That Mysterious Leap from Mind to Body
To get a sense of where mind/body medicine is going, we need to know where it has been. Here an esteemed historian and philosopher of psychology outlines a colorful history of the discovery of the subconscious, depth psychology, the placebo effect, psycho-neuroimmunology, and neurotheology. It all begins appropriately with a man cured by a train wreck on the way to see his physician…
This article appeared in our December 2003 issue.
1872 Mind/Body Science Begins
England's Daniel HackTuke is traveling on a train to see his physician when the train crashes. Tuke is physically unhurt but deeply shocked. Afterward, he finds that the symptoms of his illness have disappeared. Intrigued, he collects similar cases, which he publishes in the book Illustrations of the Influence of the Mind Upon the Body in Health and Disease, Designed to Elucidate the Action of the Imagination. It is perhaps the first book on the science of mind/body medicine. Soon thereafter, the New York neurologist George Miller Beard gives a talk to the American Neurological Association on the mind's influence on disease, calling on physicians to use the power of the doctor-patient relationship to assist recovery. The talk creates an uproar. Beard is accused of claiming that physicians should abandon the stethoscope and scalpel for the begging bowl and the robe.
1880s The Surging of the Subconscious
French psychopathologists, using such techniques as hypnosis, crystal-gazing, and automatic writing, articulate the psychogenic hypothesis, suggesting that ideas associated with traumas can become split-off fragments rather than integrated experiences residing in our consciousness. Traumas buried as subconscious images could later surface (or burst forth) into consciousness in the form of physical symptoms such as hysteria, fainting, paralysis, or even full-blown alternate personalities. The study of subconscious motivation is born, as is dynamic psychiatry, also known as depth psychology.
1884 What Is an Emotion?
The American philosopher, psychologist, and physician William James (above) proposes the revolutionary idea that emotions are produced by unconscious processes in the body, not the brain. He believes emotions are tied to perception — that it is not what happens to us but our immediate perception of the event that evokes emotion. James' work signals that it is now acceptable to study both the physiology and the pathology of emotions.
1895 The Couch
In Vienna, Sigmund Freud (below) and Josef Breuer publish Studies on Hysteria and invent psychoanalysis. Soon after, Freud attempts to ground it in neurophysiology. He abandons the effort in favor of the language of symbolism, because not enough is known about the brain. He develops techniques of free association and dream interpretation, relating unconscious imagery to sexual symbolism, and tries to establish psychoanalysis as a legitimate clinical science.
1904 Pavlov's Dog
Ivan Pavlov's (below, center) work on "classical conditioning," based on experiments in which he taught hungry dogs to associate a ringing bell with food, leads to the new field of learning theory in which food, hunger, sex, avoidance of pain, and pursuit of pleasure all get paired with a host of secondary behaviors that we have come to call culture.
1915 The Neurochemical Basis of Emotions
The American physician Walter Cannon identifies the hypothalamus (above, in black circle) as the brain's emotional center, apparently refuting his teacher William James' claim that emotions are purely visceral. He identifies the fight-or-flight reflex, the body's first line of defense against danger, whereby blood rushes to the skeletal muscles and chemicals are dumped into the nervous system — the first major neurochemical discovery. Cannon later formulates the concept of homeostasis, the body's tendency to seek equilibrium in all its systems.
1929 Brain Waves
The German neurologist and psychiatrist Hans Berger publishes the first paper on the human electroencephalogram, or EEG (pictured below). The technique is subsequently used to diagnose numerous brain diseases and revolutionizes the study of epilepsy.
1930s and 1940s Psychosomatic Medicine Is Born
Edmund Jacobson, Ph.D.'s You Must Relax becomes a classic on the health benefits of physiological relaxation (it is still in print today). Psychologists and psychiatrists now study the same phenomena: the emotional components (red area, above) of physical ills such as lower back pain, headaches, and insomnia, and the effects of stress on the nervous system. Conventional medical researchers grudgingly acknowledge that psychological factors may accompany — or cause — physical illness.
