Preventive Medicine And The Inner Smile

While visiting my GP recently, he began talking with me about his own health. This was not unusual as we had known each other for twenty years and he had read my self-help book The Endorphin Effect. He was committed to a holistic approach and believed that good medicine enabled patients into self-care.

“If only I had practiced what I preach,” he said wryly, “I would have caught my own condition much earlier and probably avoided surgery.”

We then chatted for a while about the archetype of the wounded healer and the self-sacrificing hero, and that medics have a calling to relieve the suffering of others, but not themselves. Self-care is hardly on the clinical map and hardly possible in a busy day.

“You could do the self-examination in the bath or lying in bed or even commuting to work,” I nudged. “You know exactly where to scan.”

He sighed. He agreed. He then had to see more patients and I left.

The interesting thing for me about clinicians is that of all people, they know how to scan a body for signs of ill health. They know the crucial importance of early diagnosis and appropriate adjustments in behavior, diet, exercise and life style. But they rarely do it for themselves. When they examine patients they get a quick sense of their state from their body posture, skin tone, breathing and the condition of their eyes. With careful hands and appropriate poise, they touch, push, look, listen and feel their patients. They know all the sensory methods for assessing health, but they rarely do it for themselves.

We all have the necessary apparatus to assess our own state of health. We have the mental ability to scan, sense and cognize what it feels like inside the body, to know exactly what signs are important. All this requires is the self-discipline of an intentional pause and then deliberately focusing down into one’s own physicality.

This sensory, felt awareness of one’s self is crucial. It is the sovereign individual alone who can really know and experience their own state, and is able to self-assess and catch early signs of threatening symptoms. Who else can notice those signals that require just a tad of relevant adjustment: a bit more exercise, regular stretching, earlier nights, less caffeine, better food, more fresh air?

Self-care as preventative medicine is not, of course, a new model. Indeed, in classical Chinese medicine, the art of being in a friendly clinical relationship with your own body is considered the foundation of good health. There is even a clear set of instructions on precisely how to conduct this practice. At its heart is a relaxed and friendly bedside manner towards your own physicality.

Sometimes this self-care practice is translated from Chinese as The Inner Smile, which may sound quirky to a cynical ear, a prime candidate for a bad science award. But unpack the Inner Smile tolerantly and we can see that it meshes extremely well with a modern understanding of the integration of brain, nervous system, endocrine system and gut ecology.

The Inner Smile is in fact a good example of psychoneuroimmunology (PNI) and polyvagal theory put into practice. The practitioner is advised to do it daily, when the body is at ease, with a particular focus on letting the abdomen drop down and sink into relaxation. With a calm and friendly attitude the practitioner then conducts an internal scan, especially checking in on all the major organs and noticing how they feel. Moreover the practitioner is asked to come into a direct and personal relationship with each organ, greeting it with a smile.

Is this hippy-dippy? Anyone with the slightest knowledge of mind-body anatomy and PNI will understand that this internal focus triggers signals from the brain through the nervous system into the endocrine system. It is crucial therefore that the practitioner’s attitude be friendly. If the self-examination is conducted with a purely clinical, impatient or, worst, an inquisitorial attitude, the message triggered in the neuro-endocrinal system will be that of threat, thereby precipitating the production of cortisol and adrenalin. If however the attitude is friendly and comfortingly parental then the neural signal is reassuring and soothing, triggering a cocktail of wellbeing hormones: endorphins, oxytocin and serotonin. Just as an external caring parent can do wonders for our health, so an internal caring persona can have a similar positive effect.

Scanning with the Inner Smile, then, serves two purposes:

  • It brings into conscious awareness the felt state of your own body — early diagnosis leading to appropriate early intervention.
  • It self-soothes — relaxing and opening up tissue, integrating heart rate variability, settling and balancing gut ecology — all of which support general good health and a strong immune system.

Done on a daily basis the benefits are obvious. But people are predictably human and, despite how sensible and positive this practice is, there is resistance to adopting it. Consider my GP who was bemoaning that he had not followed his own advice and caught an early diagnosis on his own illness.

So why is there resistance? In my opinion it is good to be realistic about the sources of this self-sabotage, because recognizing them makes them easier to manage.

Possibilities Of Why I Don’t Self-Care

  • Can’t break old habits
  • New behavior to learn
  • It wasn’t in my training
  • Embarrassing and awkward to care for self
  • Internalized authority figure judging you for appearing soft and narcissistic
  • Pretending there is not enough time
  • Frightened to look at what might be wrong
  • Addicted to role of stoic hero and healer
  • Scared of feeling feelings
  • Lazy and lack discipline
  • Depressed and no motivation

Those are all extremely good and normal reasons for avoiding self-care. What, therefore, might motivate someone to push through the resistance? You could just wait for a harsh health crisis to be prodded into action — the stick. Or — and I write this carefully after decades of experience in the field — you could just exercise sensible self-discipline, similar to washing your hands after the loo. Other than the unpleasant shock of a severe illness, the only thing that seems to motivate regular self-care is a disciplined rhythm that ultimately, like hand-washing, becomes a part of your normal life style. The carrots of self-care and early intervention are obvious.

Inner Smile Self-Care

  1. Do it daily — perhaps in bed, lunch break, watching television, whenever suits you.
  2. Allow your body to sink down into being at ease.
  3. Let your abdomen slump and let your breath soften.
  4. Switch on the attitude of good bedside manner, like a friendly parent.
  5. Focus down into your own body and scan it.
  6. In whatever sequence works for you, give awareness to and feel into each organ and each region; sense into your systems.
  7. Notice how it all feels and the indications.
  8. Think about the appropriate health benefitting activities.
  9. Action the appropriate health benefitting activities.

The long-term benefits for you and your community are immense.

Chapter by William Bloom adapted and reprinted with permission of the author from the book Health and Self-Care: Inner Balance for an Effective Life for Health Professionals by Andrew Tresidder. Download a full PDF of the book at

William Bloom is Britain’s leading author and educator in the mind-body-spirit field with over thirty years of practical experience, research and teaching in modern spirituality. He is founder and co-director of The Foundation for Holistic Spirituality and the Spiritual Companions project. Visit

See also:
Be The Support You Seek
Family Medicine — We’re All In This Together