Recent advances in technology allow us to visualize blood flow changes to different parts of the brain by the use of sophisticated imaging equipment called P.E.T. scanners (Positron Emission Tomography). Researchers have shown that the same parts of the brain are activated whether people actually experience something or vividly imagine it.
In other words, picturing an image of a beautiful sunset activates the same area of the cerebral cortex (brain) as actually seeing a beautiful sunset. Listening to our favorite music triggers the same area of our brain as does imagining the music in our mind. Imagining the touch of a warm cotton shirt hot from the drier activates the same area of our brain as actually feeling the warm touch on our skin.
This information helps us to understand how visual imagery can actually influence our physical body and our biochemistry. Vivid imagery actually stimulates the same brain centers as the "real thing", in turn sending signals to our limbic system (the "feeling center" of our brain), our autonomic nervous system (which controls our bodily functions like heart rate, blood pressure, perspiration, respiratory rate, etc.) and the endocrine system (the control center for all our hormones, including stress hormones like cortisol, adrenaline, norepinephrine and the like). We all know what it is like to awaken from a scary dream and feel our heart pounding, our muscles aching, our breathing quickened and our skin sweating. That is the power of the "imaginary" world of visualization and imagery.
One basic premise of mind/body medicine is that all our thoughts and feelings are chemical. When we imagine a soothing walk on a warm, sandy beach (a vivid thought and feeling), our body produces neuropeptides (chemical messengers for those thoughts and feelings) which in turn circulate throughout our body, exerting their influence (spreading their message) to the cells of our immune system, nervous system, endocrine system and the like. This is how our body converts our ideas and expectations into biochemical realities. When properly harnessed, we can utilize appropriate ideas, expectations and instructions to help us activate and augment our human healing system, thereby improving our capacity for health and healing.
(For further information, see: Kosslyn, S., N.M. Alpert, W.L. Thompson, V. Maljkovic, S.B. Weise, D.F. Chabris, S.E. Hamilton, S.L. Rauch, and F. S. Buonanno. "Visual Mental Imagery Activates Topographically Organized Visual Cortex: PET Investigations." Journal of Cognitive Neuroscience 5 (1993): 263-87.)
One of the basic premises of mind/body health is that in order to activate our internal healing system, we must participate in the process of getting well. No area displays this better than the emerging field of "behavioral anesthesia", where research has shown us that simple preparation (and participation) before an operation can significantly influence the outcome of surgery. Many of these benefits include: diminished blood loss, decreased need for post-operative pain medication, improved wound healing, decreased anxiety and speedier return home from the hospital.
One such study by H.L. Bennett, Ph.D. (the leading researcher and pioneer in the field of behavioral anesthesia) examined the effect of simple preoperative instructions in decreasing blood loss during spinal surgery. Surgical procedures involving fusions or instrumentation of the spine are typically bloody surgeries, often requiring transfusions. In this particular study, 94 patients scheduled for spinal surgery were randomly assigned to one of three groups.
All three groups received a 15 minute intervention from a psychologist. The first group received information about neurological monitoring during spinal surgery. The second group was taught about neurological monitoring and was also taught to relax their muscles during the operation. The third group received all of the above instruction PLUS specific directions for how to move blood away from the surgical incision site during the operation (in order to minimize blood loss) and then how to move blood back toward the surgery site after the operation (in order to maximize wound healing).
The findings showed that patients in the third group were able to exert positive mental control over their blood loss during the surgery. Patients in the third group lost an average of 500 cc of blood compared to 900 cc of blood loss in the first and second groups. These results held true even after controlling for the length of incision and the length of time under anesthesia.
It is important to understand that the technique for delivering these instructions to preoperative patients was direct and simple, involving no hypnosis or relaxed suggestible state. Patients were simply told in normal conversation about the importance of blood conservation with statements like "the blood will move away" from the area of surgery during the course of the operation. Then, after the operation, the blood would "return to the area". All instructions were given in one 15 minute sitting.
Once again, we see the amazing ability of the mind to convert our ideas and expectations into biochemical realities. The future will further elucidate the mechanisms by which these changes in physiology occur. But for now, results from studies such as the one above provide us encouragement in our ability to exert some measure of positive control in our lives, even in situations such as major surgery where we tend to feel out of control and somewhat helpless. This positive control comes as a result of our willingness to fully participate in our own healing.
For further information, please see: Bennett, HL Ph.D., Benson, DR M.D., Kuiken, DA M.D. Preoperative Instructions For Decreased Bleeding During Spine Surgery. Anesthesiology V65, No. 3A, Sept. 1986.
When we put words to our feelings, the healing begins.
