Mind-body medicine

What is mind-body medicine?

Mind-body medicine uses the power of thoughts and emotions to 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 mind-body medicine in a nutshell.

What is the history of mind-body medicine?

Most ancient healing practices, such as Traditional Chinese Medicine and Ayurvedic medicine, emphasize the links between the mind and the body. Western medical views were shaped by systems of thought that emphasized the opposite, that the mind and body are separate.

In 1964, psychiatrist George Solomon noticed that people with rheumatoid arthritis (RA) got worse when they were depressed. He began to investigate the impact emotions had on inflammation and the immune system in general. The new field was called 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 how meditation could affect blood pressure. More understanding of the mind-body link came in 1975, when psychologist Robert Ader showed that mental and emotional cues could affect the immune system.

Today, there is renewed interest in ancient 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. Studies show these nondrug treatments may require a longer time period to experience benefits than drugs, but their effects may be broader and more durable.

What are mind-body techniques?

The key to any mind-body technique is to "train" the mind to focus on the body without distraction. In this state of "focused concentration," a person may be able to improve their health. Some of the most commonly used techniques include:

Biofeedback

With biofeedback, people are trained to control certain bodily processes that normally occur involuntarily, such as heart rate or blood pressure. These processes are measured and displayed on a monitor that the person watches. The monitor provides feedback about the internal workings of your body. You can then use this display to gain control over these "involuntary" activities, such as lowering your blood pressure. Biofeedback is effective for a number of conditions, but it is most often used to treat tension headache, migraine headache, and chronic pain.

Cognitive behavioral therapy (CBT)

CBT is used to help people recognize and change harmful thoughts. For example, people with phobias might deliberately expose themselves, under the direction and guidance of a therapist, to what they are afraid of. Or people who are depressed can learn to counter negative thoughts and feelings with positive ones.

Relaxation techniques

There are several types of relaxation techniques:

• Autogenic training: This technique uses both visual imagery and body awareness to create a deep state of relaxation. You imagine a peaceful place and then focus on different physical sensations, moving from your feet to your head. For example, you might focus on feeling that your arms and legs are heavy and warm; on your breath; or on a calm heartbeat.
• Progressive muscle relaxation: This technique involves slowly tensing and then releasing each muscle group in your body, starting with your toes and finishing with your head.
• Meditation: The two most popular forms of meditation in the U.S. are transcendental meditation and mindfulness meditation. In transcendental meditation, students repeat a mantra (a single word or phrase). In mindfulness meditation, students focus their attention on their thoughts and sensations, moment by moment.
• Hypnosis: During hypnosis a person's body relaxes while their thoughts become more focused and attentive. In this state of deep concentration, some people are highly responsive to a hypnotherapist's suggestions. Many mental health professionals use hypnosis to treat people with addictions, pain, anxiety disorders, and phobias.
• Spirituality: Researchers have been studying how spiritual beliefs, attitudes, and practices affect health. In a recent study on people with human immunodeficiency virus (HIV), for example, those 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 using prayer and social support, 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 fight disease and promote health. In 1989, for example, a clinical study by David Spiegel, M.D. at Stanford University School of Medicine 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 standard care plus weekly support sessions. In these sessions, 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 clinical study in 1999 showed that in people with breast cancer, helplessness and hopelessness are associated with lesser chance of survival.

Other studies also show how meditation affects mood and symptoms in people with different conditions (such as high blood pressure, irritable bowel syndrome, and cancer). It also improves quality of life. More recently, researchers have found that 70 primary care physicians who participated in a mindfulness education program over one year showed dramatic improvement in mindfulness skills, burnout, mood, disturbance, and empathy.

How does mind-body medicine work?

When you are physically or emotionally stressed, your body releases stress hormones that can affect all your systems and organs. 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.

Certain emotions have been associated with disease. For example, hostile attitudes may increase your risk for coronary heart disease, obesity (especially around the waist), insulin resistance (which can lead to diabetes), and abnormal cholesterol (specifically, high triglycerides and low levels of high density lipoprotein or HDL, the good kind of cholesterol).

There is no evidence that negative emotions actually cause disease, but research shows that being stressed and having negative emotions can be unhealthy. One study found that unconsciously being defensive or stifling feelings may result in medical consequences, such as high blood pressure. High blood pressure is also associated with feelings of hopelessness. How a person deals with emotions may also affect how long they survive with a chronic illness.

The goal of mind-body techniques is to get the body and mind to relax, and to reduce the levels of stress hormones in the body, so that your immune system is better able to fight off illness.

What is mind-body medicine good for?

Mind-body techniques can be helpful for many conditions because they encourage 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 pain. Symptoms of anxiety and depression also respond well to mind-body techniques.

Mind-body techniques may help treat many different diseases, including:

• Cancer
• High blood pressure
• Asthma
• Coronary heart disease
• Obesity
• Pain and nausea/vomiting related to chemotherapy
• Insomnia
• Diabetes
• Stomach and intestinal problems (including indigestion, irritable bowel syndrome, constipation, diarrhea, ulcerative colitis, heartburn, and Crohn disease)
• Fibromyalgia
• Menopausal symptoms such as hot flashes, depression, and irritability
• Mental health issues, such as anxiety and depression
• RA and other autoimmune conditions

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). Relaxation techniques, hypnosis, and biofeedback also helped. Some researchers believe that chronic fatigue syndrome, which affects the immune system, can be treated with mind-body medicine.

Is there anything I should watch out for?

Mind-body medicine should not make you feel that your attitude is the cause of your illness.

Mind-body medicine is generally very safe and works well when combined with conventional medical care. Each mind-body technique may have its own risks and side effects. Talk with your health care provider about any concerns you may have.

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

Biofeedback

Specialists who provide biofeedback training include psychiatrists and psychologists, nurses, dentists, and physicians. The Association for Applied Psychology and Biofeedback (www.aapb.org) is a good resource for finding qualified biofeedback practitioners.

Relaxation

Many clinics and hospitals around the country have included relaxation techniques in their health care programs. Contact the Stress Reduction Clinic at the University of Massachusetts Memorial Medical Center in Worcester, MA, (www.umassmed.edu/cfm) for a list of the health care 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 who 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. For a directory of hypnotherapists near you, contact:

• The American Society of Clinical Hypnosis: www.asch.net
• The Society for Clinical and Experimental Hypnosis: www.sceh.us