Mind – Body

Interventions
Complementary and Alternative Medicine

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Content Outline:
I. Meditation
II. Cognitive-behavioural Therapy

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Mind-Body Interventions
• Focus on the interactions among the brain, mind, body, and
behaviour, with the intent to use the mind to affect physical
functioning and promote health
• Mind-Body relations are always mutual and bidirectional – the
body affects the mind and is affected by it
• Mind and body are so integrally related that, in practice, it
makes little sense to refer to therapies as solely “mental” or
“physical”

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Mind-Body Interventions
• For example, activities that appear overwhelmingly “physical”,
such as aerobic exercise, yoga, and dance, can have healthful
effects not only on the body but also on such “mental”
problems as depression and anxiety; and “mental” approaches
such as imagery and meditation can benefit physical problems
such as hypertension and hypercholesterolemia as well as have
salutary psychological effects.

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Historical Note
• The concept that the mind is important in the treatment of
illness is integral to the healing approaches of traditional
Chinese medicine and ayurvedic medicine. It was also noted by
Hippocrates that the moral and spiritual aspects of healing and
treatment could occur only with consideration of attitude,
environmental influences and natural remedies.

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Current Use
• According to NIH (2007) report, several mind and body
approaches ranked among the top 10 CAM practices in adults.
It was found that 12.7% of adults used deep-breathing
exercises, 9.4% practiced meditation and 6.1% practiced yoga.

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A. Meditation
• It is a self-directed practice for
relaxing the body and calming the mind
• The meditator makes a concentrated
effort to focus on a single though – peace, for instance; or a
physical experience, such as breathing; or a sound (repeating a
word or mantra, such as “one” or a Sanskrit word such as
“kirim”)

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A. Meditation
• Aim: To still the mind’s “busyness” – its inclination to mull over the
thousand demands and details of daily life
• Most meditative techniques have come to the West from Eastern
religious practices – particularly those of India, China, and Japan –
but they can be found in all cultures of the world
• Until recently, the primary purpose of meditation has been religious,
although its health benefits have long been recognized. During the
past 15 years, it has been explored as a way of reducing stress on
both mind and body. Cardiologists, in particular, often recommend it
as a way of reducing high blood pressure
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Different Types of Meditation
1. Transcendental meditation – it was developed by the
Indian leader Maharishi Mahesh Yogi, who eliminated from
yoga certain elements he considered nonessential
- TM is simple. To prevent distracting thoughts a student is given a
mantra (a word or sound) to repeat silently over and over again while
sitting in a comfortable position. Students are instructed to be passive
and, if thoughts other than the mantra come to mind, to notice them
and return to the mantra. A TM student is asked to practice for 20
minutes in the morning and again in the evening.

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Different Types of Meditation
• Published results from these studies report that the use of TM is
discretely associated with:
• Reduced health care use
• Increased longevity and quality of life
• Reduction of chronic pain (Kabat-Zinn et al., 1986)
• Reduced anxiety
• Reduction of high blood pressure
• Reduction of serum cholesterol level
• Reduction of substance abuse
• Longitudinal increase in intelligence-related measures

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Different Types of Meditation
• Published results from these studies report that the use of TM is
discretely associated with:
• Treatment of posttraumatic stress syndrome in Vietnam veterans
• Blood pressure reduction in African-American persons
• Lowered blood cortisol levels initially brought on by stress

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Different Types of Meditation
2. Imagery – is both a mental process (as in imagining) and a
wide variety of procedures used in therapy to encourage changes
in attitudes, behaviour, or physiological reactions
- It is often defined as “any thought representing a sensory
quality” (Horowitz, 1983)
- It includes the visual, all the senses – aural, tactile, olfactory,
proprioceptive, and kinesthetic

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Different Types of Meditation
2. Imagery – is used synonymously with visualization which is
considered to be misleading since the latter refers only to seeing
something in the mind’s eye. Imagery means imagining through
any sense as through hearing and smell
- Imagery can be taught either individually or in groups, and the
therapist often uses it to affect a particular result, such as
quitting smoking or bolstering the immune system to attack
cancer cells. It can also be taught as a form of meditation since it
often involves directed concentration.

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Different Types of Meditation
2. Imagery
- Clinical Applications:
- Procedures for imagery fall into at least three major categories:
A. Evaluation or diagnostic imagery
B. Mental rehearsal
C. Therapeutic intervention

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Different Types of Meditation
3. Evaluation imagery
• Done early in a therapy session and serves as a format for
designing both mental rehearsal and therapeutic intervention
strategies
• It is an indicator of the person's understanding of the
mechanisms of health and disease and provides opportunity for
patient education

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Different Types of Meditation
4. Mental rehearsal
• An imagery technique used before medicinal techniques, usually in an
attempt to relieve anxiety, pain, and side effects, which are exacerbated
by heightened emotional reactions
• A cornerstone of certain natural childbirth practices. It has also been
tested in burn debridement (Kenner and Achterberg, 1983) and as a
preparation for spinal surgery (Lawlis et al., 1985), cholecystectomy,
pelvic examination, cast removal, and endoscopy (Johnson et al., 1978)
• Rehearsal through imagery Has been found to diminish pain and
discomfort and to reduce side effects

