First, the QR Book is out.
QR is the stress-containing "Quieting Reflex" developed by Dr. Charles F. Stroebel, psychiatrist, specialist in behavioral medicine and research director of the Institute of Living in Hartford, Conn.
And between Stroebel and his wife Elizabeth, who has adapted QR for use with young children, this 6-second technique for controlling the ravages of daily stress is beginning to catch on. Already available on audio-tapes for adults and in a teaching kit for children, QR is now available in the book, QR, the Quieting Reflex (Putnam, $12.95).
Some 400,000 have received QR training from several thousand professionals, and now, with a little application, it can be self-taught using the book as a guide.
QR is not just another stress-reducer. The technique's development has been gradual and meticulously researched. Stroebel conceived it for himself, really. He is a self-described unregenerate "A-type" personality who saw patient after patient suffering from stress-related physiological and psychiatric ailments. Himself a longtime sufferer from tension headaches, he began to see the handwriting on the wall over his own biofeedback machine.
He found he had no patience whatsoever for the briefly popular methods of achieving deep relaxation--he calls them the "drop-out" systems--and his skepticism proved out with recent studies suggesting that such passive meditation techniques as TM or the Relaxation Response lose between 70 to 95 percent of their adherents after the first three months.
So he began his search for something that would permit his cherished A-type mind to function--but in a B-type body, something that would permit his body to move into high-stress passing gear when it was required, but automatically put the brakes on when fight-or-flight was inappropriate.
QR began as an adjunct to biofeedback therapy, which permits patients first to electronically monitor and subsequently to regulate the tension in their smooth muscles.
But Stroebel soon discovered that QR could be taught alone, without biofeedback equipment. Once it is learned--it takes adults about 6-months of daily practice--it is triggered into effect by stressful events, from that jerk cutting you off on the freeway to your boss's morning scowl.
Basically, the QR steps are these: first, the cue--the boss's frown or the highway driver. Then, because humor is an important element, comes the inward smile with mouth and eyes. Say to yourself "Alert mind; calm body." Third is inhalation of a deep, easy, natural breath, through imaginary breathing holes in the feet. Fourth is exhalation while jaw, tongue, shoulders go loose and a wave of limp, heavy warmth flows through the body and out the imaginary breathing holes in the feet.
Children are able to pick up the technique with only a few hours of training, and its value is being demonstrated in 700 school districts involving about half a million youngsters from Connecticut to Arizona. Elizabeth Stroebel will be demonstrating the so-called "Kiddie QR" system to Montgomery County school psychologists next week in Rockville.
For more information on Kiddie QR write: Dr. and Mrs. Charles Stroebel, 119 Forest Dr., Wethersfield, Conn. 06109.
For information on the Stroebel audio cassettes for adults write: BMA Division, Guilford Publications, 200 Park Ave. S., New York, N.Y. 10003.
A second summer health-reading bet is Michelle Harrison's A Woman in Residence (Random House, $13.95.)
Harrison is a feminist doctor who quit an ob-gyn residency--and wrote a scathing book--out of her disillusionment with training programs that taught doctors to view their patients as things, instead of people.
The book is another depressing look at the system that produces the medical professionals, another look at the Caesarian sections that are done routinely, at births that are induced at the doctor's convenience. (She heard of a doctor only last year, she said recently, "who has births on Tuesdays and Fridays. If you're his patient, you'll have your baby on a Tuesday or on a Friday.")
And the exhaustion of doctors. "The sleep deprivation," she says, "the total ignoring of human needs for rest, for food, adds to the way in which patients are seen as de-humanized. Because when you're that tired and worn out you can't really respond to someone. It's really hard after 36 hours to feel kindly. You spend a couple of years being that way and that's how you'll be. You get lots of poor feedback because none of those patients are happy with you. So by the time you're finished, you're really soured on patients . . ."
She disagrees with the conventional wisdom that the residents' brutal hours prepare them for later emergencies. "I believe that if you learn the craft well, then when you're under stress you draw on that. What happens in this case is that you never learn to do the craft well."
Harrison does not name the hospital at which her residency was begun, but it has been identified as Beth Israel in Boston. She still believes it is one of the better hospitals in the country, especially since her book, out only a few weeks, has elicited a raft of horror stories from colleagues at other institutions. One doctor told her that he was told during his own ob-gyn residency that "it would be a shame if your moral dilemmas got in the way of finishing this program."
But says Harrison, "Nowhere are you helped with the human problems . . . ethics courses, when they exist, are on Saturday mornings or at lunchtime. Not high priority. And during my training no one ever sat down and discussed death or pain."
Perhaps in the wake of Harrison's book, and similar revelations about medical training, or perhaps coincidentally, Harvard this week announced a pilot project aimed at an eventual recasting of its medical school so as to produce more caring and compassionate physicians.
Says Harrison, "When I go to medical schools the freshmen come up to me and say, 'Michelle, tell me how I can keep from changing.' The tragedy is," she says, "I can't."