Mind-Body Medicine in the Healthcare System. A Conversation with One of its Pioneers

Introduction

As Mind-Body pioneer James S. Gordon M.D. has noted, Mind-Body Medicine focuses on the interactions between mind and body and the powerful ways in which emotional, mental, social and spiritual factors can directly affect health. These techniques include self-awareness, relaxation, meditation, exercise, diet, biofeedback, visual imagery, self-hypnosis and group support. Mind-Body approaches use the conscious mind to directly affect the workings of the brain and the rest of the body. The techniques exert their effect on the hypothalamus, the switching station in the brain, which exercises control over the autonomic nervous system (which controls heart rate, blood pressure etc.), the endocrine (glandular) system and the immune system.

Mind-Body Medicine also has come into vogue in the past several years. Popular magazines such as Time and Newsweek have featured the topic on their covers and exercises like yoga and meditation have exploded in popularity. Additionally, medical research demonstrating that various mind-body techniques effectively reduce stress levels and improve a variety of chronic conditions is now robust and growing.

But what about its integration into mainstream medicine and our system of healthcare? Surveys demonstrate that patients certainly want information about these techniques from their doctors and other healthcare providers.

The author sat down with one of the fields noted authorities, Dr. Gordon, who has spent almost 40 years teaching health professionals and the lay public, to discuss the state of Mind-Body Medicine. Recently, he and his organization, the Center for Mind-Body Medicine in Washington, DC, have implemented training programs in areas facing significant stress and trauma, such as in New York with firefighters after 9/11, the Middle East, New Orleans after Hurricane Katrina, and now with veterans returning from Iraq. This is a reprint of that interview, originally published in the organizations newsletter.

Interview

Q: You created the Mind-Body [Professional] Training in 1994. Why did you start the program?

A: Initially we needed more trained professionals to lead Mind-Body Skills Groups at The Center for Mind-Body Medicine. We hoped a dozen professionals would come and that we would find two or three more gifted group leaders among them. To our great surprise and pleasure, thirty professionals participated in that first, year-long program! Some of them are still on our faculty. A year later we offered the program nationally and 120 professionals came.

Q: How has the program influenced the practice of medicine?

A: The premise of our work is that self-awareness and self-care are central to the prevention and treatment of all illness, that everyone can be taught, and that group support is a powerful force for healing. Our model which combines scientific understanding with the wisdom of a meditative approach has obviously struck a resonant chord. Our [1,500 graduates, as of this printing] (in the United States alone) are bringing the specific practices and the empowering spirit of our work back into every conceivable kind of therapeutic setting from academic medical centers to rural practices, from inner-city programs for abused women to the suburban offices of cardiologists and surgeons.

Q: The program has sold out the past couple of years. Why has it grown in popularity?

A: More and more health and mental health professionals are realizing the limits of the work they do. They want to learn more effective ways to help people with chronic problems and they want to feel more fulfilled in their work and their lives. They see our work as a path to their goals. Also, by raising money from forward-thinking donors, weve been able to provide more scholarships for those working with the underserved. Finally, the people who come through the program are spreading the word, telling colleagues and friends that this work can change your life and transform your practice.

Q: How much is the new research on mind-body approaches contributing to the appeal of the programs?

A: The research, which we present in considerable and regularly updated detail, is powerfully attractive. If you look at the evidence in an unbiased way, its pretty clear that the mind-body approach, used thoughtfully, should be included in a comprehensive approach to treating and preventing every chronic illness and in many other situations as well (for example, in preparation for and recovery from surgery or childbirth).

Q: Who typically attends the training?

A: A third of the participants are MDs or DOs, divided about equally between primary care physicians and specialists; 15% are nurses, with a preponderance of oncology and psychiatric nurses; 40% are psychotherapists-psychologists, social workers, marriage and family counselors and pastoral counselors. Most of the remainder comes from the other health professions: physician assistants, acupuncturists, chiropractors, body-workers, dietitians, and physical therapists. There are always a small number of program administrators, educators, community activists and philanthropists.

Q: Why are so many medical schools sending faculty?

A: Increasingly, medical schools around the country are recognizing that self-awareness and self-care are critical to the education and well-being of their students as well as to clinical treatment. In order to teach self-awareness and self-care, faculty have to first learn it themselves. Our model is appealing because it is scientific and experiential, easy to use with students, and is being carefully studied. A dozen schools are using our work and our program at Georgetown is already yielding good data. By the end of this year, we will have trained some 18 faculty there [as of original publishing]. Theyre offering mind-body skills groups to first and second-year students and residents, and were doing research on the groups. Students have decreased levels of stress; they understand themselves and their classmates better; and feel more compassion for patients, and a renewed enthusiasm for becoming physicians.

Q: What major developments do you see coming up in the field of mind-body medicine?

A: Self-awareness and self-care are the most direct way to deal with the epidemic of chronic illness to which our kids are becoming vulnerable. Its crucial that mind-body approaches, nutrition and exercise become central to the education of our children as well as all our health professionals and teachers.

Its up to all of us to make this happen.