Unit 4 - Overview of Mind-Body Therapies Flashcards

1
Q

What is the NCCAM (or similiar definition of mind-body therapies?

A

Mind and body practices focus on the interactions between the mind and body, and how their relationship affects health and wellbeing.

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2
Q

List 5 or more examples of mind-body therapies and practices.

A

Relaxation, meditation, yoga, hypnosis, and guided imagery.

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3
Q

What is the difference between the mind and the brain?

A

Note that “mind” is not synonymous with brain. Instead, in our definition, the mind consists of mental states and the brain is the hardware that allows us to experience these mental states (many of which have been studied and linked to patterns of activation in specific brain areas).

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4
Q

T/F Each mental state as a physiology associated with it.

A

True. Either conscious of subconscious. The mental state of anxiety produces physiological state characterized by the production of stress hormones.

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5
Q

What are some mind-body integrative practices?

A

Meditation, relaxation, patient support groups, cognitive-behavioral therapy, prayer and yoga.

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6
Q

What are some body-mind integrative practices?

A

Yoga, tai chi, qi gong, and some types of dance.

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7
Q

T/F Body affects the mind and the mind affects the body; they’re interrelated.

A

True.

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8
Q

What is generally incorporated in mind-body therapies?

A

Relaxation, Breathing, Psychological growth, exercise and movement, and social support.

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9
Q

What bodily systems are affected by the mind?

A

Autonomic, endocrine, and immune systems.

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10
Q

T/F An individual’s mental outlook cannot impact physical health (and vice versa).

A

False. It can.

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11
Q

What is the general consensus on the Placebo effect?

A

It is commonly appreciated that placebo effects induce healing.

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12
Q

T/F Mind-body therapies deliberately employ the so-called placebo effect to initiate the self-healing capacities of the individual.

A

True.

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13
Q

T/F The placebo is not an intended or positive outcome, but “the effect that is due to the meaning of the therapeutic for a particular patient and context.

A

False. It is not an unintended or negative outcome… It is another example of how the mind (which creates meaning) can impact the body.

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14
Q

T/F There is well-established body of research shows that social support enhances and sustains health.

A

True. More studies are being conducted to form a new area of research around healing environments that has significant implications not only on the individual level, but also at a societal and public health level.

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15
Q

A physiologist, Walter Bradford Cannon, at Harvard in the 1930s/40s was one of the first researchers in the area that determined what?

A

The central nervous system (Collects and processes information from the senses via nerves and the brain and tells the muscles to contract to cause physical actions.) responds to threatening situations through its sympathetic arm, which he called the “fight or flight” response.

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16
Q

Bonus: What is the Sympathetic Nervous System?

A

Directs the body’s rapid involuntary response to dangerous or stressful situations. A flash flood of hormones boosts the body’s alertness and heart rate, sending extra blood to the muscles.

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17
Q

What part of the brain stimulates the sympathetic nervous system?

A

The hypothalamus. Not only does it “communicate” with the centers in the lungs, heart, and arteries, but with the medulla or inner portion of the adrenal gland. Epinephrine and norepinephrine are then released and further stimulate the heart and respiratory rate.

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18
Q

What is the endocrine system?

A

Influences the function of the body using hormones.

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19
Q

What is the immune and lymphatic system?

A

Defends the body against pathogens that may harm the body.

The system comprising a network of lymphatic vessels that carry a clear fluid called lymph.

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20
Q

In the 1930s as well, Hans Selye studied the long-term impact on the endocrine and immune systems and determined what consistent physical responses occurred when an animal was sick and stressed?

A
  • Enlargement of the part of the adrenal gland that secretes steroid hormones, such as cortisol.
  • Shrinkage of the thymus, spleen, and lymph nodes, which are the major organs of the immune system.
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21
Q

What theories were developed in psychiatry around the 1930s/40s where Franz Alexander made a proposal?

A

Many chronic disturbances are not caused by external factors but caused by continuous functional stress arising during everyday life of the organism in its struggle for existence.

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22
Q

What theory did Freud develop about conversion disorders?

A

Repression of painful emotions can lead to physical symptoms, while the expression of emotions can release physical effects.

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23
Q

Who suggested a physiological basis for correlations between early or ongoing emotional trauma (loss of parent or spouse) and increased incidence of chronic disease-namely that the immune functioning was compromised by prolonged secretion of steroids (Gordon, 1996)?

A

Selye

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24
Q

In the 1970s, Cardiologists Meyer Friedman and Ray Rosenman suggested what?

A

A continual flight or fight response contributed to human disease states, most significantly in the arteries and heart.

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25
Q

What phrase was coined by Meyer Friedman and Ray Rosenman that describes the characteristics present in most of their patients with coronary disease?

A

Type A personalities were constant hurriedness, free-floating hostility, and intense competitiveness. In a 8 year study, Type A men developed coronary disease twice as often as the opposite, Type B personalities.

