The Role of Transformation, Spirit and Psychospiritual Approaches on Human Brain Activity and Immunity

Cassandra Vieten, PhD

The word transcendent conjures images of seeking a mountain top experience, of catapulting above the mundane physical world into a realm where one is unaffected by day-to-day complaints. One definition of the term transcendent is "separate from" or "beyond." But the root of the word transcend is "to climb over or across," which may more accurately describe the lived experience of one facing an illness or other challenging experience. In the real world, transcending life's events has less to do with finding a way to avoid or remove them and more to do with developing ways to live with them on a daily basis.

Defined this way, transcendent healing implies a shift in worldview in which we are not attempting to get away from the body and all the mundane realities it holds, but are moving further into the lived experience of our sensations, thoughts and feelings. This realm of experience is profoundly personal and at the same time, paradoxically, a place where individuals often find common ground. Often, it seems that it is through full engagement with the deeply personal that we connect to a transpersonal or existential experience that is shared by all. One path to this kind of transcendence that is recommended by contemplative traditions includes disciplined attention to this subjective realm of experience not readily observed by third persons, but directly experienced and embodied here and now in our daily activities.

What do we know about how mental-emotional (i.e., "mind") states can affect healing? Perhaps the most robust evidence for the mind-body connection is the placebo effect-a mind-body phenomenon so well accepted that the degree to which the mind can heal the body based on expectation of the patient is now the baseline against which all interventions are evaluated (e.g., the "double-blind, placebo-controlled trial"). The effects of the mind on the body in the area of stress are also well established, in that we know that mental distress-particularly if experienced chronically-can alter hormone function, cardiac health, immunity and learning and memory at the neuronal level. To date, the vast majority of mind-body science involves studying the effects of negative and involuntary mental states such as fear and stress on physiology. Relatively little research exists on how conscious, voluntary efforts to attend to and regulate subjective experience affect physiology and psychological, emotional and behavioral functioning.

Historically, medical science has deferred examination of the role of subjective experience in healing to the "softer," social sciences, due to difficulty measuring the constructs involved and caution about blurring the distinction between science and religion. However, relatively recent interdisciplinary fields such as psychoneuroimmunology and affective neuroscience are yielding a growing body of evidence suggesting that attention to the subjective (transcendent) realm of human experience can have very real and observable physiological benefits.

Techniques oriented toward cultivating a disciplined attention to one's subjective experience have been recommended for millennia by the world's contemplative traditions as paths toward healing and optimal functioning. Although a thorough review of the literature on mind-body medicine is beyond the scope of this article, a number of recent studies and meta-analyses suggests that specific methods of attending to one's inner experience can be beneficial in a number of conditions and populations.(1)

One mind-body approach that has been receiving increased scientific attention is mindfulness. Mindfulness principles and practices-their essential components having largely been secularized and extracted from their original religious and cultural-historical context-have been integrated into a number of behavioral medicine interventions with very promising results. The philosophical roots of mindfulness can be traced to both eastern and western contemplative practices, most notable among these being Buddhist meditation. Mindfulness, or the cultivation of moment-to-moment, non-judgmental awareness of one's present moment experience, is the basis of Mindfulness-Based Stress Reduction (MBSR), an intervention that is typically delivered in weekly two-hour sessions over eight weeks, with one day-long session.(2)

In a randomized controlled trial, MBSR reduced mood disturbance and stress symptoms in cancer patients,(3) and when combined with cognitive therapy, decreased the rate of relapse in chronically depressed patients by one-half in comparison to cognitive therapy alone.(4) In addition, in non-clinical populations, MBSR decreased psychiatric symptoms and increased empathy and sense of control.(5,6) A comprehensive behavioral therapy incorporating principles of mindfulness and radical acceptance has improved significantly upon standard treatments in notoriously difficult to treat patients with borderline personality disorder and drug dependence.(7) In uncontrolled studies, mindfulness-based interventions have shown promise in treating anxiety and panic disorders(8) and binge eating.(9)

