The physiology of mind-body interactions: the stress response and the relaxation response.

There are key differences between mind-body medicine and alternative medicine. A central tenet of mind-body medicine is the recognition that the mind plays a key role in health and that any presumed separation of mind and body is false. Alternative medicine, however, does not focus on the role of thoughts and emotions in health and, therefore, is separate from mind-body medicine. Also, while there has been little scientific research on alternative medicine, the literature on mind-body medicine comprises more than 2000 peer-reviewed studies published in the past 25 years. The groundwork for understanding the physiology of mind-body interactions was established by pioneering studies in the 1930s by Walter Cannon, and in the 1950s by Walter Hess and by Hans Selye that led to an understanding of the fight-or-flight response. Later work by Holmes and Rahe documented measurable relationships between stressful life events and illness. Other research has shown clinical improvement in patients treated with a placebo for a variety of medical problems. The effectiveness of placebo treatment can be interpreted as compelling evidence that expectation and belief can affect physiological response. Recent studies using spectral analysis and topographic electroencephalographic (EEG) mapping of the relaxation response demonstrate that by changing mental activity we can demonstrate measurable changes in central nervous system activity. These, and other, studies demonstrate that mind-body interactions are real and can be measured.

Clinical applications of the relaxation response and mind-body interventions.

Several hundred peer-reviewed studies in the past 20 years have shown that the relaxation response and mind-body interventions are clinically effective in the treatment of many health problems that are caused or made worse by stress. Recent studies show that mind-body interventions may improve prognosis in coronary heart disease and can enhance immune functioning. It is hypothesized that mind-body interventions reduce sympathetic nervous system activation and increase parasympathetic nervous system activity, and thereby restore homeostasis. Researchers have also concluded that cognitive therapy is as effective, and possibly more effective than antidepressant medication in the treatment of major depression. This report provides an overview of some studies that have shown a beneficial role of the relaxation response and cognitive restructuring in the treatment of headaches, insomnia, and cardiovascular disorders. Studies to date suggest that mind-body interventions are effective and can also provide cost savings in patient treatment. It is also clear, however, that mind-body therapies are not panaceas, and should be used in conjunction with standard medical care.

Topographic EEG mapping of the relaxation response.

The purpose of this study was to assess the central nervous system effects of the relaxation response (RR) in novice subjects using a controlled, within- subjects design and topographic EEG mapping as the dependent measure. Twenty subjects listened to a RR and control audiotape presented in a counterbalanced order while EEG was recorded from 14 scalp locations. The RR condition produced greater (p < .0164) reductions in frontal EEG beta activity relative to the control condition. No significant differences were observed for any other frequency band or scalp region. These findings suggest that elicitation of the RR produces significant reductions in cortical activation in anterior brain regions in novice subjects.

Perceived benefits in a behavioral-medicine insomnia program: a clinical report.

PURPOSE: This clinical replication series assessed the perceived outcome of individuals with chronic insomnia who spontaneously sought treatment at a hospital behavioral-medicine insomnia program. PATIENTS AND METHODS: Chronic insomnia patients who were treated with a group multifactor behavioral intervention completed posttreatment (n = 102) and 6-month follow-up (n = 70) questionnaires that assessed improvement. RESULTS: All patients reported improved sleep at posttreatment, with the majority (58%, 59) reporting significant improvement. Of sleep medication users, 91% (62/68) either eliminated or reduced medication use. At 6-month follow-up, 90% (63/70) of respondents rated improvement in sleep as either maintained or enhanced. CONCLUSION: These results suggest that patients spontaneously seeking treatment for insomnia, including sleep medication users and those with psychological comorbidity, derive significant benefit from a group multifactor behavioral intervention. Several factors, including maintenance of therapeutic gains at long-term follow-up, the average pretreatment duration of insomnia, previous unsuccessful treatment with psychotherapy and pharmacotherapy, and previous research, argue against nonspecific effects playing a significant role in these results.

Frontal brain asymmetry predicts affective style in men.

Recent research suggests that a significant relationship between frontal brain asymmetry (FBA) and affective style can be documented in women with 1-measurement occasion. The purpose of this study was to determine whether this finding is generalizable to men. Resting electroencephalogram (EEG) activity was recorded from male adults during 5 60-s baselines on 1 measurement occasion. Mean alpha power asymmetry was extracted in midfrontal and lateral-frontal sites. For the lateral-frontal site, but not the midfrontal site, there was a significant relationship between relative left anterior activation and positive affective style. These results suggest that lateral FBA is a robust and state-independent measure of affective style in men.

