Too often Modern Medicine forgets that this relationship is crucial. As long ago as 400 BC, Hippocrates wrote: “The patient, though conscious that his condition is perilous, may recover his health simply through contentment with the goodness of the physician.” Throughout history, a good bedside manner and a doctor’s warmth were acknowledged as having an important therapeutic effect. Unfortunately doctors today talk about not giving “false” hope, yet they often engender false fears, which can undermine your ability to heal. Although we should never underestimate the seriousness of any medical problem, at the same time, we should not underestimate the ability of the patient to mount an exceptional response.

In childhood, most of us experienced a healing relationship with our parents or another adult, such as a grandparent or a teacher. They soothed us and eased our physical and emotional wounds with their love and affection. Think back on the times your mother kissed a scratch to make it better. That simple act of nurturing alone was effective medicine stimulating the powerful self-healing capacity of the body. This kind of care should be a component of the doctor-patient relationship, too. I continually observe how a good relationship with my patients lays the foundation for positive outcomes and stimulates their innate ability to self-heal.

Although we take it for granted, the body is engaged in self-healing all the time. When you cut yourself, your body heals the wound. When you get a cold, your body’s immune system usually fights it off after a few days. Your body is continually healing and repairing itself. In fact a lot of what I do in my practice is remove obstacles to healing so the body can heal itself.

And it is well accepted that the belief in something can stimulate the body to heal itself. In the scientific community the positive impact this has on healing is known as the placebo effect. The placebo effect, which has a negative connotation in Western Medicine, is really the body healing itself. In fact I believe the art of medicine is putting the patient’s belief system to work and stimulating the placebo effect.

Doctors generally disregard this phenomenon because it is beyond their control, and researchers try to limit its impact on their studies since about one-third of the patients in clinical trials typically improve even when given non-active substances such as sugar pills instead of the actual medication.

Interestingly, doctors are using this placebo effect frequently without patients even realizing it. Take sore throats for example: most sore throats are caused by viruses, yet frequently patients are given antibiotics and get better even though antibiotics don’t work against viruses. So it is the belief in the antibiotics and not the antibiotic per se, which makes people get better. In other words, the belief in the antibiotics or the doctor stimulates the body’s own healing capacity or the placebo effect.

And the negative is true too. Just as our minds can create wellness, they can create sickness from projected beliefs. This is called the nocebo effect, since it is the placebo’s negative counterpart. Here is an all too typical example. You leave your doctor’s office frustrated, angry, and possibly anxious because he didn’t address your questions. The nocebo goes into effect.

Over the centuries, medicine was always considered an art and wise physicians would mobilize every possible medical resource, including the patient’s own healing system. It is only fairly recently, in our pursuit of science, that we doctors often forget this. We know more about the disease and less about the patient. Over the years I have learned that my knowledge of medicine and the many alternatives I have studied is important, but who I am and how I am with patients is even more important. When I work with patients, I always think to myself “How can I also stimulate his or her placebo response?”

No matter what your diagnosis or treatment, it is essential to believe in your doctor and the treatment you receive. In addition, a strong relationship with your doctor, built on honesty, trust, clear communication and compassion sets the stage for healing and contributes to your wellbeing.

Here are a few ways to stimulate your placebo response:

• Seek out a doctor who treats you as an individual and has respect for your role in your healthcare, one that listens to you and respects your beliefs, attitudes and emotional responses. Remember, character is as important as knowledge.

• Your doctor should be an advisor or consultant, someone who has expertise and knowledge beyond your own, but someone who is willing to partner you on your health journey.

• Look for a doctor who knows about alternatives to Mainstream Medicine or works with practitioners who practice them. He or she should help you choose what’s best for you without any attachment to any system or dogma.

• In difficult situations or when facing complex medical decisions, weigh your options carefully and believe fully in the course you have chosen.

Follow Dr. Frank Lipman on Twitter: www.twitter.com/lipmo

Most important quote for you-(Get Moving. Exercise (specifically 20-30 minutes of aerobic) is one of the single best ways to improve the quality of your sleep. Research shows that those who have a regular exercise program get deeper sleep. Try not to exercise less than 2 hours before bed.)

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Every New Year the sleep-related resolutions being made seem to disappear within a few weeks. Most of the time we make resolutions without understanding how our habits affect our sleep.

I ask my patients to follow proper Sleep Hygiene in order to get better sleep, and when they do, their success in making and keeping those resolutions is much greater. Some of the basic Sleep Hygiene recommendations include:

    * TV or not TV, that is the question. Many of my patients sheepishly tell me that they sleep with the TV on, well, so does my wife! If it helps then I am fine with it, but put on a TV timer so it does not keep anyone up the rest of the night.

    * Wean the Bean. Drink higher caffeinated beverages in the morning and move to lower ones in the mid afternoon. Try to move to fruit juices and water by 2-3 pm. While many of my patients tell me "I can drink an espresso and go to bed" they may be correct but the sleep they are getting is more jittery than they are!

