Mind/Body Medicine Health Article

Definition

Mind/body medicine, also known as behavioral medicine, is the field of medicine concerned with the ways that the mind and emotions influence the body and physical health.

Origins

There was a time not long ago when Western medicine believed that health depended solely upon the physical mechanisms of the body. That is, a person is made up only of physical and chemical reactions that can be measured and manipulated scientifically. The notion that the mind and body live in separate compartments, so to speak, goes back to certain philosophers of classical antiquity. This concept of mind/body separation was also present in such religious groups as the Gnostics and some sects on the fringes of medieval Christianity. The scientific version of this split between mind and body is generally traced back to the seventeenth-century French philosopher Rene Descartes, whose thinking aided the development of science. It has taken a lot of time and research, three centuries after Descartes, for mainstream medicine to begin to accept that the mind plays a major role in health and disease.

The idea that the mind and body interact is not new, however. It can be traced to the Wisdom literature in the Old Testament and to Hippocrates, the father of Western medicine. The ancient Hebrews attributed some physical illnesses to grief or anger. Hippocrates believed that health depends upon a balance of the body, mind and environment, and that disease is caused by imbalances in these areas. As modern science progressed, the mind and emotions became neglected, since researchers found it difficult to measure and quantify mental states with the scientific methods and equipment that were so highly valued.

In the early 1900s, Harvard physiologist Walter Cannon coined the term "fight-or-flight response" for the body's reaction to threats, a response that causes increases in heart rate, blood pressure, blood sugar, muscle tension and respiration. During the 1950s, Hans Selye of McGill University pioneered research in what he called stress. Selye determined that the fight-or-flight response could be triggered by psychological factors as well as by physical threats. Stress includes having fight-or-flight reactions in situations where there is no immediate threat except mental perceptions and worries. Stress is not necessarily negative, except when people fail to cope with it effectively. Selye's work laid the groundwork for researchers to determine that stress and reactions to it play an integral role in health and disease.

Other mind/body relationships became apparent to medical researchers. The so-called placebo effect has been studied by doctors and psychologists for years. In clinical experiments, people who are given inert substances made to look like medicines, such as sugar pills, often experience the same improvements as those patients who are given real medications. It is estimated that nearly one out of every three patients improves with medication simply because of the placebo effect, and not because of the drug itself. Researchers have also noted that some conditions and illnesses have no physical explanations. Doctors termed these conditions psychosomatic illnesses, as they seem to be caused by the psyche, or mind.

Researchers then theorized that certain personality types are susceptible to particular conditions. For instance, "Type A" personalities tend to be aggressive, ambitious, and always rushed. They tend to cope with stress by getting angry and upset. Researchers have found that these personalities are more prone to heart disease, high blood pressure, and other stress-related conditions. "Type B" personalities are those who cope with stressful situations with communication and balance instead of anger and aggression, and have been found to be less prone to stress-related conditions. Researchers have added a "Type C" personality, who tends to suppress emotions and has trouble with self-expression. Some clinicians have proposed a link between suppressed emotions and the development of cancer.

In the past few decades, researchers have begun to unravel the complex ways in which the mind and body interact. Many findings have demonstrated that the mind and body are intimately interconnected. Medical science has shown that the nervous system works closely with the immune system, systems that were at one time believed to be separate. Nerve endings have been found that connect directly to important components of the immune system called lymph nodes. This connection demonstrates that there is a physical link between the mind and the immune system. Studies have also shown that thoughts and emotions alone can influence the activity of immune system cells.

In the 1970s, Dr. Herbert Benson at Harvard Medical School discovered what he called the "relaxation response." Benson observed that trained yoga specialists (yogis) could control bodily functions that had previously been believed to be autonomic, or beyond the control of the mind. During meditation, these yogis could reduce their heart rates, blood pressure, metabolism, body temperature, and other physiological processes to surprising levels. Other people who were then taught meditation were able to reach deep states of relaxation and calmness as well. This relaxation response, as Benson termed it, is essentially the opposite of the fight-or-flight response. The relaxation response reduces blood pressure, respiration, heart rate, oxygen consumption, muscle tension, and other bodily processes that are elevated by stress. Researchers soon began to theorize that if stress could have harmful effects on health, then the relaxation response might have the opposite effect. It wasn't long before the Harvard Mind/Body Medical Institute was founded, and other major medical clinics followed by integrating mind/body practices and studies into their health programs. A new field opened up in academic medicine called psychoneuroimmunology (PNI), which is the study of how the mind and nervous system affect the immune system. Studies have since shown that the mind and emotions play roles in many diseases, including cancer, diabetes, heart disease, gastrointestinal problems, and asthma.

In 1993, Dr. David Eisenberg wrote in the New England Journal of Medicine about a study that showed that one out of every three adults in America had used some form of unconventional medicine. Of those alternative treatments, mind/body practices were used most often. The popular PBS series by journalist Bill Moyers, called Healing and the Mind, brought mind/body medicine into millions of homes. Dr. Benson of Harvard claims that mind/body medicine should no longer be considered alternative. Despite the acclaim and success, however, there is still resistance to the simple idea that the mind is an important part of health, and many mainstream doctors still adhere to the belief that medicine is just a matter of "drugs killing bugs."