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Minding the Body, Mending the Mind

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By Joan Borysenko

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The New York Times bestseller — “practical, easy to understand, and based on solid research that you can trust…an inspiring exploration of what it means to be fully human” (Andrew Weil, MD)

Based on Dr. Borysenko’s groundbreaking work nearly thirty years ago at the Mind/Body linic in Boston, Minding the Body, Mending the Mind continues to be a classic in the field, with time-tested tips on how to take control of your own physical and emotional well-being. The clinic’s dramatic success with thousands of patients — with conditions ranging from allergies to cancer — offers vivid proof of the effectiveness of the mind/body approach to health and its power to transform your life. With tips on how to elicit the mind’s powerful relaxation response to boost your immune system, cope with chronic pain, and alleviate symptoms of a host of stress-related illnesses, this book is a must-have for anyone interested in taking an active role in their own healing.

Excerpt

To Miroslav Borysenko
Once husband, always friend


FOREWORD
When I first met Dr. Borysenko in the late 1970s, she was a young cancer researcher on the faculty of the Tufts University School of Medicine in Boston, teaching both histology (microscopic anatomy) and an unusual elective course in what was then called holistic medicine. On her lunch breaks she taught hatha yoga and meditation, sometimes inviting students and colleagues back to her laboratory to sample healthful vegetarian fare afterward. Those impromptu samplings often included organic produce from her garden and wild foods foraged from the fields and forests surrounding the rural Massachusetts home where she lived. Among those foods were mushrooms she'd collected as a passionate amateur mycologist.
Joan's personal interest in health and natural living, coupled with her academic expertise in medical science, placed her at the leading edge of the field that later evolved into integrative medicine, which is my passion. In the twenty years that have passed since she wrote Minding the Body, Mending the Mind it has taken its place as an enduring classic. The book found its way into college and medical school classrooms, doctors' offices, and hundreds of thousands of households. Joan outlines a simple, yet comprehensive and effective, approach to mental and physical well-being that has stood the test of time and the trials of modern research.
Diet and exercise are now universally recognized as critical factors affecting health and well-being. Healing practices originating in the East—from hatha yoga to acupuncture and chi gong—are now used as adjuncts to Western medicine. We have much evidence that meditation reduces stress and enhances immunity; now sophisticated neuroimaging studies show that it also stimulates areas of the brain that regulate happiness. And although pharmaceutical drugs have their place in the treatment of severe conditions, natural remedies, stress reduction, and lifestyle change can often achieve results that are equal to or better than prescription medications with far less risk and expense in the management of common ailments.
Whether you're a young person who hopes to live a healthy, vital, and happy life; an older person who is trying to age well and maintain your energy level and physical function; a stressed-out person yearning for balance; or someone with an acute or chronic illness that you'd like to address on all levels—body, mind, and spirit—this book can help you. It's practical, easy to understand, and based on solid research that you can trust. Furthermore, Minding the Body, Mending the Mind is an inspiring exploration of what it means to be fully human—present in each moment with an open mind and an open heart. In the last analysis, that may be one of the best definitions of well-being and what it means to live your best life.
Andrew Weil, M.D.
Tucson, Arizona
May 2007