The beneficial effects of mindfulness-based interventions on psychiatric symptoms are promising, and also understandable given their cognitive emphasis. However, recent evidence for the effects of these interventions' effects on physiological outcomes is perhaps even more intriguing. A randomized trial with healthy individuals showed that those who received MBSR training showed increased left-side anterior brain activation as measured by EEG (previously shown to be associated with great positive emotion) in comparison with a waiting list control group. In addition, the meditation group showed significant increases in antibody titers to influenza vaccine, with the left-activation predicting the magnitude of rise in antibody titer.(10) In uncontrolled trials, MBSR has shown promise for improving chronic pain symptoms,(11) clearing of psoriasis,(12) fibromyalgia(13) and changes in hypothalamic-pituitary axis function and cytokine production in breast and prostate cancer patients.(14, 15) Several of these studies suggest that benefits remain at six months to several years follow-up.(10, 11) Other interventions involving attention to subjective experience, such as expressive writing, appear to have health benefits as well.(16)

Though promising, these results are in need of replication, and several controlled trials are underway. At UCSF, the Cultivating Emotional Balance project, originally conceived in conversations between scientists and the Dalai Lama,(17) will commence a randomized controlled trial with schoolteachers in January 2005, evaluating the effects of an intervention combining meditation with emotion regulation techniques derived from Western scientific study of emotion (www.cultivatingemotionalbalance.org).

Other local organizations have been involved for a number of years in studying the effects of consciousness on healing. Over the last several years, the Complementary Medicine Research Group at the California Pacific Medical Center Research Institute (CPMCRI) has conducted several studies on mind-body medicine, including such topics as psychospiritual interventions for cancer patients and barriers to integration of mind-body approaches into medicine.

The Institute of Noetic Sciences (IONS) (www.ions.org), located in Petaluma, was founded 30 years ago for the purpose of rigorous scientific exploration of the realm of subjective experience. The word noetic is derived from the Greek "nous," meaning "to know." IONS was founded by the Apollo 14 astronaut Edgar Mitchell, who on the return journey from the moon looked at the Earth from space and had a profound experience of the lack of boundaries between countries, and the interconnectedness of all life. He describes this experience as a subjective knowing that was as real and valid as any knowledge he had obtained through his years of formal scientific training and objective observation.

Over the last 30 years, IONS has supported and conducted hundreds of studies on various aspects of consciousness, including a recent series of studies exploring how transformational practices such as meditation and yoga affect one's quality of life. IONS researchers Marilyn Schlitz and Tina Amorok have edited a book published by Elsevier Press to be released in October 2004 entitled Consciousness and Healing: An Integral Approach to Mind-Body Medicine. IONS hosts a yearly Global Medicine Foundation month-long rotation for fourth year medical students interested in integrating consciousness into healing (www.globalmedicineeducation.com).

Perhaps even more intriguing than the idea that one's subjective experience has a profound effect on his or her own health, and certainly more challenging to the reigning paradigm, is the idea that one's state of mind can influence the physiology of another, possibly even from a distance.(18,19) CPMCRI and IONS have conducted a number of studies on distant healing for cancer and AIDS patients, whether training in various forms of compassionate intention for both health care providers and intimate partners of cancer patients can aid healing, and whether conscious healing intention and empathy are skills that can be developed.

There is a burgeoning interest in the field of mind-body medicine on the part of both health care providers and patients. Now that robust evidence for the effects of subjective states on illness and healing exists, more research is needed examining the underlying mechanisms of these effects. Promising initial results have led to well-justified studies looking at whether optimal states have a similar degree of impact on the body as negative states, whether these optimal states can be cultivated through training and which practices work best for whom, in what doses and for what conditions.

Questions about the degree to which practices originally developed in spiritual contexts can or should be secularized are being explored. These topics have served to stimulate the evolution of scientific methodology as well, since they demand an interdisciplinary approach, integration of rigorous qualitative and quantitative measurement strategies and novel techniques to assess subtle and complex constructs. Novel techniques are being developed to reliably assess subtle and complex, yet fundamental aspects of human experience such as compassion and empathy, beauty and awe,(20) and to link these subjective experiences to neurobiological substrates in the laboratory. In addition, techniques are being developed to measure processes that are dynamic, highly context dependent and nonlinear.

Lillian Smith said, "No journey carries one far unless, as it extends into the world around us, it goes an equal distance into the world within." Similarly, to the extent that we improve our capacity to diagnose and treat based on physically observable phenomena, evidence suggests that attending to the realm of subjective experience can have profound and lasting health benefits.

Cassandra Vieten, PhD, is an associate scientist at California Pacific Medical Center's Research Institute and a research psychologist at the Institute of Noetic Sciences. She is currently researching mindfulness-based interventions to improve regulation of emotion, mind-body aspects of healing and factors involved in the process of consciousness transformation.

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