By: Jean Johnson for Medtech1“I’d probably be dead by now if it weren’t for antibiotics. I’m grateful for that – at least most of the time,” said Dan Day of Astoria, Ore., chuckling. “But I have other problems that pills don’t seem to fix.”
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The most common methods for practicing Kabat-Zinn’s mindfulness-based stress reduction are the body scan and hatha yoga.
Body scan
A person lies down in a comfortable position and tunes into the breathing starting at their belly.
“There’s no need to manipulate it. Just experience its natural rising and falling, one breath after another,” says Kabat-Zinn on his guided imagery tapes.
Once the breathing is “located,” then the body scan begins first with one leg, breathing down into the toes, noticing any feelings, and then on the out breath, letting them go.
Proceed up the leg in this manner, then the other leg, torso, hands and arms, and finally neck and head helps relax and soften the body.
To finish off, the practitioner visualizes the breath oscillating through the entire body like a tide coming in through the toes and going out through the head, and then in through the head and out from the toes in a rhythmic, cyclical way.
Kabat-Zinn’s research has demonstrated that it takes eight weeks of practice of “body scan” with a minimum of 20 minutes daily or the preferred hour-long sessions to make a significant long term difference.
Even then, daily practice is required. “Meditation is not for the faint-hearted,” wrote Kabat-Zinn. |
Day’s eyes are sea green and there’s a rueful, weathered look about them. His worn flannel shirt looks salty like he just got off one of the fishing boats moored at the dock where locals buy fresh catch just outside town.
“Basically, the way I see it is the doctors have kept me kicking,” Day added, “but half the time I’m so miserable that I’m not too sure if I appreciate the favor.”
Day has a lot of stress and chronic pain, problems that his medical team tells him he has to learn to live with. The 40-something man puts his hands on the small of his back and stands a little straighter. “I just don’t know what to do half the time. I do have muscle relaxants, and they’ve tried different meds on me for sleeping and what they tell me is anxiety, but it can be tough on a guy.”
Many of us like Dan Day would not be alive today were it not for antibiotics, one of modern medicine’s more significant achievements. The impressive list goes on. X-rays have opened windows onto the impenetrable and are facilitating surgical breakthroughs in interventional radiology. Stents in coronary arteries allow us to go on ticking. And there’s a pill for just about everything that ails us – including the angst and stress of living in a highly mobile, urban society.
Recounting the benefits science and technology have brought to the world of medicine is an exercise seemingly without end. Pretty much, at any rate.
The problem is though, say an increasing number of alternative and mainstream medical researchers, that in our haste to embrace rational thought and dismiss things that smack of subjective mysticism, we might have sold ourselves short.
Antibiotics, chemotherapy, open heart surgery and Prozac are all wonderful advances that have enabled many to enjoy longer, better quality lives. Yet, if we would just attend to another aspect of our existence – and deal more directly with stress – these pundits agree that we’d find even greater benefits.
Stress
Reacting to stress is the body’s way of protecting itself. The heart rate speeds, digestion slows so blood flow can be diverted to the muscles, muscles tense in readiness for “fight or flight.” It’s an ingenious arrangement that serves us well when real physical danger threatens.
But when stress becomes chronic it’s another matter since the body does not differentiate between real physical threats and those that a worried, fearful mind can conjure up. Consequently, when stress becomes sustained, normal cyclical patterns are disrupted.
Relief. Relaxation. Respite. Restoration. These lovely states that inspire images of cool, green glades remain elusive as unmitigated chronic stress and pain slowly insinuate themselves into daily life.
So the question is how to introduce an easy quality into one’s life. How to find at least some nice sunglasses and a broad-brimmed hat to mellow out the intensity of that otherwise chronic white light.
It can be done, say the pundits.
The caveat, of course, is that relaxation techniques require more commitment and effort than many of us are accustomed to. As Dan Day is quick to acknowledge, as a culture we’ve gotten a little flabby around the middle; used to just popping a pill to cure what ails us. Hence the problem: How will we get the motivation to add this kind of work to our already over-taxed lives?
We at Medtech1 think there’s nothing like information to empower. So we canvassed the research and came up with what we think are some pretty good reasons to save time in the day for healing stress reduction work.
Studies Point to Stress Reduction as Beneficial
Part of the reason why as a society we are not widely aware of how stress reduction can help heal is because change doesn’t come overnight. It’s taken considerable time to build a body of material complete with clinical studies that suggest stress reduction is beneficial.
In 1979, for example, Jon Kabat-Zinn’s Stress Reduction Clinic at the University of Massachusetts Medical Center in Worcester was just getting off the ground. Nonetheless, his results using mindfulness-based stress reduction techniques were encouraging, and to date 13,000 people have completed his eight-week intensive mindfulness-based stress reduction program. Further, Kabat-Zinn’s 1990 book “Full Catastrophe Living” was a best seller and he was featured in Bill Moyer’s PBS documentary Healing and the Mind.
