Mind-Body Medicine—At Last

At the University of Massachusetts Medical Center, 30 patients with diverse medical conditions—including heart disease, cancer, diabetes, chronic back pain, and colitis—sit meditating with eyes closed, focusing in utter stillness on th e feeling of their breath moving in and out of thehir bodies. Most who practice this on a daily basis report relief from many medical symptoms.

At a hospital in Cleveland, children with chronic, intractable pain from cancer are being taught to escape it by visualizing themselves in a relaxed, happy place.

Such studies are producing an evergrowing body of evidence that portends a sea change in the way health-care professionals and patients are viewing the role of the mind in the treatment of illness. Relaxation, hypnosis, and other mind-body approaches have been used in Western medicine for decades by traditional healers. Two things are different today: these approaches are gaining more respect and interest from researchers in major medical institutions; and evidence is mounting that mind-body techniques may actually affect the course of disease itself.

Scientists laboring to unravel the physiology of the mind/body connection have begun to outline plausible ways in which the mind and emotions could affect physical health. They have deepened our understanding of the effect of stress on the body, and are accumulating convincing evidence that the immune system, along with other organs and systems in the body, can be influenced by the mind.

Taken together, these research efforts and clinical experiments are suggesting that the split between mind and body, long taken for granted in Western philosophy, is illusory indeed. The studies are also part of a new synthesis in medical science. They are part of mind/body medicine: an approach that sees the mind-our thoughts and emotions - as having a central impact on the body's health.

For patients, this new synthesis has a very practical significance. It means that by paying attention to and exerting some control over emotional and mental states, you may help yourself stay healthy or recover more rapidly from being sick.

The scientific evidence for the mind's influence on the body now comes from three converging areas of research:

o Physiological research, which investigates the biological and biochemical connections between the brain and the body's systems. The key physiological question is whether the biological changes that stem from psychological factors actually make a difference to health. For example, even if stress or depression does lower the effectiveness of the immune system, is the drop in activity great enough to increase the risk of illness?

o Epidemiological research, which shows correlations between certain psychological factors and certain illnesses in the population at large. Some researchers are now trying to unravel the reasons why upsetting experiences are associated with illness and why strong social networks are linked to better health.

o Clinical research, which tests the effectiveness of mind/body approaches in preventing, alleviating, or treating diseases. For instance, support groups for patients might work because they encourage better compliance with what their physicians tell them to do, or because the emotional changes the groups produce help boost immunity directly.

Each of the findings taken from these fields of research, examined alone, will be incomplete. Taken together, however, the research is beginning to show a coherent picture of mind/body medicine.

One basic tenet of mind/body medicine is that it is best to treat the whole person. Treating emotional distress should be an essential complement to standard medical care. Another is that people can be active participants in their own health care, and may be able to prevent disease or shorten its course by taking steps to manage their own psychological states.

Of course, these principles must be tempered with a realistic view of the many other factors at work in health and illness. No one is promising that people can cure themselves of disease just by thinking happy thoughts. That simplistic idea ignores the complexities of biology and the wired-in destiny of our genes. Worse, it leaves people feeling guilty about being sick at all. That is not the message of mind/body medicine.

But the evidence is growing stronger that states of mind can affect physical health. Psychological factors affect the way people experience medical symptoms, even when the mind does not affect the underlying disease process. Mind/body approaches can greatly improve the quality of life for people with physical illnesses, especially for people with cancer, whose primary treatments often have extremely unpleasant side effects.

Mind/body medicine describes a variety of treatments and approaches, ranging from meditation and relaxation training to social support groups, that are designed to enlist the mind in improving emotional well-being and physical health. A growing body of research now supports the use of these techniques.

Although many questions remain to be answered, we believe mind/body approaches can and should become more widely used as a regular part of medical care, for several reasons:

o The physical and emotional risk of using these techniques is minimal, while the potential benefit is high.

o The economic cost of most mind/ body approaches is low; many can be taught by paraprofessionals and involve no high-tech interventions.

o These techniques can and should be used along with standard medical care. They are not alternative measures, but can easily be applied in the context of conventional medicine, rather than standing in opposition to it.

More and more people are looking for medical care that takes into account their thoughts and emotions as well as their overt medical problems - in short, mind/body medicine.

ILLUSTRATION: (RICK SEALOCK)

From Mind/Body Medicine by Daniel Goleman, Ph.D. and Joel Gurin. Copyright (C) 1993 by Consumers Union of United States, Inc. Yonkers, NY Reprinted with permission.