Mind and Body Therapies
When I was a medical student, we were taught
that there were two categories of illness: organic-real disease and
functional-imagined illness. If an organic cause of disease could be diagnosed
and treated, we were relieved; but when no obvious physical diagnosis was
available, we quickly relegated these patients into the large wastebasket
terminology of functional illness (i.e. these patients are not really sick)
and quickly transferred their care to the psychiatrists.
What is most interesting to me now as I look
back a quarter of a century is that as a group of stressed out medical
students, we were displaying the full range of mind/body symptoms without
connecting the cause and effects, while looking down our noses at the
"functional" patients we were referring to as "crocks" or
"cricks".
Many of us had skin eruptions, diarrhea,
irritable bowel symptoms, gastritis, ulcers, and headaches - all attributable
to stress and high anxiety, but usually disregarded and relegated to viral
symptoms or causes undiagnosable. Times have changed. Now we are beginning to
understand and make connections between the mind and the body. The scientific
evidence for the mind’s influence on the body now comes from three
converging areas of research:
- Physiological research, which
investigates the biological and biochemical connections between the brain
and the body’s systems.
- Epidemiological research, which shows
correlations between certain psychological factors and certain illnesses
in the population at large.
- Clinical research, which tests the
effectiveness of mind/body approaches in preventing, alleviating, or
treating specific diseases.
Physiological research in mind/body medicine
dates back to Walter B. Cannon, who discovered the "fight-or-flight
response" to stress in World War I. The modern study of mind/body
physiology began in the 1940’s when pioneer researcher Hans Selye began the
investigation of the physical effects of psychological stress. This avenue of
investigation was a precursor of current physiological research, which ranges
from studying the intricacies of Psycho Neuro Immunology (PNI) to examine the
ways in which emotions like anger may lead to biological changes that raise
heart attack risk.
Epidemiological studies look for relationships
between psychosocial factors and patterns of illness in large populations.
They date back to the early 1960’s when a large study done for the U. S.
Navy showed that men who had gone through severe life changes -- a divorce,
move, or job loss -- had an increased chance of becoming seriously ill within
months following these upsets. A more recent, and very significant, series of
studies covering thousands of people has shown that men and women with few
social ties are significantly more likely to become ill and die than people
with a rich network of family, friends and other social involvements. Clinical
research provides the third major line of evidence. David Spiegel’s work in
the mid-1970’s took women with a diagnosis of advanced breast cancer and
divided them into a group that received regular follow-up care and a group
that met regularly to talk over their day-to-day troubles. The second group
showed an eighteen month longer survival rate (almost twice as long as the
non-support group). Spiegel published this study in Lancet, 1989.
Taken together, the research efforts and
clinical experiments suggest that the split between mind and body, long taken
for granted in Western philosophy (Descartes’ Error), is illusory. What is
becoming evident is that our thoughts and emotions have a central impact on
our body’s health.
For individuals, the new synthesis has a very
practical significance. It means by paying attention to and exerting some
control over emotional and mental states -- your worries, hostility, habitual
reactions, pessimisms, and depression -- you may help yourself stay healthy or
recover more quickly from illness. From the perspective of health care
professionals, this new enlightenment suggests there is much to be gained if
we go beyond attending to physical disease and attend as well to the overall
experience of illness -- the way the disease affects a patient’s spirits and
emotional reactions. The 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 tenet 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.
Mind/body therapies include:
