What is mind/body medicine?

Mind/body medicine is an approach to healing that uses the power of thoughts and emotions to positively influence physical health. As Hippocrates once wrote, "The natural healing force within each one of us is the greatest force in getting well." This is the essence of mind/body medicine.

What is the history of mind/body medicine?

Most ancient healing practices, such as Traditional Chinese Medicine and Ayurvedic medicine, emphasize the important links between the mind and the body. Western medical views were shaped by systems of thought that emphasized the opposite: the mind and body are separate. As science developed and with Louis Pasteur's discovery of germs, the notion of a connection between mind and body was thought to be superstition.

In 1964, psychiatrist George Solomon saw that rheumatoid arthritis worsened when people were depressed. This led him to investigate the impact of emotions on inflammation and immune function in general. Thus began the new field of psychoneuroimmunology ("psycho" for psychology; "neuro" for neurology, or nervous system; and "immunology" for immunity).

In the 1960s and early 1970s, a physician named Herbert Benson, who coined the term "relaxation response," studied the effects of meditation on blood pressure. Further understanding of how the mind/body link came in 1975, when psychologist Robert Ader showed that mental and emotional cues affect immunity.

Today, there is renewed interest in age-old traditions such as yoga and meditation. No longer viewed with suspicion, mind/body programs are now established at prestigious medical schools in the United States and around the world.

What are mind/body techniques?

The key to any mind/body technique is to "train" the mind to focus on the body without distraction. It is in this state of "focused concentration" that an individual may be able to change his or her health. The following are some of the most commonly practiced techniques.

Biofeedback: Biofeedback is a technique in which people are trained to improve their health by learning to control certain internal bodily processes that normally occur involuntarily, such as heart rate or blood pressure. These activities can be measured with electrodes and displayed on a monitor that both the participant and his or her practitioner can see. The monitor thereby provides feedback to the participant about the internal workings of his or her body. This person can then be taught to use this information to gain control over these "involuntary" activities. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat tension headache, migraine headache, and chronic pain.

Cognitive behavioral therapy: This technique is used to help people recognize and change dysfunctional thought patterns. For example, people with phobias might deliberately expose themselves, under the direction and guidance of the therapist, to what they are afraid of. Brain scans show that over time this therapy can actually change how the brain functions.

Relaxation Techniques: There are three major types of relaxation techniques:

• Autogenic training. This technique uses both visual imagery and body awareness to move a person into a deep state of relaxation. The person imagines a peaceful place and then focuses on different physical sensations, moving from the feet to the head. For example, one might focus on warmth and heaviness in the limbs; easy, natural breathing; or a calm heartbeat.
• Progressive muscle relaxation. This technique involves slowly tensing and then releasing each muscle group individually, starting with the muscles in the toes and finishing with those in the head.
• Meditation. The two most popular forms of meditation in the U.S. include Transcendental Meditation (students repeat a mantra [a single word or phrase],) and mindfulness meditation (students focus their attention on their moment-by-moment thoughts and sensations).

Hypnosis: During hypnosis (taken from the Greek term hypnos, meaning "sleep") a person's body relaxes while his or her thoughts become more focused and attentive. It is in this state of deep concentration that people are highly responsive to a hypnotherapist's suggestions. Today, many mental health professionals use hypnosis to treat people with addictions, pain, anxiety disorders, and phobias.

Spirituality: Many researchers have been studying how spiritual beliefs, attitudes, and practices influence health. In a recent study on people with human immunodeficiency virus (HIV), for example, people who had faith in God, compassion toward others, a sense of inner peace, and were religious had a better chance of surviving for a long time with acquired immune deficiency syndrome (AIDS) than those who did not have such faith or practices. Research suggests that qualities like faith, hope, and forgiveness and the use of social support and prayer have a noticeable effect on health and healing.

Does mind/body medicine work?

While phrases such as "mind over matter" have been around for years, only recently have scientists found solid evidence that mind/body techniques actually do combat disease and promote health. In 1989, for example, a landmark study by David Spiegel, M.D. at Stanford University School of Medicine dramatically demonstrated the power of the mind to heal. Of 86 women with late-stage breast cancer, half received standard medical care while the other half received the standard care plus weekly support sessions in which the women were able to share both their grief and their triumphs. Spiegel discovered that the women who participated in the social support group lived twice as long as the women who did not. A similar study in 1999 showed that in breast cancer patients, helplessness and hopelessness are linked to lesser chances of survival.

Many recent studies also document the effect of meditation on mood and symptoms in people with different types of conditions (such as high blood pressure, irritable bowel syndrome, and cancer) as well as improve quality of life.

How does mind/body medicine work?

