Coherence

More coming soon...

2009-05-08T14:12:00.002-05:00

It has been quite some time since I last posted. I have the typical excuses of courses to teach, research to do, and committees with which to meet. Nonetheless, stay tuned...more posts are on the way with the start of the summer term!

The compassion of healing...

2007-02-26T21:43:00.000-06:00

Perhaps the relaxation response renders the individual receptive to compassion. If this idea is accurate, then compassion is truly the key to healing. Regardless of its locus, be it internal or external, the presence of compassion may be necessary for some subconscious process or set of processes to orchestrate a coherence among the functional systems of the mind-body toward health. This would suggest (as my colleague and I are seeking to do in an article about to be submitted for publication) that the relaxation response is a necessary but insufficient condition for healing. It may also suggest that medicine, and more certainly psychotherapy, are but technical approaches built upon a much more important phenomenon.

A change in the wind...

2006-10-11T14:45:00.000-05:00

I have been thinking much about this blog, and my intentions for it, during the past few months. Initially, I envisioned Coherence as an opportunity to provide timely reviews of the literatures relevant to the intersection of mind-body medicine, clinical hypnosis, and psychoneuroimmunology. However, I have found myself over the past year increasingly drawn to offer this blog as a forum for broader discussion regarding the potentials for intention and contemplation to affect healing.

For example, although it is now widely held that psychological processes can affect healing, little if anything is actually understood as to the underlying mechanisms of such mind-body interactions. Indeed, it seems that most if not all of the basic questions remain if we are to construct a basic theory of mind-body healing:

1. Is there a difference in the potential of conscious versus subconscious modes to affect healing? Indeed, what is the fundamental difference, if any, between these two constructs?

2. Is the use of a focus (i.e., presumably attention and concentration) actually necessary to effect a relaxation response? This would seem to be a question central to hypnosis, guided visual imagery, and even meditation. Yet the former two approaches are not illuminated via a wealth of literature on this point.

3. If the "mind" is truly capable of effecting or merely affecting physiological healing, how does it actually do this? Is mind an emergent or necessary property of the mind-body?

4. What is the role of metaphor in mind-body healing? Relatedly, to what extent may suggestion become internalized toward health?

These are merely some of the questions that are demanding my attention whenever I consider mind-body healing. I suspect that these questions do not even scratch the proverbial surface of the processes involved. Nonetheless, one must pose questions as a start.

An alternate consideration of stress...

2006-05-20T20:24:00.000-05:00

In 1929, Cannon dubbed the response of the sympathetic nervous system to an acute stressor as a fight-or-flight response. This historic analogy has withstood the test of time for nearly a century, and is ostensibly as hallowed as any other single concept within the psychoneuroimmunological literature. Indeed, there is little doubt that a substantial body of research with human and infrahuman animal subjects demonstrates the presence of such a response to perceived stress. What is not beyond doubt, however, is whether fight-or-flight encapsulates the entirety of the human psychophysiological response to a stressor. In 2000, Taylor, Klein, Lewis, Gruenewald, Gurung, and Updegraff* proposed the presence of a complimentary component of the stress response. Specifically, Taylor, et al., identified the existence of a “tend-and-befriend” response among human females. According to Taylor, et al., the tend-and-befriend response is based upon the biobehavioral attachment system wherein a female engages in behaviors relevant to caregiving (i.e., tending) and the solicitation and maintenance of a social network (i.e., befriending). Interestingly, such behaviors are known to both stimulate the production of, and be mediated by, oxytocin. Oxytocin furthermore plays a central role in physiological healing by protecting the individual against the effects of stress. However, as stated by Taylor, et al., the role of oxytocin to healing must be understood relative to the supremacy of neocortical regulation in the human animal. Such an understanding is admittedly not yet extant. Nonetheless, the potential presence of a tend-and-befriend stress response suggests that there remains much to learn about the fundamental aspects of mind-body healing.

*Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A. R., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107(3), 411-429.

The wheat and the chaff...

2006-04-11T11:41:00.001-05:00

Without doubt, one of the grails of current meditation research is to elucidate the the neuroanatomical and neurofunctional correlates of mind-body healing. Cahn and Polich* (2006) recently reviewed the wealth of literature addressing just these points. They defined meditation as "practices that self-regulate the body and mind, thereby affecting mental events by enggaing a specific attentional set" (p. 180). In addition, Cahn and Polich importantly recognized the pragmatic differences between mindfulness meditation and concentrative meditation. Their subsequent consideration of electroencephalographic (EEG), evoked potential (EP), and neuroimaging studies was indeed comprehesive. However, perhaps most illustrative were the authors' comments throughout the paper that the relevant literature has often lacked the methodological sophistication and conceptual agreement to provide results that are meaningful across studies. Cahn and Polich cited a somewhat better state of affairs regarding the research on the psychological and clinical aspects of meditation. Regardless, as stated in the final section of the review, what remains absent from the the majority of empricial inquiries into meditation and its related practices (e.g, hypnosis and guided visual imagery) is an integrqation of first-person, subject experiences with third-person, objective measures.

*Cahn, B. R., & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 132(2), 180-211.

A review of what may be...

