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Mind Body Medicine

What is this?

 Mind body medicine, clinically called psychoneuroimmunology, refers to the interactions between the mind, brain/nervous system, endocrine, and immune systems.

Our perceptions, through our thoughts and senses, create instantaneous responses in the body, relayed through neuropeptides and neurotransmitters.  An example: You unexpectedly hear glass break during the night and have an immediate physical stress response of fear or alarm.  Your first thought is that someone is breaking into your home.   However, upon checking things out, you find your cat knocked a glass off of the counter.  Now your response might be annoyance or relief.

To the mind, everything is real. You can be in a wonderful, peaceful place, but if you are focused on something upsetting or threatening, your thoughts trigger the fight-or-flight response.  In that response your adrenals release cortisol into the bloodstream, elevating blood pressure and heart rate, and prompting shallow breathing.  Likewise, thoughts of gratitude elevate mood, increase the release of dopamine from the brain, lower blood pressure and heart rate, deepen breathing, and increase positive energy.

Mind body techniques have been proven effective in reducing stress, inflammation, and re-balancing the immune system.  They play a significant role in healing, reducing treatment side effects, managing pain, and lowering the risk for complications.  These powerful techniques improve self-mastery, self-confidence, peace of mind, locus of control, and quality of life.  There is evidence that managing the mind-body interaction is very important for healing and staying well (Vitetta 2005).

Mind body healing techniques include meditation, guided imagery, self-hypnosis, breath work, yoga, autogenic training (a relaxation technique), and biofeedback.  Self-expression tools such as journaling, drawing, other expressive arts, and exercise are also helpful.  Mind body techniques have been integrated into the standard patient care in some of most prestigious hospital systems and university medical centers.

How can this help?

While stress is a normal part of daily life, prolonged and high levels of unmanaged stress contribute to an imbalance in the immune system.  Over time, this kind of imbalance can result in an overactive immune system, which can contribute to the development of autoimmune disease or a suppressed immune response (Kiecolt-Glaser & Glaser, 1998).  Other stress-related problems include increased inflammation, increased pain, and slow healing as well as cell death (Vilasco 2011).

Unmanaged stress also contributes to the adoption of unhealthy lifestyle behaviors in an effort to cope and self-soothe.  These behaviors include eating for comfort, using alcohol, tobacco, pain relievers and other substances, inactivity, and other extreme coping mechanisms which can lead to obesity, heart disease, diabetes, high blood pressure, high cholesterol, cancer, and other lifestyle diseases.

For people with ITP,  physical or psychological stress and the resultant oxidative stress in the body can potentially cause ITP (Imbach 2011), exacerbate fatigue (Solomon 2010) and is associated with longer lasting cases in children (Akbayram 2010, Zhang 2011).  As a group, people with ITP are often dealing with more fear, mental turmoil, fatigue, and are more emotionally taxed than those without the disease (Snyder 2008).

Mind body techniques can be used alone or in combination to reduce stress, reduce inflammation, and increase well-being (Olivo 2009), the very conditions that contribute to low platelets and low quality of life for people with ITP.

Here are examples of mind body techniques along with illustrative research.

Meditation

Dr. Herbert Benson, founder of the Mind Body Medical Institute of Harvard University Medical School, pioneered the scientific study of meditation in the 1960s and 70s.  He termed the positive results he found the ‘relaxation response.’ Since his initial work, he and his team continued researching the subject and have provided a compelling body of evidence highlighting the many positive benefits of mediation and like techniques.  His work and that of others showed these techniques can lower blood pressure, reduce stress, enhance well-being, reduce inflammation, improve immune function, and induce positive changes in the brain. (Dusek and Benson 2009; Dusek 2008; Tang 2010)  Dr. Benson’s latest book, Relaxation Revolution, shows that breath work and meditation can alter genetic expression.

Guided Imagery, Positive Thinking & Positive Attitude

In the PDSA survey of non-traditional treatments of ITP approximately 40% of the responders believed that meditation, imagery (visualization), and positive thinking helped their platelet count and their bleeding symptoms.  Thirty-seven percent of people felt that positive thinking was instrumental in providing a sustained response, the highest ranking of the three questions.