Introduction to the New Edition
Twenty years have passed since I first wrote Minding the Body, Mending the Mind. The day I was told that it was going to appear on the New York Times best seller list, I was sitting at the desk in my hospital office, reviewing medical charts. The phone rang, and it was George Gibson, the book's publicist, enthusiasm and excitement bubbling through his voice. "Are you sitting down?" he asked breathlessly, before sharing the news. "The New York Times best seller list," I mused, unimpressed. "Is that a good thing?"
In the insular world of medical science and clinical practice, best sellers weren't much of a consideration back then. Publication of studies in peer-reviewed journals, where the results of meticulous research were shared with colleagues—now that was something to get excited about. But in the twenty years that have passed, more and more books have appeared aimed at educating (or sometimes taking advantage of) a public that is increasingly stressed out, anxious, alienated, sick, and depressed.
It's a marvel that in the last twenty years we've learned so much about health and well-being. The average person knows more about exercise, diet, psychology, supplements, and pharmaceuticals now than ever before in history. Why, then, is there such an obvious slip between the cup and the lip? We're more obese, sedentary, and stressed out now than ever before. And these lifestyle choices impact our health in a serious way. More than 70 percent of all cancers, greater than 80 percent of all heart disease, and over 90 percent of type 2 diabetes are related to unhealthy lifestyles.
Finger pointing doesn't help figure out why we Americans take such poor care of ourselves. Yes, there is a raging fast-food epidemic, spurred by the kind of television commercials that feature lissome young ladies gulping down giant burgers and frolicking in fields of french fries. And surely most of us realize that endless hours of staring at computer monitors or playing video games are no match healthwise for being outside and moving around. And yet, as a society, we've all but forgotten how to inhabit the natural world.
But perhaps the most obvious explanation for the gap between what we know and how that translates into taking care of our health, is our emotional state. Dr. Martin Seligman, who founded the field of positive psychology in 1998, cites data that, despite our better standard of living, Americans have become progressively more depressed since World War I—and at a much younger age. Seligman credits self-absorption—being more interested in our own individualistic agenda than in the good of the whole—as one obvious culprit. Altruistic people, who think about helping others, are less depressed and anxious than most—and they live longer. The same is true of those of us who can manage our stress and accentuate the positive rather than marinating in the negative.
When we feel bad—overwhelmed by anxiety, uncertainty, depression, and stress—most of us act in the most human possible way. We try to comfort ourselves. But going to the gym, jumping on a bike, or even taking a walk isn't most people's first choice for comfort. It's easier to numb out watching the television, hunting for happiness in cyberspace, drinking, smoking, doing drugs, or eating something full of fat, sugar, or salt that is instantly satisfying.
I'm convinced—as a medical scientist, a psychologist, a busy professional, a mother, a grandmother, and a wife—that taking care of the mind, which in turn generates our emotions, is the missing link when it comes to taking care of the body. I learned this lesson many years ago. When I was twenty-four I was working on my doctoral dissertation at the Harvard Medical School, investigating the way cells maintain their attachment to one another. I was living on coffee and cigarettes, broke and tired, trying to cope with a troubled marriage and an infant son for whom I had far too little time. Furthermore, I was a relentless perfectionist, trying to control and succeed at everything. My emotions were in an uproar, and anxiety and irritability were my constant companions.
I was also a physical wreck. Troubled by migraines all my life, I found that the intense competition added crippling stomach pains and vomiting to my list of psychosomatic illnesses. As a graduate student, I also came down with severe bronchitis four times in two years and had to study for my doctoral exams while my head spun in a fever. As if this weren't enough, I also developed the high blood pressure that ran in my family.
My marriage fell apart during this year. I was now a single parent plagued with fainting and crippled by abdominal pains that were diagnosed as spastic colon. I was given antispasmodics, painkillers, and tranquilizers—all to no avail. Then a viral infection in the lining of my lungs created suffocating pain that took me to the emergency room of the nearest hospital.
The field of mind/body medicine didn't exist yet, but there was a friend in the lab where I conducted my graduate research who was excited about his new hobby: yoga and meditation. He compared these to a minivacation in which he could switch off his cares and concerns and come out refreshed and ready to tackle whatever came up. My first thought was that meditation was for ascetics who lived in caves. I was a hardheaded scientist, literally killing myself to master the ways of the medical establishment.
Nevertheless, I gave meditation a try—largely out of desperation—practicing each day. The test came a few weeks later while I was sitting at an electron microscope, trying to unlock the secrets of cancer cells. I felt the familiar stabbing behind my right eye, the light sensitivity and nausea that heralded a migraine. It was time for an experiment.
Retreating to my office, I pulled the shades and shut the door. I settled into a chair, relaxed my muscles from head to foot, shifted my breathing from tense chest breathing to relaxed diaphragmatic breathing, and began to meditate. In time the pain subsided. After the meditation was over, I was left with a feeling of having been washed clean, like the earth after a heavy rain. I ran around the laboratory announcing that I had performed the most important experiment of my life. It was the beginning of a tremendous change in my life that led to greater happiness, increased emotional resilience, and a much healthier lifestyle.
