Fracasso, C., Krippner, S., & Friedman, H. (2013). Mind and body. In M. Shally-Jensen (Ed.).

Mental health care issues in America: An encyclopedia (pp. 453-459). Santa Barbara, CA:
ABC/CLIO.

Mind and Body Approaches to Mental Health

Stanley Krippner
Cheryl Fracasso
Harris Friedman
Defining the field of mind and body medicine is challenging since there are
no clear-cut boundaries that differentiate many of the modalities that fall
within its domain. In fact, mind and body medicine is a subfield of the larger
umbrella referred to as complementary and alternative medicine (CAM),
which encompasses a diverse group of modalities and health care systems
that are not considered to be part of conventional medicine. According to the
National Center for Complementary and Alternative Medicine (NCCAM
website 2011), a branch of the National Institutes of Health (NIH), CAM
consists of fields that fall under the broad category of holistic health and
natural approaches, including phytochemicals, mind and body medicine,
manipulative and body-based practices, integrative medical systems, energy
medicine, exercise and movement therapies, expressive art therapies, and a
broad array of other practices that do not fit neatly into one category.
Complementary practices complement mainstream practices (e.g., exercise
and movement therapies) while alternative practices are alternatives to
mainstream practices because they are based on different premises (e.g.,
homeopathic theory, which simply does not make sense under conventional
ways of thinking about the relationship between dose and effect of
medicines). Some practices fall under both categories (e.g., Chinese
traditional medicine, some aspects of which are complementary, such as
massage, and some of which are alternative, such as moxibustionthe
burning of herbs on segments of the patients body).
According to NCCAM, the main premise behind mind and body medicine is
that a focus on the interactions between the mind and body (i.e., brain, and
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behavior) will impact physical and mental well-being and promote health.
The historical roots of integrating the mind and body as an important
element in the treatment of illness dates back over 2,000 years ago to
traditional Chinese medicine, ancient Greek medicine, Ayurvedic medicine,
and similar holistic approaches. In the past few decades, CAM has gained
increasing popularity in Western cultures, as indicated in the 2007 National
Health Interview Survey (NHIS). which revealed that 38 percent of
Americans used some type of CAM (NCCAM website 2011).
The modalities that fall under the domain of mind and body medicine include
yoga, meditation, acupuncture, guided imagery, hypnotically facilitated
psychotherapy, progressive muscle relaxation, QiGong, Tai Chi, and
biofeedback, to name a few. However, it could be argued that all healing
modalities fall under the mind and body domain to some extent, since at a
deeper level there is no justifiable way to delineate mind from body.
However, CAM approaches are geared toward integrating what a culture
considers body and what that culture considers mind (including
emotions and spirit) to improve health, whereas more conventional
medical approaches segment these into separate domains. For example,
Reikiwhich also falls under the energy medicine domainis geared
toward the movement of the hypothetical construct of some sort of energy
to remove mind and body blockages to promote health. While this technique
does not use physical touch, its clients are typically passive recipients of its
treatment. Clients do not have to meditate, visualize, or relax. The hoped for
result is that the effects of this treatment will impact the mind and body by
at least inducing relaxation and perhaps by more deeply affecting other
mechanisms that remain unknown.
Since these mind and body modalities are so diverse, for purposes of this
entry we will overview some of the most widely used modalities as reported
by adults in the 2007 NHIS survey. For example, the survey found that
12.7 percent of adults practiced some sort of deep breathing, 9.4 percent
practiced some form of meditation or self-regulated attention (ranging from
mindfulness meditation to guided imagery), 6.1 percent practiced yoga,
1.4 percent had used acupuncture, with smaller percentages reporting
employing other practices, such as Reiki. The 2007 NHIS survey showed that

utilization of mind and body modalities substantially increased as compared

with the previous NHIS survey in 2002 (NCCAM website 2011). We have
selected four of these modalities for our overview, namely yoga, guided
imagery, acupuncture, and Reiki.
Four Popular Modalities
Yoga
Yoga consists of a variety of techniques but in the West is usually seen as a
set of relatively gentle stretching postures that purport to increase flexibility,
balance,
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453
and strength, invoke relaxation, as well as provide cardiovascular benefits
when practiced vigorously over a long period of time (Kabat-Zinn 1990).
Physical yoga (i.e., Hatha yoga) can also be performed strenuously as an
athletic event (e.g., Bikrim yoga), or it can be devoid of a physical emphasis,
such as in a focus on good deeds (i.e., Karma yoga) or sharpening the
intellect (i.e., Agni yoga). The procedures behind most physical yogas
involve a focus on breathing while relaxing into various postures and holding
them for a few minutes, and for some types of yoga, then holding each
posture for a period of at least five minutes. According to Kabat-Zinn (1990),
being mindful of how the body feels during each of these stretches invokes
the feeling of being comfortable in the body, as well as realizing wholeness
and connectedness through disciplined practice. Some yogas, however,
focus on increasing discomfort to alter consciousness, such as breath of
fire movements involving rapid hyperventilation combined with strenuous
movement, such as deep knee bends. This can be done for several hours in
some forms of kundalini yoga practice.
Research has shown that yoga can help patients suffering from
cardiovascular disease, osteoporosis, multiple sclerosis, back and neck pain,
as well as the recovery of patients who have suffered a stroke (Butler et al.
2008). Studies also showed that yoga can improve cholesterol readings,
lower blood pressure, lower the pulse rate, as well as reduce stress, anxiety,
and chronic pain (Wahbeh, Elsas, & Oken 2008). Likewise, Schure,