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26
Q

What studies how the mind and emotions are connected to three of the body’s regulatory systems: autonomic nervous, endocrine, and immune systems?

A

Psychoneuroimmunology

27
Q

How did George Solomon demonstrate that the hypothalmus is the headquarters of the immune regulation as well as autonomic nervous and endocrine system functioning.?

A

Destroyed the hypothalmus in rats and saw a decrease in immune functioning.

28
Q

Robert Ader was able to demonstrate that the mind in fact has an impact of immune activity. How did he prove this?

A

He gave rats an immunosuppression and saccharin. He gave the same rats just saccharin and water and noticed that the rats’ minds, conditioned to associated a taste with a physical result, had impacted immune activity.

29
Q

What mechanism was discovered by which the mind can impact the immune system?

A

Both brain and immune system had similar receptors for short-chain proteins called peptides (such as endorphin), which suggested that peptides were acting as messengers between the brain and the immune system.

30
Q

What is the opposite physiologic and biochemical response of the flight and fight response?

A

The Relaxation Response. It reduced blood pressure, heart and respiratory rate, oxygen consumption, and carbon dioxide output.

31
Q

How can you consciously create the relaxation response?

A

Meditation, yoga and other practices.

32
Q

Benson’s and Miller’s work in biofeedback demonstrated what?

A

They demonstrated that humans do have an ability to control “involuntary or autonomic” biological functions, such as heart rate and body temp.

33
Q

What are some examples of research that helps demonstrate mind-body therapy efficacy in the second half of the 20th Century?

A
  • Breast cancer patients survive longer with support groups.
  • Social support, relaxation, changes in diet and exercise reversed severe coronary heart disease (atherosclerosis) in 1 year. Something previously never seen.
  • 10 week mindfulness mediation with patients of chronic pain showed reduction in that pain and anxiety, depression and hostility.
  • After 10 days of practice in yoga, breathing exercises and stress management; overweight and chronic inflammatory patients showed lowered markers.
34
Q

What was the direct link between stress and aging, a study performed by the National Academy of Sciences?

A

A study of chromosomes of 39 women, who cared for children with serious chronic illnesses (thus higher levels of stress) and women caring for healthy children (less stress). Women with higher levels of stress had changes in telomeres equivalent to at least one decade of additional aging compared with women with lower stress.

35
Q

What are telomeres?

A

Segments in DNA found at the tip of each chromosome in nonbacterial cells. Everytime a cell divides, its telomere shortens. In the natural aging process, telomeres gradually shorten until they can no longer divide; then, the cell dies. This is why we see changes in body function such as eye sight, as we age.

36
Q

What else has showed evidence of prematurely shortened telomeres?

A

Findings in 3,000 adults result of work-related exhaustion and long-term stress.

37
Q

Lastly, it wasn’t only the years of care giving and stressful work environments that related to shortened telomeres and telomerase activity. Who fared the worst?

A

Those with the perception of high stress.

38
Q

Richard Davidson’s research with monks and meditation demonstrated what significant differences in the brain using MRI scans?

A

Activity in the left prefrontal cortex (associated with positive emotions) greatly exceeded activity in the right prefrontal cortex (home of anxiety and other negative emotions).

39
Q

What was the other finding Richard Davidson found in regards to less unpleasantness in pain?

A

Long-term meditators experienced less pain than non-meditators when a thermal stimuli was applied to their skin.

40
Q

Understand the Reaction

A
  • Perceived threat
  • SNS releases stress hormones to arouse organs
  • increase in heart and respiratory rate; muscle tension; decrease in intestinal activity; size increase in pupils
  • Relaxation response engages paraSNS
  • Blood pressure and respiratory lowers, heart rate lowers, and muscle tension.
41
Q

How can you activate the relaxation response?

A

Repetition of a word, sound, prayer, breath, and when intrusion occurs, passively return to the object of focus.

42
Q

What exactly is stress?

A

A physiological reaction. What happens in the body when a stressor meets an individual response.

43
Q

What are events that induce stress?

A

Stressors.

44
Q

T/F Stress is caused by negative and positive life experiences.

A

True

45
Q

What is associated with elevated catecholamines and cortisol levels that can lead to to conditions such as hypertension, cardiac arrhythmias, anxiety, insomnia, persistent fatigue, digestive disorders, psychological dysfunction, diminished fertility, and disruption of normal glycemic control?

A

Chronic, long-term threat, constant sympathetic arousal by the flight or flight response.

46
Q

What can result from long-term stress can also result in prolonged immunosuppression?

A

Enhanced disease acquisition, reactivation of latent disease, and increased susceptibility to cancer

47
Q

What is one simple example of enhanced disease acquisition with constant stress?

A

People are significantly more likely to become seriously ill or die in the year after the death of their spouse.

48
Q

Barbara Fredrickson, a leading positivity researcher, notes that positive emotions have the ability to “undo” the negative physical consequences of stress. What specific strategies does she provide that can increase the amount of positive emotions a person feels (and thus decrease the negative effects of stress)?

