Mind-Body Medicine

Mind-Body Medicine Tara Saenz

Learning Objectives • Define mind-body medicine. • According to the national survey, what are the most common mind-body medicine techniques (besides prayer) used by adults in the U.S.? • Why is the western world less accepting of mind-body medicine? • What occurred in the early 1900s that sparked an interest in the research of mind-body medicine? • What two positive outcomes of mind-body medicine interventions is there considerable evidence for?

Introduction Mind-body medicine focuses on the interaction among the brain, mind, body, and behavior, and the powerful ways in which emotional, mental, spiritual, and behavioral factors can directly affect health.

Cognitive-behavioral therapies Relaxation Hypnosis Imagery Meditation Yoga Biofeedback Tai Chi Qigong Group Support Autogenic Training Spirituality Mind-Body Medicine Techniques

Prevalence • According to a national survey* in 2002: • 30% of adults in the U.S. were currently using one or more of the following mind-body medicine techniques: • Relaxation • Visual/Guided Imagery • Biofeedback • Hypnosis • 50% of adults in the U.S. were using prayer Wolsko PM, et al. Use of mind-body medical therapies. Journal of General Internal Medicine. 2004;19:43-50

Background • The concept of mind-body medicine dates back more than 2000 years • Integral to the healing approaches of traditional Chinese and Ayurvedic medicine • Hippocrates believed that treatment could only occur with the consideration of attitude, environmental influences, and natural remedies.

The East vs. The West • The acceptance of mind-body medicine is divided between eastern and western cultures • The East still value the integrated approach of mind-body medicine • Beginning in the 16th and 17th centuries, the West began to separate the dimensions of the mind from the physical body • Redirection of Science • Technological Advances • Discovery of bacteria and antibiotics • Fixing or curing an illness became a matter of science and took precedence over the healing of the soul.

Stress Response and Placebo Effect • Walter Cannon – “Fight or Flight” • Sympathetic and adrenal activation in response to perceived danger • Henry Beecher, M.D. – Placebo Effect • Low supply of morphine during WWII • Found that pain could be controlled by saline injections • As a result, since the 1960s, mind-body interactions have become an extensively researched field.

Focus of Research • Mind-Body Interventions and Disease Outcomes • The treatment of disease • Decrease pain • Improve mood, QOL, and coping • Improve disease or treatment related symptoms • Mind-Body Influences on Immunity • Positive and negative effects of emotions on people’s susceptibility to infection • Meditation and Imaging • Use of fMRI to investigate the effects of meditation on the activation of regions of the brain • Placebo Response • Cognitive and conditioning mechanisms • Stress and Wound Healing • Positive and negative effects of mood or stress on the rate of wound healing • Surgical Preparation • Reduce discomfort and adverse effects

Study #1The evaluation of mind/body intervention to reduce psychological distress and perceived stress in college studentsJournal of American College Health2002;50:281-287

Study #1 • Specific Aim • The effectiveness of a mind-body intervention on psychological distress and perceived stress in college students • Study Design • Randomized, placebo-controlled • Subjects • 128 college students • 25% freshman/sophomores • 41% junior/seniors • 34% graduate students • Median age = 21 years old

Study #1 • Treatment • Six 90-minute group-training sessions

Study #1 • Outcome Measures • Symptom Checklist-90-Revised • Spielberger State-Trait Anxiety Inventory • Perceived Stress Scale • Health-Promoting Lifestyle Profile II • A demographic and health habits survey

Study #1 • Results • 90 students completed the post-assessment measure • Significantly greater reductions in psychological distress, state anxiety, and perceived stress were found in the experimental group

Study #1 • Conclusions • A 6-week RR and CBI training program for students can significantly reduce self-reported psychological distress, anxiety, and the perception of stress. • Found a trend toward improvements for the intervention group on trait anxiety and health-promoting lifestyle profiles.

Study #2Efficacy of ‘functional relaxation’ in comparison to terbutaline and a ‘placebo relaxation’ method in patients with acute asthmaPsychotherapy and Psychosomatics2001;70:151-157

Study #2 • Specific Aim • The effectiveness of functional relaxation (FR) on pulmonary function in patients with acute asthma in comparison to inhaled terbutaline (IT) and a placebo relaxation technique (PRT) • Study Design • Randomized, prospective, single-blind, placebo-controlled, crossover experimental investigation • Subjects • 21 asthmatics with acute bronchoconstriction • 7 male; 14 female • Average age: 48.9 years

Study #2 • Treatment • On 3 consecutive days they were given either: • A 5-minute verbal standard instruction in elementary exercises of FR, which they were to practice during subsequent body plethysmographic measurement • IT (a fast-acting bronchodilator) • An unspecific PRT • Each subjects tried all 3 treatments in random order

Study #2 • Outcome Measures • Standard pulmonary function measurements measured by a body plethysmograph

Study #2 • Results • There was a significant decrease in specific airway resistance with FR, which was not as pronounced as IT, but it was significantly greater than with the PRT

Study #2 • Conclusions • This study shows that clinically relevant effects can be achieved for patients with asthma through mind-body interaction, which can be triggered by reproducible procedures • Further development of the FR approach could lead to a non-pharmacological and effective supplementary treatment for asthma

Other Evidence • Evidence from randomized controlled trials and systematic reviews of the literature suggest: • Mechanisms may exist by which the brain and central nervous system influence immune, endocrine, and autonomic functioning, which is known to have an impact on health. • Multi-component mind-body interventions may be appropriate adjunctive treatments for coronary artery disease and certain pain-related disorders, such as arthritis.

Continued • Multimodal mind-body approaches, such as cognitive-behavioral therapy, can be effective adjuncts in the management of chronic conditions • An array of mind-body therapies when employed pre-surgically, may improve recovery time and reduce pain following surgical procedures. • Neurochemical and anatomical bases may exist for some of the effects of mind-body approaches.

Summary & Recommendations • Considerable evidence that mind-body interventions have positive effects on psychological functioning and QOL • Physical and emotional risks are minimal • Mind-body interventions can be taught easily • Mind-body medicine should be used in conjunction with modern medicine as a combined approach to improving health

Questions?

Mind-Body Medicine