Mind-body therapies not only improve overall health but also have a positive and measurable effect on specific conditions and diseases. Two key principles underpin the various therapies. First, the mind can affect the body in positive or harmful ways. Second, whatever you do physically also has an impact on consciousness. A great deal of research reveals that psychological and spiritual practices, such as meditation, relaxation, guided imagery and biofeedback, can have a useful impact on physical problems, including pain.
The Role of Mind-Body Medicine
Doctors are traditionally sceptical about innovation. When the stethoscope was introduced in 1916, for example, critics were concerned that the unorthodox diagnosis device might distance doctors from their patients. Integrating mind-body medicine fully with other forms of medicine remains a challenge, but of all CAM (complementary and alternative medicine) therapies, mind-body practices are supported by the greatest body of scientific evidence for the greatest number of conditions for the largest number of people. Compared to other CAM therapies, they have also gained the widest acceptance within conventional healthcare systems. In fact, mind-body medicine is so widely used by the public and by the medical profession that it may be considered to belong more to conventional than to complementary medicine.
According to the National Center for Complementary and Alternative Medicine (NCCAM) in the US, “Only a subset of mind-body interventions are considered CAM. Many that have a well-documented theoretical basis – for example, patient education and cognitive behavioural approaches are now considered mainstream.” On the other hand, meditation, dance, music and art therapy, and prayer and mental healing are categorised as alternative. NCCAM states that “Many CAM therapies are called holistic, which generally means they consider the whole person, including physical, mental, emotional, and spiritual aspects.”
What is mind-body medicine?
In 2001, NCCAM defined mind-body practices as those that employ “a variety of techniques designed to facilitate the mind’s capacity to affect bodily function and symptoms.” Generally speaking, mind-body practices, which include meditation, relaxation, guided imagery, hypnosis and biofeedback, produce a beneficial, biologically regenerative, relaxed state, in which the body is more able to heal itself and function optimally. Under the direction of a skilled clinician, these therapies can be used to treat a wide array of medical and psychological conditions. However, they can also be safely used by everyone as “self-care practices” to prevent and reverse the harmful effects of stress and to complement conventional treatments.
Generally, the extensive research into the efficacy of mind-body medicine focuses on major chronic diseases, such as general pain syndromes and insomnia (see below), where a combination of professional therapy and self-care practice is the most effective way of achieving the maximum improvement in health and well-being.
History of Mind-Body Medicine
Mind-body medicine is an ancient concept. Until about 300 years ago, virtually all philosophy and medicine treated the body and mind as an integral whole. Then, in the 18th century, adherents of the Enlightenment introduced a mechanistic and reductionistic scientific model that meant the study of body and mind were separated. The 18th- century paradigm reached its height in the 20th century when modern scientific medicine helped to end the epidemics of infectious diseases, such as smallpox, cholera and tuberculosis which had formerly been major causes of mortality. (It should be said, though, that these diseases had already declined due to public health measures, such as improved sanitation, safer water, improved housing and better nutrition.)
Currently, the diseases that are killing more people in the developed nations worldwide are no longer these infections, but chronic degenerative conditions, such as coronary artery disease, high blood pressure, cancer and diabetes, for which there are no chemical “magic bullets”. These diseases are inextricably related to psychological, environmental and lifestyle factors. Increasingly, stress is recognised as a major causal factor in both the onset of acute diseases and in chronic diseases. Mind-body practices can give people the skills to manage the inevitable stress of life and, therefore, have an increasingly important role in preventing and reversing the effects of stress and disease.
Asian healing systems
The rise in popularity of mind-body medicine has been stimulated by the introduction of Asian healing methods and systems, such as yoga and Traditional Chinese Medicine, into mainstream Western culture. In the 1970s, Western medical researchers discovered that people who practised advanced forms of yoga, for example, were able to regulate physical functions that were once considered beyond the reach of conscious control. These include the electrical activity of the brain, the temperature of the body, the heart rate and blood pressure. Incorporating some of these Asian healing systems, researchers have discovered new ways to forestall and heal diseases that have long been considered inevitable consequences of ageing.
