“The brain and peripheral nervous system, the endocrine and immune systems, and indeed, all the organs of our body and all the emotional responses we have, share a common chemical language and are constantly communicating with one another.”
–Dr. James Gordon (founder of the Center for Mind-Body Medicine)
Mental states can be fully conscious or unconscious. We can have emotional reactions to situations without being aware of why we are reacting. Each mental state has a physiology associated with it – a positive or negative effect felt in the physical body. For example, the mental state of anxiety causes you to produce stress hormones. Mind–body medicine (MBM) focuses on improving our understanding of how the interactions between the brain, mind, body, and behavior can be used to promote health. Right from the start, there was the observation that connections and interactions between the brain, mind, body, and behavior can activate psychophysiological changes and a health-promoting potential in the individual – paths toward better health. As a generic term, MBM, from the start, included mental or behavioral medicine approaches and other techniques from the areas of exercise, relaxation, stress regulation, and nutrition.
For example, well-educated, slender, and attractive, Shubhra seems to have it all. She has a PhD, an interesting career, and good friends. So everything's great, right?
Not exactly. Shubhra also has diabetes. And while she loves her job, she feels anxious about running a business. She often gets angry at herself, and snaps at others for small mistakes. Even scarier, despite careful monitoring of her blood sugar, she finds herself in a coma once or twice a month. What's going on?
It turns out that despite Shubhra's generally healthy habits, her anxiety prevents her from paying attention to the cues her body gives her when her blood sugar is too low.
On her doctor's advice, Shubhra tries mindfulness-based stress reduction (MBSR) classes along with her regular diabetes care program. The MBSR practices help her slow down and actually pay attention to her body.
Shubhra begins to notice when her blood sugar is dropping, so she can eat to prevent herself from going into a diabetic coma. She also finds it easier to control her diabetes with insulin, probably because reducing her anxiety helps reduce her stress hormones. Her anger, a product of her stress, also fades away.
CONNECTION OF MIND–BODY
Shubhra's story is a great example of what we call the mind–body connection. This means that our thoughts, feelings, beliefs, and attitudes can positively or negatively affect our biological functioning. In other words, our minds can affect how healthy our bodies are!
On the other hand, what we do with our physical body (what we eat, how much we exercise, even our posture) can impact our mental state (again positively or negatively). This results in a complex interrelationship between our minds and bodies.
Mind–body therapies are therapies that use the body to affect the mind, such as yoga, tai chi, qigong, and some types of dance (these are sometimes called body–mind therapies). Ultimately, mind–body and body–mind therapies are interrelated: The body affects the mind, which in turn impacts the body (and the mind).
Here, it is important to note that “mind” is not synonymous with the brain. Instead, in our definition, the mind consists of mental states such as thoughts, emotions, beliefs, attitudes, and images. The brain is the hardware that allows us to experience these mental states.
HISTORY OF MIND–BODY CONNECTION
Awareness of the mind–body connection is by no means new. Until approximately 300 years ago, virtually every system of medicine worldwide treated the mind and body as a whole. But during the 17th century, the Western world started to see the mind and body as two distinct entities. In this view, the body was kind of like a machine, complete with replaceable, independent parts, with no connection whatsoever to the mind.
This Western viewpoint had definite benefits, acting as the foundation for advances in surgery, trauma care, pharmaceuticals, and other areas of allopathic medicine. However, it also greatly reduced scientific inquiry into humans' emotional and spiritual life, and downplayed their innate ability to heal.
In the 20th century, this view gradually started to change. Researchers began to study the mind–body connection and scientifically demonstrate complex links between the body and mind. Integrative psychiatrist James Lake, MD, of Stanford University, writes that “extensive research has confirmed the medical and mental benefits of meditation, mindfulness training, yoga, and other mind-body practices.”
Amalgamation of modern medicine with mind–body medicine, is giving rise to a phenomenal way to preserve well-being and it is now coming to be known as - Integrative Medicine!
PRESENT SCENARIO
Mind–body medicine techniques are those that:
- Focus on the mind to influence physical functioning and promote health
- Enhance individual capacity for self-knowledge and self-care. MBM is thus based on the recognition of a central mind–body axis, which is a concept that encompasses consciousness, behavior, and the interactions between the brain and the body. A central principle of MBM focuses on how psychological, emotional, spiritual, social, experiential, and/or behavioral factors influence human health. Effective MBM techniques are those that support individual self-regulation of the mind–body connection based on these observations. In this narrative review, we discuss underlying factors and overarching mechanisms associated with MBM, including a general consideration of motivation and reward systems in the central nervous system (CNS). We also present a rational framework for the various therapeutically effective interventions that are typically used in MBM practice.
