Dr. Doug Hanner

Dr. Doug Hanner

Dr. Hanner is particularly interested in how the chronic effects of trauma and prolonged stress impact both our mental and physical well-being. He has seen first-hand how resolving and integrating the effects of trauma in an individual, can have miraculous effects on both physical and mental illness.

Lifestyle: Stress Management

Things are always changing in our lives, and as they change, we adapt. When changes occur that challenge our ability to adapt, we experience stress. This stress is associated with thoughts, feelings, and behaviors in our everyday lives. Even if stress is purely emotional, it can have seriously damaging effects on the body.

Stress activates the sympathetic nervous system, which governs the ‘Fight or Flight’ response, releasing epinephrine (adrenaline). It also activates the Hypothalamic-Pituitary-Adrenal (HPA) Axis, which causes the release of certain hormones, including cortisol. When this activation occurs, the body immediately redirects its available resources away from normal physiologic activities such as digestion and tissue regeneration, to things like increasing blood sugar, and blood flow to the heart, lungs, and extremities.

This stress response system has been critical in the survival of our species over millions of years. When a threat presents itself, we instantly have an increased focus, vigilance, strength, and energy to fight or flee. Once the threat has ended, our systems are designed so that normal physiology should return to baseline in short order. This topic is covered with great skill in Dr. Robert Sapolsky’s book, Why Zebras Don’t Get Ulcers.

As good and as important as the stress response is to our survival in the short term, long term activation causes significant damage to almost every system in our bodies. Let’s look at the short-term effects of stress that have helped humans survive for 70,000 generations. Think about the benefits of these in terms of a response to a sudden threat.

  • Heart rate, blood pressure, and respiration increases to provide the muscles and brain more oxygen.
  • Blood flow is diverted from the liver, kidneys, gut, and skin and to the brain and muscles.
  • The immune system is suppressed.
  • The reproductive system is suppressed.
  • Blood sugar is increased.
  • Increased awareness, sharper vision, and improved hearing.

Now think about what would happen if those same changes persisted over the long term.

  • Increased blood sugar
  • Hypertension
  • Poor digestion leading to nutrient deficiencies
  • Leaky gut syndrome
  • Increased sugar cravings
  • Impaired cognitive function
  • Impaired thyroid function
  • Increased abdominal and visceral fat
  • Depression and anxiety
  • Infertility

Prolonged stress can negatively impact nearly every system in the body. We must eliminate stress when possible. When eliminating the source of stress is not possible, we must learn to manage it.

2 Essential Steps for Stress Management

Step #1 – Avoid stress altogether

  • Turn off the news
  • Don’t get involved in online debates or arguments
  • Avoid people who aren’t positive
  • Clear anything that you can off of your plate so you can focus on the things that bring you joy
  • Learn how to say “No.” Just say, “I’m sorry, but I am going to have to decline at this time”. You’ll feel better that you did.

Step #2 – Manage the stress you can’t avoid

  • Practice appreciation – Begin writing in an appreciation journal every day
  • Don’t be a perfectionist – Accept what is
  • Practice time management – Don’t focus on the time you don’t have – Cherish every moment you have
  • Embrace the idiosyncrasies in your friends and loved ones – that is what makes them unique.
  • Reframe stressful circumstances – Always look for the hidden treasure in every person and situation.

Strategies for Stress Management


Exercise reduces stress, depression, and anxiety through the release of many “feel good” hormones. Exercise also helps to build physiologic resilience, which is the foundation for being happy, healthy, and strong. See the Exercise section for more details.

Deep Breathing

Stress activates the sympathetic nervous system and causes the release of cortisol and adrenaline. The effects that these hormones have on our bodies are to prepare us to face or flee danger. Muscles tense, and the heart begins to beat more rapidly. The physical changes that occur in our body then send signals to our brains that there is imminent danger, and the vicious cycle continues.

Deep Breathing is a way to quickly switch your nervous system activation from sympathetic (fight or flight) to parasympathetic (rest and repair). It is imperative that you never perform these techniques when you are driving or operating machinery. Pick a method and begin doing it once per day. This exercise will start to have a beneficial effect right away and can be a great transition into a meditation practice. We will review two techniques.

Method #1

  • Lie comfortably or sit in a straight back chair with lower back support.
  • Breathe in through your nose as deeply as you can.
  • Your belly should move out first, then your chest expands and rises.
  • When your lungs are full, take in just a bit more.
  • Slowly let the air out for 15-20 seconds. Don’t force the air out.
  • Repeat a minimum of 10 times.

Method #2

  • Lie comfortably or sit in a straight back chair with lower back support.
  • Breathe in through your nose as deeply as you can.
  • Your belly should move out first, then your chest expands and rises.
  • When your lungs are full, take in just a bit more.
  • Release the air through your mouth without any force. (Generally, 3-5 seconds)
  • Repeat 30 – 40 times.
  • After the last inhalation, let all the air out and hold your breath, with air out, as long as you can.


