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M
ind/Body Medicine
 

He tells the following story about his devotion to doing his imagery practice:

"My girlfriend at the time and I had taken a backpacking trip to the Grand Tetons. This was nine months into my treatment. We'd get out there on the trail and after lunch, which was one of my times, I'd want to sit on the trail or on a rock, or lean against a tree and do my visualization.

This woman was go-go-go, very achievement oriented. She was a very dynamic and pushy and controlling person. 'We're going to hike to this point, have lunch . . . by such and such a time we'll be at the campground,' and she would get terribly impatient with my after-lunch visualization.

It started leading to more and more friction, but I maintained my ground. I was insistent that this is what I was going to do. By the time the trip was over, we weren't speaking. We flew back from Wyoming, not even sitting together on the plane, but that was very important for me, because I didn't often put myself first when it came to her."

Since his recovery, Larry has remained involved with a cancer self-help program as a lecturer in imagery. His story inspires many others to challenge difficult odds. There is no medical explanation for his recovery. The chemotherapy of the day was not considered curative for his condition, yet somehow he was able to marshall the resources to heal.

When in a hypnotic state, the mind is perfectly aware of the surroundings and the situation, but because it is so highly focused, it is able to concentrate on a task without being easily distracted. This enables the person to use imagery, relaxation, or autogenic suggestions in a richer, more powerful way.

Hypnosis is especially useful for relief from pain, reducing the distress from other symptoms or the side effects of treatment, and establishing a greater sense of control. Hypnotic states can be self-induced or facilitated by a hypnotist or hypnotherapist. Finally, it can help in overcoming one's resistance to healthful behavior change, such as reducing smoking or changing one's eating habits.

Biofeedback
Biofeedback uses special instruments attached to the body to give the person information about what is happening in the body. The instruments serve to amplify the signals that the person may not otherwise be able to detect so they can then use this visual or auditory feedback to learn to regulate certain bodily functions. Many people find this form of assistance very helpful for learning to relax.

The most commonly used form is electromyographic (EMG) biofeedback. An EMG sensor is attached to the skin and reveals the amount of electrical activity related to muscle tension in the area of the sensor. This is very useful in helping people learn to relax the muscles, for they have direct feedback—which may be visual readouts, lights, beeps, or tones—as to the degree of tension. This approach is often used for tension headaches and chronic pain conditions.

Other kinds of biofeedback include thermal, sensing the temperature of the skin as an indication of blood flow and relaxation; electrodermal (EDR), measuring subtle changes in amounts of perspiration; finger pulse, for measuring heart rate and force, useful for anxiety or cardiovascular symptoms; and monitoring breathing patterns—rate, volume, rhythm, and location (belly or chest) of each breath.

Biofeedback has many applications, such as headache and migraines, anxiety, chronic pain, teeth grinding and clenching, Raynaud's disease (vascular disorder causing cold hands and feet), incontinence, asthma, and muscle disorders (including helping people learn to reuse arms or legs that have been traumatized). Essentially any bodily process that can be measured can potentially be controlled or influenced through the help of these techniques.


Scientific Support

There are four areas of research that support mind/body medicine: studies describing the physiology of mind/body interactions, those measuring the effects of mind/body therapy techniques, research on the health outcomes of structured mind/ body programs employing a variety of techniques, and studies of cost effectiveness.

Mind/Body Interactions

The Mind/Heart Connection. Scientists have pieced together how stress affects the heart. This work is well summarized by Cynthia Medich, Ph.D., R.N., a cardiovascular specialist and researcher at the Mind/Body Medical Institute, Harvard Medical School and New England Deaconess Hospital, Boston. What Medich describes as the mind/heart connection involves the release of two kinds of stress hormones into the bloodstream: corticosteroids and catecholamines.

These hormones set off a cascade of changes in the body including increased platelet aggregation (tendency for blood clotting); increased coronary artery tone; a surge in coronary artery pressure; increased blood pressure, glucose levels, and lipid levels; a more rapid and powerful heartbeat; and, paradoxically, a constriction in the coronary arteries. In short, the demands on the heart all increase.11

OAM-Funded Studies

Eight of the initial thirty studies funded by the Office of Alternative Medicine, National Institutes of Health deal with mind/body medicine.

Biofeedback. Angele McGrady of the Medical College of Ohio in Toledo is studying the use of biofeedback-assisted relaxation in reducing the dosage of insulin required in type I insulin-dependent diabetes mellitus. The method is being studied as an alternative to increasing the dosage when the person is under stressful conditions. Richard Sherman at Fitzsimmons Army Medical Center in Aurora, Colorado, is evaluating biofeedback in treating chronic musculoskeletal low back pain and muscle-related orofacial pain.

