Mind-Body Medicine

If the mind, that rules the body, ever so far forgets itself as to trample on its slave, the slave is never generous enough to forgive the injury, but will rise and smite the oppressor.  Henry Wadsworth Longfellow

In the 1600s, philosopher René Descartes gave the world the concept of mind-body dualism. The body was composed of physical substance, visible, weighable and measurable. The mind was something else. Over the next three centuries, as scientists deconstructed the body to discover its secrets, the mind reclaimed its place as an inseparable part of the body. (Soul is another matter, not open to scientific inquiry.) Some rudimentary examples of the mind-body connection are the blush of embarrassment, the adrenaline rush following a near miss accident or the receipt of bad news, and the cotton mouth that accompanies emotional distress. The mind perceives and the body reacts. The mind decides  and the body acts.  Not only are mind and body inseparable, but most often the body responds to a vast subconscious system rather than to the aware part of the mind known as consciousness.

The powerful subconscious mind

In Sigmund Freud’s (1856-1939) introductory rendering, the unconscious mind was a cauldron of seething resentments that gave rise to neurotic behaviors and bad dreams. Modern research softened this view and today the unconscious mind seems more like an executive secretary who relieves the boss of routine work.  It sorts through incoming information, keeps track of the environment and runs the motor system that operates the body, all with such subtlety that much of the time you, the boss, think you are in charge. But if you have an electrode placed in your brain recording the action of the nerve cells that put your arm in motion, the recording will show activation of those cells before you are consciously aware of your decision to reach for that candy bar. Before you “know” it, the choice has been made in your subconscious mind.  But this doesn’t mean we are automatons – after all, you can still decide not to eat the candy.

The neuropeptide network: connection of mind to body

The subconscious mind may have even more power than we suspect.  The same chemicals that transmit information in the brain are found in virtually every organ of the body. This neuropeptide network, discovered around 1980, bridges the gap between the brain and the body, making a psycho(mind)somatic(body) connection.  Since the time of Freud, the word psychosomatic has a bad reputation, often synonymous with “hysterical” or “without physical cause.”   All symptoms, however, are technically psychosomatic because they arise in the body and are perceived in the mind. The discovery of the chemical interplay between brain and other body organs forces us to consider whether the flow of information goes the other way too.  Can the mind cause diseases to happen? Can it help heal disease?

Placebo effect

Eastern medical practices have always regarded the body/mind as one entity.  Since the 1950s, Western medicine has acknowledged the mind’s influence over the body by taking into account the placebo effect in studies of new treatments.  The placebo effect is the relief that happens when a patient believes he has received a real treatment, despite the treatment being a sham.  The phenomenon may reflect the power of belief or it may reflect the fact that many disease processes get better on their own – the only way to tell is to add a third, no-treatment group to each study.  The fact that the placebo effect occurs in more than 30% of patients in many studies demonstrates the mind’s significant role in disease and health.

Conventional medicine takes a look at the alternatives

Western medicine’s gradual acceptance the mind/body connection culminated in the establishment of a National Center for Complementary and Alternative Medicine (NCCAM) within the National Institute of Health (http://nccam.nih.gov/) in 1991. The center conducts controlled studies on subjects such as the effect of regular meditation on chronic pain, anxiety, high blood pressure, cholesterol, health care use, substance abuse, post-traumatic stress syndrome in Vietnam veterans.  It offers objective descriptions of Eastern medical theories which for which science has no proof.  Part of the NCCAM’s mission is also to educate the public to become discerning customers within the vast alternative care and wellness industries that capitalize on the tantalizing possibility that good health may be a byproduct the “right” frame of mind.

The alternative and the conventional medical industries operate side-by-side, sometimes, but not always complementing each other.  Conventional medicine is increasingly fragmented, with care delivered on an organ by organ basis. The whole person and his mind- body relationship can get lost in the process; unwanted side effects occur, and sometimes treatments hurt more than they help.  But conventional methods save many lives and provide much needed comfort.  Alternative practices that teach wellness via mind-body wholeness also do much good, mostly in preventing disease by emphasizing the back- to- basics factors: nutrition, sleep, exercise, relaxation, relationships and environment.  Importantly, most of them do no harm except if they keep patients from seeking conventional help when necessary.

The importance of habits

In this century, the commercial spotlight is trained on the role of the mind in sickness and in health, which may obscure an important fact: most of the mind’s effects on health are subconscious, embedded in long years of mental and physical habits and not amenable to conscious adjustment over short periods of time.  The right thinking and attitudes will help only insofar as they can work their way into the subconscious underpinnings of the mind by the diligent practice that leads to habit formation.  Whether the mind-body practices are called meditation, yoga, Tai-chi, guided imagery, art and music therapy, biofeedback or acupuncture,  they should be undertaken as long term projects  requiring persistence,  just like all those other low-tech habits that promote good health. The mind may be the body’s master, but it cannot change the laws of nature that govern all biologic systems. There are no quick and easy fixes.

 

Interesting Reading

Blink: The Power of Thinking Without Thinking, Malcolm Gladwell, Little Brown, Boston, 2005

Anatomy of an Illness as Perceived by the Patient, Norman Cousins and Rene Dubos, W.W. Norton & Co., NY, 1979.

 

 

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