The scientific literature reveals that meditation can:

  • Reduce stress and anxiety
  • Reduce the amount of circulating cortisol
  • Optimize gene expression
  • Improve self-awareness and self-image, creating a more positive outlook on life
  • Increase the ability to concentrate and improve memory
  • Decrease blood pressure
  • Control pain
  • Help people fall asleep faster and stay asleep longer

With all of the benefits known about meditation, why is it that according to the National Institutes of Health (NIH), only 8% of Americans use mediation as a part of a healthy lifestyle? Here are some common objections:

  • It is a new age gimmick
  • It is too hard
  • It takes too long to get good and benefit from it
  • I don’t have time
  • It is part of a religion I don’t practice

Of course, all of these objections are false. Meditation is simply a way to teach our minds to become the observer of our thoughts. By doing this, we can learn to detach from those thoughts and the emotions attached to them. By changing our perception, we can disconnect the body’s damaging stress response that is so interconnected with our thoughts and feelings.

Meditation Tips:

  • Sit upright in a comfortable chair with lower back support
  • Start small – 3-5 minutes is great
  • Focus on your breath
  • Begin with a relaxation technique
    • Notice how your scalp feels – allow the muscles to relax
    • Notice how your jaw feels – allow the muscles to relax
    • Notice how your neck feels – allow the muscles to relax
    • Notice how your shoulders feel – allow the muscles to relax
    • Notice how your arms feel – allow the muscles to relax
    • Notice how your chest feels – allow the muscles to relax
    • Notice how your upper back feels – allow the muscles to relax
    • Continue working your way down to your feet
    • Spend more time in tighter areas
    • When completed, sit and observe
  • When thoughts come, observe them and let them pass, like a cloud passing in the sky
  • When your mind drifts, gently bring it back

There are some apps available that are very helpful as they guide you step by step through the meditation process. Some recommendations include:

  • The Mindfulness App
  • Headspace
  • Calm

The Meditation of Gratitude – Once you are comfortable entering into your meditative state, try practicing gratitude by thinking of something or someone in your life for which you are very grateful. As you are meditating, allow your mind to move back and forth between the thought and the feeling that thought brings to your body.


Yoga has been shown in scientific literature to be an excellent tool for stress management. The word yoga refers to a group of physical, mental, and spiritual exercises that have their origins in ancient India. In the Western World, the term Yoga generally refers to movement-based exercises and mindfulness practices. The poses and movements in yoga help to improve circulation, balance, strength, and flexibility. The breathing and mindfulness component of yoga are great ways to begin to learn about meditation.

When people begin to meditate, they often struggle with sitting still and focusing. The combination of movements with mindfulness in yoga makes those initial steps easier for some. If you are very self-motivated, you may do well streaming a yoga class online or getting a DVD. However, the direction, sense of community, support, and encouragement received from physically going to a good yoga class is an ideal way to start.

Craniosacral Therapy

Craniosacral Therapy (CST) is a light-touch manual therapy that focuses on releasing tensions and imbalances within the body and correcting the flow of cerebral spinal fluid within the head and spinal column. This can soothe pain and release both emotional and physical stress and tension. CST is also thought to help restore cranial mobility and ease or release restrictions of the head, neck, and related nerves.

Freedom of motion is especially important when it concerns the deep tissues and fluid that surround, protect, and nourish the brain and spinal cord. Because of this, CST can have profound healing and regulating effects on the Central Nervous System. However, the benefits of CST are not limited to the head and spinal column. It can be used anywhere in the body to release tensions and imbalances, thereby normalizing function and relieving pain. CST is extremely gentle, so individuals of all ages can benefit from it safely.


There are different types of massages for different purposes. The most common types are:

  • Deep Tissue Massage
  • Sports Massage
  • Trigger Point Massage
  • Swedish Massage

Massage is an excellent way to help us reduce the effects of stress. Stress and trauma can affect the body in many negative ways. One common result is tension in the neck and shoulders. We all know that this tension can be uncomfortable and annoying. We understand that mental stress and trauma can cause these issues. What is not commonly known is that this problem is bi-directional. In other words, the tension in the body becomes a source of emotional distress. The wiring goes both ways. Here is a simplified version of how it works:

  • We experience perceived emotional stress or trauma
  • Our bodies undergo physiologic changes
  • Muscles become tense and shortened in a predictable pattern
  • The pattern of muscle tension is associated with the sympathetic nervous system ‘Fight or Flight’ response
  • The pattern of tension remains after the stressor is gone
  • That pattern of muscle tension sends messages to our brain that there is an imminent threat
  • Instead of looking inside to find the source of the problem, our brains look outside, to our external environment to locate the source of danger
  • This leads to increased irritation and anxiety

Even though the cause of this increased muscular tension may have happened long ago, the emotional toll can go on in perpetuity. When the message of ‘Danger’ is sent to our brain, the brain will find an external threat, real or imagined. Massage therapy can help to relax and stretch tightened muscles and trigger points, and by doing so, give us a brighter perspective on life. Ask your friends and health care providers for recommendations to find a highly skilled therapist.

Dr. Doug Hanner

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