Mind-Body Medicine

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Mind-Body Medicine

• Tara Saenz

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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?

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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.

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Mind-Body Medicine Techniques

• Cognitive-behavioral therapies
• Relaxation
• Hypnosis
• Imagery
• Meditation
• Yoga
• Biofeedback
• Tai Chi
• Qigong
• Group Support
• Autogenic Training
• Spirituality

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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.
20041943-50
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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.

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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.

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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.

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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
  peoples 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

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Study 1 The evaluation of mind/body
intervention to reduce psychological distress and
perceived stress in college studentsJournal of
American College Health200250281-287
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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

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Study 1

• Treatment
• Six 90-minute group-training sessions

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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

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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

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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.

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Study 2 Efficacy of functional relaxation in
comparison to terbutaline and a placebo
relaxation method in patients with acute
asthmaPsychotherapy and Psychosomatics2001701
51-157
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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

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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

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Study 2

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

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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

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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

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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.

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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.

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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

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Questions?