1938 Skinner's Pigeons
Working with rats and then pigeons, B. F. Skinner (right) identifies what he calls" operant conditioning." He shows how organisms quickly learn which operations bring a reward and which do not, so a host of behaviors are initiated by chains of "reinforcers," positive and negative. Skinner repeats these experiments on humans, paving the way for others to develop the theory of the placebo effect, the body's natural healing reaction to expectation, and for biofeedback, in which patients learn to control their own physiological processes.
1939 Cat in a Trance
Walter Rudolf Hess identifies the diencephalon (limbic system) using EEGs. He wins a Nobel Prize for his work on trophotropic response in cats, which leads to new insights into stress, hypertension, pain control in humans, and even hibernation in mammals such as whales. His findings lay the groundwork for Herbert Benson's elucidation of the relaxation response 40 years later.
1949 The Triune Brain
Paul McLean shows that structures formerly associated with the primitive core of the mammalian brain in the limbic system (below) are also connected to the brain cortex in three evolutionary layers. This work sheds light for the first time on the neural connections between higher cortical functions and the instinctual centers of the emotions.
1950 Adapting into Sickness
Hans Selye, a neuroendocrinologist, describes what he calls diseases of adaptation. Selye argues that adapting to stress is a natural mechanism. But in the long run, harsh environments — including the stress of modern living — cause increasing levels of stress adaptation, and eventually result in exhaustion and death.
1955 The Placebo Effect
The anesthesiologist Henry Knowles Beecher at Massachusetts General Hospital announces that 30 percent of a drug's or a doctor's ministration is due to the patient's expectation of a desired outcome, an idea that sends drug companies scrambling to prove that their products can beat the "placebo effect."
1957 Neurology Meets Theology
Researchers Basu Bagchi and M. A. Wenger haul EEG machines up to Himalayan caves to measure the trance states of meditating yogis. Ten years later, in Japan, Akira and Harai measure the brain waves of Zen monks in deep meditation and compare them to those of yogis. About that same time, neurophysiologists associated with the transcendental meditation movement propose the radical idea that meditation is not sleep, but a fourth state of consciousness beyond waking, dreaming, and deep sleep.
Researchers in the U.S. and Europe focus on the new technique of biofeedback (below), in which the patient learns to control unconscious physiological processes such as heart rate and blood pressure. Soon, biofeedback laboratories such as the Menninger Foundation in Topeka, Kansas, begin to teach housewives and truck drivers to ward off migraine headaches, lower their blood pressure, and manage stress.
1969 Altered States of Consciousness
The transpersonal psychologist Charles Tart publishes his landmark book Altered States of Consciousness, which discusses meditation, psychic phenomena, aboriginal dream psychology, and psychedelics in the context of health and growth, lending scientific credibility to Abraham Maslow's conception of the self-actualizing personality. Tart conceives of "state-specific sciences," holding that altered states of consciousness contain their own sources of knowledge and power, and that it is inappropriate to judge one state by the methods and assumptions of another.
1971 The Science of Meditation
The prestigious journal Science publishes "A Cartography of the Ecstatic and Meditative States," delineating an electrophysiological spectrum of these higher states. Studies of the physiology of meditation and self-induced relaxation culminate in Robert Wallace and Herbert Benson's 1972 study of transcendental meditators, which shows that meditation can dramatically affect metabolism.
1974 America Gets a Mantra
Herbert Benson at Harvard publishes his classic work on the relaxation response, a simple secular method for lowering heart rate and blood pressure, decreasing metabolism, and controlling pain. Benson's later studies suggest that the state induced by the relaxation response is common to many of the world's traditions of prayer and contemplation. He gives credibility to the idea that spirituality, translated into mental visualization and coupled with advanced breath control and deep muscle relaxation, is the medium by which consciousness communicates with the unconscious and so can transform both body and mind.
1978 Psycho-neuroimmunology Is Born
Robert Ader, an experimental psychologist at the University of Rochester, reports that he has accidentally discovered a way to condition the immune system in rats. Soon other researchers show that ideas can affect the natural immune response. In one ingenious experiment, psychologist David McLelland shows films of Nazi atrocities to a group of college students while measuring their salivary immunoglobulins, the body's first defense against respiratory infections. The immunoglobulins plummet, but when the same group watches films of Mother Teresa, their immunoglobulins surge. The field of psycho-neuroimmunology gains ground.