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• Imagery as a therapeutic intervention
• It is based on the idea that the images have either a direct or an
indirect effect on health
• The patients are shown how to use their own flow of images about the
healing process or, alternatively, they are guided through a series of
images that are intended to soothe and distract them, reduce any
sympathetic nervous system arousal, or generally enhance their
relaxation
• The practitioner may also use “end state” types of imagery, having
patients imaging themselves in a state of perfect health, well-being, or
successfully achieved goals

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B. Hypnosis
- Derived from the Greek word
hypnos (sleep), and hypnotic
suggestion have been part of
healing since ancient times
- The induction of trance states
and the use of therapeutic
suggestion were a central
feature of the early Greek
healing temples, and
variations of these techniques
were practiced throughout the
ancient world
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B. Hypnosis
- Modern hypnosis began in the 18th century with Franz Anton
Mesmer, who used what he called “magnetic healing” to treat a
variety of psychological and psychophysiological disorders,
such as hysterical blindness, paralysis, headaches, and joint
pains
- The famous Austrian neurologist Sigmund Freud at first
found hypnosis extremely effective in treating hysteria and
then, troubled by the sudden emergence of powerful emotions
in his patients and his own difficulty with its use, abandoned it
- It is a state of attentive and focused concentration in which
people can be relatively unaware of, but not completely blind
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• Hypnosis has three major components:
• Absorption (in the words or images presented by the hypnotherapist
• Dissociation (from one’s ordinary critical faculties)
• Responsiveness

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• Clinical Applications:
• One of the most dramatic uses of hypnosis is the treatment of
congenital icthyosis (fish skin disease), a genetic skin disorder that
covers the surface of the skin with grotesque hard, wartlike, layered
crust
• Dermatologists thought icthyosis was incurable until an
anesthesiologist, Arthur Mason, in the mid-1950s used hypnosis by
chance to effectively treat a patient he though had warts. After Mason
used hypnosis on the patient (16 year old boy), the boy’s scales fell off,
and within 10 days, normal pink skin replaced it. Since that time,
hypnosis has been used to treat ichthyosis – not always resulting in
complete cure but often resulting in dramatic improvement (Goldberg,
1985)

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• Hypnosis is, however, most frequently used in more common
ailments, either independently or in concert with other
treatment. The following are examples:
• Pain management – pain increases with heightened fear and anxiety.
Because hypnotherapy helps a person gain control over fear and
anxiety, pain is also reduced. Hypnotic suggestion (one may suggest
that a part of the body become numb) can be used instead of or
together with an anesthetic
• Dentistry – some people have learned how to tolerate dental work
with hypnotherapy as the only anesthetic. Even when an anesthetic is
used, hypnotherapy can also be employed to reduce fear and anxiety,
control bleeding and salivation, and reduce postoperative discomfort

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• Pregnancy and delivery – women who have hypnosis prior to
delivery have shorter labors and more comfortable deliveries. Women
have also used self-hypnosis to control pain during delivery (Rossi,
1986)

• Anxiety – hypnosis can be used to establish a new reaction to specific

anxiety-causing activities such as stage fright, plane flights, and other
phobias

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• Immune system function – hypnotherapy can have a positive effect
on the immune system. One study has shown that hypnosis can raise
immunoglobulin levels of healthy children (Olness et al., 1989). Another
study reported that self-hypnosis led to an increase in white blood cell
activity (Hall, 1982-83)

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 • Originated in the late 1960s
C. Biofeedback • It is a treatment to feed back
to patients physiological
information of which they are
normally unaware
• Patients can learn by trial and
error to adjust their thinking
and other mental processes in
order to control bodily
processes thought to be
involuntary

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• This can be used to treat a wide variety of conditions and
diseases ranging from stress, alcohol and other addictions,
sleep disorders, epilepsy, or muscle dysfunction caused by
injury, migraine headaches, and a variety of vascular disorders.
More applications are being developed yearly
• In a normal sessions, electrodes are attached to the area being
monitored (the involved muscles for muscle therapy, the head
for brain wave activity); these electrodes feed the information
to a small monitoring box that registers the results by a sound
tone that varies in pitch or on a visual meter that varies in
brightness as the function being monitored decreases or
increases

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• The most common forms of biofeedback involve the
following:
• Measurement of muscle tension (electromyographic, or EMG, feedback)
• Skin temperature (thermal feedback)
• Electrical conductance or resistance of the skin (electrodermal
feedback)
• Brain waves (electroencephalographic, or EEG, feedback)
• Respiration

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• Like all other forms of therapy, biofeedback is more useful for
some clinical problems than for others
• For example:
• Biofeedback is the preferred treatment in Raynaud’s disease/syndrome
(a painful and potentially dangerous spasm of the small arteries) and
certain types of fecal and urinary incontinence
• Treatments for muscle contraction (tension) headaches, migraine
headaches, IBS, HTN, asthma, and neuromuscular disorders, especially
during rehabilitation
• EEG biofeedback therapy is one of several preferred
treatments for certain patients with epilepsy or attention deficit
disorder

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