This paper was presented at
Psychology: The Indian Contribution
National Conference on
Indian Psychology, Yoga and Consciousness
organised by the Indian Council of Philosophical Research
at the Sri Aurobindo International Centre of Education
Pondicherry, India, 10-13 December 2004

(click to enlarge)

Mind-Body Interactions in Health and Healing: A Yogic Perspective

Arthur Brownstein, M.D., M.P.H., D.Y.Ed.
John A. Burns School of Medicine
University of Hawaii
USA

"Wherever nerves are, activities of the mind can travel."
Andrew Weil, M.D.

“The brain writes prescriptions for the body.”
Robert Eliot, M.D.

“Our bodies are our gardens, to which our wills are gardeners.”
Shakespeare

Brief History of Mind-Body Medicine in the West

• In the West, for many years, the role of the mind was ignored as a major contributing factor to physical health.

• Drs. Sigmund Freud, in the late 1800’s and early 1900’s, and later, Carl Jung, his student, brought attention to the role that the mind plays in health and wellness, and, in the process, elevated the status and scientific credibility of the fields of psychiatry and psychology. Among other major contributions, they described how physical symptoms could result from unresolved mental conflicts.

• Slowly, in the 1800’s and early to mid 1900’s, the field of Psychosomatic Medicine emerged, which further recognized and studied the relationship between mind and body in sickness and health. Dr. Flanders Dunbar was among one of its early, well-known proponents.

• In 1957, Milton Erickson, M.D., founder of the American Society of Clinical Hypnosis, was a major proponent in investigating the growing evidence linking mind and body in health and illness. He championed the cause of hypnosis as a valid clinical tool that could bypass conscious defense mechanisms and penetrate into the deeper layers of the subconscious mind, potentially dismantling mental conflicts and exposing the roots of many physical disorders and maladies. To this day, hypnosis has proven to be an effective tool for many difficult to treat conditions.

• Walter Cannon, a Harvard physiologist, in the early 1900’s studied stress and its influence on human physiology.

• Hans Selye, MD, a student of Dr. Cannon’s, further refined the study of stress, and how it contributes to illness. He is credited for discovering adrenaline (epinephrine), a potent substance produced by the adrenal glands, and released during the “Fight or Flight reaction, which occurs when a perceived threat is presented to an individual, and includes

• Herb Benson, MD, a Harvard cardiologist, in the early 1970’s, studied meditation and relaxation, and their ability to neutralize the “Fight or Flight” reaction. He becomes the first person in the world to prove that quieting the mind through meditation can reduce blood pressure. He went on to conduct numerous studies, and write a best-selling book for lay people, in which he defines and describes the “Relaxation Response.”

•Dr.Elmer Green, psychologist, and pioneering proponent of biofeedback, in the 1960’s and 70’s conducts studies on numerous yogis, including Swami Rama, at the Menninger Institute. Dr. Green documents voluntary mental control over heart rate and blood flow to extremities, including the hands. Biofeedback, as advocated by the Association of Applied Psychophysiology and Biofeedback, eventually becomes recognized as clinically helpful in temporalmandibular joint syndrome, migraine headache, high blood pressure, and, under certain circumstances, is reimbursable by American insurance companies.

• Robert Ader, Ph.D. experimental psychologist, at the U. of Rochester Medical Center in New York, (in the 70’s and 80’s), conducts a series of experiments in laboratory animals that confirm, through specific mental conditioning, alterations in immune response at the cellular level that can be measurably observed. It is he who is credited with being the first scientist to coin the phrase: Psychoneuroimmunology, or PNI, which ushers in an exciting new era of research in mind-body interactions.

• Norman Cousins, writer and international diplomat, and consultant to numerous American presidents, and celebrities, who also served as Dr. Albert Schweitzer’s literary agent, writes a best-selling book in 1979, entitled: Anatomy of an Illness, which spent 40 weeks on the NY Times Best-Seller list. Cousins also writes a series of articles for the New England Journal of Medicine, becoming the first non-scientist to have an article published in this prestigious medical journal. He becomes a hero among medical students, doctors striving to practice a more humane form of medicine, and, through enthusiastic patient advocacy, becomes popular in the lay public as well. Considered the father of the modern Mind-Body Medicine movement, he eventually ends up at UCLA where, in 1980, with the help of an 11 million dollar donation, he establishes the first internationally recognized program in Psychoneuroimmunology, which investigates the relationship between the mind, the nervous system, and the immune system. Assembling a team of some of the top researchers in the world, from the fields of psychiatry and psychology, neurology, and immunology, findings from this field have advanced our current scientific understanding of how the mind and body relate to each other, and, have additionally benefited many patients with chronic illnesses, particularly those with cancer and AIDS.

