Mind-body medicine—the belief that the mind and the body work in concert to create wellness—is an ancient concept that continues to stir up controversy in today’s medical community. Hippocrates, a founding father of mind-body medicine, wrote that “the natural healing force within each one of us is the greatest force in getting well.” Of course, a lot has changed in the past several thousand years, but today many believe that a positive mind-set can be a powerful factor in health and healing.
But how it works—even if it works—has been a continuous source of controversy within the medical community and throughout traditional and popular culture.
So why does a vigorous debate regarding the validity of mind-body medicine continue? Based on philosophical stances regarding the mind and body that date back centuries, the issue is as much attitudinal as it is rational. A paper titled Mind-body dualism: a critique from a health perspective, published by the National Center for Biotechnology Institute, offers some good answers. The monograph deals with the theory of Cartesian Dualism, credited to Rene Descartes of the 17th century. Descartes believed that human beings consist of two “unlike substances which could not exist in unity.” The body was subject to mechanical laws, while the mind was not; while the body was subject to laws of the physical world, the mind existed only in a separate mental world.
The Cartesian concept of mind-body dualism was a way to get around the prevalent orthodox Christian view that had greatly thwarted the development of medical science. These views held that humans were strictly spiritual beings and disease was attributed to nonmaterial forces such as personal or collective wrongdoing. Implications of this thinking prohibited dissection, making the study of human anatomy impossible. Since Descartes’ dualism theory liberated medical science by separating the physical body from the mind (or spirit), medical science has been hardwired to embrace the theory for centuries. If the mind and the body are independent “unlike substances,” how can the mind have any influence over the body?
Cultures that never experienced the shackles of Christian orthodoxy were free to develop more liberal theories of mind-body medicine. Traditional Chinese medicine and ancient Hindu Ayurvedic medicine each draw a direct link between the mind and the body. In our modern Western community there are well-known practitioners and evangelists of mind-body medicine, including such luminaries as Deepak Chopra and Bernie Siegel. Mixing metaphysical and spiritual philosophy with observational science, they have converted millions to acceptance of mindfulness as a path to wellness. These modern day mind-body evangelists have developed their own belief systems, and have done so without disputing the power of spirituality. In the process they’ve sold a lot of books, turning mind-body medicine into an entrepreneurial enterprise. But mainstream Western medical science is slowly opening the door to mind-body medicine as a complementary adjunct to hard science.
Hurdles remain in the medical and scientific community. There’s a widespread belief in the medical establishment that only sugar pills administered in a clinical setting, or prescribed by a physician, trigger the fabled Placebo Effect. When a patient’s blood pressure elevates when taken in a doctor’s office, the argument goes, it’s a good example of how the mind can influence the body—in effect, trick the body. To many in today’s medical community the Placebo Effect is little more than an interesting phenomenon that is of minor importance compared to the burgeoning school of evidence-based medicine.
Mind-body medicine most commonly uses a set of behavior-modifying techniques that require discipline and training. As such, with few exceptions, behavioral science and medical science are delineated into two separate camps. Practitioners of mind-body medicine emphasize the need for “focused concentration”—training the mind to focus on the body without distraction. There are several commonly used mind-body techniques. Biofeedback involves controlling certain bodily processes that normally occur involuntarily, such as the regulation of blood pressure or heart rate. Cognitive behavioral therapy is used to help people recognize and change harmful thoughts. Cognitive behavior techniques, for example, are used to combat depression, a substitute therapeutic approach to medications.
Western medicine becomes mired in circular logic when it comes to curing many diseases. It has little to offer that will “cure” late-stage terminal cancer, for example, yet we don’t conclude that medical treatments such as chemo and radiation are useless. Virtually no physicians would call their colleagues who offer these therapies charlatans. Yet they tend to demand that nontraditional approaches stand up to the standards of clinical trials in order to be valid—even as some of their own therapies fail to offer a cure. Is it better to prolong life through medical intervention, or enrich what’s left of a life through a mind-body medicine approach? In this era of medicalized aging, that’s an important question.
“Positive thinking” is a loaded term that doesn’t capture the mind-body philosophy. If positive thought doesn’t include a deeply felt sense of the connection between our spiritual mindfulness (not to be confused with traditional religious doctrine) and our corporeal, material body in all its complexities and frailties, then it is not only useless but it is potentially counter-productive. Dr. Kevin Pho, author of the MedPage Today blog KevinMD, writes about “the tyranny of positive thinking.” He describes such thinking as the enforced, unwelcome, negative message from well people that sick people get better or worse depending on their attitude—that they are somehow responsible for the outcomes of their treatment, good or bad.
Indeed, a recent large-scale study conducted in England and published in Lancet concluded that happiness—an assumed byproduct of positive thinking—has nothing to do with an individual’s general health or longevity. The study, which was adjusted for baseline health, concludes that any connection between unhappiness and an early death were actually “reverse causality,” and unhappiness was a byproduct of the illness that led to death. While we can all agree that happy people are much more fun to be around than their unhappy brethren, there doesn’t appear to be a penalty for grumpiness when it comes to our health.
Contrary to popular culture, many pessimists survive and many optimists die from their diseases—being one way or the other is no guarantee of a favorable outcome. But a reasonable assumption that the mind and the body can work in concert to promote overall better outcomes is rooted in logic as well as belief. The mind—our most powerful, yet least understood resource—may indeed play a critical role in our health, wellness, and healing.