1980s A New Era of Behavioral Medicine
Several researchers working independently, such as Benson, Robert Ader, and Ian Wickramasakera, suggest that the placebo effect is a conditioned response naturally linked to the body's health and well-being. Benson calls this remembered wellness: In the midst of illness the body remembers what health was like and strives to restore that state. Neuroscience begins to link physics and biology, integrating molecular genetics, neurology, immunology, endocrinology, and psychiatry. After the discovery of endorphins, the body's natural pain-killing opioids, research focuses on communication between brain and body through an array of chemical messengers such as neuropeptides. Scientists discover that these messengers, once thought to play a role only at the synapses between neurons, also allow individual brain cells to communicate with receptors on specific cells throughout the body. They find that messengers are carried through the body's ambient cellular fluid as well as through the wiring of the nervous system.
1984 How Ideas Affect Our Health
Candace Pert and colleagues at the National Institutes of Health map an array of neuropeptide receptors throughout the body. Neuropeptides are found in the limbic system, up and down the dorsal horn of the spine (where sensory information first enters the central nervous system), throughout the gut, and even on individual cells of the immune system floating through the body. These receptor sites send cascades of chemicals through the system every day. The researchers theorize that this is fundamental to the biochemistry of emotion. In other words, William James was on the right track in 1884 when he suggested that emotions are located in the body and not exclusively in the brain.
1993 Alternative Medicine Becomes Mainstream
David Eisenberg, a doctor at Harvard Medical School, publishes a historic epidemiologic study on alternative and complementary therapies, including acupuncture, massage, herbs, and meditation. He estimates that alternative medicine is a $13-billion cash-out-of-pocket industry in the U.S. annually, exceeding the amount spent for hospitalizations. In 1997, Eisenberg repeats the study, finding that the amount spent for alternative treatments has jumped to $30 billion annually, a result that sends shock waves through the medical community. Physicians begin to recognize that they must ask their patients about these treatments and be familiar with how they interact with conventional drugs. The rush to submit alternative therapies to scientific scrutiny is on.
1998 Are We Hardwired for God?
James Austin, a distinguished neurologist and meditator of 30 years, publishes his award-winning work Zen and the Brain. The book reviews extensive experimental evidence for the effects of meditation, and suggests that to understand the effect of these practices, one must take a systems approach to studying the brain and the body. At the same time, Eugene D'Aquili and Andrew Newberg coin the term neurotheology. Using positron emission tomography, they are able to view the brains of Buddhist meditators and Christian nuns during contemplative ecstatic states. The researchers propose a continuum of ecstatic experience located in specific sites in the brain, and suggest an evolutionary function for heightened spiritual experience.
Today Neurochemistry of the Placebo Effect and Meditation?
In a recent review of the literature, Herbert Benson and his colleagues hypothesize that the placebo effect is a natural bodily reaction like the fight-or-flight response. But instead of preparing for battle or escape, the placebo effect rejuvenates and restores. In other words, the placebo effect is the organism's inborn, unconscious evolutionary response to reestablish health whenever it is threatened. The evidence suggests that the placebo effect is triggered by nitric oxide made by the sympathetic bundles of the brain, producing a flow of endorphins, cannabinoids, and estrogens with various effects: getting rid of pain, reducing inflammation, killing viruses and bacteria, and even defending us against chronic conditions. The relaxation response brought about through prayer or meditation is thought to trigger the same healing effect, which would explain the relation between spiritual states of higher consciousness and the qualities of healthful living often associated with the goals of spiritual practice.
- In the near future, we may see the science of brain chemistry merging with the psychotherapeutic counterculture, since both are clearly driving current interest in consciousness.
- Historical advances in mind/body medicine, such as the placebo effect and the doctor-patient relationship, may explain the success of alternative therapies, particularly those from non-Western cultures.
- While depth psychology has dropped out of the scientific picture, it may return. As mind-body medicine points to individual empowerment through self-care, we may see a fusion of integrative health practices such as yoga, meditation, biofeedback, and psycho-neuroimmunology with some new form of psychology that emphasizes emotional language, mental imaging, and self-realization.
- Finally, we will no doubt see even greater challenges to establishment thinking from those who advocate personal and planetary transformation and have mastered aspects of the mind/body effect on their own.