Title:  Advances in Mind-Body Medicine September 2004 (Periodical Reference)




Resource Type: Peer-reviewed Digital Journal
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September, 2004 - VOL. 20, NO. 3 September, 2004
"Never the twain shall meet": spirituality or psychotherapy?
Gerald Epstein, MD
My thesis for this article speaks to a sort of anti-theme. My direction since 1974 (when I shifted from the practice of conventional medicine and psychiatry to a spiritually-based healthcare direction), has hinged not on spirituality and psychotherapy, but on spirituality or psychotherapy. From my experience, they are antithetical to each other. The tenets and principles of spirituality are opposed to those of psychotherapy, as they represent two separate domains of thought that are quite distinct from each other: spirituality is an analogical acausal system of inquiry and discovery of relationships and correlations, whereas psychology is a logically-based cause-and-effect system.

September, 2004 - VOL. 20, NO. 3 September, 2004
Mental imagery: the language of spirit
Gerald Epstein, MD
This article defines the intimate relationship that exists between mental imagery and the Western spiritual tradition. In the latter, the image process represents a central spiritual practice of all three religious traditions that sprang from their parent source, monotheism. In addition, the application of imaginal practice which was, and still is, used as a therapeutic technique to help resolve daily problems in living, is discussed. The multifaceted meanings of mental imagery and its connection to spiritual life are then spelled out. For the Western spiritual tradition, mental imagery represents a unique and seminal technique that stands as the centerpiece for Western spiritual practice. One of its unique attributes is that it can be applied as a therapeutic method to deal with the problems of everyday life. Also, mentalimagery can be used to bring the devotee to self-transformation and self-realization.

September, 2004 - VOL. 20, NO. 3 September, 2004
Psychosocial factors in hear disease: a process model
Henry Dreher
The depth and scope of research on psychosocial factors in heart disease is breathtaking. But so is the lack of attention paid to it (and its clinical implications) by physicians, biomedical scientists, healthcare institutions, and even, in important ways, the mind-body investigators whose fine work has established the rich repository of findings about the role of the mind in heart disease. The public health ramifications of this research are monumental since heart disease remains the leading cause of mortality in the United States. According to the American Heart Association, in 1999 cardiovascular diseases claimed more than 958,000 lives, accounting for 40% of all deaths in the United States.1 Among these deaths, more than 529,000 were due to coronary heart disease (CHD), including deaths from heart attacks and sudden cardiac arrest (SCA).

September, 2004 - VOL. 20, NO. 3 September, 2004
Mind and heart, body and soul
Sheldon Lewis
Among the most enduring themes in mind-body medicine are the ability of our imagination to impact our health through the images we conjure in our mind; the role of spirituality in health and healing; and the well-documented relationship between the mind and heart in health and illness. In this issue of Advances, two longtime contributors to this journal, Gerald Epstein, MD, and Henry Dreher address these themes.

September, 2004 - VOL. 20, NO. 3 September, 2004
Mindfulness meditation to reduce symptoms after organ transplant: a pilot study
Cynthia R Gross, PhD; Mary Jo Kreitzer, PhD, RN; Valerie Russas, BSN
Context: Solid organ transplant patients require life-long immune suppression that can produce distressing side effects and complications. Objective: To evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce symptoms of depression, anxiety, and sleep disturbance and improve quality of life after solid organ transplantation. Design: Longitudinal with evaluations at baseline, postcourse and 3-month follow-up. Participants and setting: Kidney, lung, or pancreas transplant recipients (N=20), aged 35 to 59 years, living in the community. Intervention: An MBSR class (2.5 hours weekly, for 8 weeks), modeled after the program of Jon Kabat-Zinn. Home practice (goal: 45 minutes, 5 days weekly) was monitored. Main Outcome Measures: Self-report scales for depression (CES-D), anxiety (STAI-Y1), and sleep dysfunction (PSQI). Results: Nineteen participants completed the course. Findings suggest improvement from baseline symptom scores for depression (P=. 006) and sleep (P=.011) at the completion of the MBSR program. At 3 months, improvement in sleep continued (P=.002), and a significant improvement in anxiety scores was seen (P=.043); scores for both symptoms demonstrated a linear trend and dose-response relationship with practice time. In contrast, depression scores showed a quadratic trend, and at 3 months were no longer different from baseline. A composite symptom measure was significantly improved at 3-month follow-up (P=.007). Global and health-related quality of life ratings were not improved. Effects of group support and instructor attention were not controlled, and sample size and follow-up time were limited. A randomized trial to overcome these shortcomings should be done, as symptom distress in transplant recipients appears responsive to MBSR.

September, 2004 - VOL. 20, NO. 3 September, 2004
Stress-induced alternative gene splicing in mind-body medicine
Ernest Lawrence Rossi, PhD
Recent research documents how psychosocial stress can alter the expression of the acetylcholinesterase gene to generate at least 3 alternative proteins that are implicated in a wide variety of normal mind-body functions, as well as pathologies. These range from early embryological development, plasticity of the brain in adulthood, post-traumatic stress disorder (PTSD), and stress-associated dysfunctions of the central nervous, endocrine, and immune systems, to age-related neuropathologies. Such stress-induced alternative gene splicing is proposed here as a major mind-body pathway of psychosocial genomics—the modulation of gene expression by creative psychological, social, and cultural processes. We explore the types of research that are now needed to investigate how stress-induced alternative splicing of the acetylcholinesterase gene may play a pivotal role in the deep psychobiology of psychotherapy, meditation, spiritual rituals, and the experiencing of positive humanistic values that have been associated with mind-body medicine, such as compassion, beneficence, serenity, forgiveness, and gratitude.

September, 2004 - VOL. 20, NO. 3 September, 2004
The idea of imagination: an anlysis of "imagery"
Victoria Menzies, PhD, RN; Ann Gill Taylor, RN, MS, EdD, FAAN
Background: Although the benefits of guided imagery are now more widely recognized, the definitions of imagery used by various health science disciplines are inconsistent. Purpose: To conduct an analysis of the concept of imagery as understood among the health science professions. Methods: An inductive, descriptive means of inquiry was used to clarify the concept of imagery. Data were analyzed by categories: surrogates, attributes, contextual information (antecedents; consequences), related terms, and references. Findings: The prevailing surrogate term for mental imagery is visualization. Attributes of imagery include psychophysiological, mental, quasi-reality, dynamic, and process. References include therapeutic settings. Conclusions: This concept analysis has led to the following working definition: “Imagery, a mental function, is a lived experience that is a dynamic, quasi-real, psychophysiological process.” The analysis was intended to identify consensus on the concept of imagery within the health professions, and provide a foundation for further research.

September, 2004 - VOL. 20, NO. 3 September, 2004
Images of healing
Sheldon Lewis
One of the foundations of mind-body medicine is the premise that the pictures, symbols, and feelings we conjure in our “imagination” can have a profound impact not only on our mental states, but also on our overall well-being and physical health. A wealth of clinical studies and reports suggest that “imagery” serves as a language of healing, inspiration, and hope. Just as we all know that being in the presence of a magnificent sunset, waterfall, or other natural setting can instantly change our mental state or mood, imagining such a scene, someone we care about, or an activity that we enjoy can relax, uplift, excite, or move us. Conversely, “negative imagery,” such as recalling a painful experience, worrying—or in the extreme, “catastrophizing”—can set off a cascade of deleterious psychophysiological effects.