Is There Good Evidence? | Taking Charge of Your Wellbeing

Evidence

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man rubbing back in pain In a word, yes! According to Astin and other researchers from the Harvard Medical School and the California Pacific Medical Center:

"There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions."

Their review of the research finds considerable evidence of efficacy for mind-body therapies in the treatment of:

Coronary artery disease
H eadaches
Insomnia
Incontinence
Improving postsurgical outcomes
Chronic low back pain
Cancer (alleviation of disease and treatment-related symptoms)

In addition, there is moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis.

Can you give me some examples?

Many studies show great potential for improved health outcomes. For example:

Jon Kabat Zinn's classic research on mindfulness meditation for patients with chronic pain. In 1987, 90 chronic pain patients in Kabat Zinn's study showed dramatically decreased levels of pain, as well as lessened anxiety and depression, after a ten-week course in mindfulness meditation.
Rollin McCraty's study with diabetic patients using the HeartMath emotional shifting technique. This technique consists of relaxing and re-creating a positive experience. Diabetic patients in this study dramatically improved glycemic levels by employing this technique. In a 2009 study, correctional officers trained in the HeartMath emotional shifting techniques demonstrated decreased stress, as well as improved cholesterol, glucose, heart rate, and blood pressure.
Research in neuroplasticity by Richard Davidson and his colleagues links meditation practice to positive changes in the brain and more focused attention.

The best way to find evidence is to search PubMed for a specific mind-body therapy or practice.

What general issues exist with mind-body research?

yoga pose Although mind-body research is constantly evolving, some characteristics of these therapies make them more difficult to study than, say, standard drug treatments. This can influence the attitude of the mainstream medical world towards these therapies. It also raises interesting questions about the nature and reliability of all medical research. For example, mind-body therapies and practices:

Often employ more than one approach, making it hard to isolate effects. (For example, yoga includes a variety of postures, but also uses breathwork and meditation.)
Are often used in conjunction with other therapies, complicating cause/effect.
Often deliberately use the placebo response (see below for a discussion of this).
Often use the therapist as part of the therapy, so double-blind studies are impossible. (Double-blind studies occur when neither the therapist or patient knows who is getting treatment and who the placebo.)

In addition, it is also sometimes difficult for researchers to interpret outcomes because

Factors may be difficult to measure

For example:

How engaged is the therapist with the patient?
How can one's overall wellbeing be quantified?

Important factors may be inadvertently eliminated

If a study takes place outside a normal therapy-delivery environment (like a physician's office), environmental factors (like comfort of the physical space, privacy, or distraction) may not be considered.

Numerous outcomes can complicate the study

For example, studies on meditation have measured everything from objective elements (such as decreased heart rate and body temperature) to subjective matters (like overall wellbeing or anxiety level).

Changes may be gradual, subtle, and difficult to measure

Because the focus of mind-body therapies is on the whole person, changes may be more gradual and subtle than with a specific intervention like surgery.

What is the placebo effect?

provider shaking hands with patient You have probably heard about drug trials where some of the participants are given a new drug and some are given a placebo - a substance that looks like the drug, but has no active ingredients. The drug company is hoping that their drug will show more benefit to patients than the placebo. While it might seem obvious that the drug would show more benefit, in some cases (particularly in some cultures), the placebo effect is so strong that that the difference is slight. What this means is that the patient's expectation of a desired outcome actually causes it to occur, not the drugs.

The placebo effect can also come into play when patients believe their health provider can help them--the so-called "white-coat effect."

Deliberate use of the placebo effect

Many mind-body therapies deliberately employ this so-called placebo effect to initiate the self-healing capacities of the individual. In this context, the placebo is not an unintended or negative outcome. Rather, it is another example of how the mind (which creates meaning) can impact the body.

In an extensive review of the clinical research, top researchers Walach and Jonas concluded that the placebo effect is real and that healthcare providers should seek to use it to benefit their patients. A 2010 meta-analysis confirmed that the placebo effect is useful for subjective measures, such as pain and nausea.

Want to learn more?

In addition to this study on stress and aging, there is much important research on the mind-body connection. The PDF available on this screen lists key studies, historical and current on the physiology of the mind-body connection. (It does not list research on specific mind-body practices.)

Click for PDF listing key studies.

Astin, J., Shapiro, S., Eisenberg, D., Forys, K. (2003). Mind-Body Medicine: State of the Science, Implications for Practice. The Journal of the American Board of Family Practice, 16, 131-147.

Epel, E.S., Blackburn, E.H., Lin, J., Dhabhar, F.S., Adler, N.E., Morrow, J.D., and Cawthon, R.M. (2004). Accelerated telomere shortening in response to life stress. Proceedings of the National Academy of Sciences. December 7, 2004: 101(49), 17312-17315.

Hróbjartsson, A., Gøtzsche, P.C. (2010). Placebo interventions for all clinical conditions. Cochrane Database of Systematic Reviews;(1):CD003974.

Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163-190.

Lutz, A., Slagter, H.A., Rawlings, N.B., Francis, A.D., Greischar, L.L., Davidson, R.J. (2009). Mental training enhances attentional stability: neural and behavioral evidence. Journal of Neuroscience;29(42):13418-27.

McCraty, Atkinson, and Lipsenthal (2001). Emotional Self-Regulation Program Enhances Psychological Health and Quality of Life in Patients with Diabetes. HeartMath Research Center, Boulder Creek, Calif.: Institute of HeartMath.

McCraty, R., Atkinson, M., Lipsenthal, L., Arguelles, L. (2009). New hope for correctional officers: an innovative program for reducing stress and health risks. Applied Psychophysiology and Biofeedback; 34(4):251-72.

Pelletier, K. (2000). The Best Alternative Medicine. New York: Simon and Schuster.

Slagter, H.A., Davidson, R.J., Lutz, A. (2011). Mental training as a tool in the neuroscientific study of brain and cognitive plasticity. Frontiers in Human Neuroscience;5:17.

Walach, H. and Jonas, W. (2004). Placebo Research: The Evidence Base for Harnessing Self-Healing Capacities in Towards Optimal Healing Environments in Health Care. Corona del Mar, Calif.: Samueli Institute.