by James Adams
Traditional systems of medicine such as Chinese medicine and Ayurveda have long claimed that the basis of good health lies in balance. In Chinese medicine it is the proper balance of the body's vital energy (qi or chi), and in Ayurveda a balance among three physiological principles called doshas is required for optimum health. In the writings of the legendary ancient Greek physician, Hippocrates, we find a reference to the humors, four properties, which again, must be in balance for the patient to be in the best of health. In all of these systems, the balance between mind and body is a key factor, with a belief that state of mind can influence the state of the body, and vice versa.
Western science and medicine, heavily influenced by Cartesian philosophy, which makes a sharp distinction between mind and body, observer and observed, subject and object, has focused mainly on external causes and treatments for disease. Descartes’ most famous statement, “I think, therefore I am,” announces the basis of his philosophy and science, in which he views the outside world (the human body included) as a clockwork mechanism that can be objectively broken down into its component parts. The mind, in this view, is autonomous, neither altering the universe by observation, nor being altered by its interaction with its environment. Western science has largely adhered to this outlook, and has made tremendous progress in understanding the universe in which we live. In the last few decades, limitations have been recognized in sciences such as quantum physics, with the discovery that the role of the observer is not clearly distinct from the phenomenon being observed, and in medicine, where it is becoming clear that the mind and body cannot be so easily divided.
While many of the tenets of traditional medicine can be taken as philosophical or metaphorical, instead of scientific, there is evidence the balance between the mind and body that these ancient systems prescribe has a basis in modern Western medicine, in a balance between the brain and the immune system.
The body responds to stress by releasing hormones and other chemical agents that alter physiological processes in order to deal with the stressful situation. This biochemical/physiological process is known as the stress response. One key hormone in the stress response is corticoreleasing hormone (CRH). This hormone is released mainly by the hypothalamus in the brain, and, through a cascade of chemical events, leads to the release of cortisol by the adrenal glands. Cortisol causes elevation in heart rate, increased strength of heart contractions, and an array of other physiological events. Cortisol also seems to act as an important regulator of the immune system and as an anti-inflammatory agent. It plays a key role in keeping the immune system from overreacting and damaging healthy tissues. Studies have also shown that white blood cells within the immune system produce molecules — called cytokines — that send signals to other parts of the immune system, and also to the brain. The brain then responds by inducing some of the behaviors associated with the stress response such as anxiety, and also the behaviors often associated with sickness such as lethargy and fatigue. Cortisol also has an inhibitory effect on the production of CRH, working in a feedback loop to shut off its own production.
Thus, through these chemical processes the brain and the immune system communicate and interact in order to regulate the body's responses to stress, both external and internal. If this system is somehow altered or interrupted, miscommunications can occur and the body may respond improperly. For instance, continuous stress results in overproduction of cortisol, which in turn has a negative effect on the immune system, and may potentially lead to higher susceptibility to infection and disease.
Improper regulation of the stress response is associated with a number of conditions affecting the brain. For instance, people with classic depression have been shown to have high levels of cortisol in the blood. Depressed patients can often exhibit symptoms of the physiological stress response, such as anxiety and sleeplessness. Some studies have shown a correlation between the high level of cortisol and suppressed immune responses, but further study is needed to confirm these results. Also, patients who suffer from “atypical” depression often exhibit a reduced stress response and have impaired CRH production, which leads to fatigue and lethargy. Sufferers of seasonal affective disorder (SAD) also exhibit some of these symptoms. Chronic stress has also been shown to have other negative effects on brain function, such as impairment of learning and memory. Also, as mentioned above, stress, acting through the brain and immune system, has an effect on inflammatory responses in some diseases, such as arthritis. Stress can affect the level of inflammation, and thus the pain, associated with disease. The details of all the biochemical and physiological processes involved are far from worked out, but scientists are continuing research on the chemical pathways and interactions that take place between the brain and the immune system.
At the level of medical treatment, work is being done with several therapeutic techniques that integrate stress reduction and mind/body interaction. Traditional meditation techniques have been used to successfully reduce stress, high blood pressure, and chronic pain. It has helped Vietnam veterans deal with the effects of post traumatic stress syndrome and may help reduce serum cholesterol levels and ease the struggle with substance abuse.
Guided imagery is a related technique in which the patient's imagination is brought into play by using imagery and other imagined sensory experience to alter physiological processes. It has been used successfully to control pain and enhance immunity.
Biofeedback is a procedure that combines methods of relaxation and meditation with high-tech monitoring. A patient's physiological functions are monitored, providing immediate feedback showing the effect of any relaxation techniques being practiced. Patients can learn to control heart rate, body temperature and brain wave activity, among other things. The use of monitoring devices lets the patients see the results of their thinking and mental efforts at controlling these physiological functions, and allows them to adjust their efforts accordingly to reach the maximum desired effect. With practice, a patient can learn to achieve the desired effect without the use of the monitoring devices. Biofeedback is used in the treatment of many disorders, including stress, high blood pressure, pain, epilepsy and sleep disorders.
Other therapies that aim to integrate body and mind and/or use the power of the mind to help treat illness include support groups, which have been shown to be highly successful in helping breast cancer patients confront their disease; yoga; art and dance therapy, which help patients express concerns and emotions and feelings related to their illness and to help improve self image and self understanding; music therapy; and hypnosis. This list is far from complete and many more new techniques and uses for the therapies listed here are being studied and developed.
There is still a long way to go and much left to learn, both at the biological level and at level of medical treatment, about the interactions of the mind and body. Many medical institutions have created centers to study and utilize alternative types of therapy, including therapies intended to bring the mind and body into balance and to use the power of the mind to aid in healing and recovery. The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institute of Health, conducts and supports research on a wide variety of alternative treatments. Many feel that the wisdom of traditional medicine is largely in its recognition of the importance of balance within the mind and body. Modern medicine is recognizing some of the benefits of mind/body interactions, and the balance of traditional and modern techniques may lead to treatments that neither system alone could achieve.
American Psychological Association. Rallying the troops inside our bodies. 1995. Available at: http://helping.apa.org/mind_body/pnia.html
Association for Applied Psychophysiology and Biofeedback Web site. Available at: http://www.AAPB.org
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Sternberg EM. Emotions and disease: From balance of humors to balance of molecules. Nature Medicine. 1997;3(3):264267.
Sternberg EM, Gold PW. The mindbody interaction in disease. Scientific American (special issue: Mysteries of the Mind). 1997;7(1):815.
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