What is the emerging role of this work? Benson regards it as an integral part of comprehensive health care. He offers the metaphor of a three-legged stool: "One leg is pharmaceuticals, another is surgery, and the third is what you can do for yourself. Mind/body medicine is strengthening the third leg, integrated with the other two legs.4
Key Principles
The Biopsychosocial Perspective
In the late 1970s the eminent medical researcher George Engel of the University of Rochester made the bold statement that modern medicine needed a new way of thinking about health and illness.5 He proposed what he called the biopsychosocial model, in which health is the outcome of many factors interacting together. This provides the theoretical framework underpinning mind/body medicine.
In this view, health is not just a matter of "the drugs keeping up with the bugs." Rather, health is determined by an interaction among our genetic vulnerabilities; environmental inputs such as germs, viruses, or pollutants; psychological factors such as stress, lifestyle, attitudes, and behavior; and social factors such as supportive relationships, economic well-being, access to health care, and family and community patterns of behavior.
Turning Down the Dial on Pain
Jim is a forty-six-year-old assembly line worker who received a disc injury in his neck and developed a chronic pain syndrome involving head, neck, arm, and shoulder pain. He was referred by his physiatrist to Karen Carroll, a biofeedback clinician practicing in Waterloo, Iowa, for pain control.
Carroll used EMG, first for general muscular tension and then for muscular tension around the upper body and neck. Jim was able to discover a direct connection between his thoughts, his level of nervous system arousal, muscular tension, and eventually his pain level.
After eight sessions spaced progressively further apart and accompanied by home practice of breathing exercises and progressive relaxation, his headaches and neck pain completely disappeared. He was then able to use physical therapy to further strengthen his neck and shoulders, and subsequently returned to work. He stated, "I never really knew what it felt like to relax until now." According to Carroll, this case illustrates the benefits of commitment to self-regulation and daily practice at home for someone who was motivated to avoid medication and surgery if possible.
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Engel's perspective is gradually penetrating the thinking of mainstream medicine. When we look at the big picture of all the factors that influence health, we can see that many are within our direct control. Along with this new way of thinking has come a growing openness and receptivity to the contributing of mind/body approaches.
Mind/Body Communication
Our thoughts and feelings influence the body via two kinds of mechanisms: the nervous system and the circulatory system. These are the pathways of communication between the brain and the rest of the body.
The brain reaches into the body via the nervous system. This allows it to send nerve impulses into all the body's tissues and influence their behavior. The brain can thus affect the behavior of the immune system with its nerve endings extending into the bone marrow (the birthplace of all white cells), the thymus, the spleen, and the lymph nodes.
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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 
