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About This Series
"Mind-Body Medicine: An Overview” is one of five background papers on the major areas of complementary and alternative medicine (CAM). The series was prepared
as part of the National Center for Complementary and Alternative Medicine’s (NCCAM’s) strategic planning efforts for the years 2005 to 2009. These brief reports should not be viewed as comprehensive or definitive reviews. Rather, they are intended to provide a sense of the overarching research challenges and opportunities in particular CAM approaches. To find out more about topics and resources mentioned in this fact sheet, see “For More Information.”
“I would rather know the person who has the disease than know the disease the person has.”
- Hippocrates
Introduction
Mind-body medicine focuses on the interactions among the brain, mind, body, and behavior, and on the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health. It regards as fundamental an approach that respects and enhances each person’s capacity for self-knowledge and self-care, and it emphasizes techniques that are grounded in this approach.
Definition of Scope of Field
Mind-body medicine typically focuses on intervention strategies that are thought to promote health, such as relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, tai chi, qi gong, cognitive-behavioral therapies, group support, autogenic training, and spirituality.(Certain mind-body intervention strategies listed here, suhc as group support for cancer survivors, are well integrated into conventional care and, while still considered mind-body interventions, are not considered to be complementary and alternative medicine.) The field views illness as an opportunity for personal growth and transformation and health care providers as catalysts and guides in this process.
Mind-body interventions constitute a major portion of the overall use of CAM by the public. In 2002, mind-body techniques, including relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis, were used by about 17 percent of the adult U.S. population. Prayer was used by 45 percent of the population for health reasons.1
Background
The concept that the mind is important in the treatment of illness is integral to the healing approaches of traditional Chinese and Ayurvedic medicine, dating back more than 2,000 years. It was also noted by Hippocrates, who recognized the moral and spiritual aspects of healing, and believed that treatment could occur only with consideration of attitude, environmental influences, and natural remedies (ca. 400 B.C.). While this integrated approach was maintained in traditional healing systems in the East, developments in the Western world by the 16th and 17th centuries led to a separation of human spiritual or emotional dimensions from the physical body. This separation began with the redirection of science, during the Renaissance and Enlightenment eras, to the purpose of enhancing humankind’s control over nature. Technological advances (e.g., microscopy, the stethoscope, the blood pressure cuff, and refined surgical techniques) demonstrated a cellular world that seemed far apart from the world of belief and emotion. The discovery of bacteria and, later, antibiotics further dispelled the notion of belief influencing health. Fixing or curing an illness became a matter of science (i.e., technology) and took precedence over, not a place beside, healing of the soul. As medicine separated the mind and the body, scientists of the mind (neurologists) formulated concepts, such as the unconscious, emotional impulses, and cognitive delusions, that solidified the perception that diseases of the mind were not “real,” that is, not based in physiology and biochemistry.
In the 1920s, Walter Cannon’s work revealed the direct relationship between stress and neuroendocrine responses in animals.2 Coining the phrase “fight or flight,” Cannon described the primitive reflexes of sympathetic and adrenal activation in response to perceived danger and other environmental pressures (e.g., cold, heat). Hans Selye further defined the deleterious effects of stress and distress on health.3 At the same time, technological advances in medicine that could identify specific pathological changes, and new discoveries in pharmaceuticals, were occurring at a very rapid pace. The disease-based model, the search for a specific pathology, and the identification of external cures were paramount, even in psychiatry.
During World War II, the importance of belief reentered the web of health care. On the beaches of Anzio, morphine for the wounded soldiers was in short supply, and Henry Beecher, M.D., discovered that much of the pain could be controlled by saline injections. He coined the term “placebo effect,” and his subsequent research showed that up to 35 percent of a therapeutic response to any medical treatment could be the result of belief.4 Investigation into the placebo
effect and debate about it are ongoing.
Since the 1960s, mind-body interactions have become an extensively researched field. The evidence for benefits for certain indications from biofeedback, cognitive-behavioral interventions, and hypnosis is quite good, while there is emerging evidence regarding their physiological effects. Less research supports the use of CAM approaches like meditation and yoga. The following is a summary of relevant studies.
Mind-Body Interventions and Disease Outcomes
Over the past 20 years, mind-body medicine has provided considerable evidence that psychological factors can play a substantive role in the development and progression of coronary artery disease. There is evidence that mind-body interventions can be effective in the treatment of coronary artery disease, enhancing the effect of standard cardiac rehabilitation in reducing all-cause mortality and cardiac event recurrences for up to 2 years.5
Mind-body interventions have also been applied to various types of pain. Clinical trials indicate that these interventions may be a particularly effective adjunct in the management of arthritis, with reductions in pain maintained for up to 4 years and reductions in the number of physician visits.6 When applied to more general acute and chronic pain management, headache, and low-back pain, mind-body interventions show some evidence of effects, although results vary based on the patient population and type of intervention studied.7
From the National Center for Complementary and Alternative Medicine. http://nccam.nih.gov.
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