Christopher, and Christopher (2008) pointed out that the practice of Hatha
yoga has been able to decrease mood disturbances, lower rates of
depression, as well as increase immune system functioning by decreasing
psychological distress and physical discomfort.
Guided Imagery
Guided imagery is a consciously guided cognitive process that may utilize all
the major senses (i.e., sight, hearing, touch, kinesthesia, smell, taste),
which can have a profound impact on the bodys physiology and
biochemistry (Lynn et al. 2000). Uses of this technique can be found in
hypnosis and biofeedback, along with various forms of meditation to invoke
relaxation and manage stress (Leon-Pizzaro et al. 2007). Guided imagery
has been used to treat many disorders ranging from phantom limb syndrome
(MacIver et al. 2008), breast cancer (Nunes et al. 2007), stroke,
posttraumatic stress disorder in survivors of sexual assault (Krakow et al.
2001), anxiety and depression in hospitalized patients (Toth et al. 2007),
and even to increase breast milk production in women with premature
infants (Feher et al. 1989). Additional applications of guided imagery include
pain management for many types of cancers, tension and/or migraine
headaches, diabetes, severe burn trauma, as well as for reducing pain and
inflammation caused by arthritis (Freeman 2004). Overall, guided imagery
has been used to treat many
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disorders within many specialties of behavioral medicine and is employed
adjunctively with many other forms of CAM.
Acupuncture
Acupuncture operates from the assumption that there are various energy
centers (acupuncture points) and pathways (meridians) located throughout
that body. Originating from the practice of traditional Chinese medicine
(Brown 2009), meridians reside on the various acupuncture points located
throughout the body. They are thought to channel the bodys flow of energy
or life force (Eden & Feinstein 2008). Meridians allegedly impact and feed
the bodys metabolism, major organs, and physiological systems, and even

are thought to impact changes at the cellular level. Key systems of

meridians are allegedly connected to the immune, nervous, endocrine,
circulatory, respiratory, digestive, skeletal, muscular, and lymphatic systems
(Eden & Feinstein 2008, 3). Moreover, practitioners of this approach suggest
there are hundreds of acupuncture points. Consequently, the theoretical
assumption is that if a meridian is blocked, it will impact the corresponding
organ/physiological system to which it is supposedly connected. Hence,
practitioners of acupuncture inserts tiny needles into these various
acupuncture points to clear any meridians that may be blocked to promote
increased health in any corresponding organs to which these meridians may
be connected. Variants of acupuncture include massaging these points (as in
Japanese shiatsu), stimulating or tonifying them with heat (as in
moxibustion), or even directing a laser beam to specific acupuncture points
in more contemporary approaches.
Acupuncture has been used to treat a number of disorders ranging from
depression, drug/alcohol addiction, and anxiety, to managing chronic pain
and reducing stress in patients diagnosed with chronic diseases, such as
fibromyalgia, cancer, and asthma (Ainsworth 2009). While the studies on the
results of its long-term effectiveness are mixed, acupuncture seems to show
promising results for managing pain and treating various stress disorders.
Often sham treatments, in which stimulation is not given to the designated
points but to points not on so-called meridians, have been found to be as
effective as real acupuncture (Harris et al. 2009). However, most of these
investigations fail to realize that classical acupuncture was only one part of
traditional Chinese medicine; a fair research study would include the other
elements (such as nutrition and movement) as well.
Reiki
The term Reiki is derived from two Japanese characters that can be
translated as rei (universal) and ki (life energy) (NCCAM website 2011). In
short, practitioners of this method place their hands above a clients
hypothetical energy fields (such as the chakras that are an integral part of
yoga and Ayurvedic medicine) to
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help stimulate the clients own natural healing mechanisms, while