Researchers have found that stress hormones are associated with particular unhealthy emotions. These hormones affect systems and organs throughout the body. For example, stress related to hostility and anxiety can result in disruptions in heart and immune function. Similarly, depression and distress may diminish the body's natural capacity to heal. In contrast, emotional expression that encourages openness and active coping with problems helps stabilize the immune system.

Certain emotions have been linked to disease. For example, hostile attitudes may increase your risk for coronary heart disease, obesity (particularly having excess fat around the waist), insulin resistance (which can lead to diabetes), and abnormal cholesterol (specifically, high triglycerides and low HDL – the good kind of cholesterol).

Generally, research shows that being stressed and having negative emotions is unhealthy. One study found that unconsciously being defensive or stifling feelings resulted in serious medical consequences, such as high blood pressure. High blood pressure is also associated with feelings of hopelessness. How a person processes emotions also affects how long he or she may survive a chronic illness.

The goal of mind/body techniques is to activate the relaxation response and reduce the stress response. When you are relaxed, the levels of hormones related to stress are reduced and your immune system is more efficient. High levels of stress hormones circulating in the body may actually prove to increase one's susceptibility to infection as well.

What is mind/body medicine good for?

Mind/body techniques are helpful for many conditions because they promote relaxation, improve coping skills, reduce tension and pain, and lessen the need for medication. For example, many mind/body techniques are used (along with medication) to treat acute pain. Symptoms of anxiety and depression also respond well to mind/body techniques.

Because they improve coping skills and give a feeling of control over symptoms, mind/body techniques may help treat many different diseases including:

• high blood pressure
• asthma
• coronary heart disease
• obesity
• cancer, such as pain and nausea/vomiting related to chemotherapy
• insomnia
• anxiety
• diabetes
• stomach and intestinal disorders (including indigestion [dyspepsia], irritable bowel syndrome, constipation, diarrhea, ulcerative colitis, heartburn, and Crohn's disease)
• fibromyalgia
• menopausal symptoms such as hot flashes, depression, and irritability

In an analysis of mind/body studies, researchers found that cognitive behavioral therapy is the most long-lasting treatment for tinnitus (ringing in the ears), but relaxation techniques, hypnosis, and biofeedback were all also effective treatments. Some researchers believe that chronic fatigue syndrome, which affects the immune system, is best understood and treated with mind/body medicine.

Is there anything I should watch out for?

There is a danger that mind/body medicine might encourage you to feel that you caused your illness because you lacked a healthy mental attitude. This incorrect idea can lead to blame, and blame only causes feelings of distress and guilt.

Mind/body medicine is generally very safe and works well as an adjunct to usual medical care. Each mind/body technique may have its own risks and side effects associated with the practice; please check the monograph on individual topics, such as spirituality, hypnotherapy, and biofeedback, to review. Talk with your doctor about any concerns you may have.

How can I find more information on mind/body medicine?

Biofeedback: Specialists who provide biofeedback training range from psychiatrists and psychologists to nurses, dentists, and physicians. The Association for Applied Psychology and Biofeedback (www.aapb.org) is the national membership association for professionals using biofeedback and is a good resource for finding qualified biofeedback practitioners in your area. To receive a directory of trained biofeedback specialists in your area, write to the AAPB at 10200 W. 44th Avenue, Suite 304, Wheat Ridge, CO 80033-2840 or call them at 800-477-8892.

Relaxation: Numerous clinics and hospitals around the country have integrated relaxation techniques into their healthcare programs. To learn more about relaxation techniques and to locate healthcare facilities that include them as part of their practice, contact the Stress Reduction Clinic at the University of Massachusetts Memorial Medical Center in Worcester, Mass. at 508-856-2656. You can also visit them on the Web at www.umassmed.edu/cfm/mbsr to find a list of the healthcare facilities in 38 states that offer information on and training in relaxation techniques.

Hypnosis: Most hypnotherapists are licensed medical doctors, registered nurses, social workers, or family counselors that have received additional training in hypnotherapy. For example, members of the American Society of Clinical Hypnosis (ASCH) must hold a doctorate in medicine, dentistry, podiatry, or psychology, or a master's level degree in nursing, social work, psychology, or marital/family therapy with at least 20 hours of ASCH-approved training in hypnotherapy. To receive a directory of professionals practicing hypnotherapy near you, contact either the American Society of Clinical Hypnosis (visit them on the Web at www.asch.net or call 312-645-9810) or the Society for Clinical and Experimental Hypnosis (on the Web at sunsite.utk.edu/IJCEH/scehframe.htm or by phone at 509-332-7555).

Spirituality: To learn more about spirituality's role in health (including the latest research on this topic), call the National Institute for Healthcare Research at 301-984-7162, or visit their website at www.nihr.org.

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