Benefit of the Doubt
January 2007
By Dr Uma Ladiwala
Science is gradually beginning to recognize the healing benefits of non-medical factors such as prayer, meditation, acceptance and guided imagery
A newspaper article titled Comeback Kings and Queens, about people in showbiz who survived calamities in their lives and bounced back stronger, caught my attention. Mentioned in it were singer/actor Raageshwari who had a form of facial paralysis, but bounced back with another album; wellness expert Deepika Mehta who met with a rock-climbing accident and was bed-ridden for a year, but is now a successful spiritual yoga teacher; Shah Rukh Khan, who survived a severe back problem; Ejaz Khan, who had a severe shoulder injury in an accident and was told he would never be able to move it but is normal again. On being asked, all attributed their recovery to having a positive, hopeful attitude or looking upon it as a challenge to grow.
Such cases of recovery from fairly serious illness are not all that uncommon. In their book, Remarkable Recovery, the authors Hirschberg and Barasch interviewed almost four dozen patients who recovered from cancers that should have been fatal and asked them their personal opinions on why they recovered. Surprisingly, the leading factors attributed to this were prayer (68 per cent), followed by meditation (64 per cent), exercise (64 per cent), guided imagery (59 per cent), walking (52 per cent), music/singing (50 per cent), and stress reduction (50 per cent). When they were asked what psycho-spiritual factors they felt were important to recovery, the commonest ones mentioned were hope (75 per cent), a fighting spirit (71 per cent), and acceptance of the disease (71 per cent). In their own way, most of the patients experienced hope and found some meaning in their illness, although there was no specific formula for recovery that could be applied to all.
there any scientific evidence that prayer, meditation, music and a positive, hopeful psychological attitude really can heal? The concept that the mind is important in the treatment of illness is integral to the healing approaches of traditional Chinese and Ayurvedic medicine, dating back more than 2,000 years. It was also noted by Hippocrates (400 BC), who recognized the moral and spiritual aspects of healing, and believed that treatment could occur only with consideration of attitude, environmental influences, and natural remedies.
the advent of technological advances and pharmaco-therapeutics ousted the older healing practices like faith healing and shamanism, modern medicine has mostly ignored the role of the mind in disease and health (apart from obvious mental illness). Fixing or curing an illness became a matter of science (i.e., technology), and not a matter of healing the mind or the soul.
Sychoneuroimmunology
It was only in the 1920s, that Walter Cannon’s work revealed the direct relationship between stress and neuroendocrine responses in animals. Coining the phrase “fight or flight,” Cannon described the primitive reflexes of sympathetic and adrenal activation in response to perceived danger and other environmental pressures.
Hans Selye first described in 1976, the occurrence of various diseases like gastric ulcers and heart problems in experimental animals under stress, accompanied by disturbances in their immune system, and subsequently studies have established the role of the mind in health and disease.
The human body, since ancient times, has been modelled to deal with a challenge or threat with physiological changes. This follows the pathway of the brain, hypothalamus, pituitary (steroids), and sympathetic nervous system (adrenaline), leading to profound alterations in heart rate, blood circulation, metabolism, breathing, and muscle action.
The emotions can be looked as an internal mechanism for marshaling these forces. With the disappearance of the challenge, the physiology shifts back to baseline functioning. When the perceived challenge continues or the state of hyper-arousal persists, described now as a state of “stress”, the continual defensive responses described above produce a profound deterioration in health.
There is clear evidence that stressors such as bereavement, inability to cope and depression undermine the immune system and lower resistance to almost any disease. This is under further intensive investigation as the new field of psychoneuroimmunology.
Evidence of the brain-immune system connection at the molecular level was provided by the studies of Blalock and Ruff in the 1980s. They showed that the same neuropathies (brain messenger proteins)
We not only experience emotions; they run every system of our bodies and are involved in physiology, health and disease.
and their receptors found in the brain could be found in cells of the immune system. It is believed that the immune system is not only involved in defence against infections but is also involved in the actual healing.
In 1985, Candace Pert and others published a paper titled Neuropathies and their Receptors: a Psychosomatic Network. This showed the neuropathies were secreted by cells all over the body, and acted through their receptors, which were also found in parts of the brain concerned with emotions such as the amygdale and the hypothalamus. Candace Pert does not subscribe to the classical brain-centric view, where thoughts, emotions and mind are all in the head. Her concept attributes each cell as having a “consciousness” mediated by various receptors.
According to her, emotions are not a result of chemical peptides but occur independently at a subtle, spiritual level, almost like transitional elements, forming a bridge between the realm of the physical, the molecular and the spiritual. Hence we not only experience emotions; they run every system of our bodies and are involved in physiology, health and disease.