The mind body can have a direct effect on the blood as illustrated by two clinical studies of guided imagery.  In one study, guided imagery reduced the number of white blood cells to improve the immune response (Trakhtenberg 2008).  In another study, guided imagery tapes improved immune function as measured by IgA, an antibody in the blood. (Rider 1990)

Studies at Ohio State Medical School showed the benefits of guided imagery on immune response (Kiecolt-Glaser and Glaser 2002) and many studies show the positive benefits of using guided imagery for surgeries (ex. Hart 1980; Holden-Lund 1988; Tusek 1997).

Yoga

For thousands of years yoga has been included with other life-extending practices and used with great success in India and Tibet (Olivo 2009).  In its ancient roots yoga encompassed a strong spiritual and philosophical component, but for many today it is a breathing/stretching/relaxation mind body exercise.  Yoga is very effective in quieting the mind, calming the body, re-oxygenating muscles/tissues/organ systems, and improving the flexibility of the body mind.

Research shows that those who consistently practice yoga have reduced IL-6 levels compared to novice practitioners (Kiecolt-Glaser 2010).  It is important to note that IL-6 is the same inflammatory cytokine that is elevated in people with ITP who have more problems with fatigue (Solomon 2010).

Risks

There are a small percentage of people who experience some dizziness or mild anxiety when first learning mind body techniques.  The dizziness may be caused by moving into a deeper state of relaxation quickly.  Simply placing their feet on the floor or imagining standing on firm ground will relieve this sensation.

Occasionally, individuals with high anxiety many experience mild anxiety at the first sensations of relaxation because it feels somewhat foreign and therefore uncomfortable.  With time and practice, this sensation goes away.

It is normal to experience intrusive thoughts while meditating.  The mind naturally wanders and brings up a variety of thoughts, some normal, funny, strange, or sad.  Whenever the mind has wandered, simply re-focus to the meditation without judgment.

Before beginning a new exercise program consult a healthcare provider.

Our Experiences

“My son [who has ITP] was about 12 year old.  I knew it would be very hard to ask a 12 year old kid to meditate. We have four people in our house:  me, my wife, my wife's sister, and my son. After work I convinced all of our family members to join together and meditate every evening in order to lead my son to a more peaceful situation.  After an IV injection, his platelet count usually went up to about 197 and gradually dropped down.  But this time after he had a treatment, it dropped down to 56 and then stayed around 56 for a couple of weeks.  It gradually went back up and stayed about 95, above a dangerous level.  Now he is back up to 195.”  Harry

“Now my platelets are consistently in the 85-100,000 range.  This change was accomplished without drugs or surgery, but it took several years of consistent effort, money, and patience.  I attribute this success to, consistently over a one year time period, with the support and supervision of my doctor, eliminating sugar and junk/processed food from my diet, taking a multivitamin daily, increasing intake of a wide variety of healthy food, reducing stress in my job, going to spas three to four times a year, exercising and getting massages, doing anti-anxiety activities like yoga and meditation for 20 minutes daily, drinking water and otherwise reducing my exposure to chemicals where possible.” Christina

“I found a counselor who helped me with meditation and visualization techniques and the power of positive thinking to help me mentally.  It did bring my platelets back up to 5-6K, so I could keep working, but mostly it kept me calm and searching for other options.” Rebecca

Resources

Akbayram S et al. “The association of oxidant status and antioxidant capacity in children with acute and chronic ITP.” J Pediatr Hematol Oncol. 2010 May;32(4):277-81. http://www.ncbi.nlm.nih.gov/pubmed/20404751

Astin JA, et al. “Mind-body medicine: state of the science, implications for practice.” J Am Board Fam Pract. 2003 Mar-Apr;16(2):131-47. http://www.ncbi.nlm.nih.gov/pubmed/12665179

Dusek JA et al. “Genomic counter-stress changes induced by the relaxation response.” PLoS One. 2008 Jul 2;3(7):e2576. http://www.ncbi.nlm.nih.gov/pubmed/18596974

Dusek JA, Benson H. “Mind-body medicine: a model of the comparative clinical impact of the acute stress and relaxation responses.” Minn Med. 2009 May;92(5):47-50. http://www.ncbi.nlm.nih.gov/pubmed/19552264

Hart RR. “Benefits of guided imagery for surgery.” International Journal of Clinical and Experimental Hypnosis 28, 1980, 324-332.