•O. Carl Simonton, M.D., a radiation oncologist, pioneers the use of mental imagery, or visualization, for cancer patients, and observes marked improvement in survival rates. His first book, Getting Well Again, published in 1978, which describes this work, is now an international classic.

• Bernie Siegel, Yale University cancer surgeon, and student of Dr. Simonton, also uses imagery and artwork, while acknowledging the role of psychosocial factors, the mind, and the emotions in the genesis of many cancers. His classic, international best-selling book: Love, Medicine, Miracles, published in 1986, describes this work, and includes case histories of many cancer patients who outlived their predicted deaths, a large number even reversing their illnesses, by paying attention to the mental and emotional factors that govern their health. His classic saying: “Love is the most powerful stimulant of the human immune system” has inspired many patients and doctors to go outside of the box of conventional, western, allopathic medicine in seeking better health and improved quality of life.

• Ken Pelletier, Ph.D., a psychologist and Clinical Associate Professor of Medicine at Stanford Medical Center, and author of over 200 professional medical articles, writes, in 1977, a classic book: Mind as Healer, Mind as Slayer. Continuing in the tradition of Dr. Hans Selye, this book describes in great detail how stress and mental factors figure into the equation of health and disease, and how autonomic nervous system physiology plays a key role in this relationship. His premise is that the same mind that can kill you can also heal you. He teaches that it is important to learn how to harness the powers of the mind through proper training, focus, and discipline, which can be achieved through Yoga.

• Joan Borysenko, Ph.D., psychologist and cell immunologist, research associate of Dr. Herbert Benson at Harvard, as well as Yoga student, writes a classic bestseller in 1986: Minding the Body, Mending the Mind, which presents provocative evidence through documented studies and case histories that there is indeed a biochemical and physiological connection between the mind and the body, and that this connection is key to both health and disease processes.

• Marty Rossman, M.D., faculty member of UCSF School of Medicine, (Healing Yourself, 1987), and David Bressler, Ph.D. psychologist, and Director of the UCLA Pain Management Program, (Free Yourself from Pain, 1979) collaborate on the emerging disciplines of guided imagery and visualization. They go on to found the Academy of Guided Imagery, training thousands of health care providers in the uses of patient-oriented guided imagery in clinical medicine.

•Robert Eliot, MD, cardiologist with the American Academy of Cardiology, suffers a heart attack and, through personal exploration, goes on to discover mental factors at play in the pathogenesis of his disease. After his recovery, he conducts studies with other heart patients to verify his theories, and in 1984 writes a classic best selling book: Is It Worth Dying For? As advice to his patients, he coins the popular phrase: “Don’t sweat the small stuff,” and “Its all small stuff.” He goes on to sponsor an annual conference entitled: “Stress and the Heart,” with many years still in the running. This conference is typically attended by cardiologists and psychologists/psychiatrists, working in teams, examining how mental factors contribute to heart disease.

• Alan Rozansky, M.D., a nuclear cardiologist, in the 1980’s pioneers a “Mental Stress Test” to detect coronary artery disease. His work provides further evidence that the heart is affected by the mind.

•Hans Ruddell, M.D., Ph.D., a board certified German cardiologist, leaves his cardiology practice in the 1980’s and gets a Ph.D. in psychology to further study the relationship between stress, mental factors, and heart disease. He currently heads up a research team at the U. of Bonn in Germany, with many cardiologists working under him.

•Dean Ornish, M.D., of the Preventive Medicine Research Institute and University of California at San Francisco, student of Swami Satchitananda, employs a Yogic approach in becoming the first person in the world to prove that heart disease, the world’s #1 killer, is reversible without drugs or surgery. Championing the need to make changes in diet and lifestyle, Ornish’s intervention, in addition to a low fat vegetarian diet and mild to moderate exercise, relies strongly on Yoga, meditation, relaxation, and paying attention to psychological and social factors in the treatment and prevention of heart disease. A thoroughly impeccable scientist, his personal experiences with Yoga lead him to a deeper, more holistic understanding of heart disease and how to successfully treat and prevent it.

