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 Chronic Fatigue Syndrome: The Scientific Rationale for Behavioral Medicine in CFIDS 

A controlled study of healthy adults measured the effects of relaxation and guided imagery on cellular immune functioning. Over a ten-day period, subjects practiced the techniques for an hour per day. A significant increase in NK cell function was demonstrated.7

A hypnosis/relaxation/imagery process was found in a controlled study to result in significant improvements in neutrophil adherence. (Neutrophils are important immune cells in defense against bacterial and fungal infection, and in mediating tissue damage in conditions such as inflammatory arthritis in autoimmune diseases.)8

Another study examined immune effects of a single 45 minute intervention using relaxation with imagery. Results included a significant increase in a mitogen measure and a marginally significant increase in white blood count.9

A study of metastatic cancer patients using a weekly group program and daily imagery processes for a year found significant improvements in NK cell activity, interleukin 11 levels, Rozet formation (total proliferating lymphocytes), IgA, IgG, mixed lymphocyte response, and other measures.10

A study examined the effect of a guided breath therapy experience on salivary immunoglobulin A (S-IgA). Forty-five participants in a group program gave samples before and immediately after the process, which involves abdominal breathing accompanied by post-hypnotic suggestion. A 46% increase in S-IgAlevels was found.11 (S-IgA is the body's first line of defense against pathogens entering through the mouth and nose which produce, among other illnesses, respiratory tract infections [colds, flu, sinusitis, etc.]12)

A controlled study of a group program for metastatic breast cancer patients found a near doubling of survival time compared with controls receiving only conventional treatment.13 It may be presumed, if the immune system is the main defense against cancer progression, that improved immune functioning was probably a factor.

The effects reported on NK cells in some of the above studies are especially important for CFIDS in that depressed NK cell activity is one of the features of this syndrome.

It should be understood that statistically significant findings do not necessarily translate into tangible clinical benefits for patients. Such findings do, however, support the notion that potentially beneficial physiological effects are possible. One can only imagine the demand if a drug were developed which could achieve the above results at no cost, with no side effects, and no toxicity.

Learning from Other Illnesses
CFIDS is obviously an organic disease, probably of an infectious origin. However, while its etiology is clearly not psychogenic, this does not mean that clinically significant benefits cannot be gained by the incorporation of psychotherapeutic and behavioral approaches. Cancer, heart disease, and AIDS have all gone through stages of evolution in which behavioral interventions were first considered irrelevant, then shunned as irresponsible or "unproven," and finally, in the face of convincing data, embraced as essential to comprehensive care.

Psychoneuroimmunology researcher Alastair Cunningham articulates this point well with regard to cancer: "Although epidemiological considerations suggest that the contribution of psychological factors to cancer onset is small... no upper limit to what can be achieved (by psychological intervention) is necessarily thereby set: the relative influence of the psyche on outcome may be greatly expanded by such therapy, overriding the usual progression of disease."14 Might this reasoning apply to CFIDS as well?

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 About The Author
William Collinge MPH, PhDWilliam 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......more
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