Most traditional medical systems appreciate and make use of the extraordinary interconnectedness of the mind and the body and power of each to affect the other. In contrast, modern Western medicine has regarded these connections as of secondary importance.
The separation between mind and body was established during the 17th century. Originally it permitted medical science the freedom to explore and experiment on the body while preserving for the church the domain of the mind. In the succeeding three centuries, the medicine that evolved from this focus on the body and its processes has yielded extraordinary discoveries about the nature and treatment of disease states.
However, this narrow focus has also tended to obscure the importance of the interactions between mind and body and to overshadow the possible importance of the mind in producing and alleviating disease. The focus of medical research has been on the biology of the body and of the brain, which is part of the body. Concern with the mind has been left to non-biologically oriented psychiatrists, other mental health professionals, philosophers, and theologians. Psychosomatic medicine, the discipline that has addressed mind-body connections, is a subspecialty within the specialty of psychiatry.
During the past 30 years, there has been a powerful scientific movement to explore the mind's capacityto affect the body and to rediscover the ways in which it permeates and is affected by all of the body's functions. This movement has received its impetus from several sources. It has been spurred by the rise in incidence of chronic illnesses -- including heart disease, cancer, depression, arthritis, and asthma -- which appear to be related to environmental and emotional stresses. The prevalence, destructiveness, and cost of these illnesses have set the stage for the exploration of therapies that can help individuals appreciate the sources of their stress and reduce that stress by quieting the mind and using it to mobilize the body to heal itself.
During the same time, medical researchers have discovered other cultures' healing systems, such as meditation, yoga, and tai chi, which are grounded in an understanding of the power of mind and body to affect one another; developed techniques such as biofeedback and visual imagery, which are capable of facilitating the mind's capacity to affect the body; and examined some of the specific links between mental processes and autonomic, immune, and nervous system functioning -- most dramatically illustrated by the growth of a new discipline, psychoneuroimmunology.
The clinical aspect of the enterprise that explores, appreciates, and makes use of mind-body interactions has come to be called mind-body medicine. The techniques that its practitioners use are mind-body interventions. The chapter discusses the evidence that supports the mind-body approach, describes some of these techniques, andsummarizes the results of some of the most effective interventions.
This approach is not only producing dramatic results in specific arenas, it is forming the basis for a new perspective on medicine and healing. From this perspective it is becoming clear that every interaction between doctors and patients -- between those who give help and those who receive it -- may affect the mind and in turn the body of the patient. From this perspective all of can be enhanced by it.
Meditation is a self-directed practice for relaxing the body and calming the mind. The meditator makes a concentrated effort to focus on a single thought -- peace, for instance; or a physical experience, such as breathing; or a sound (repeating a word or mantra, such as "one" or a Sanskrit word such as "kirim"). The aim is to still the mind's "busyness" -- its inclination to mull over the thousand demands and details of daily life.
Most meditative techniques have come to the West from Eastern religious practices -- particularly those of India, China, and Japan -- but they can be found in all cultures of the world. Christian contemplation -- saying the rosary or repeating the "Hail Mary" -- brings similar effects and can be said to be akin to meditation. Michael Murphy, the cofounder of Esalen Institute, claims that the concentration used in Western sports is itself a form of meditation. While most meditators in the United States practice sedentary meditation, there are also many moving meditations, such as the Chinese martial art tai chi, the Japanese martial art aikido, and walking meditation in Zen Buddhism. Yoga can also be saidto be a meditation.
Until recently, the primary purpose of meditation has been religious, although its health benefits have long been recognized. During the past 15 years, it has been explored as a way of reducing stress on both mind and body. Cardiologists, in particular, often recommend it as a way of reducing high blood pressure.
There are many forms of meditation -- with many different names -- ranging in complexity from strict, regulated practices to general recommendations, but all appear to produce similar physical and psychological changes (Benson, 1975; Chopra, 1991; Goleman, 1977; Mahesh Yogi, 1963).
If practiced regularly, meditation develops habitual, unconscious microbehaviors that produce widespread positive effects on physical and psychological functioning. Meditating even for 15 minutes twice a day seems to bring beneficial results. While many individuals and groups have examined the effects of meditation, two major meditation programs have extensive bodies of research: transcendental meditation and the relaxation response.
Transcendental meditation (TM) was developed by the Indian leader Maharishi Mahesh Yogi, who eliminated from yoga certain elements he considered nonessential. In the 1960s he left India and came to the United States, bringing with him this reformed yoga, which he felt could be grasped and practiced more easily by westerners. His new method did not require the often difficult physical or mental exercises required by yoga and could be easily taught in one training session. TM was soon embraced by some celebrities of that day, such as the Beatles, and can now probably claim well over 2 million practitioners.
TM is simple. To prevent distracting thoughts a student is given a mantra (a word or sound) to repeat silently over and over again while sitting in a comfortable position. Students are instructed to be passive and, if thoughts other than the mantra come to mind, to notice them and return to the mantra. A TM student is asked to practice for 20 minutes in the morning and again in the evening.
In 1968, Harvard cardiologist Herbert Benson was asked by TM practitioners to test them on their ability to lower their own blood pressures. At first, Benson refused this suggestion as "too far out" but later was persuaded to do so. Benson's studies and an independent investigation at the University of California at Los Angeles were followed by much additional research on TM at Maharishi International University in Fairfield, IA, and at other research centers. Published results from these studies report that the use of TM is discretely associated with reduced health care use; increased longevity and quality of life; reduction of chronic pain (Kabat-Zinn et al., 1986); reduced anxiety; reduction of high blood pressure (Cooper and Aygen, 1978); reduction of serum cholesterol level (Cooper and Aygen, 1978); reduction of substance abuse (Sharma et al., 1991); longitudinal increase in intelligence-related measures (Cranson et al., 1991); treatment of posttraumatic stress syndrome in Vietnam veterans (Brooks and Scarano, 1985); blood pressure reduction in African-American persons (Schneider et al., 1992); and lowered blood cortisol levels initially brought on by stress (MacLean et al., 1992).
Convinced that meditation was a possible treatment for high blood pressure, Benson later pursued his investigation at the Mind-Body Medical Institute at Harvard Medical School. He identified what he calls "the relaxation response," a constellation of psychological and physiological effects that appear common to many practices: meditation, prayer, progressive relaxation, autogenic training, and the presuggestion phase of hypnosis and yoga (Benson, 1975). He published his method in a book of the same name.
Over a period of 25 years, Benson and colleagues have developed a large body of research. During this time, meditation in general and the relaxation response specifically have slowly moved from alternative to mainstream medicine but are still overlooked by many conventional doctors.
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