Health Studies 301 Complementary and Alternative Therapies

Study Guide: Unit 3

Mind–Body Interventions

René Descartes proposed a separation of mind and body as depicted in his Meditations on First Philosophy, published in 1641, and the mind–body debate continues to this day. Public Domain.

In Unit 3, we explore several forms of mind–body interventions, including psychotherapy, stress management, meditation, hypnosis, biofeedback, and guided imagery. In this area, there is no clear dividing line between conventional medicine and CAM.

Learning Objectives

Upon completion of Unit 3, you should be able to

• describe the major types of mind–body interventions, including meditation, hypnosis, biofeedback, and guided imagery.
• identify situations in which various forms of mind–body interventions are commonly used.
• determine the effectiveness of mind–body interventions by analyzing available research.

Learning Activities

Study Questions

As you complete the activities for Unit 3, keep the following questions in mind. You may want to use the Personal Learning Space wiki on the course home page, and answer these questions as a way of keeping notes to focus your learning.

1. What is the “mechanism of action” of hypnosis? Discuss ways of understanding hypnosis as a clinical treatment.
2. What is stress? (What is it not?) Discuss its health effects, as well as its potential benefits.
3. What are the health effects of meditation? Give examples.

Unit 3 Discussion Forum

When you have completed the other activities for this unit, answer at least one of the questions in the Unit 3 Discussion Forum and respond to at least one post by a fellow learner.

The more questions you answer, the better prepared you will be for the final exam!

Read

In addition to the notes provided here, read in the textbook:

Micozzi, M. (2019). Fundamentals of Complementary, Alternative, and Integrative Medicine. Pages 86–95.

Mind, Body, and Health

For several decades, there has been much interest in the ways the mind can be used to exert direct control over body functions and to improve health. The reading in the textbook (Chapter 8) provides a useful background for mind–body interactions. The first part of the reading (up to the first heading on page 91) is rather technical; you will not be tested on the details of this. However, the rest of the reading provides interesting evidence for the effectiveness of various mind–body techniques, such as yoga.

Learning Activity

Read

Read in the textbook:

Micozzi, M. (2019). Fundamentals of Complementary, Alternative, and Integrative Medicine. Pages 98–101 and 129–153.

Chapters 9, 11 and 12 in the textbook continue from Chapter 8 in exploring the role of the mind in health and body function. Much of this is common to both conventional medicine and CAM. Many types of psychotherapy are accepted by conventional medicine (pages 129–130). Similarly, there is nothing controversial about the discussion of stress management and the value of relaxation (pages 134–135). However, several of the various therapies discussed from pages 136 to 153 are clearly well outside the domain of conventional medicine and belong to CAM.

Pages 136–138 discuss meditation. As it is often used on healthy people, it is first and foremost a way to improve mental and physical functioning rather than a therapy. In that sense it is comparable to exercise or eating a healthy diet. The textbook discusses two types of meditation, namely transcendental meditation (TM) and mindfulness meditation. This is an example of where there is no clear dividing line between conventional medicine and CAM, but based on the practitioners who use it, the former is a type of CAM therapy, while the latter is conventional medicine.

The next modality discussed is hypnosis (pages 141–143). As with some types of meditation, it is accepted by conventional medicine. Much the same applies to biofeedback (pages 143–145) and guided imagery (pages 145–147).

The textbook refers to numerous research studies. Here we will compare two of them because they illustrate the pros and cons of different research designs. Look at the paragraph on page 137 that starts with the word “Herron.” This discusses a study by Herron and Hillis. The comment clearly states the limitations of observational research. The researchers discovered that people who practise TM have lower health care costs than other patients. At first glance, this suggests that TM improves health. However, as explained in the previous unit, such research is prone to serious error. This is because people freely choose whether or not to practise TM.

It is entirely possible that those who practise TM are different from the general population in a number of ways, including choosing to live a generally healthy lifestyle, and that is the real explanation for their lower health care costs. As the textbook points out, a randomized controlled trial (RCT) would be needed to determine whether TM really does improve health. However, such research studies take much longer to carry out and are much more expensive than observational research.

Contrasting results are seen with the study described in the paragraph on page 146 that starts with the words “Of the many. . . .” In this study on guided imagery, patients were randomized into two groups. This experimental design is therefore much more reliable than the previous study. Nevertheless, there are still limitations. First, the study was fairly small (53 patients). Second, the patients obviously knew which group they were in, but we don’t know if the medical staff who recorded the findings were also aware. If they were aware (i.e., the study was unblinded), then that would introduce an important source of potential bias.

A more important problem arises from the fact that the patients knew whether or not they were in the group that practised guided imagery. These patients experienced less pain and anxiety (among other benefits). This invites the question: Was the benefit due to the effect of guided imagery or merely the placebo effect? A little thought tells us that it really doesn’t matter. If guided imagery works, then it does so via the mind, which is also how placebos achieve their effect. In each case, a therapy was carried out where the patients were told that this should be of benefit. They then experienced relief from pain and anxiety which are, of course, entirely in the mind.

We shall come across similar examples in later units where CAM therapies induce relief from symptoms. In each case, we must pay careful attention to the study design and ask the question: Were the observed changes caused by the intervention, or were they due to the placebo effect?

Often when reading articles about CAM therapies, you will come across claims that are clearly contrary to current scientific knowledge. One such case appears in the textbook in relation to nonlocality (pages 147–148). It is imperative to be on the lookout for such instances and treat all such statements with great skepticism.

However, some positive findings have emerged from high-quality research studies. Meditation, including mindfulness, has shown good evidence of effectiveness for depression and anxiety (Lorenc et al., 2018).

The section titled “Spirituality and Healing” can be read for interest (pages 148–150). The final section (pages 150–153) looks at several studies that generated positive results when a combination of mind–body techniques was used.

Learning Activity

Self-test Quiz

Do the self-test quiz for Unit 3 as many times as you wish to check your recall of the unit’s main points. You will get a slightly different version of the quiz each time you try it. (This quiz does not count toward your final grade).

If you have trouble understanding the material, please contact your Academic Expert.

Reference