2006-03-01T10:52:00.000-06:00

Although the ubiquity of mind-body interactions during normal and abnormal functioning is increasingly well-accepted, little true understanding exists regarding the potential import of these interactions for healing. In a recent article, Wrona (2006)* provides a comprehensive review of the more molecular aspects of current neuroimmunologic functioning. Her paper is notable for its inclusion of current work, a feat seemingly made more difficult by the continuing pace of discovery among the mind-body sciences. A number of interesting concepts exist within Wrona's review. For example, she cites research suggesting that the various regions of the hypothalamus modulate immune responses by integrating pathways from the neorcortex, limbic system, and neuroendocrine axis. However, perhaps more intriguing is her concluding statement that "such communication suggests an immunoregulatory role for the brain and a sensory function for the immune system." (p. 51) Wrona moreover states that research indicates that positive reinforcement in the guise of "attitudes and hopes" (p. 51) may foster pro-immune effects. Indeed, research increasingly demonstrates the fecund potential of neuropsychological processes to promote and even guide healing. One must therefore consider to what extent such contemplative practices as guided visual imagery could be used to facilitate greater conscious awareness and thus influence over the traditionally subconscious processes of healing.

*Wrona, D. (2006). Neural-immune interactions: An integrative view of the bidirectional relationship between the brain and immune systems. Journal of Neuroimmunology, 172, 38-58.

Placebo in the bones...

2006-02-08T13:18:00.000-06:00

Over the past decade, the placebo response has garnered much research within the behavioral and neurosciences. More commonly referred to as an "effect", the placebo response has been repeatedly demonstrated to modulate perceptions of pain. Although the original work on this topic seemed to consider the broader issues of expectancy and suggestion as central, more recent research has ostensibly focused on the neural substrate of this curious phenomenon. In this vein, Matre, Casey, and Knardahl (2006)* recently provide what appears to be the first demonstration that a placebo response can affect the spinal processing of pain. What is of note is the authors' suggestion that expectancies may directly modulate the spinal processing of pain via the cortical down-regulation of analgesia. Such a finding seems pregnant with potential as clinical technology improves and the process of suggestion becomes better understood.

*Matre, D., Casey, K. L., & Knardahl, S. (2006). Placebo-induced changes in spinal cord pain processing. The Journal of Neuroscience, 26(2), 559-563.

Social healing in our genes...

2005-12-23T09:15:00.000-06:00

Perhaps one of the more profound discoveries of genomics is the existence of activity-dependent genes. One example of such environmentally responsive genes is zif-268, which among its apparently multiple roles is found to activate in hippocampal neurons during rapid eye movement (REM) sleep and to be involved in the encoding of long-term memories. More recently, Burmeister, Jarvis, and Fernald (2005)* have demonstrated that egr-1 (i.e., zif-268) is also implicated in rapid changes in phenoypic coloration and dominance behavior within cichlid fish (Astatotilapia [Haplochromis] burtoni). Although seemingly distant from direct applicability to the human species, such research nonetheless suggests intriguing potentials for the mind-body to respond at the most molecular level to environmental stimuli. One is prompted to wonder whether experiential sets, both accidental (illness, trauma, war) as well as intentional (compassion, guided visual imagery, meditation), may likewise be found to affect such psychophyiological pathways of healing.

*Burmeister, S. S., Jarvis, E. D., & Fernald, R. D. (2005). PLoS Biology, 3(11), 1-9.

Beyond stress reduction...

2005-12-14T13:06:00.000-06:00

In a fairly recent study, Lutz, et al., (2004)* found that Buddhist monks expert at meditation demonstrated at baseline abnormaly high gamma-wave synchrony relative to slower-wave activity as measured by electroencephalogram (EEG). Moreoever, these meditators were reportedly capable of evincing even greater neural synchrony during periods of meditation. What is particularly interesting about this study is that the type of meditation entailed a "state of unconditional loving-kindness and compassion." These findings appear importantly congruent with those of McCraty and colleagues (e.g., 2002)^. McCraty has demonstrated evidence suggesting a potential coherence between cardiac and neural electrical activity as respectively monitored via electrocardiogram (ECG) and EEG. This coherence seems absent during emotional upset, whereas it may be partially present during a state of relaxation. However, such psychophysiological coherence between the heart and brain has been found to be greatest during the experience of positive emotions such as compassion. Taken together, it appears these two separate lines of investigation support the notion of a central importance for the role of mind-body coherence in healing.

*Lutz, A., Greischar, L. L., Rawlings, N. B., Ricard, M., & Davidson, R. J. (2004). Long-term meditators self-induce high-amplitude gamma synchrony during mental practice. Proceedings of the National Academy of Sciences, 101(46), 16369-16373.

^McCraty, R. (2002, Spring). Heart rhythm coherence: An emerging area of biofeedback. Biofeedback, p. 23-25.

Looking forward and back at PNI...

2005-12-09T08:51:00.000-06:00

Nicholas Cohen, considered to be one of the key individuals behind the early development of psychoneuroimmunology, recently authored a paper addressing the uses and abuses of the science. The paper*, a written version of his 2005 Cousins' address to the PsychoNeuroImmunology Society, details Cohen's perceptions of where PNI has been and of where it could travel. However, perhaps most provocative in the article is Cohen's statement that, "I actually believe that some alternative treatments that are currently based on the personal belief systems of their practitioners (i.e., aromatherapy, therapeutic massage) may indeed become validated as scientists apply rigorous criteria to evaluating their efficacy and modus operandi in solid clinical trials" (p. 10). This statement from a well-respected immunologist strikes me as yet another example of the increasing recognition among scientists and physicians alike that there exists far more to mind-body healing than yet meets the eye.

*Cohen, N. (in press). The uses and abuse of psychoneuroimmunology: A global view. Brain, Behavior, and Immunity.