These findings helped contribute to the formation of the concept of Type C coping.
Can the immune system be trained to respond, like Pavlov's dog was trained to salivate at the sound of a bell? In a well-designed, controlled study, participants were given a sherbet sweet along with a subcutaneous injection of a chemical known to increase NK cell activity (epinephrine). After several administrations of this regime, the epinephrine was replaced by a useless saline injection. Remarkably, the participants still increased their NK cell activity in response to eating the sherbet accompanied only by the saline injection!29
Techniques of Mind/Body Medicine
Some research on techniques has examined their effects on specific bodily functions such as immune responses, blood pressure, and heart rate. Other studies have looked at recovery from surgery, and still others have focused on psychological well-being and the quality of life.
Relaxation Training. This is by far the most widely studied subject in this tradition with hundreds of studies documenting its benefits. A few examples: Patients with ischemic heart disease who practiced the relaxation response daily for four weeks achieved significant reduction in the frequency of preventricular contractions.30
Patients with hypertension who took an eight-week (once a week) training program achieved significantly lower blood pressure and the benefits were maintained three years later.31
Patients receiving several kinds of elective surgery who were trained in relaxation had less surgical anxiety both before and after surgery. The intensity of their pain and their use of pain medication were both reduced.32
Also, a study of patients receiving angioplasty procedures showed significantly less anxiety, pain, and need for medication. In patients receiving heart surgery, those who received the training had significantly lower incidence of postoperative supraventricular tachycardia.34
A controlled study of women with premenstrual syndrome (PMS) using the relaxation response twice daily for three months found a 58-percent reduction in the severity of their symptoms.35
Two studies found increased NK cell activity as a result of practicing the relaxation response. One, involving geriatric residents in nursing homes, also found indications of lower activity of herpes viruses. In addition, there were significant reductions in symptoms of emotional distress.36
Finally, in a study of exam stress in medical students, the more they practiced the relaxation response, the higher the percentage of T-helper cells circulating in their blood.37
Meditation. Of many various forms of meditation, TM has led the way in mind/body research. Over five hundred papers have been published in 108 scientific journals, authored by scientists at 211 research institutions and universities, in twenty-three countries worldwide. Studies of TM were instrumental in discovering the relaxation response and its benefits for hypertension. Other studies have found important benefits for such diverse populations as prison inmates, drug addicts, and Vietnam veterans suffering from posttraumatic stress disorders.
In one study, patients with hypertension who practiced TM twice daily for five to six months achieved significantly lower blood pressured.38 In another, the effects of TM were compared to those of progressive muscle relaxation and usual care in hypertension. For those using TM, the decreases in systolic and diastolic blood pressure were twice as great as those for the subjects in the other groups.39 As will be seen later, TM has also shown impressive effects in reducing the utilization rates of medical services.
Imagery. Imagery is often used in combination with relaxation and meditation. A controlled study of fifty-five women examined the effects of imagery and relaxation on breast milk production in mothers of infants in a neonatal intensive care unit. They received a twenty-minute audiotape of progressive relaxation followed by guided imagery of pleasant surroundings, milk flowing in the breasts, and the baby's warm skin against theirs. They produced more than twice as much milk as those receiving only routine care.40
In another study, a group of metastatic cancer patients using daily imagery for a year achieved significant improvements in NK cell activity and several other measures of immune functioning.41
At Michigan State University, researchers found that students could use guided imagery to improve the functioning of certain white cells called neutrophils, important immune cells in defense against bacterial and fungal infection. They could also decrease, but not increase, white cell counts. At one point in the study, a form of imagery intended to increase neutrophil count unexpectedly caused a drop instead. Subsequently, students were taught imagery explicitly intended to keep the neutrophil count steady, while increasing their effectiveness. Both of these goals were achieved.42
Breath Therapy. A study examined the effect of evocative breath therapy (EBT) on salivary immunoglobulin A (S-IgA). EBT involves abdominal breathing accompanied by music and posthypnotic suggestion to promote emotional arousal and release. Forty-five adults in a group therapy program for cancer showed an average 46-percent increase in S-IgA levels after an hour-long EBT experience.43
Biofeedback. A controlled study of patients with irritable bowel syndrome found that biofeedback training brought a significant reduction in symptoms. This change was still present six months later.44 Another controlled study found a 41-percent reduction in migraine headaches in patients using a thermal biofeedback procedure at home.45
Multistrategy Group Programs
Most organized mind/body therapy programs use a regimen of several techniques. Below are described some findings of such multistrategy programs for specific illnesses.