•Michael Lerner, Ph.D., another student of Swami Satchitanda, in the 1980’s founds Commonwheal, a nationally recognized, award-winning alternative cancer care center in California. Employing Yoga, meditation, and other mind-body methods to help cancer patients cope with their illnesses, Dr. Lerner is joined by Rachel Remen, M.D., author of two best-selling books: Kitchen Table Wisdom, and My Grandfather’s Blessings, who serves as Commonwheal’s medical director.

•Jon Kabat-Zinn, Ph.D. psychologist, faculty member of the University of Massachussetts, in the 1980s establishes America’s first University-based Stress Management Center. This becomes a prototype for many other related programs around the country. He employs a combination of Yoga, mindfulness meditation, and relaxation, to help chronic pain patients reduce their pain and improve their coping skills. His books, Full Catastrophe Living, and Wherever You Go, There You Are, which describe his work, are considered classics in the field.

•Candace Pert, Ph.D. former head of the brain biochemistry section of the National Institute of Mental Health, Nobel Prize nominee, is credited for discovering the opiate receptor on lymphocytes. She has also done pioneering work on neurotransmitters, neuropeptides, and lymphocyte receptors for these compounds, in further elucidating the biochemical link between the mind and the body. She also acknowledges the work of other scientists who discover that certain lymphocytes produce specific hormones, like ACTH, that communicate with the endocrine system. She goes on to say that, because of the exquisite biochemical interchange between the mind, brain, and body, it is difficult to make a distinction between where the mind and body are actually separated, and says, as such, that this separation is artificially produced by scientists. She has gone on to write a book about her work: Molecules of Emotion, and produce a classic audio program in this vein entitled: “Your Body is Your Subconscious Mind.” Her biochemical and molecular findings are consistent with Yogic philosophy.

•David Spiegel , M.D. Stanford Psychiatrist, in the 1980’s, conducts and publishes a landmark year long study that measures breast cancer survival rates in women who benefit from a support group made up of similarly afflicted women, versus another group of women with breast cancer who received conventional medical treatment only, and who do not benefit. It is the first such study that suggests mental and psychosocial factors are important in cancer genesis, survival, and cancer treatment.

•In the close of the decade of the 80’s, a landmark national pubic broadcasting television special program airs nightly for one week in the U.S., entitled “Healing and the Mind.” Hosted by television personality Bill Moyers, this documentary showcases the work of Drs. Ornish, MD, Jon Kabat-Zinn, Ph.D., Rachel Remen, M.D., David Spiegel, MD, David Eisenberg, MD, of Harvard, and others. For the first time, the latest advances in the field of Mind-Body Medicine are presented to a national, large-scale western audience.

•John Sarno, M.D., Professor of Rehabilitation Medicine at the University of New York School of Medicine, writes his first book in 1985, Mind over Back Pain, followed by a later, more successful book: Healing Back Pain, in 1992. Both books are based on the premise that stress and the mind are at the roots of most back problems. Dr. Mary Schatz, a student of BKS Iyengar, who also acknowledges the mind-body connection in most back problems, writes Back Care Basics, (1992) a popular yoga-based approach to the treatment of back pain. A.H.Brownstein, M.D., writes Healing Back Pain Naturally, (1999) based on similar premises to that of Dr. Sarno, as well as Dr. Schatz, advocating a mind-body, Yogic approach to overcoming back pain.

