2 - Mind/Body Medicine Flashcards
Mind/Body medicine was previously interchangeable with what terms?
- Psychosomatic medicine
- Health psychology
- Behavioral medicine
What is the definition of mind-body medicine?
- practices that focus on the interactions among the brain, mind, body, and behaviour, with the intent to use the mind to affect physical functioning and promote health
- emphasizes an approach that enhances a person’s capacity for self-knowledge and self-care
What is the Placebo Effect?
- well known effect
- RCT’s must be “placebo-controlled”
- believed to be mediated through both cognitive (expectation and belief) and conditioning mechanisms
- in most placebo-controlled trials, placebos improve symptoms for approx 1/3 of control subjects
Describe the placebo effect and other ethical considerations?
Ethical issues - deception, loss of trust
-Use of placebos in clinical practise is common
Does placebo effect still work if they are told they are getting it?
Yes they can - slide 19
What are some types of mind-body therapies?
- Relaxation & Stress Reduction (progressive muscle relaxation, breathing exercises)
- Hypnosis
- Guided imagery
- Meditation
- Tai Chi/ Qi gong
- Yoga
- Biofeedback
- Cognitive-Behavioral Therapies (CBT)
What are the common mind-body therapies?
- deep breathing exercises
- meditation
- yoga, tai chi, qi gong
Impact of _____ on the body is well documented, as well as improvements in health that result from relaxation strategies
stress
Types of _______ techniques include meditation, biofeedback, hypnosis, guided imagery and progressive muscle relaxation, tai chi, yoga, deep breathing.
relaxation
Describe 4-7-8 breath
Breath in for 4 secs through nose Hold for 7 secs Breath out for 8 secs through mouth -4-8 cycles -2 times/day -anytime feeling anxious
Good for all patients, but especially for:
- anxiety/panic attacks
- increases ratio of parasympathetic to sympathetic activity
What is meditation?
a variety of techniques aimed to focus or control one’s attention
What do most types of meditation involve?
- a quiet location
- a specific, comfortable position (sitting, lying, standing, walking)
- a focus of attention (ex on breath, mantra)
- an open attitude (letting distractions come and go without judging them)
What is meditation used for?
- anxiety
- depression
- pain
- stress
- insomnia
- coping with emotional/physical symptoms associated with chronic illnesses
- overall health and well-being
What are the 2 common forms of meditation?
1) Transcendental Meditation (TM)
2) Mindfulness meditation
Describe Transcendental Meditation
- Focusing attention on the repetition of a mantra (a word, sound or phrase repeated silently)
- Goal to achieve state of relaxed awareness
Describe Mindfulness Meditation
- Focusing attention in the present, common to focus on breath
- Focus on what is being experienced without reacting or judging it
- Learn to experience thoughts/emotions with greater balance and acceptance
Can meditation enhance student performance?
Yes - slide 34
What are some daily mindfulness activities?
- mindful eating
- mindful walking
- mindfulness during routine activities (shower, washing hands, b/p)
How does meditation work?
Thought to work by affecting the autonomic nervous system
- Decreasing activity of sympathetic nervous system
- Increasing activity of parasympathetic nervous system
Describe hypnosis
- Well studied mind-body therapy
- Known since late 18th century
- “A state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion”
What does hypnosis involve?
Involves guided phases of physical relaxation and attention control:
- Progressive relaxation using imagery - induction
- Deepening techniques (further relaxation)
- Symptom specific suggestions
What is hypnosis beneficial for?
many chronic pain conditions and painful medical procedures
Are children or adults more hypnotizable ?
children - less boundaries between imagination and reality
What has hypnosis been shown to be effective for?
- painful medical procedures (ex. bone-marrow aspirations and lumbar punctures)
- post-op pain and anxiety
- chronic headaches
- chronic functional abdominal pain
- chemotherapy induced N/V
- cancer pain
- fibromyalgia
What is guided imagery?
A form of deliberate, directed day-dreaming - using the imagination in a purposeful way to support health and healing
What does guided imagery create?
- Creates sensory images by the mind - perceived by body to be almost as real as the actual events
- Relaxed, trance-like state - relaxation response
- Technique that gives the power back to the patient
- Portable
What has guided imagery been shown beneficial for?
pain, surgical preparation, depressive symptoms, anxious symptoms and quality of life
What is biofeedback?
- A technique that trains people to control certain bodily processes that normally are involuntary, in order to improve one’s health (ex. HR, BP, muscle tension and skin temperature)
- Electrodes attached to the skin or scalp measure these processes and then are displayed on a monitor (giving you “feedback” from your body “bio”)
- A person is trained to change their HR or BP through breathing exercises or techniques to control their emotions and increase their awareness
What is PMR (progressive muscle relaxation)?
- Systematically isolating a particular muscle group, creating tension for 8-10 seconds, then letting the muscle relax and the tension release
- Some evidence that can be helpful for Tx of: insomnia, caregiver stress, adherence to CPAP in patients with sleep apnea
What is Tai Chi?
- Chinese martial art involving gentle, controlled movements, generally practiced now for exercise, stress management and health benefits
- research shows improvements in balance, strength, attentiveness, sleep, anxiety, blood pressure and pain
What is Qi Gong?
- A type of moving meditation
- Slow, coordinated postures, movements, breathing and meditation
- Traditionally done to cultivate Qi or “life energy”
- Practised for exercise, relaxation, meditation, wellness, and training for martial arts
What is Yoga?
- widely practiced
- exercises involving controlled breathing, physical postures and meditation
- shows evidence of helping: back pain, depression, stress, HTN
What is Cognitive-Behavioral Therapy (CBT)?
-A type of therapy in which a patient works with a therapist to identify maladaptive cognitions (thoughts) and replace them with healthier thoughts and behaviours
What has research shown CBT to be beneficial for?
- anxiety and depression
- insomnia
- IBS
- chronic pain
Negative emotional states (depression, anxiety, hostility, social isolation, stress) linked to pathophysiological processes underlying _____
CVD
How does relaxation therapy affect CVD?
Effect of relaxation therapies in rehabilitation and secondary prevention in patients with IHD:
- Decrease resting HR, increased HR variability, improved exercise tolerance, increased HDL
- Decreased anxiety and depression
- Decreased angina, arrhythmias, and exercise induced ischemia
- Decrease frequency of cardiac events and cardiac deaths
- Return to work improved
What are some mind-body therapies for Tx of headaches?
-biofeedback, CBT, hypnosis, meditation, and relaxation training can be effective Tx H/A’s
What are some mind-body therapies for Tx of insomnia?
- good evidence for progressive muscle relaxation, CBT
- some evidence for biofeedback
What are some mind-body therapies for IBS?
-8-week mindfulness course
slide 58
What are some mind-body therapies for chronic low back pain?
stress management, topic skills training, CBT
What are some mind-body therapies for arthritis (OA, RA) ?
moderate evidence for benefit of relaxation, imagery, biofeedback, CBT
What are some mind-body therapies for asthma?
- breathing exercises beneficial
- some evidence for hypnosis in children
What are some mind-body therapies for cancer?
Mind-body therapies on cancer related side effects to:
- improve anxiety, depressive symptoms and quality of life
- improve pain and fatigue
- improve anticipatory nausea and vomiting in chemotherapy patient
What are some mind-body therapies for immunity?
Emotional traits (both negative and positive) can influence people's susceptibility to infection -Individuals who reported positive emotions had greater resistance to developing a cold after systemic exposure to a respiratory virus in a lab
Are mind-body therapies safe?
Yes - generally safe.
Same cautions for ____ as for any other exercise program.
yoga