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M
ind/Body Medicine
 

While all these changes clearly contribute to one's ability to fight or flee in an emergency, they also have a downside. If the person is experiencing the stress response regularly and for extended periods of time, these physiological changes have the effect of weakening the body's resistance to illness and lowering the effectiveness of its mechanisms of self-repair.

The Relaxation Response
Another key principle is the relaxation response, which was discovered and named by Herbert Benson, M.D., and his colleagues in 1974.7,8 They were studying a pattern of physiological changes that occurs in people practicing transcendental meditation (TM).

This pattern of changes has been found to represent a very beneficial state, one that is virtually a mirror image of the stress response. The relaxation response includes the following changes:

  • Reduced blood pressure
  • Reduced respiratory rate
  • Reduced heart rate
  • Reduced oxygen consumption (burning of fuel)
  • Reduced blood flow to skeletal muscles
  • Reduced perspiration
  • Reduced muscle tension

The relaxation response is an antidote to the effects of the stress response and it has also been found to enhance the effectiveness of the body's defenses and self-repair mechanisms. Regular practice of techniques that elicit this response also brings improved emotional well-being and better handling of stressful life events.

The relaxation response is a physiological state, not a technique as such. As we shall see later, there are many techniques that can be used to produce it and, indeed, learning to do this is at the heart of mind/body medicine.

Coping, Emotions, and Health
Researchers have identified how the ways we cope with emotions and stressful situations—our coping styles—can influence our physical health. Most firmly established are the links between coronary heart disease and the Type A behavior pattern. Type A is a way of coping characterized by constant hurriedness, intense competitiveness, and free-floating hostility.

A more recent concept is the Type C pattern, which in many ways is the polar opposite of Type A. It involves the non-expression of anger and other unpleasant emotions such as fear and sadness, unassertive and overly appeasing behavior in relationships with others, and a preoccupation with meeting the needs of others, often to the point of extreme self-sacrifice. The theory of the Type C pattern was put forward by Lydia Temoshok, Ph.D., a leading health psychologist and PNI researcher. She has found compelling evidence for a link between emotional expressiveness and the progression of cancer.

The middle ground, or Type B. is considered a more balanced way of coping that involves appropriate expression of all emotions and the ability to meet one's own needs while responding to those of others. People who cope in this more balanced way tend to be less at risk for serious illness. The cultivation of these behaviors is often a goal in mind/body medicine programs, especially for heart disease and cancer.

Lifestyle Change
The use of mind/body medicine takes place within a broader context of changing one's lifestyle to promote health. Making a daily practice of mind/body techniques is but one of several areas of lifestyle change that work together in a synergistic way. Other areas include proper diet, exercise, and social support.

While the health benefits of diet and exercise are obvious, there is a growing body of research now indicating that supportive interpersonal relationships are strongly associated with better health. They seem to ameliorate or buffer the harmful effects of stress on the body.

Turning Down the Pressure
Alice, suffering from chronic fatigue syndrome (CFS), undertook a two-week intensive treatment of intravenous Acyclovir therapy in the hospital. Acyclovir is a drug that inhibits the reproduction of herpes viruses, a family of viruses thought to be cofactors in CFS. One of the side effects of this therapy is elevated blood pressure, which needs to be closely monitored.

Alice was about halfway through her treatment protocol when she enrolled in a group mind/body medicine program. She brought her stainless steel drip apparatus with her from the hospital and stood it up beside her in the circle with the other patients and their spouses.

The first day involved a series of relaxation and deep breathing exercises. The next day Alice returned to the group bubbling with excitement. She reported that the previous evening her blood pressure had returned to normal. The nursing staff were mystified and wanted to know how she had done it.


Variations: The Many Contexts of Mind/Body Medicine

This field is uniquely cross-disciplinary, which accounts for its wide availability, helping make it the most commonly used form of alternative healing.

Its variety of techniques may be used by medical doctors, nurses, physician's assistants, naturopaths, osteopaths, practitioners of Chinese medicine and Ayurveda, bodyworkers, homeopaths, and chiropractors. Other human service providers such as psychologists, clinical social workers, marriage and family counselors, ministers, and hypnotherapists also use these tools. And of course there are very specialized applications for midwives, physical therapists, exercise physiologists, respiratory therapists, and others.

Mind/body approaches are generally taught either in office practice via private consultation with a health care provider or in group programs. Hospitals and other institutions offer various kinds of support groups or group therapy programs for people with cancer, heart disease, organ transplantation, and other conditions. Almost all such programs incorporate some use of mind/body techniques, such as relaxation exercises or imagery.

These methods are often taught to patients preparing to undergo surgery or other difficult treatments. Research has found such preparation to speed healing, reduce bleeding and complications, and result in earlier discharge from the hospital.

