Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness

The author reflects on the ever-changing nature of everyone’s lives, from conception to death, and notes that change can often be a stressful experience if it is interpreted as a “threat to our well-being” (297). He explains that the human body has evolved to cope with environmental changes by working to maintain an “internal balance” called “homeostasis” (300). However, chronic stress can impede the body’s ability to perform these functions and create dysregulation. The author marvels at the body’s many automatic systems which operate subconsciously, such as breathing, healing, hormone release, and more. These systems can be compromised when the body’s stress burden, or “allostatic load,” becomes overwhelming (302). Researchers have found that negative life changes such as losing one’s spouse correlate with an increase in physical illness. The author argues that even positive life changes, such as having children or being promoted, can become distressing if people cannot adjust to the change. Kabat-Zinn posits that major life changes are an opportunity for meditators to become mindful about their mind-body reactions to stressful events and the beliefs they are holding about themselves.

Humans tend to be resilient in the face of many physical and emotional challenges, and can use creativity, intelligence, problem-solving, and community to overcome many problems. While human biology is hardwired to try to maintain balance, these systems can be overburdened, resulting in disease. “Internal stressors” are those generated by an individual, for example, the belief that they have an illness, even if they do not. “Chronic stressors,” meanwhile, are long term sources of stress, such as being a caregiver for a sick relative. “Acute stressors” are stressful events which come and go quickly, such as an argument with a family member. These types of stress can become chronic if people develop entrenched thought patterns around them and ruminate on them; research has shown that this can cause hypertension. When people feel threatened their body produces an “alarm reaction,” which can trigger a fight or flight response and the release of several stress hormones such as adrenaline, noradrenaline, and cortisol (312). Researcher Richard Davidson has demonstrated that meditation helps to stimulate the left side of the prefrontal cortex, reducing fear and anxiety in meditators.

The author ponders how people’s fight or flight responses served humanity better in past evolutionary phases when humans experienced more frequent physical threats to life. He laments that in modern life this stress response can become “chronically activated” (318). Even imagined threats to social status can trigger these powerful responses and many people become entrenched in negative reactive patterns. Kabat-Zinn explains that suppressing these emotions and pretending to be calm is “toxic” for the body and prevents it from achieving the release that running (flight) or fighting would provide (321). The only way to wrest control away from one’s stress hormones is to activate the prefrontal cortex by becoming aware of one’s own thoughts. “Maladaptive coping” is when people try to cope with stress through denial, workaholism, busyness, rumination, or addictions to cigarettes, food, alcohol, or drugs.

The author laments the culture of frequent prescription drug use in the US, and the influence that pharmaceutical companies have on doctors and medicine in general. He argues that people should think carefully before taking medication to relieve symptoms and become curious about how they might address the root cause of their discomfort. He considers some forms of legal and illegal drug use to be maladaptive coping methods since they do not “help us optimize our own capacity for self-efficacy, self-regulation, emotional balance, and the cultivation of our own deep biological capacity for homeostasis and allostasis” (330). Due to the short-term comfort that maladaptive coping brings, it is inherently addictive. Eventually, maladaptive coping damages organs, resulting in disease, or leads to burnout and nervous breakdowns.

People with chronic stress who suffer from an ongoing state of hyperarousal are generally very sensitive to feeling threatened, which triggers a physiological and behavioral process called an automatic stress reaction. Kabat-Zinn claims that by honing one’s awareness and paying close attention to one’s thoughts people can intervene in these responses, and change them from a “Stress Reaction,” in which they are helpless to their physiological or behavioral reactions, to a “Stress Response,” in which they can respond with intention. The author instructs the reader to allow themselves to feel negative emotions and physical sensations while observing what exactly these are. He argues that this form of mindfulness allows people to be “in relationship” to their pain or discomfort, instead of helplessly triggered by it (339). Daily meditation helps people build the “‘muscle’ of mindfulness” that makes this possible. While this process often takes practice, and has varying results, the author urges the reader to try it. He points out that people often have little to lose by taking the time to reconsider a charged situation or approach a conflict with compassion for themselves and others.

The author encourages the reader to think about how their bodies are feeling and place specific reactions, such as a pounding heart or clenched jaw, to reorient themselves to the present moment. He suggests that breathing is a good way to calm down and rest one’s mind to avoid spontaneous reactions. Once the stress response is over, the author instructs the reader to move on and continue to live in the present. These strategies can help people cope with a wide variety of stressors, for instance, one woman learned to pay attention to her cravings and manage her breathing to overcome a smoking addiction.

Studies have shown that people who practice mindfulness have lower blood pressure when stressed than those who are not familiar with these tools.