One of the most powerful keys for unlocking our healing system lies in our willingness to share from our hearts and open up to our true feelings and needs. Many times when we are in pain, we use our anger and our hurt as a cover-up for our deeper fears. When we go beyond our surface emotions and begin to acknowledge our real fears, we can break through to the resentments and disappointments we hold and begin the process of true healing.
True healing, in this sense, means our ability to become "whole" again, to gather together the many fragmented pieces of our lives and make peace inside. True healing means our ability to accept ourselves as we are and begin the process of moving towards becoming who we want to be. True healing means our ability to take responsibility for our mistakes and shortcomings from a place of compassion and love, not judgement and punishment. True healing means our ability to discover who we are and our sense of purpose and meaning in this life. This is a painful and difficult process and what Joseph Campbell refers to as "the hero's journey".
We cannot "fake" this process. We cannot "pretend" to forgive ourselves or others. We must courageously go within and feel our hurts and sadness and grieve our losses. We must courageously go within and acknowledge our failures and our mistakes, even when we may feel they were justified or deserved. We must forgive ourselves through the hard and difficult path of self-disclosure and honesty. We must forgive others with compassion. We must forgive ourselves with compassion. We can find our true strength and healing only by acknowledging and accepting our own humanity, our frailties and our limitations.
Scientific evidence for the healing power of self-disclosure and honest self-examination comes form the work of James Pennebaker, professor of psychology and author of Opening Up: The Healing Power of Confiding in Others (New York: Avon 1991). Pennebaker found that writing about traumatic experiences for as little as 15 minutes a day for 4 days can reduce physician visits for illness, improve serum immune function and enhance work performance up to 6 months time. (Pennebaker, Kiecolt-Glaser & Glaser 1988: Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology 56: 239-245).
This is what we mean when we say that sharing our true feelings and needs helps us unlock the power of our healing systems. Pennebaker says "to hold back your thoughts, feelings or behaviors requires work...People who have had traumas about which they cannot speak are more likely to visit physicians for illness, to be hospitalized and to be diagnosed with major (cancer, hypertension) or minor (colds, flu) health problems than people who have spoken with others about the same traumas."
Why does this disclosure improve our health and trigger our healing system? Pennebaker hypothesizes that "talking helps us to find meaning in complicated life circumstances...writing helps to reconstruct painful thoughts and images into a story or narrative. Once we can give an upsetting event some degree of structure - with a clear beginning, middle and an end - we are better able to move past it."
We need to further understand that the type of disclosure Pennebaker refers to in his studies is not a "surface" diary of events and feelings. The disclosure is a deep and sometimes painful exploration of our deepest thoughts and feelings involved in the traumatic event. Somehow, when we move our disturbing thoughts, feelings, fears, hurts, disappointments and resentments onto paper, we take that energy "out of our bodies" in an appropriate manner (i.e. not dumping it onto others or kicking the cat) and begin to "free up" our own internal healing energies.
Clearly, the disclosure we are talking about allows us to find a sense of meaning or purpose in our pain. That sense of meaning is life giving. Viktor Frankl, psychiatrist and author of Man's Search for Meaning, states that "to live is to suffer. To survive is to find meaning in the suffering."
Belief becomes biology.
Norman Cousins, the great scholar and humanitarian, says in his book Head First: The Biology of Hope that ".. the human mind converts ideas and expectations into biochemical realities." This notion is confirmed in a recent study by psychologist Henry Bennett, a leading pioneer in the field of behavioral anesthesia. (Bennett HL 1996 A comparison of audiotaped preparations for surgery: evaluation and outcomes. Paper presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Tampa, FL.)
In this randomized, placebo-controlled, double-blind clinical trial, 335 surgical patients were randomly assigned to either a control group or one of four different audiotape programs: 1) Bennett’s informational instructions about the surgical procedure including specific post-op outcomes 2) a relaxation tape of soothing music with a voice-over about the difficulty of surgery and the healing potential of relaxation 3) a relaxation tape of tonal sounds alleged to "drive" the brain toward greater relaxation with a voice over prompting the patient into deeper relaxed states and 4) a guided imagery tape with emphasis on spiritual connectedness and metaphors regarding positive outcomes, like faster wound healing, less pain, no nausea, etc.
The patients were assigned to take the tapes home several days prior to surgery and listen to them as often as they wanted to. Most patients averaged four listenings. When compared with the control group, the first three tapes produced no significant benefits with regard to three measured outcomes (blood loss during surgery, length of hospital stay, and use of post-operative pain medication). The fourth tape of guided imagery (produced by a highly regarded therapist and imagery practitioner, Belleruth Naparstek) produced highly significant results on 2 of the 3 outcomes (less blood loss and less time spent in the hospital).