    * A Glass for a Glass. If you are drinking alcohol remember that while it may make you fall asleep quickly, it prevents you from reaching deep sleep. Drink one glass of water for every glass of alcohol. Not only will it slow down your drinking but it will prevent you from getting dehydrated which is why you get a hangover!

    * Watch out for the Double Whammy. If you are going out with friends and have a few drinks try to get to bed on time! Most people do both, they stay out late and they drink too much-no wonder they feel horrible in the am.

    * Timing is everything. Some people get relaxed from exercise while others get energized, which one are you? If running relaxes you then do it about 4 hours before bed.

SLEEP 101: Sleep is actually a combination of 2 systems, your sleep drive (like hunger) and a biological clock that tells you when to sleep. When both are working well together, you sleep best. This is why a regular sleep schedule is so important. Interestingly enough, with all the sleep research out there, we still do not understand why we sleep. But we sure know what happens when we don't: disaster. And when we do get great sleep, really good things happen (increased immune system, look better, weight loss, and increased performance).

Here are the five questions (and answers with tips!) to ask yourself to help guide you through your personal Sleep Challenge in 2010 with Arianna Huffington and Cindi Leive:

1. How can my sleep be better?

Answer: There are two main aspects to sleep that most of us want to improve: the quantity (the number of minutes of sleep) and the quality (how refreshing is the sleep that you get).

    * The easiest way to increase your quantity of sleep is to give yourself a bedtime. When was the last time you had a bedtime? When you were ten, and someone else made you go to bed?? Many of my patients tell me that they get involved with something (TV, the internet, a good book) and then "don't know where the time went, " look up and it is 1 am.

      Here is a quick trick: Set your alarm clock for 8 hours before you are supposed to wake up (waking at 7am? Set the alarm for 11pm). This forces you into your room to turn it off and should remind you that it is time for bed. Try to get in bed within the next 30 minutes.

    * The easiest way to increase the quality of your sleep is to reduce caffeine. Caffeine can have a half-life (the time it stays effective in your system) of between 8 and 10 hours! I am not saying to give it up (you wouldn't listen anyway), but try a method called caffeine fading: have your highest caffeinated beverage in the morning and then slowly move to less caffeinated beverages throughout the day. By 2:30 p.m. try to be caffeine free.

2. How can I fall asleep more quickly?

Answer: There are many things that prevent people from falling asleep but two that are quite common include: your body is not ready (sleep is not just an on/off switch it needs time to unwind) and your mind is racing (when you get in bed this may be the first opportunity you've have all day to think or focus on things that matter to you!) To help fall asleep more quickly:

    * The easiest way to get your body ready for sleep is a HOT bath about an hour before bed. Make it a bubble bath with lavender aromatherapy (the bubbles keep the water hotter longer and lavender helps with relaxation and sleep.

    * The easiest way to prevent your mind from racing is to distract yourself. My easy quick trick here is to count backwards from 300 by 3's. It is complicated enough that you cannot think of anything else, and it is so boring, you are out like a light.

3. Am I doing something to keep myself awake in the middle of the night?

Answer: There are several things that can wake us up and keep us up at night that are both biological and psychological.

    * One of the easiest things to help you go back to sleep, biologically: Do not turn on the lights! Lights makes your brain think that is it morning, and makes it hard to return to sleep. Put a night light in your bedroom, hallway or bathroom. That way you can get to where you are going, without telling your brain it is morning.

    * One of the easiest things to help you go back to sleep, psychologically: Do not look at the clock. Who really cares how much time you have left to sleep, just go back to sleep. Watching the clock only causes added anxiety about the next day: something we do not need at night. Turn it around and do not look!

4. Could my bedroom be affecting my sleep?

Answer: YES! It is critical to have an environment that is conducive to better sleep.

    * One of the easiest ways to have a healthy sleep environment: Get the right equipment. Just like exercise, the right equipment will help performance. A great start for the New Year is a new pillow. If you have not bought one in the last year, it is time!

    * Another way to better your sleep environment: Set the mood. When you walk in to your bedroom, how does it make you feel? Relaxed? Tense?! What could you add, or take away that might help your bedroom be more tranquil. Dim the lights one hour before bed, and never bring your laptop into your bedroom.

5. What can I do during the day to set myself up for good sleep at night?

Answer: There are many different activities you do during the day that will affect your sleep at night. The top two: what you consume and your activity level.

    * You are what you eat and what you eat affects how you sleep. Try to limit meals to three hours before lights out, but do not go to bed hungry. If you must eat late make it a lighter meal, with simple carbohydrates.

    * Get Moving. Exercise (specifically 20-30 minutes of aerobic) is one of the single best ways to improve the quality of your sleep. Research shows that those who have a regular exercise program get deeper sleep. Try not to exercise less than 2 hours before bed.

So there you have it. My five questions to ask yourself and the quick fixes to help you out with your Sleep Hygiene as you look at your sleep and take the Sleep Challenge this year! Remember, everything you do, you do better with a good night's rest.

Next: A Pre-Sleep Routine to help you fall asleep and stay asleep!

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™