Holden-Lund C. “Effects of Relaxation with Guided Imagery on Surgical Stress and Wound Healing.” Research in Nursing and Health. 1988 Aug;11(4):235-44. http://www.ncbi.nlm.nih.gov/pubmed/3043570

Imbach P. “Oxidative stress may cause ITP.” Blood. 2011 Apr 28;117(17):4405-6. http://www.ncbi.nlm.nih.gov/pubmed/21527538

Keicolt-Glaser, J.K and Glaser, Psychological influences on surgical recovery: perspectives from psychoneuroimmunology, American Psychologist, 1998; 53 (11): 1209-1218. http://www.ncbi.nlm.nih.gov/pubmed/9830373

Kiecolt-Glaser JK et al. “Stress, inflammation, and yoga practice.” Psychosom Med. 2010 Feb;72(2):113-21. http://www.ncbi.nlm.nih.gov/pubmed/20064902

Kiecolt-Glaser JK, et al. “Psychoneuroimmunology: psychological influences on immune function and health.” J Consult Clin Psychol. 2002 Jun;70(3):537-47. http://www.ncbi.nlm.nih.gov/pubmed/12090368

Olivo EL. “Protection throughout the life span: the psychoneuroimmunologic impact of Indo-Tibetan meditative and yogic practices.” N Y Acad Sci. 2009 Aug;1172:163-71.http://www.ncbi.nlm.nih.gov/pubmed/19735248

Praissman S. “Mindfulness-based stress reduction: a literature review and clinician's guide.” J Am Acad Nurse Pract. 2008 Apr;20(4):212-6.http://www.ncbi.nlm.nih.gov/pubmed/18387018

Rider MS et al. “Effect of immune system imagery on secretory IgA.” Biofeedback Self Regul. 1990 Dec;15(4):317-33. http://www.ncbi.nlm.nih.gov/pubmed/2125839

Snyder CF et al. “Health-related quality of life of immune thrombocytopenic purpura patients: results from a web-based survey.” Curr Med Res Opin. 2008 Oct;24(10):2767-76.  http://www.ncbi.nlm.nih.gov/pubmed/18715526

Solomon, J et al. “Impact Of Cytokine Levels On Hrqol In Patients With ITP.” June 11, 2010.  Poster at 15th Congress of the European Hematology Association. http://www.eventure-online.com/eventure/publicAbstractView.do?id=137910&congressId=3446

Tang YY et al. “Short-term meditation induces white matter changes in the anterior cingulate.” Proc Natl Acad Sci U S A. 2010 Aug 31;107(35):15649-52. http://www.ncbi.nlm.nih.gov/pubmed/20713717

Trakhtenberg EC. “ The effects of guided imagery on the immune system: a critical review.” Int J Neurosci. 2008 Jun;118(6):839-55. http://www.ncbi.nlm.nih.gov/pubmed/18465428

Tusek D et al. “Guided imagery as a coping strategy for perioperative patients.” 1997 Oct;66(4):644-9. http://www.ncbi.nlm.nih.gov/pubmed/9337466

Vilasco M et al. “Glucocorticoid receptor and breast cancer.”Alternative Medicine Breast Cancer Res Treat. 2011 Aug 5 http://www.ncbi.nlm.nih.gov/pubmed/21818591

Vitetta et al. “Mind-body medicine: stress and its impact on overall health and longevity.” Ann N Y Acad Sci. 2005 Dec;1057:492-505. http://www.ncbi.nlm.nih.gov/pubmed/16399915

Zhang B et al. “The role of vanin-1 and oxidative stress-related pathways in distinguishing acute and chronic pediatric ITP.” Blood. 2011 Apr 28;117(17):4569-79. http://www.ncbi.nlm.nih.gov/pubmed/21325602

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PDSA thanks Jane P. Ehrman, M.Ed., CHES for her contributions to this page.