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to Menu PageAny discussion of mind-body interventions brings the old questions back to life: What are mind and consciousness?1 How and where do they originate? How are they related to the physical body? In approaching the field of mind-body interventions, it is important that the mind not be viewed as if it were dualistically isolated from the body, as if it were doing something to the body. 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." 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. Even the use of drugs and surgery has its psychological side. The use of these methods often requires placebo-controlled, double-blind studies to estimate and factor out the physical effects of patients' beliefs and expectations.
When the term mind-body is used in this report, therefore, there is no implication that an object or thing--the mind--is somehow acting on a separate entity--the body. Rather, "mind-body" could perhaps best be regarded as an overall process that is not easily dissected into separate and distinct components or parts. This point of view, which was put forward a century ago by William James, the father of American psychology, has recently been reaffirmed by brain researchers Francis Crick and Christof Koch (1992).
Throughout history the value of "human" factors in healing has been recognized. These factors include closeness, caring, compassion, and empathy between therapist and patient. Though these factors are theoretically acknowledged by contemporary medicine, they are largely ignored in current practice, partly because they are hard to define and measure and cannot be easily taught. In many mind-body interventions, however, their relevance is ~obvious. A research agenda for the future should include an investigation of the impact of these qualities on healing--not only on alternative, mind-body interventions but on orthodox therapies as well.
Mind-body interventions frequently lead patients to new ways of experiencing and expressing their illness. For example, although healing usually denotes an objective improvement in health, patients commonly state that they feel "healed" but not "cured"--that is, they experience a profound sense of psychological or spiritual well-being and wholeness although the actual disease remains. Distinctions between curing (the actual eradication of a disease) and healing (a sense of wholeness and completeness) have little place in contemporary medical practice but are important to patients. A place should be made for these distinctions. Acknowledging that "healing without curing" is both permissible and honorable requires the recognition of spiritual elements in illness.2 It also requires honoring the wishes of individuals in deciding what is best in the course of their disease process. ~Sometimes, zealous attempts to cure may have disastrous effects on patients' quality of life for the years they have left.