Imagery. James Halper of Lenox Hill Hospital in New York City is conducting a controlled study of the benefits of guided imagery for patients with asthma.

Mary Jasnoski of George Washington University, Washington, D.C., is examining the effects of imagery on the immune system, with potential implications for use in cancer and AIDS.

Blair Justice of the University of Texas Health Sciences Center in Houston was funded to conduct a controlled study examining the effects of a group imagery/relaxation process on immune function and quality of life in breast cancer patients.

Hypnosis. Helen Crawford of Virginia Polytechnic Institute and State University in Blacksburg is examining how the use of hypnosis affects the electrophysiology of the brain in patients with low back pain. Carol Ginnandes of McLean Hospital in Belmont, Massachusetts, is studying whether hypnosis can be used to speed the healing of broken bones. Patricia Newton of the Good Samaritan Hospital and Medical Center in Portland, Oregon, is conducting a pilot study of the effects of hypnotic imagery on psychological and immunological factors in breast cancer patients.

With this understanding it is easy to see how individuals who experience stress on a chronic basis are at greater risk for heart diseases. This connection was dramatically illustrated in a study of air traffic controllers, considered to be in a very stressful occupation, who were found to have five times the incidence of hypertension as a comparison group of second-class airmen.12

Other research has been able to anticipate who will develop hypertension and heart disease. One study followed 1100 adults for twenty years. Those who had the highest levels of anxiety at the beginning of the study turned out to have the highest rates of hypertension two decades later.13

An eight-year study of over three thousand people found that those with the Type A behavior pattern were twice as likely as Type Bs to develop coronary heart disease.14

Depression has also been found to affect the heart adversely. A study of patients with a history of heart disease found that those who were also depressed were eight times as likely to develop ventricular tachycardia as the patients who were not depressed. (Ventricular tachycardia is a condition of abnormal and potentially deadly heart rhythms.)15

A ten-year study was conducted to follow the mortality rates of people who had experienced stroke. Those who had been diagnosed with either major or minor depression were 3.4 times as likely to have died within the follow-up period. The death rate among depressed patients with few social contacts was especially high: over 90 percent had died.16

In a study of 194 heart attack patients, those who reported lower amounts of emotional support in their lives were nearly three times as likely to die within six months as those with higher levels of emotional support.17

The Mind and Immunity. In addition to affecting the heart, the chemistry of the stress response has been found to lower immune functioning. This is illustrated by studies of the effects of exam stress on medical students that have found significant drops in the activity of natural killer (NK) cells18 as well as in the numbers19,20 of NK cells (NK cells are a key in fighting cancer cells and viruses) and a significantly lower percentage of T-helper cells in the blood21,22 (the cells that arouse the immune response to fight off an infection).

In a study of recently divorced people, those who wanted the divorce, for whom it brought relief, were found to have better immunity than those who did not want the divorce.23

A study of the effects of stress on salivary immunoglobulin A (S-IgA, the antibody that fights infections in the mouth and throat) found that a higher frequency of daily hassles was significantly associated with lower levels of S-IgA. However, the effects were less severe in people who scored higher on a scale measuring sense of humor. This suggests that sense of humor can counter the negative effects of stress on the immune system.24

Research has shown that depression can have an adverse effect on immunity. A study that took place in a mental hospital compared natural killer (NK) cell activity in depressed patients, schizophrenic patients, and staff members. The patients with major depressive disorder had significantly lower NK functioning than schizophrenic patients and staff members.25

A study involved 132 college students to determine the effects of positive emotions on S-IgA levels. Half watched a morbid documentary about power struggles in World War II, while the other half watched an inspiring film about Mother Teresa, a Roman Catholic nun selflessly serving the poor and sick in Calcutta. The latter group had significantly increased S-IgA concentrations, indicating heightened immune responsiveness.26

Mind/body researcher Lydia Temoshok, Ph.D., studied the psychological factors associated with malignant melanoma. Among her findings was the discovery that emotional expressiveness was directly related to the thickness of the patients' tumors as well as the course of their disease.27,28

Major findings of Temoshok's research include the following:

  • Patients who were more emotionally expressive had thinner tumors and more slowly dividing cancer cells.
  • The more emotionally expressive patients had a much higher number of lymphocytes (immune cells) invading the base of the tumor.
  • Patients who were less emotionally expressive had thicker tumors and more rapidly dividing cancer cells.
  • Patients who were less expressive had relatively fewer Lymphocytes invading the base of the tumor.
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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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