A Review of Stress Medicine

  • The Physiology of Stress
    • Stress: increased fear-based thoughts
    • Stimulates sympathetic nervous system
    • Stimulates Adrenal glands
    • Releases adrenaline (epinephrine)
    • “Fight or Flight”: Cannon, Selye
  • Fight or Flight Reaction
    • Rise in blood pressure
    • Increased heart rate
    • Increased muscle tension
    • Rise in breathing rate
    • Shunts blood away from internal organs
    • Increases catabolism
    • Works against healing system
  • Diseases linked to Stress
    • Heart disease, high blood pressure, stroke
    • Peptic Ulcer
    • Asthma
    • Inflammatory bowel disease: irritable bowel, Crohn's ulcerative colitis
    • Autoimmune Diseases, (e.g. Multiple Sclerosis, Lupus)
    • Rheumatoid Arthritis
    • Back Pain
    • Cancer
  • Relaxation: Stress Management
    • Relaxation is the foundation of successful stress management programs
    • Most westerners don’t know how to relax
    • Relaxation occurs when mind is peaceful, calm, quiet
    • Physiological benefits of relaxation first described by Benson: Harvard cardiologist: “Relaxation Response”
    • Counters “fight or flight” reaction
    • Relaxation is psychophysical
  • Relaxation Response (Benson)
    • Lowers blood pressure
    • Reduces heart rate
    • Decreases breathing rate
    • Reduces oxygen consumption
    • Decreases muscle tension
    • Increases blood flow to internal organs
  • Mental Benefits of Relaxation
    • Relaxes mind
    • Decreases mental tensions
    • Decreases anxiety
    • Decreases output of fear-based thoughts
    • Calms nervous system
  • Yoga Relaxation
    • Yoga relaxation is the “grandfather” of all relaxation techniques and methods
    • Time-tested method for achieving mental and physical relaxation
    • Powerful method for inducing “relaxation response.”
    • Convenient, cost-effective stress management
    • Safe, easy to learn, no harmful side effects
    • Proven to help reverse heart disease, lower blood pressure
    • Utilized by Dr. Ornish as “stress management” for heart patients
    • Helpful with cancer, AIDS, other diseases
  • Diseases where Yoga Relaxation Methods Have Been Successfully Applied
    • Heart disease, (Ornish, et al)
    • High blood pressure (C. Patel, Brownstein)
    • Asthma (Nagendra, Nagarathna)
    • Diabetes (Ornish)
    • Cancer (Lerner, Remen: Commonwheal Institute)
    • Mutliple Sclerosis (Breslow, others)
    • Other
  • Stress and Sleep Disorders
    • Studies show majority of Americans and westerners chronically sleep-deprived (Insomnia)
    • Insomnia linked to heart disease, autoimmune diseases, depression
    • Stress linked to decreased quality of sleep
    • Studies show rest and relaxation can improve immune function and prevent chronic fatigue
    • Recent studies by Sat Bir Khalsa at Harvard suggest Yoga is helpful in treating insomnia
  • Physical Benefits of Relaxation
    • Decreases sympathetic nervous system activity
    • Reduces adrenaline/epinephrine
    • Brings physiological rest to body
    • Favors anabolism: growth and regenerative phase in body
    • Supports healing system activity in body

The Contribution of Yoga to Mind-Body Medicine

Yoga and the Mind

In the vast field of Yoga, there are many layers, aspects, and dimensions. And while many westerners usually only focus on the most superficial aspect of Yoga, seeing it as a system of physical postures designed to bring strength and flexibility to the body, more scholarly experts agree, however, that the essence of Yoga is given in Patanjali’s second sutra: “Yogas citta-vrtti-nirodhah.” In this sutra, Yoga is described as both the process of calming and quieting the mind, as well as the end result of possessing a calm and quiet mind. In the third sutra, Patanjali describes what happens through the practice and achievement of the second Sutra: “Tada drastuh svarupe vasthanam.” “Then the Seer is established in his own essential and fundamental nature.”  This is the ultimate goal of Yoga: union with the Higher Self, often referred to as Samadhi, enlightenment, or pure bliss consciousness (Satchitananda). (Translations from Tamini: The Science of Yoga, Theosophical Publishing House, 10th printing: 2001)

Yoga and Stress Management

With its emphasis on calming and quieting the mind, Yoga offers a multitude of techniques and approaches to reduce stress. These methods have been described not only by Patanjali, but by many other subsequent authors in the field. Benson has shown that Yoga and related methods are highly efficient at eliciting the “Relaxation Response, ” and in so doing, can neutralize the devastating effects of prolonged stress. As you’ll recall, stress has been linked to almost every major modern disease, including heart disease, high blood pressure, asthma, diabetes, and cancer. Theoretically and practically speaking, then, Yoga should be implemented as a primary therapeutic strategy in the treatment and prevention of these disorders.  It is here, at the interface of mind and body, where Yoga’s greatest contribution to health and healing can be realized and where our research efforts in both mind-body medicine and Yoga should be directed.

