From Catalyst, 2000

Mind/Body Medicine

by Bill Asenjo, PhD, CRC

Definition

Mind/body medicine, also known as behavioral medicine, focuses on the ways the mind and emotions influence physical health.

Origins

Western medicine once believed that health depended solely on the body's physical mechanisms, ie, a person consists of physical and chemical reactions that need to be scientifically measured and manipulated. This notion that mind and body are separate entities is often associated with Descartes, who coined the phrase, "I think, therefore I am." Recently, University of Iowa's famed neuroscientist, Antonio Demasio, took this theory to task in his highly regarded book, Descartes Error. Beyond philosophy, the concept of mind/body separation can be traced to religious groups such as the Gnostics and some sects of medieval Christianity.

On the other hand, the idea that mind and body interact can be traced to Hippocrates, the father of Western medicine. Hippocrates believed that health depends on a balance of body, mind and environment, and that disease emanates from imbalances. But as science progressed, researchers found it difficult to measure and quantify mental states.

During the 1950s, Hans Selye pioneered stress research proving that the fight-or-flight response could be triggered by psychological factors. Stress is not necessarily negative, except when it isn't handled effectively.

The so-called placebo effect has been studied extensively. In clinical experiments, people given sugar pills often experience the same improvements as those patients who receive medications. It is estimated that one out of every three patients improves with medication simply because of the placebo effect, not because of the drug itself. Researchers also note that some conditions and illnesses have no physical explanations, commonly called psychosomatic illnesses (caused by the psyche, or mind).

Certain personality types are susceptible to particular conditions. "Type A" personalities tend to be aggressive, ambitious, and rushed. They react to stress by getting angry and upset. Researchers have found that these personalities are more prone to heart disease, high blood pressure, and other stress-related conditions. "Type B" personalities cope with stressful situations by communicating and maintaining emotional balance. They are less prone to stress-related conditions. "Type C" personalities suppress emotions and have trouble with self-expression. Some clinicians link suppressed emotions and the development of cancer.

In the past few decades, researchers have demonstrated that the mind and body are intimately interconnected, that the nervous system influences the immune system. Studies have shown that thoughts and emotions influence the immune system.

In the 1970s, Dr. Herbert Benson at Harvard Medical School discovered what he called the "relaxation response." Benson observed that trained yoga specialists (yogis) could control bodily functions previously believed to be beyond the control of the mind. During meditation, yogis reduced their heart rates, blood pressure, metabolism, and body temperature. People taught meditation were able to reach deep states of relaxation. This relaxation response is the opposite of the fight-or-flight response. The relaxation response reduces blood pressure, respiration, heart rate, muscle tension, and other bodily processes elevated by stress. With the founding of the Harvard Mind/Body Medical Institute, a new field opened up: psychoneuroimmunology (PNI) -- the study of how the mind and nervous system affect the immune system. Studies have shown that the mind and emotions play a role in many diseases, including cancer, diabetes, heart disease, gastrointestinal problems, and asthma.

In 1993, Dr. David Eisenberg's study, published in the New England Journal of Medicine, revealed that one out of three adults in America had used some form of unconventional medicine. Of those alternative treatments, mind/body practices were used most often. The popular PBS series by Bill Moyers, Healing and the Mind, brought mind/body medicine into millions of homes. Despite the acclaim and success, however, there is still resistance to the idea that the mind is an important part of health.

Benefits

Mind/body therapies have shown promise in treating cancer, heart disease, hypertension, asthma, and mental illness. They have been used as effective complementary therapies in conjunction with surgery and chemotherapy. Mind/body therapies have also been shown to increase quality of life, reduce pain, and improve symptoms for people with chronic health conditions. By reducing stress, mind/body therapies may prevent many diseases. Mind/body therapies are typically inexpensive or free, and pose very little risk. Most have few side effects.

Description

Many alternative techniques draw on the interconnection between mind and body. Such modalities include art therapy, assertiveness training, biofeedback, breath therapy, mental imagery, dance and movement therapy, dreamwork, Gestalt therapy, group therapy, hypnosis, meditation, mindfulness training, Jungian psychoanalysis, prayer and faith healing, progressive relaxation, psychodrama, psychotherapy, Reichian therapy, support groups, and yoga.

As it becomes increasingly evident that such modalities reduce medical costs, insurance companies have become more willing pay for some mind/body treatments and training sessions.

Meditation

There are many forms of meditation, but all have the same goal - to calm and focus the mind. However, calming and clearing the mind is easier said than done. When practiced routinely, meditation is an efficient way of promoting the relaxation response. Meditation also eases many health problems, including stress-related conditions, chronic pain, panic disorders, tension headaches, and asthma. Meditation can be learned from books or tapes, as well as personal instruction.

Mindfulness training

Popularized by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center, mindfulness training helps patients deal with chronic illnesses, pain, stress-related conditions, as well as those undergoing surgery or chemotherapy. Many claim it helps them experience more pleasure and less stress in their everyday activities.

Mindfulness training originates from a Buddhist practice called vipassana, which teaches deep awareness of the present moment. Lack of awareness can lead to stress and bad health habits. To be mindful is to participate fully in whatever one is doing at the present moment, whether working, eating, etc. When a person pays full attention to the present moment without judgment, worries about the past and future tend to disappear, and stress is reduced.