A
  • Savor goodness by willfully generating heartfelt enjoyment for minor moments of joy. This can improve consistent emotional wellbeing.
  • Connecting with others have a profound effect on emotions and health.
  • Connecting with nature involves fascination and vastness… qualities that induce positive emotions.
49
Q

What are other ways stress can impact job performance?

A
  • Physical symptoms on work days, such as upset stomach
  • Difficulty making decisions
  • Memory lapses
  • Procrastination
  • Inefficiency
  • Mood swings (for example angry outbursts)
50
Q

What is emotional shifting?

A

Replacing negative emotions as they arise with a positive emotional experience.

51
Q

What area of CAM interventions has the most extensive research?

A

Mindbody medicine.

52
Q

What are the converging areas of research in Mindbody medicine?

A

Basic Science, epidemiological, and clinical research.

53
Q

What is basic science research?

A

Investigates the biological and biochemical connections between the brain and physical systems of the body.

54
Q

What is epidemiological research?

A

Correlations between psychological factors and illnesses in populations. (Goleman cites as an example House’s study showing that people without supportive relationships were two to four times more likely to die early than those with substantial support networks. A 2010 meta-analysis showed consistent findings–that those with strong social relationships had a 50% increased chance of survival over those who did not.)

55
Q

What is clinical research?

A

Tests the effectiveness of mind-body therapies in preventing, alleviating, or treating specific diseases by tracking physiological, epidemiological, or health outcomes data.

56
Q

What are the issues with applying the gold standard of research on mind-body therapies and practices?

A
  • Often employ more than one approach, so it is difficult to isolate effects.
  • Often used in conjunction with other therapies, complicating cause-and-effect.
  • Often deliberately use the placebo response.
  • Often use the therapist as part of the therapy, so double-blind studies are impossible. For example, guided imagery.
57
Q

How are outcome measures complex in mind-body therapies and practices?

A
  • Factors are difficult to measure. (e.g., how engaged the therapist is with patient)
  • Important factors may be inadvertently eliminated. (environmental factors eliminated because research is conducted elsewhere)
  • Numerous outcomes can complicate study.
  • Changes can be gradual, subtle, and difficult to measure.
58
Q

T/F Patient expectation can be indirectly or directly altered by suggestion.

A

True. “The data show that expectation is probably the most important meaning factor of a treatment and can be as powerful as a specific pharmacologic intervention.” – Walach and Jonas

59
Q

What are ways to optimize healing in relation to patient expectation?

A
  • Working with patient’s expectations
  • Using the treatment that most conforms to the patient’s expectation for improvement.
  • Working to change harmful expectations
    “Placebo effects, reframed as meaning responses, can evoke powerful healing and should be cherished rather than chided.” – Walach and Jonas
60
Q

What Dr. Dean Ornish’s program has an extremely high success rate in treating or actually reversing coronary heart disease and is now offered at many hospitals and is covered by Medicare as well as many Health Maintenance Organizations (HMOs)?

A

Vegetarian diet, combined with yoga, meditation, and support groups.

61
Q

What are mind-body therapies and practices useful for?

A

Prevention of stress and documented effects on conditions such as hypertension, cardiac arrhythmias, anxiety, insonmnia, persistent fatigue, digestive disorders, psychological dysfunction, diminished fertility, and disruption of normal glycemic control. Stress causes prolonged immunosuppression, resulting in enhanced disease acquisition, reactivation of latent disease and increased susceptibility to cancer.

62
Q

T/F Mind-body therapies and practices can impact the way people experience symptoms. (Mind-body therapies and practices can impact the way people experience symptoms, even when the mind does not contribute to the underlying disease process. The experience of pain for insistence, can be radically transformed with mind-body therapies and practices. Mind-body practices can foster a sense of control, can enhance optimism, or provide social support that improve the quality of life or allow the patient to cope better with symptoms. For example, two people my have a similar arthritis condition, but one may be incapacitated and the other functioning fairly well, in part because of his or her attitude to the disease.)

A

True

63
Q

T/F Treatment: Mind-body therapies and practices can help treatment by facilitating the body’s power to heal itself. (Mind-body therapies and practices can help treatment by facilitating the body’s power to heal itself. As the research we have cited throughout this module shows, mind-body therapies and practices can impact the immune system, lower blood pressure, reduce damaging stress hormones, and reduce the need for some medications.)

A

True

64
Q

What are 4 points of research on cost effectiveness in mind-body medicine?

A
  • Patients who meditate regularly saved 28% in healthcare costs over the course of five years.
  • Mutual of Omaha studied Dean Ornish’s program for two years and determined that they save $6.50 for every dollar they spend on the program.
  • A review of the literature on psychosocial factors’ effects on surgery recovery showed that social support significantly improved recovery and shortened hospital stays.
  • Correctional officers who learned emotional shifting techniques saved $1,179 per year in healthcare costs.