Yoga is a Holistic Science

“Yoga is an integral subject which takes into

consideration man as a ‘whole.’ It does not divide him

into water-tight compartments of body, mind, spirit, etc.”

Swami Kuvalyananda
Pioneering researcher in Yoga
Founder of Kaivalyadhama Institutes
Author of Yogic Therapy, Asanas, Pranayama

Yoga: Mind, Body and Spirit

While most Yoga experts recognize that the mind exerts a powerful influence on the body, the body is also recognized for its ability to influence the mind. For this reason, Yoga pays due respect to the body in its contribution to total health and wellness.

For example, it is well known that certain ingested physical substances, such as caffeine and nicotine, can stimulate the central and sympathetic nervous system, elicit the “fight or flight reaction,” cause emotional upheaval through the release of adrenaline and related hormones, and agitate the mind. Because every ingested substance carries with it a specific vibrational energy, it is for this very reason that diet is an important part of Yoga. Specifically, because of its ultimate impact on the mind and nervous system, a vegetarian, “satvic” diet is recommended in Yoga.

Additionally, numerous studies have verified the healthful benefits of exercise that few of us would dispute. For example, it has been shown that exercise improves circulation and helps prevent heart disease, high blood pressure, stroke, diabetes, and other chronic degenerative conditions. Additionally, however, physical exercise has also been shown to improve mental functioning, attitude, and mood, and, in fact, is now recognized as a front line treatment for mental depression because of its ability to positively influence the mind.

While Yoga does not endorse the need for extremely vigorous, strenuous exercise in order to stay healthy, it has evolved a thorough regimen of physical culture that targets almost every organ system in the body to promote health. Asanas, which are postures usually performed in a certain sequence and held for a specified period, involve stretching, strengthening, and balancing the musculoskeletal system. These are also beneficial for the joints and endocrine system, enhance cardiovascular performance, endurance, and circulation, and additionally help to tone, balance, and improve coordination in the nervous system as well. Pranayama, or Yogic Breathing, helps further oxygenate the cells and tissues, energize the body, purify the nervous system, and calm and relax the mind. Meditation, usually considered a purely mental activity, exerts a powerful physiological effect on the body. Herb Benson, more than 30 years ago, showed that meditation can lower blood pressure. Dr. Dean Ornish, in addition to the use of asanas and pranayama, used meditation in his program for proving that heart disease could be reversed without drugs or surgery. There are also other Yogic practices designed to cleanse and purify the body, including Kriyas, Mudras, and Bandhas.

Proper attention to the body is a spiritual act;

it frees the mind from physical bondage.

Mahendra

Dr. Larry Dossey, an internal medicine physician from Dallas, Texas, author of the best-selling Healing Words, and founding editor of the Journal of Alternative Therapies, has devoted his life to studying peer-reviewed scientific articles that document the efficacy of prayer. Many other successful physicians, authors, and scientists are also coming out of the closet to endorse the importance of spirituality as an essential ingredient in health and healing. Yoga has always acknowledged and embraced the importance of developing a spiritual awareness as a necessary step toward wholeness and well being.

“The physical heart is a metaphor for the spiritual heart.”

Dr. Dean Ornish

Yoga Therapy

While originally devised as a complete science and discipline for spiritual development, in recent years, there has been growing interest in finding practical applications for the therapeutic and healing potential of Yoga. Many health-conscious individuals are turning to Yoga as a system of personal hygiene and a superior form of preventive medicine, while others, severely afflicted with illness and disease, and unsuccessfully treated by the best that western medicine has to offer, are turning to Yoga out of desperation and as a last resort. Many in this later group, as evidenced by a growing number of studies on Yoga, are finding that Yoga has much to offer in the field of healing. Ironically, if one enquires deeply into the fields of healing and spiritual growth, one will find that these fields are not mutually exclusive.

“A person who carefully practices Yoga in all its aspects, attains success, whether young, old, very old, sick, or feeble.”
Svatmarama:Hathapradipika

“The land of healing lies within, radiant with happiness

that is blindly sought in a thousand outer directions.”