Hypertension. A group program for patients with hypertension included training in the relaxation response, nutrition, exercise, and stress management.46 Findings included significant reductions in blood pressure, cholesterol, triglycerides, weight, body fat percentage, and psychological symptoms. Importantly, most of the benefits were intact when the patients were checked three to five years later.47
Surviving Heart Attacks. Patients recovering from myocardial infarction took a six-hour program of stress management training with mind/body techniques and emotional support. The result was a 50-percent reduction in subsequent rate of cardiac deaths.48
Reversing Heart Disease. A controlled study at the Preventive Medicine Research Institute, University of California, San Francisco, examined the effects of a multistrategy program on people with severe coronary heart disease. Patients were randomly assigned to either a usual care group or the experimental program. The latter involved a regimen of dietary changes, exercise, yoga, and group support that included the practice of mind/body techniques. Those in the experimental program almost universally showed reductions in coronary artery blockage, while those with usual care generally showed more blockage.49
Benefits for Infertility. A ten-week group program for infertile women included training in the relaxation response with instructions for daily practice and training in stress management, exercise, nutrition, and group support. Results included decreases in anxiety, depression, and fatigue and increased vigor. Also, 34-percent of the women became pregnant within six months of the program.50
Reducing Symptoms of AIDS. In a controlled study, patients received group training in biofeedback, guided imagery, and hypnosis. Results included significant decreases in fever, fatigue, pain, headache, nausea, and insomnia. Vigor and hardiness also significantly increased.51
Another group program for HIV found significant improvement in emotional expression, sense of control over health, tension, anxiety, fatigue, depression, and total mood disturbance.52
Psychological well-being in Cancer. Fifty-nine patients took a ten-day, sixty-hour group program that includes imagery, relaxation training, lifestyle evaluation, emotional release therapies, group support, breath therapy, and exploring the personal meaning of illness. Results included significant improvements in emotional expressiveness, fighting spirit, quality of life, sense of control over health, and optimism--including patients with metastatic disease. These improvements were still present three months after completing the program.53
Psychological well-being and Immunity in Cancer. Sixty-six patients with malignant melanoma took a six-week structured group program that included health education, stress management, training in problem solving, and psychological support.
Josephine, thirty-six, suffering from headaches, sought help from her physician. Her blood pressure was 150/100, she was twenty pounds overweight, and her cholesterol level was 280 mg/dl. She smoked a pack a day and did not exercise regularly. She was given a betablocker for high blood pressure, a cholesterol drug, and was told to lose weight and stop smoking.
Two months later her blood pressure was 160/102 She had lost no weight, she had not been able to stop smoking, and her cholesterol was 290 mg/dl. When asked why she hadn't cooperated with the recommendations she broke down in tears. She hadn't been able to afford the medications ($90/month). Her husband had left her and their two children after a stormy and abusive marriage, so she had been trying to work two jobs, felt depressed, was not sleeping well, and her headaches were now a daily occurrence.
She was referred to the Hypertension Clinic at the New England Deaconess Hospital, Boston, and participated in a twelve-week program of two-hour sessions with ten other participants. The program emphasizes the relaxation response, diet, exercise, and stress management. Her goals in the program were to control her blood pressure, lose weight, and stop smoking. During the program she regained some of her self-esteem, began to feel more hopeful, started sleeping better, was less irritable with her children, and was able to find assistance for child care and vocational training. She monitored her blood pressure once a day, which dropped to 124/90, and her medication was stopped. She was headache-free. She started walking daily and lost five pounds. Her cholesterol dropped to 220mg/dl. She practiced the relaxation response once a day and signed up for an assertiveness training class at the YWCA.
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