Meanwhile, mind–body and meditation phenomena such as self-induced blood pressure reductions or changes in peripheral body temperature, as well as changes in skin resistance or heart rate or heart rate variability in the context of relaxation, are known in many areas, including in biofeedback or autogenic training, as well as in self-hypnosis. Benson adopted this recurring physiological pattern in his concept of the relaxation response (Benson and Klipper, 2000) – the physiological antagonist of the biological stress response (Stefano et al., 2005), elicited and controlled by the CNS, i.e., its self-regulation and stress-relaxation axes. The insights into the basic mechanisms and potential of self-regulation were not new at the beginning of mind–body medicine either, as this was based, among other things, on the research of the physiologist Walter B. Cannon, who decades earlier in the same laboratory (Cannon, 1933), in which Benson also worked, had done research on stress and regulation. What was new, indeed, was that people should be able to use mental techniques to influence the “involuntary” (i.e., autonomic) regulation in a targeted (i.e., conscious, focused) way. However, there was still a long way to go from the first investigations in the Himalayas to in-depth studies according to Western standards – including experimental human biological studies under laboratory conditions. Today, MBM has been widely implemented as an important component of general health care and medical practice in the United States, typically within the framework of behavioral medicine practices. MBM includes numerous straightforward and effective approaches that can be used to promote patient-centered health care (Esch, 2020). These approaches are conceptually and practically compatible with many current trends and disciplines in both clinical medicine and research (Dobos and Paul, 2019; Esch, 2020). Of note, MBM expands the outlook of somatically oriented general medicine practices because it encourages health-care providers to focus on behavioral and lifestyle orientation as a means to promote health.
Current research on the neurobiological basis of MBM, including the molecular and autoregulatory pathways underlying the positive responses to relaxation and meditation, has shown relevant parallels to physiologic activation patterns that are similar to those associated with, for example, placebo mechanisms.
Behavior, exercise, relaxation, and nutrition (BERN) [Figure 1] have an overall positive impact on mitochondrial bioenergetics and insulin secretion and can reduce the activation of pro-inflammatory and stress-related pathways.
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Figure 1: Behavior, exercise, relaxation, and nutrition (BERN)
In this regard, as stated earlier, complex BERN and other mind–body techniques, such as yoga and meditation, have already demonstrated their neurobiological, psychological, neuroendocrinological, and immunological as well as physiological stress-reducing and health-promoting potential.
Neurochemical changes during meditation
- Meditation increases serotonin production, an important neurotransmitter and neuropeptide that influences mood and behavior in many ways. It can stimulate increased production of acetylcholine, which is involved in memory mechanisms and attention
- Meditation has also been associated with increased melatonin availability
- During meditation, locus ceruleus activity decreases, thereby decreasing norepinephrine production
- Relatively greater activity of the parasympathetic system causes decreased production of catecholamines, epinephrine, and norepinephrine by the adrenal medulla.
Meditation and the endocrine system
- Reduced blood levels of lactate, cortisol, and epinephrine.
- Reduces sympathetic adrenergic receptor sensitivity, producing a decreased response to stressful situations increased levels of gamma-aminobutyric acid (GABA), melatonin, and dehydroepiandrosterone sulfate. Meditation produces its anxiolytic effects by promoting GABA action in specific areas of the brain. Similar effects can be achieved by Reiki and acupuncture.
Meditation and neuroplasticity
- A recent magnetic resonance imaging study showed that “brain regions associated with attention, interoception and sensory processing like the PFC and right anterior insula were thicker in meditation practitioners”
- Meditation probably offsets age-related cortical thinning, thereby suggesting to promote neuroplasticity.
Meditation and psychology
- Practice of meditation improves cognitive task performance, increases mental concentration, and reduces susceptibility to stress
- Both subjective and objective examinations reveal that meditation enhances perceptual sensitivity
- It improves the attitude and personality of a person
- Improved concentration and attention, allowing for greater productivity, problem-solving, creativity, learning ability, and organization of memory
- Enhanced self-image
- Less “catastrophic reaction” to stressful situations, in survivors of attempted suicide better sociability, tolerance, and compassion
- Improved mood, sleep, and scores on self-actualization
MBM is a field that focuses on health promotion, prevention, and treatment of lifestyle-related diseases. It builds on the concepts of salutogenesis and resilience, based on principles that include general self-healing or self-care. MBM interventions follow the BERN framework. The responses to various BERN techniques converge on shared mechanisms of CNS autoregulation involving limbic reward and motivation systems. Various neurobiological signaling pathways and effector molecules within these systems overlap and converge on constitutive NO as a common effector molecule. Other key regulators – such as GABA – are modulated as well, resulting in an overall downregulating potential for MBM and BERN. Thus, NO – and related messenger substances – are critically coupled to the reward physiology as well as stress reduction and self-regulation, and they may have an impact on mitochondrial, nuclear, and/or chromosomal processes as well as the placebo.
“The natural healing force within each of us is the greatest force in getting well.”
–Hippocrates
Mental states can be fully conscious or unconscious. We can have emotional reactions to situations without being aware of why we are reacting. Each mental state has a physiology associated with it – a positive or negative effect felt in the physical body. For example, the mental state of anxiety causes you to produce stress hormones.