Swami Sri Yukteswar

“Illness is the body’s way of telling us to pay attention.

Something we are believing, doing or thinking

is not for our highest good.”

Louise Hay

“An illness of the body is always the outer expression and translation of a disorder, a disharmony in the inner being: unless this inner disorder is healed, the outer cure cannot be total and permanent.”

Sri Aurobindo

Review of Benefits from Yoga

  • Physical Benefits of Yoga
    • Yoga brings strength, endurance, and flexibility to the musculoskeletal system
    • Yoga improves health of joints and glands
    • Yoga improves health of brain and nervous system
    • Yoga improves health of internal organs
  • Mental Benefits of Yoga
    • Reduces anxiety and tension
    • Calms and quiets the mind
    • Relaxes the nerves
    • Cultivates inner peace
    • improves emotional balance
  • Spiritual Benefits of Yoga
    • Remember Patanjali’s second and third sutra’s
    • Yoga develops inner awareness, and opens the heart to a greater source of Love, both within and outside of the individual.
    • According to Bernie Siegel, M.D. “Love is the most powerful known stimulant to the immune system.”
    • According to American Holistic Medical Association: “Love is the most powerful medicine on the planet.”
    • Love is your body’s greatest ally in sickness and in health.

Closing Thoughts

While Yoga traditionally fosters a harmonious integration of body, mind, and spirit, it can be considered a holistic health system. And because a chain is only as strong as its weakest link, Yoga believes that concentration on only one of these aspects of a human being to the exclusion and neglect of the others will ultimately yield an unstable, unbalanced, unhealthy individual, who will eventually fall prey to illness, in one form or another.

Ayurveda, a cousin-brother to Yoga, and one of the oldest systems of medicine in the world, similarly holds that most diseases begin in the mind. And while physical methods of treatment must be immediately implemented once a disease has entered the body, Ayurveda believes that if the mental factors that precipitated the illness are not also addressed, the disease has a good chance of returning.  It is not surprising to see Ayurveda now enjoying resurgence, particularly in the West, where chronic diseases of a wide variety of etiologies are overwhelming the resources of conventional western allopathic doctors.

In spite of conventional western medicine’s impressive technological and scientific advancements to date, its lopsided emphasis on the importance of the body in its treatment and prevention of disease has resulted in frank neglect of the mental and spiritual dimensions that, in Yogic terms, are essential factors in the composition of a human being. As a result, not only are chronic illnesses becoming more prevalent in the West, but both human beings and doctors alike are becoming increasingly disenfranchised, hopeless, and defeated. It is ironic that in America, the most prestigious domain of western medicine, with an abundance of resources and facilities, the health care delivery system is in a current state of shambles.

For this reason, in spite of many dedicated researchers, advances, and studies published on mind-body medicine and Yoga, the job of recognizing the influence of the mind on physical health, and Yoga’s potential therapeutic contribution to western medicine in this area, remains an uphill battle.

To shed further light on the obstacles and challenges facing both Yoga and Mind-Body medicine, let’s look to the surgeon, who is among the most influential and powerful of all allopathic specialists. To a surgeon, if something cannot be operated on and removed, it does not exist. Because “the mind” has never been proven to be located in any one, specific anatomical region, in the eyes of a surgeon, it is not real. For this reason, even among their colleagues, few surgeons respect or acknowledge the specialty of psychiatry, or psychology, and fewer still will refer their patients to either of these specialties.

Clinically relevant, evidenced-based medicine is the only language that a surgeon can comprehend, and is the common language of the western scientific community. If a clinical intervention can prove beneficial results, if a therapy can produce measurable improvement in a patient’s condition, then, whether it is Yoga, acupuncture, hypnosis, Ayurveda, or any other system, it will have to be eventually accepted as valid by even the most skeptical and pessimistic physician or scholar. This was the case for Dr. Dean Ornish, who, for twenty-five years, swam upstream alone against the stiff currents of western scientific and academic prejudice. In the end, persistence and commitment to his work prevailed. It is only in this spirit that the field of Yoga can move forward, become accepted, and make its mark on the world’s playing field, enabling it to make its much needed contribution to mankind. Toward this end, the need for good studies in Mind-Body medicine, with emphasis on Yogic traditions, is imperative.

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