To understand any phenomena in nature such as disease or healing by any one particular model is self-defeating. This is where the allopathic biomedical model is limited. The scientific verification of complementary therapies is fraught with difficulties. It is difficult to scientifically research systems of treatment that do not follow known scientific principles.
Modern research is reductionism and objective, seeking to break down things to a single process or active ingredient or effect in order to verify it. It is absolutely inappropriate for the examination of a “holistic” situation where the therapist provides a unique environment that is specific for each patient. Its presumptions cannot help us understand why or how distant prayer or a religious feeling influences health status.
This results in a denial that such things do happen. Similarly, a tendency of complementary and alternative medicine to centre exclusively around concepts of qi or prana or consciousness also needs to be avoided. Overall, we need to accept with humility that everything cannot be explained or understood, but, without doubt, investigation is the need of the day.
Meditation
It has been shown that meditation can produce alterations in brain activity, and meditation practitioners have described changes in mental function that last long after actual meditation ceases, implying long-term effects. However, those studies usually examined Buddhist monks who practiced meditation as a central focus of their lives.
To investigate whether meditation, as typically practiced in the US, could change the brain’s structure, the current study enrolled 20 practitioners of Buddhist Insight meditation – which focuses on “mindfulness,” a specific, nonjudgmental awareness of sensations, feelings and state of mind. They averaged nine years of meditation experience and practiced about six hours per week. For comparison, 15 people with no experience of meditation or yoga were enrolled as controls.
standard magnetic resonance imaging (MRI) to produce detailed images of the structure of participants’ brains, the researchers found that regions involved in the mental activities that characterize Insight meditation were thicker in the mediators than in the controls, the first evidence that alterations in brain structure may be associated with meditation.
They also found that, in an area associated with the integration of emotional and cognitive processes, differences in cortical thickness were more pronounced in older participants, suggesting that meditation could reduce the thinning of the cortex that typically occurs with aging. “The area where we see these differences is involved in both the modulation of functions like heart rate and breathing and also the integration of emotion with thought and reward-based decision making – a central switchboard of the brain,” says Lazar.
An instructor in Psychology at Harvard Medical School, she also stresses that the results of such a small study need to be validated by larger, longer-term studies. This does confirm the claims that meditation not only affects physiological processes, but also emotional and attention states and thus could influence health.
Music Therapy
Music therapy has been the most studied among these interventions, with studies dating back to the 1920s, when it was reported that music affected blood pressure. Other studies have suggested that music can help reduce pain and anxiety. Music and imagery, alone and in combination, have been used to entrain mood states, reduce acute or chronic pain, and alter certain biochemical’s, such as plasma beta-endorphin levels.
Spirituality
The importance of spirituality in mental health has been known since ancient times. For the past 30 years transpersonal psychology has explored experiences in which the sense of identity extends beyond the individual or personal to encompass wider aspects of humankind, the natural world or the cosmos.
Meditation affects physiological processes, emotional and attention states, and thus could influence health.
Such states are notoriously difficult to study. True science, however, must be based on a study of all human experiences, not just those that can be manipulated in a laboratory. There is a marked lack of regulated studies concerning spiritual belief and its related paradigms such as prayer, love and forgiveness, in healing.
One recent study has looked at brain serotonin (a neurotransmitter) in spiritual experiences. A role for the serotonin system in relation to spiritual experiences is supported by the effects of drugs such as LSD, psilocybin, mescaline, and MDMA that are known to cause alterations of the serotonin system in several brain regions. On a behavioral level, these drugs elicit perceptual distortions, illusions, a sense of insight, spiritual awareness, mystical experiences, and religious ecstasy.
These effects induced by hallucinogens resemble the extrasensory perception and ideation endorsed by subjects scoring high on the spiritual acceptance scale. Their findings (in normal male subjects), indicate that the serotonin system may serve as a biological basis for spiritual experiences.
The authors speculated that the several-fold variability in a serotonin receptor density in the brain may explain why people vary greatly in spiritual zeal. One study also measured changes in the dopamine (another neurotransmitter) system and found increased activity during meditation-related practices and spiritual experiences. It is important to be reminded here that it is possible that these evidences may be correlative or resulting from rather than causes of spiritual experience.
Prayer
Intercessory prayer, in which a person prays for the healing of another person who is a great distance away, with or without that person’s knowledge, has also been studied. A review of eight non-randomized and nine randomized clinical trials published between 2000 and 2002 showed that the majority of the more rigorous trials do not support the hypothesis that distant intercessory prayer has specific therapeutic effects.
Thus, with the current increased public use of such holistic methods there is a growing movement among researchers to look for appropriate research methods to study and verify them. There is, also, a more cooperative approach involving researchers, therapists and patients and a greater importance awarded to the entire healing relationship rather than stripping it down to mere technique or chemical product.