Mind-body medicine recognises that healing does not necessarily stop when all the physical symptoms of an illness or condition disappear. Healing literally means “to make whole”. From this perspective, treating illness can be viewed as an opportunity to reclaim wholeness and restore completeness, even in the face of ongoing disease. However, this can occur only when the mind and body are integrated into a whole, dynamic healing system. It is not simply a question of “mind over matter”, but rather that mind matters. The Asian healing systems, such as Traditional Chinese Medicine, have affirmed the power of techniques such as relaxation and meditation and made it clear that a person’s inner well-being is crucial to health.
THE INTRICATE MIND-BODY CONNECTION
|Mind-body interactions are not rare events but common occurrences in our everyday lives.Often mediated by the activities of nerves and hormones, the effects that one has on the other indicate that they are integrated and part of the same whole. The table (right) lists some of these effects.
|EFFECTS OF THE MIND ON THE BODY||
EFFECTS OF THE BODY ON THE MIND
|EmotionsEmotions such as embarrassment cause physical responses such as blushing.||
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Exercise has a variety of effects on the brain including:
• improved blood flow to the brain
• release of endorphins, mood enhancers and painkillers similar to morphine
• alteration of serotonin levels in the brain
• increased production of a chemical called BDNF (Brain- Derived Neurotrophic Factor). This chemical helps neurons (brain cells) to grow and connect.
|Stress responsesStress and anxiety raise the levels of the hormones cortisol and adrenaline in the body. These have a variety of physical effects including:
Massage and physical contact
Physical contact with another human (or an animal) can induce feelings of relaxation and well-being.
Massage is a recognised destressing agent.
|HumourLaughter has been shown to:
• lower blood pressure
• reduce levels of stress hormones
Sex hormones (testosterone and oestrogen) alter thoughts and behaviour.
We can affect the way our body behaves just by using our imagination. For example, imagine unwrapping a chocolate. Feel the paper crinkling under your fingers, smell the aroma that is released, then imagine the taste and feel of it melting that is released, then imagine the taste and feel of it melting on your tongue. This imagery will no doubt have activated your salivary glands!
Studies have established that if we stand upright, head erect, smile and breathe deeply, it is impossible to “feel” depressed.
Placebos (dummy treatments, such as sugar pills) can be effective in around 30 per cent of patients. In other words, believing that the treatment will work can produce positive physiological responses.
Immune molecules known as cytokines can initiate brain actions. Some cytokines help the body recuperate by sending messages to the brain that set off a series of sickness Sresponses, such as fever. The immune molecules also can trigger feelings of sluggishness, sleepiness and loss of appetite – behaviours that encourage people to rest while trigger feelings of sluggishness, sleepiness and loss of appetite – behaviours that encourage people to rest while they are ill.
Music can enhance mood and even have a painkilling effect through encouraging endorphin release.
Biological sounds, such as a mother’s heartbeat, have been used to de-stress infants. Conversely, noise can increase heart rate, blood pressure, respiration rate and blood cholesterol levels.
By controlling breathing patterns, it is possible to reduce anxiety and stress responses..
Benefits of Mind-Body Medicine
Essential to all complementary and alternative therapies, but often overlooked, is the notion that the healing process does not work independently of the individual. Rather, it relies on internal changes in an individual’s consciousness and behaviour – their attitude, lifestyle, self-orientation and environmental awareness are all important. Such a holistic approach demands continuous change from an individual – he or she has to transform their psychology and actively engage in the well-being of their mind and body. Since mind-body approaches necessitate such an orientation, they constitute an integral and vital part of all complementary and alternative therapies.
From the perspective of mind-body medicine, the mind, body and spirit are interrelated, not only with each other but also with the larger social and physical environment. Physical interventions are not solely physical in their effect, but also have an impact on consciousness.