Interestingly, the patients who listened to the two relaxation tapes did WORSE than the control group on all 3 medical outcomes. This confirms Bennett’s view that tapes emphasizing relaxation alone, do not necessarily produce desired benefits. One possible explanation for this is akin to having someone "over-relax" prior to a difficult final exam at school. Far better test results would be expected if that student is properly "prepped" for the exam, knowing what to expect, the difficult test areas to be encountered, etc. Then, once properly prepared, a mild "relaxation" might be of benefit in that it would prevent panic and "over-stressing" on the exam. This is referred to a s a "relaxed form of readiness" or a state of "calm confidence". In this way, we realize the greatest benefit when proper preparation is given coupled with a measured amount of relaxation to optimize clarity, recall, relaxed readiness and calm confidence.
This appears to be the reason that only Naparstek’s tape provided positive outcomes. In her tape, she gave proper preparation about the effects of surgery on the body (using guided images to promote wound healing, minimize blood loss, less pain, no nausea, etc.) combined with a sense of relaxation, safety and calmness. Naparstek herself says the imagery is designed to "evoke spirit, to generate love and gratitude."
So, once again, we see the critical importance of belief becoming biology; that our thoughts, feelings and expectations are converted into biochemical realities. Our mind seems to hold within it a natural pharmacy, or healing system, which when evoked and called upon, can bring about changes in our physiology, biochemistry and immunology; helping us to heal physically and to calm ourselves emotionally.
Belief in something greater than ourselves activates our healing system.
One of the basic principles of mind/body medicine is that our healing system lies within us. This means that our body has its own natural ability to heal. In certain situations, surgery or drugs may be life saving, but it is the internal healing system that allows ultimate life. When we fully accept and express all parts of ourselves (our physical, mental, emotional and spiritual bodies), the healing process is strengthened and optimal healing can begin.
One fascinating study by House and colleagues (House, J.S., Robbins, C. and Metzner, H.L. in Advances Volume 7; Number. 3, Summer 1991) helps us to see that our internal healing system is strengthened by a strong network of social support. After adjusting for age, they found the odds of dying (from any cause) are significantly related to what the researchers call "social integration" or feeling a part of a family or a social network.
Somehow being connected to something greater than ourselves (i.e. family, friends, a higher power, nature, God) is protective and activates our internal healing system. In fact they found that a lack of "social integration" is associated with about a twofold increase in age-adjusted mortality. This is about the same magnitude as the relationship between smoking and death from lung cancer.
Is this the power of love at work? No doubt, feeling connected to something greater than ourselves is one of the key factors in activating our healing systems. Being connected to something greater than ourselves is the foundation of our spirituality. We can use this knowledge to improve our own health by remembering the importance of family, friends and a sense of connection to something greater than ourselves. By making those choices which move us in the direction of greater acceptance (of ourselves and others), we can move to overcome the isolation in our lives and re-establish a strong foundation of "social integration" in our lives.
When we feel loved and supported, our body benefits.
We all intuitively know that our emotions and our state of mind influence our physical health. When we are in a state of conflict or anger, we can feel the drain on our body and on our energy level. Conversely, when things are "going well" (our way!) we can feel the sense of energy, lightness and well-being in our bodies.
What if that sense of inner calm and lightness of being actually helped us to fight off disease and stay healthy. In fact, that's just what Seeman & Syme found in their 1987 study published in Psychosomatic Medicine 49:341-354, titled "Social networks and function of social relations as predictors of disease."
They studied 119 men and 40 women who underwent angiography, a procedure which outlines how much damaging cholesterol plaque is built up inside the arteries of the heart. In their study, they found that the more people felt loved and supported, the less coronary plaque they had built up at angiography. These findings were significant even when all other risk factors were taken into account.
This fascinating study underscores the importance of feeling love and support on an emotional level. When we feel loved, those feelings are translated into biochemical messengers which circulate to the cells and tissues of our bodies and exert their beneficial effects. The exact mechanism of this effect is yet to be discovered, but we certainly have circumstantial evidence (through studies on the immune system and studies like this one above) that show there is a beneficial physical effect to feeling loved and supported.
A basic premise in the field of mind/body medicine is that all our thoughts and feelings are chemical. We all have neurotransmitters in our bodies and brains, which are the biochemical messengers of thought and feeling. Furthermore, every cell in our body has what we call "receptors" for these neurotransmitters, which are like "ears" that hear the chemical messages. Deepak Chopra M.D., the Aryuvedic physician, states that "Our body literally eavesdrops on our every thought and feeling."
So we must ask ourselves, "What message are we giving our bodies?" when we are holding onto excessive anger and resentment. Are we filling our cells with angry and resentful neurotransmitters? It's probably not that simple, but certainly the current thinking is that we need to be mindful of the messages we give to our bodies. And clearly the message of the above work of Seeman & Syme is that loving and supportive feelings do produce changes in our biochemistry which help to keep our coronary arteries more open and healthy.