Additionally, the “Role of the Mind in Physical Healing and Health,” a report made to the U.S. House of Representatives by Herbert Benson, M.D., associate professor of medicine at the Harvard Medical School and founder and president of the Mind Body Medical Institute, added fuel to the growing body of information.
Benson estimated that 60 to 90 percent of physician visits are prompted by conditions related to stress. If those figures weren’t startling enough, the physician also noted that patients who used relaxation techniques cut the length of time they took to fall asleep by an hour – from 78 minutes to 19 minutes.
Similarly – according to a 1999 issue of Delicious Magazine article, “Natural Healing: Managing an Operation” – colorectal patients who used guided imagery before surgery were reported to need 37 percent less pain medication and were able to leave the hospital sooner than those in the study who were managed in conventional ways.
Kabat-Zinn reported similar observations in a study he led on healing times with patients at the UMass Medical Center. When they used his guided relaxation and hatha yoga tapes, they healed almost four times faster than their peers in the control group. Kabat-Zinn’s approach is to not empty the mind, but rather to pay attention to one’s moment-to-moment experiences in a non-judgmental, non-reactive fashion.
As a 2004 issue in Internal Medicine News noted, “In mindfulness meditation, the person focuses directly on the process of breathing, but attends to all thoughts, images, and sensations as they arise. The goal is to be more acutely aware of the details existing in one’s field of consciousness, including sensations of pain and stress.”
Kabat-Zinn confirms that people can learn “how to use their innate resources and abilities to respond more effectively to stress, pain, and illness. The central focus of the clinic is intensive training in mindfulness meditation and its integration into the challenges/adventures of everyday life.”
In other words, Kabat-Zinn’s technique lets people develop an alternative way to perceive discomfort. Instead of being consumed by it, relaxation allows individuals to gain enough perspective to distance themselves from their nemesis. In so doing, struggle and avoidance leaves as does much of the hold chronic stress or pain has over a psyche. Instead of feeling fear, anger, or agitation, patients learn to pay closer attention to the present. Become one with the moment where rather than fear, their companion is pure, nonjudgmental awareness. The irony is, of course, that by going deeper into the moment, one is freed from its bonds.
Cardiovascular Diseases and Psychosocial Stress
The World Health Organization (WHO) estimates that cardiovascular diseases cause the premature deaths of 17 million people worldwide each year. Also, WHO investigators determined that the rate could be cut by 50 percent if major risk factors such as high blood pressure, high cholesterol, obesity, and smoking were controlled.
In an article in a 2005 issue of Behavioral Medicine, a team of authors argued that controlling what they termed “psychosocial stress” could reduce the above risk factors. The particular form of relaxation these authors evaluated was transcendental meditation.
The University of Florida is also recruiting participants to evaluate the effectiveness of relaxation and meditation on heart disease, although they are using Kabat-Zinn’s mindfulness-based stress reduction approach. The study of 150 people will employ three groups exposed to differing conditions: A mindfulness meditation condition, a disease education condition, or a stress-monitoring usual case control condition.
Researchers are interested in part because new imaging techniques (like CT scans) have demonstrated relationships between acute psychological stressors and myocardial ischemia (lack of blood flow to the heart) in some patients with cardiovascular disease. Also, preliminary stress interventions like meditation and yoga have been shown to have positive impact.
The World Arena
Kabat-Zinn’s work is gaining national and international attention. Today over 240 similar programs are in operation in North America. The Duke University Diet and Fitness Program recommends Kabat-Zinn’s approach to its clients with behavioral issues.
The Germans, as well, have shown considerable interest in mindfulness-based stress reduction work. Paul Grossman, Ph.D. of the Freiburg Institute for Mindfulness Research completed a meta-analysis of 25 mindfulness meditation studies on chronic pain and found the intervention was “moderate to above moderate.”
More, one of the studies Grossman looked at focused on patients with various types of cancer including breast, ovarian, and prostate. Those that used stress reduction techniques had 65 percent reduction in what he termed “mood disturbance” and even higher percentages of relief from feelings of anxiety, depression, anger, and confusion.
New Zealanders are exploring this new frontier as well. Psychologists from the Waikato District Health Board started recruiting patients for a study in 2005. They plan to follow the Kabat-Zinn model of eight week sessions, two to two and half hours daily and one full day per week. It is “quite a commitment,” writes Phillipa Thomas, Ph.D., lead investigator and consultant clinical psychologist, but given that mindfulness-based stress reduction “has now been used with a wide variety of chronic health and psychological problems, it is probably worth it.”
So, what does Dan Day say back in Oregon?
“Gosh, I don’t know if I hurt quite that bad yet,” he said. “But if I get to getting to, it’s good to know there’s something out there that could help.”
