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Integrative Psychiatry

Exercise Recommendations for Symptom Clusters by Jenn Pilotti, MA

By February 23, 2021No Comments

We all have habits. We go about our days moving. It’s what we do. It’s how we interact with the world. Often, we don’t think much about it. This has its pros and its cons. By taking a moment to start to observe and experience your movements, you can alter not just your body, but your mind.

Come join us as Jenn Pilotti talks about her Exercise Recommendations for Symptom Clusters.


We all have habits. We go about our days moving. It’s what we do. It’s how we interact with the world. Often, we don’t think much about it. This has its pros and its cons. By taking a moment to start to observe and experience your movements, you can alter not just your body, but your mind.

Exercise: Definition

Let’s look at how the CDC defines exercise because I think if you can understand the definition of exercise, you might be able to see why so many people are hesitant to do it. It’s defined as a sub category of physical activity that is planned, structured, repetitive, and purposive in the sense that the improvement of one or more components of physical fitness is the objective. How much fun does that sound? Who in the world wants to spend their free time doing that?

Physical activity, on the other hand, is any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. Physical activity generally refers to the subset of physical activity that enhances health.

Health Risk Related to Lack of Exercise

Anxiety, depression, loss of balance, bone fracture, erectile dysfunction, pain, and diverticulitis. And you guys see a lot of those things I suspect in your practices.

Exercise and anxiety disorders

One of the things you’re going to see with anxiety is it’s comorbid. Well, it’s often correlated to balance issues. Anxiety and depression are both often present in fibromyalgia, IBS, lower back pain, headaches, and nerve pain. Anxiety is correlated with hypermobility. Balance is predicated upon your proprioceptive, your visual and your vestibular systems, your proprioceptive system, ligaments. When that is not accurate, that’s going to affect your balance. If you suspect joint hypermobility, find a practitioner, a movement professional in your area that you can at least talk to, to understand how to work with these people. Because it becomes a very much a graded exposure therapy type of approach. If you do too much, too soon, they flare up, they don’t want to come back. So, there’s this balance that you have to create. And that’s really what happens with trying to get people who aren’t generally physically active, when you’re trying to get them more physically active. You’re constantly playing this game. How can I push them a little bit without pushing them too much that they don’t want to come back?

Depression and Mind/Body Interventions

Mind Body intervention. Here’s where the yoga and the Tai Chi and Qi Gong and all of the mind body interventions come in handy. They also come in very, very handy with PTSD.

Mind Body exercise techniques appear to have positive effects on treatments of major depressive disorder. And I am going to speculate that it’s partially due to the learning response that occurs. Again, it becomes interesting. I’m learning about my body; I’m learning a new movement and learning to move my body in a way I’ve never moved it before. Balancing in and of itself is going to be a focused attention exercise. With meditation and with learning, there are two things that show up over and over and over again, the two easiest types of meditation to teach someone are open monitoring and focused attention. Open monitoring means observing yourself without judgment, observing, observing your thoughts without judgment. Focused attention means paying attention to the task at hand. So, a lot of different exercise modalities can be taught in a way that is with a mind body connection.

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.