supposedly unblocking any restricted energy (Baldwin, Wagers, & Schwartz
2008; Bossi, Jane, & DeCristofaro 2008).
There are two main types of Reiki, referred to as traditional Japanese Reiki
and Western Reiki, which both consist of three levels of knowledge (Herron
et al. 2009). Level 1 practitioners are able to heal both themselves and
others; level 2 practitioners can perform healing from a distance (often using
standard symbols); and level 3 practitioners (the so-called Masters level)
are able to teach others.
According to NCCAM (2011), Reiki is used in various types of health care
settings and has shown promising results for treating various diseases and
disorders. For example, Reiki has been shown to reduce anxiety among
cancer patients (Bossi, Jane, & DeCristofaro 2008; Mansky & Wallerstedt
2006), reduce stress in children and adults (Barnett 2005), reduce chronic
headaches (Sutherland et al. 2009), reduce phantom limb pain (Leskowitz
2009), increase healing following coronary bypass surgery (MacIntyre et al.
2008), increase problem-solving abilities among stressed-out nurses
(Raingruber & Robinson 2007), and reduce chronic pain associated with
fibromyalgia (Assefi et al. 2008), as well as other applications. In a review of
1,321 studies done on the use of Reiki in various health care settings, the
practice was often found to have overall positive effects on both physical and
psychological health (Herron-Marx et al. 2008).
More recently, Morse and Beem (2011) found that Reiki was effective in
improving a patients absolute neutrophil (or white blood cell) count (ANC).
The patient was a 54-year-old male who was severely ill with hepatitis C
types 1 and 2 who did not respond to conventional treatments. The patient
was administered an experimental high dose of interferon/riboviron therapy,
which resulted in extreme anemia and neutropenia (i.e., low red and white
blood cell count). Reiki therapy was administered to increase the patients
well-being and to reduce anxiety associated with these side effects, and was
found not only to improve his ANC count but to assist him in tolerating the
interferon treatment. Initially, the patient had only a 5 percent chance of

being free of the virus, but in this case he was free of the virus when
followed up after one year.
Conclusion
While the above offers a brief overview of a few modalities that fall within
the field of mind and body medicine, along with mention of some promising
research showing its possible effectiveness for treating various disorders,
there is still much to be learnedand the jury is not yet out regarding the
efficacy or inefficacy of any of these approaches. Consequently, we caution
potential consumers that although research data from the utilization of these
modalities preliminarily have shown mixed results, there is little research in
regard to their long-term effectiveness. For example, one of the drawbacks
with acupuncture is that some studies
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Mind over Matter

American psychiatrist and psychoanalyst Elio Frattoroli, author of Healing
the Soul in the Age of the Brain, offers a provocative view of the relationship
between mind and body. He notes that seasoned psychiatrists like himself
know well that treating the mind produces benefits for the disordered brain.
Frattoroli describes how, before the era of managed care, a patient
hospitalized for a major mood disorder or psychosis might, in fact, go
several days without being administered a drug while doctors worked with
him or her to understand the nature of the problem. Doctors typically were
able to do so, says Frattoroli, because the mere act of hospitalization,
wherein the patient came into contact with professional caretakers, had
salutary effects. Experience showed, he writes, that even the most
dramatic biological symptoms of mental illness often disappear quite rapidly
once the patient feels he is in a safe, nonstressful, and caring environment.
So does this mean that the psychiatric patients he examined were not
actually suffering from chemical imbalances in the brainthe contemporary
conception of illness? No, says Frattoroli, in many cases they likely were;
but, as he also came to appreciate over the length of his career, such
neurophysiological disturbances occurred and had meaning within a

psychological context and [were] triggered, at least in part, by psychological

stressors.Frattoroli goes on to condemn the nearly exclusive focus in
contemporary psychiatry on biological causes and presents his own case for
understanding anxiety as an emotion or experience that plays a central role
in the connection between mind and body:
The proposition that mental illnesses are merely brain disorders is not a
scientific fact but an unprovable and implausible philosophical prejudice, an
attempt to evade the awareness of existential anxiety by simply defining it
out of existence. Denying the existence of the Spirit will not make the
anxiety go away. It remains as ineradical evidence of the mind-body problem
[or relationship]. In fact, I would go so far as to say that anxiety is the
mind-body problem. It is an uneasy combination of physiological response
and dawning awareness; an unconscious feeling trying to become conscious,
something that has existed only in physiological form in the body, now
beginning to emerge painfully into psychological form in the mind. (Frattoroli
2001: 95, 100)
EditorSource: Elio Frattoroli, Healing the Soul in the Age of the Brain:
Becoming Conscious in an Unconscious World (Viking, 2001).
indicate that clients must repeatedly use acupuncture in order for it to
remain effective, while sham acupuncture can give effects as robust as
traditional acupuncture in brief trials. These data suggest that expectation,
belief, and other elements of placebos may have much to do with the
outcome. In regard to other practices, such as meditation, yoga, Tai Chi, and
QiGong, it should be noted that
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ongoing practice under qualified guidance is thought to be required in order
to maintain any beneficial effects of these modalities. Thus these modalities
are generally geared toward lifestyle change, rather than a quick fix that
can be used in short-term emergencies.
See also Culturally Competent Mental health Care;
See also Humanistic Theories and Therapies;

See also Hypnosis and Hypnotherapy;

See also Nutritional Therapies;
See also Stress and Stress Management

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