Exercise, yoga, meditation, dance, relaxation therapies, visualisation, imagery and manipulative therapies can not only resolve problems in the physical organism, but can also create an enhanced psychological and spiritual sense of well being. Psychological treatments, such as meditation, psychotherapy or imagery work, can have a demonstrable impact on physical problems, such as pain and high blood pressure, as well as their extensive psychological benefits.
Relieving stress and depression
An ever-growing body of evidence has demonstrated that psychosocial stress is an important factor in many medical conditions, ranging from coronary artery disease and chronic pain to immune problems. Within the confines of our modern environment, mental cues such as anxious thoughts, crowds, work pressures and traffic jams, are often perceived as threatening and can trigger the fight-or-flight response, even though no physical threat is involved. Moreover, psychological stressors may linger and allow the alarm response to persist far beyond its useful time. Powerful hormones released during this stress response have a specific physical impact on the body and can contribute to disease.
Other negative emotions and personality traits have also been found to be associated with the risk of chronic disease. It was once thought that the “Type A” personality, which is marked by highly stressed, time-pressurised and aggressive behaviour, was a reliable predictor of mortality from coronary artery disease. Actually, “hostility” is the Type A factor that seems to be predictive of heart attacks.
In 1995, Dr Murray Mittleman and other researchers at Harvard Medical School in the US reported their analysis of interviews with patients after they had had a heart attack. They reported that the likelihood of having a heart attack was 2.3 times greater within two hours of having an angry outburst than at other times.
Depression is also common in patients with coronary artery disease and is associated with a higher incidence of heart disease as well as an increased mortality rate following heart attacks. In 1996, a team of researchers led by Dr Barefoot at Duke University in the US studied mortality statistics for people who had a documented history of heart disease. They discovered that the mortality rate was 78 per cent higher in those individuals with moderate to severe depression compared to those who were not depressed. Of course, this depression could have been the result rather than the cause of the physical illness, but clearly the entanglement of mind and body influenced the outcome of the illness.
Among their other benefits, most mind-body therapies create a relaxed state which is the opposite of the arousal characteristic of the stress response. Practising meditation, relaxation techniques, imagery work, hypnosis and movement therapies, such as yoga and qi gong, can all produce a beneficial relaxed state.
Techniques from cognitive behavioural therapies are also employed in teaching stress management. Individuals learn to recognise stress triggers and respond to them in a different, healthier way by learning a technique called reframing, which allows them to think more positively about the stress-inducing situations they encounter. Through practising a wide variety of CBT techniques, people learn to master symptoms that had previously been overwhelming. This allows them to build up self-confidence which then spills over into other aspects of their professional and personal life and enables them to make positive lifestyle changes which go well beyond the alleviation of specific symptoms.
Self-care for good health
Eighty per cent of all medical symptoms are self-diagnosed, self-treated and self-limiting, which means they resolve without the need for formal medical care. Nevertheless, people often need help in learning how to take care of their health (self-care) in order to avoid more serious conditions. Mind-body therapies address the kind of psychosocial issues that need to change before people can successfully implement effective self-care. The therapies provide simple structured steps for individuals to take to benefit their health and well-being. Meditation, for example, helps people to relax and become more focused. Consequently, they find it easier to give up smoking, which in turn sets up an upward spiral of health improvement.
In 1993, Dr McGinnis and Dr Foege published an article in the Journal of the American Medical Association citing a dire yet familiar litany of mortality – in other words, the ten leading causes of death. Their contention was that this list, which included cancer, heart disease and HIV, belied a more fundamental issue. These are the terminal diseases cited in a pathologist’s report or upon autopsy, but the actual causes of death include factors such as tobacco, alcohol, poor diet and inactivity patterns, stress, certain infections, drug use, deadly drug interactions from prescription medications, and so on.
Many of these “causes of death” can be avoided with better self-care practices. Mind-body therapies provide the behavioural basis for individuals to make healthy changes and so are the foundation for helpful self-care strategies, such as exercise, good nutritional habits and more appropriate use of conventional medicines.