Procedures and Techniques

The repertoire of mind/body medicine includes all psychological strategies that directly influence physiological states. Following are the most commonly used methods.

Meditation
There are hundreds of varieties of meditation. The most basic approach for facilitating the relaxation response is that described by Herbert Benson. The process should take place in a quiet environment, a setting where one can be quiet, undisturbed, and in a comfortable position for at least fifteen to twenty minutes. Given this setting, there are only two essential steps: the silent repetition of a word, sound, phrase, or prayer and the passive return back to the repetition whenever other thoughts intrude.

Variations on these instructions are at the core of many forms of meditation from diverse spiritual traditions. The simplicity of these instructions, however, makes the approach available to virtually anyone, regardless of their spiritual or religious beliefs. This is because the person can use as their repetitive focus a prayer or any other words that reinforce their beliefs (e.g., "God is love"), thereby adding a further dimension of comfort to the experience.

Mindfulness
This is actually another approach to meditation, which involves the ability to focus completely on only one thing at a time. In other words, in mindfulness the mind is full of whatever is happening right now. This can include walking, cooking, sweeping the floor, dancing, watching a bird, hearing the sound of a river, or any other focus you may choose. Whenever thoughts intrude, you simply return your attention back to the focus. This is a traditional Buddhist approach and has been widely popularized by Jon Kabat-Zinn, Ph.D., in the Stress Reduction Clinic, University of Massachusetts Medical Center, Worcester.

Progressive Relaxation
This is another common approach to eliciting the relaxation response. In this technique the body itself is used as the focus of attention. It may be done either lying down or sitting. They technique involves progressing through the body one muscle group at a time, beginning with the feet, moving up the legs, and so on, spending approximately a minute in each area. For each muscle group, you hold or clench the muscles in the area for a count of ten and then release for a count of ten before moving on to the adjacent area.

The remaining techniques described below, while they also can lead to induction of the relaxation response, are also used for other purposes.

Mental Imagery
This involves using symbols to imagine that the changes you desire in your body are actually happening. For example, you might imagine that pain is melting away and dripping like a warm liquid out of your fingertips. Or you might develop an image of your immune cells actively subduing and preying on cancer cells or viruses, like birds of prey swooping down to engulf field mice in a meadow. This is a highly personalized technique and you would use images that are uniquely exciting and meaningful to you.

Studies of mental imagery have found that people can actually influence their immune functioning as well as significantly reduce pain and tension in the body with this method. But aside from the physiological benefits, which take some practice to achieve, there is also the knowledge that you are doing something to help yourself, channeling your energy into a healing activity. This in itself helps to improve emotional well-being and build a sense of self-efficacy or confidence, which research has found to improve immune functioning.

Autogenic Training
This approach involves using a combination of autosuggestion and imagery. Phrases are used to describe to oneself what changes in the body are desired as if they are happening now. For example, "My legs are warm and heavy," "All the muscles of my back are softening and melting," "I am calm," and "Warm, peaceful relaxation is flowing throughout my body." These phrases are repeated while maintaining one's focus on those parts of the body being addressed. Whenever the mind wanders, the attention is gently and passively returned to the focus.

Breath Therapy
A variety of breathing exercises can help one to release tension, anxiety, and pain. They can be used in conjunction with imagery or autosuggestion. They can also be used to encourage fuller breathing in general and give the body a greater supply of energy, which it can use for healing. It takes energy to fuel the body's self-repair mechanisms including the immune system. Since we take a thousand breaths every hour, each breath is an opportunity to contribute to a healing process.

Some breath therapy techniques use the breath in a calm, peaceful way to induce relaxation, to release pain, or to prepare for imagery. Another variety is Evocative Breath Therapy (EBT), which uses stronger breathing, sometimes accompanied by music, to stimulate emotions and emotional release.

Hypnosis
A simple description of hypnosis is offered by Karen Olness, M.D., of Case Western Reserve University who calls it "a form of self-induced, focused attention that can make it easier for you to relax or learn to control your body's functions."10 It is this experience of extraordinary focus of attention that makes it possible to influence bodily states.

A Hike in the Tetons

Larry was a successful forty-two-year-old architect at the time he developed pancreatic cancer with metastases in 1978. He integrated meditation and imagery into his chemotherapy treatment and though the road was long, he recovered completely, with no further signs of cancer three years later.

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About The Author
William Collinge, PhD, MPH is a consultant, author, speaker and researcher in the field of integrative health care. He has served as a scientific review panelist for the National Institutes of Health in mind/body medicine, complementary therapies, and health care services; and for the Congressionally Directed Medical Research Programs on breast cancer, prostate cancer, and......more
 
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