Mind-Body Medicine
Tara Saenz
Learning Objectives
1. Define mind-body medicine.
2. According to the national survey, what
are the most common mind-body
medicine techniques (besides prayer)
used by adults in the U.S.?
3. Why is the western world less accepting
of mind-body medicine?
4. What occurred in the early 1900s that
sparked an interest in the research of
mind-body medicine?
5. What two positive outcomes of mindbody 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.
Mind-Body Medicine Techniques
•Cognitive-behavioral therapies
•Relaxation
•Hypnosis
•Imagery
•Meditation
•Yoga
•Biofeedback
•Tai Chi
•Qigong
•Group Support
•Autogenic Training
•Spirituality
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 #1
The evaluation of mind/body intervention
to reduce psychological distress and
perceived stress in college students
Journal of American College Health
2002;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 postassessment 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 #2
Efficacy of ‘functional relaxation’ in
comparison to terbutaline and
a ‘placebo relaxation’ method in patients
with acute asthma
Psychotherapy and Psychosomatics
2001;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 mindbody interaction, which can be
triggered by reproducible procedures
– Further development of the FR
approach could lead to a nonpharmacological 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 mindbody 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?