and deeply regret the inconvenience this has caused my patients.  I appreciate the outpouring of support that has been offered me.  I also appreciate the opportunity I was given by Littleton Adventist Hospital to open Chatfield Family Medicine in my home neighborhood.  I have a number of exciting practice and writing opportunities in front of me, and I have created this website for patients and friends who are interested in my progress and plans, so please check in periodically over the next few months.  Although I will not be able to provide medical advice for the time being, I encourage you to stay in contact with me through my new email address, drmarkfoster@gmail.com.  Also, please leave comments on this blog if you feel so inclined.

In my absence, I have complete confidence in Dr. Lisa Walker and Chatfield Family Medicine to continue to provide excellent and compassionate care for my patients.

I wish all of you health and wellness in the future.