Biofeedback

Biofeedback uses instruments to measure heart rate, perspiration, muscle tension, brain wave activity, body temperature, and respiratory patterns. Patients learn to control bodily functions and initiate a relaxation response. Biofeedback has proven effective in treating hypertension, stress-related headaches, migraine headaches, attention-deficit disorder, and diabetes. Biofeedback is used in physical therapy to rehabilitate damaged nerves and muscles.

Breath therapy

Breath therapy works on the premise that breathing plays a central role in the body and mind. People under stress tend to breathe rapidly and shallowly, whereas slow, deep breathing has been shown to reduce stress and promote the relaxation response. In Ayurvedic medicine and traditional Chinese medicine, breath is considered the most important metabolic function. In yoga, the science of breathing techniques is known as pranayama, which is designed to reduce stress and promote health.

Breath therapy is often used in conjunction with meditation and other mind/body techniques. It can be learned from books and tapes, or from a yoga or mind/body specialist. An inexpensive treatment, it can be practiced anywhere.

Hypnosis

A deeply focused attention that brings about a trance state, during hypnosis the mind becomes open to suggestion. Mental imagery is often used in conjunction with hypnosis to maximize positive thinking and healing.

Hypnosis, or hypnotherapy, reduces stress, anxiety, pain, and helps patients with chronic diseases. It is also used to assist those addicted to nicotine, alcohol and drugs. Some dentists use hypnosis to help patients relax. Hypnosis is best performed by trained hypnotherapists, who can teach the patient self-hypnosis techniques.

Mental imagery

This technique uses the imagination to stimulate healing responses. Studies have shown the imagination can cause the same brain and immune system activity as real events. Patients are taught to imagine places or situations in which they have felt happy, healthy, or safe. Patients also focus on images to increase confidence, reduce stress, and promote healing. Cancer patients are taught to imagine their immune cells eliminating cancer cells. Heart attack survivors are taught to imagine their hearts getting healthy and strong. Proven effective in improving the performance of Olympic athletes, imagery enables patients to see themselves successfully going through surgery in preparation for the real event.

Mental imagery has shown promise treating immune system problems, and is often used in treating cancer, AIDS, irritable bowel syndrome and asthma. Mental imaging techniques are used in conjunction with other mind/body techniques like meditation and hypnosis, in promoting positive mental attitudes. Mental imaging techniques can be learned from books, audiotapes, videos, and from professional therapists and teachers.

Movement therapy

Dance therapy, martial arts, yoga, and tai chi often work for people who have trouble sitting still for meditation, and are an excellent way of improving physical strength and mental health.

Precautions

Mind/body practices are safe and have few side effects. They should not, however, be relied upon solely when other medical care is required, particularly for serious conditions like heart disease, cancer, or diabetes. Consumers should also seek out reliable and properly trained practitioners, particularly in those modalities for which certification is not required by law.

Research & general acceptance

Because of its increasing acceptance by mainstream medicine, mind/body medicine has been the subject of much research. Studies have shown that the immune and nervous systems are positively influenced by mind/body therapies such as meditation and guided imagery. Studies have also shown that cancer and heart disease patients utilizing mind/body techniques have significantly longer survival rates on average than those patients who do not use mind/body therapies.

For further information:

Biofeedback Certification Institute of America lists certified biofeedback practitioners. Address: 10200 W. 44th Ave., Suite 304. Wheatridge, CO 80033. (303) 420-2902.

American Society of Clinical Hypnosis is the largest organization for certifying hypnotherapists. Address: 2200 East Devon Ave., Suite 291. Des Plaines, IL 60018. (708) 297-3317.

Academy for Guided Imagery provides resources for mental imaging treatments. Address: PO Box 2070. Mill Valley, CA 94942. (800) 726-2070.

Vipassana Meditation Center is a resource for those interested in mindfulness training and meditation. Address: PO Box 24. Shelbourne Falls, MA 01370. (413) 625-2160.

Resources

Books

Benson, Herbert, MD. The Relaxation Response. New York: Random House, 1992.

Borysenko, Joan. Minding the Body, Mending the Mind. New York: Bantam, 1988.

Cousins, Norman. Head First: The Biology of Hope and the Healing Power of the Human Spirit. New York: Viking, 1990.

Goleman, Daniel, and Joel Gurin, eds. Mind/Body Medicine. Yonkers, NY: Consumer Reports Books, 1993.

Kabat-Zinn, Jon. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Dell, 1990.

Periodicals

Advances: The Journal of Mind-Body Health. 9292 West KL Ave. Kalamazoo, MI 49009. (616) 375-2000.

Organizations

The Mind/Body Medical Institute. Deaconess Hospital. 1 Deaconess Road. Boston MA 02215.

Center for Mind-Body Medicine. 5225 Connecticut Ave. NW, Suite 414. Washington, DC 20015. (202) 966-7338.

Center for Attitudinal Healing. 19 Main Street. Tiburon, CA 94920. (415) 435-5022.

Bill's dissertation research focused on alternative medicine and disability. His article on UI Hospital's meditation program and alternative medicine clinic appeared in the Cedar Rapids Gazette's October Mind/Body section. He can be reached at basenjo@avalon.net or 351-1528.

© 2001 by Bill Asenjo

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