Multifactor behavioral treatment of chronic sleep-onset insomnia using stimulus control and the relaxation response. A preliminary study.

Sleep latency changes following behavioral interventions for sleep-onset insomnia are only moderate because the majority of insomniacs do not achieve good sleeper status at posttreatment. This study evaluated the efficacy of a multifactor behavior intervention consisting of stimulus control and relaxation-response training (n = 10) compared to stimulus control alone (n = 10) for sleep-onset insomnia. Only the multifactor subjects' mean posttest sleep latency fell within the good sleeper range. They also exhibited a 77% improvement on mean sleep-onset latency compared to the stimulus control group (63%). Thus a multifactor intervention may be more effective than stimulus control alone for treatment of sleep-onset insomnia.

Three case reports of the metabolic and electroencephalographic changes during advanced Buddhist meditation techniques.

To examine the extent to which advanced meditative practices might alter body metabolism and the electroencephalogram (EEG), we investigated three Tibetan Buddhist monks living in the Rumtek monastery in Sikkim, India. In a study carried out in February 1988, we found that during the practice of several different meditative practices, resting metabolism (VO2) could be both raised (up to 61%) and lowered (down to 64%). The reduction from rest is the largest ever reported. On the EEG, marked asymmetry in alpha and beta activity between the hemispheres and increased beta activity were present. From these three case reports, we conclude that advanced meditative practices may yield different alterations in metabolism (there are also forms of meditation that increase metabolism) and that the decreases in metabolism can be striking.

Spectral analysis of the central nervous system effects of the relaxation response elicited by autogenic training.

This study examined the effects of the relaxation response, elicited by autogenic training, on central nervous system (CNS) activity. We used computerized spectral analysis of EEG activity as a dependent measure. After baseline EEG data were obtained for all subjects, the experimental group practiced standard autogenic exercises for 15 experimental sessions with home practice. The control subjects received the same number of sessions under identical conditions, except that they listened to a pleasant radio show without home practice. Subjects were then posttested to assess the acute and chronic effects of autogenic training and the relaxation response on CNS activity. The results indicated significant acute effects differences between groups; the experimental group showed greater increases in theta and greater decreases in alpha percent total power. The results suggest that the relaxation response elicited by autogenic training produces significant acute changes in EEG activity and a characteristic spectral pattern; the results also suggest that focusing attention on a repetitive, internal stimulus is a key element in Benson's relaxation response model.

Further research on accident rates in developing countries.

Earlier studies have shown that by using cross-sectional data for a group of developing countries, a significant relationship can be established between fatality rates and vehicle ownership levels. This paper updates relationships established in earlier years and identifies whether or not the slope of the regression line has continued to increase (and suggests that for the group of countries as a whole, there is a worsening in the safety situation). Similar relationships are also established for casualty rates. A detailed analysis is made of the relationship between fatality rates and parameters which describe, in part, the social, physical and economic characteristics of the developing countries. These include vehicle ownership, gross national product per capita, road density, vehicle density (per kilometre of road), population per physician and population per hospital bed. Again, comparisons are made with results obtained on earlier studies.

The effects of short term flotation REST on relaxation: a controlled study.

The purpose of this study was to compare the effects of restricted environmental stimulation using a flotation tank (Flotation REST) to the effects of a normal sensory environment on relaxation. All of the subjects were first introduced to a simple relaxation program to be used during the experimental sessions. The program consisted of guided point-to-point relaxation, breathing techniques, and visual imagery techniques. Subjects were then pre-tested on measurements of electromyogram (EMG), galvanic skin response (GSR), peripheral skin temperature, and systolic and diastolic blood pressure. The experimental group experienced ten 45-minute sessions practicing the relaxation program in a Flotation REST environment. The control subjects practiced the same relaxation program in a similar body position for 45 minutes in a normal sensory environment. All subjects answered a five-question Subjective Relaxation Questionnaire on trials five through ten and were then post-tested on EMG, GSR, skin temperature, and blood pressure. The results indicated significant differences between groups from pre-test to post-test on systolic and diastolic blood pressure; the experimental group showed greater reductions. Significant differences also were observed on three of five questions on the Subjective Relaxation Questionnaire; the experimental group reported greater subjective relaxation and trends in a similar direction on the remaining two questions. The results of this study indicate that flotation REST enhances point-to-point relaxation, breathing techniques, and visual imagery techniques and, when combined with these techniques, can be an effective means of teaching normal subjects to lower systolic and diastolic pressure and heighten their subjective perception of relaxation.