In the following chapters, you'll share my journey of healing and those of some of the people I've had the privilege to work with. Many attended the programs that I cofounded with Drs. Herbert Benson and Ilan Kutz at Boston's Beth Israel Hospital, and that I directed between 1981 and 1988. Our programs at the Mind/Body Clinic, which were shown through peer-reviewed research to decrease anxiety, depression, and medical symptoms, and to increase health and well-being, form the basis for many of the recommendations in this book. Although I left the clinic in 1988, Dr. Benson and his colleagues have continued these programs and added to them. They now practice at the Benson-Henry Institute for Mind Body Medicine, located at Boston's Massachusetts General Hospital.
The people I've worked with, both in the early days of the clinic and in the two decades since that time, have ranged in age from seventeen to ninety-three, and they come from all walks of life. Their struggles and victories have been inspirations and challenges that constantly push me beyond the limits of what I know. They are people who want to participate in their own healing but are wary of fads and unproven claims. They are students, executives, housewives, physicians, laborers, scientists, and engineers, and they come with migraine, insomnia, hives, ulcers, allergies, chronic pain, and more serious illnesses such as cancer and AIDS. At times, in this book, the experiences of more than one person are combined in a single story to protect confidentiality and illustrate what I believe to be basic principles.
Many people over the years were referred to me by physicians, often after years of suffering and sometimes after endless rounds of medications that had not worked. As a rule, other therapies had failed because they addressed only the physical symptoms rather than the underlying causes.
Although the problems of a stressed overachiever may appear very different from those of a young mother suffering from multiple sclerosis and different still from those of an older man with cancer, all these people face similar crises. The underlying issues have as much to do with the meaning of life as with learning to use the power of the mind to reduce symptoms.
Major studies indicate that approximately 75 percent of visits to the family practice physician are either for illnesses that will ultimately get better by themselves or for disorders related to anxiety and stress. For these conditions, symptoms can be reduced or cured as the body's own natural healing balance is reinstated. For many other chronic or potentially life-threatening disorders, symptoms may be lessened, but the progress of disease will lead inevitably toward death. Death, after all, is part of the natural progression of life, and its reality can be a powerful reminder to live life in a way that maximizes contentment, creativity, and love. This is what I call healing. And the underlying desire for healing—for wholeness—is what all people have in common, regardless of the condition that needs healing.
In the chapters ahead you'll read about people who seem like yourself and others who seem very different. In the end, what is so miraculous is that, despite our differences, we're all alike. Beyond identities and desires there is a common core of self—an essential humanity whose nature is peace and whose expression in thought, emotion, and action is unconditional love. When we identify with that inner core, respecting and honoring it in others as well as ourselves, we experience healing in every area of life.
Presenting this material in a book, rather than through personal interaction, was a fascinating challenge. Each reader is different, and honoring those differences is the key to learning. With that in mind, be flexible with yourself as you work along with the book. You may want to skim it first for content and then go back and experience the techniques, mastering the tools at your own pace. Alternatively, you might wish to read through quite slowly, taking eight or ten weeks to work along with the program as if you were actually part of a group process. You might even enjoy setting aside two hours once a week to work with the book, practicing the techniques you have learned during the week before moving on to the next chapter.
In writing and updating the first chapter on mind/body interactions, I gave as much scientific background as concisely as I could. You may find that it's too much for you, just right, or perhaps too little. In the first case, you may want to skim the chapter lightly, coming back to it later if you feel the need. In the latter case, you can supplement the material from the reading list provided at the end of the text.
Chapters 2 and 3 are foundational—building the skill of becoming aware of how to mind the body. In these chapters you will learn how to elicit the relaxation response through meditation, breathing, and stretching exercises. The practice of these exercises has two purposes. First, you learn to shift your physiology, gaining control of the stress response and learning to control the autonomic, or automatic, nervous system, as well as learning to let go of tension in the musculoskeletal system. Second, these basic skills begin to train you in the art of observing your mind.
Chapter 4 is a bridge between the fundamental skills of minding the body and the more advanced skills of taming the mind. It concerns a critical area that most of us can immediately relate to: the ability to live life in the moment rather than being wrapped up in memories of the past or worries about the future. The ability to practice mindful awareness, and to be here now, rests on practicing the concentration and breathing exercises that come in the preceding chapters.
Chapters 5 and 6 provide tools for becoming an observer of your mind in a way that allows for a gradual process of waking up to the present by cutting through the conditioning of the past. This work culminates in learning to learn from emotions and to practice present-centered awareness in daily life as introduced in Chapter 7.
The principles presented in the book are brought together in a very personal way in the last chapter, which tells Sam's story, a true-life drama of mind and spirit overcoming the final limitation of the body—death itself. Sam's struggle with AIDS was a powerful healing experience in my own life and in the lives of many who knew him.
Before beginning your healing work with the book, I suggest that you turn to the appendix and complete the self-evaluation of your current physical and emotional state. After finishing the book, when you feel that you understand the ideas and methods, you can reevaluate your well-being by filling out the assessment a second time. Most people find the self-assessment helpful because it makes them more aware of their physical and emotional state. Completing it takes only a few minutes and will add to your self-understanding.
In going through the self-evaluation materials, use them as an opportunity to ask yourself whether you need medical or psychological help in addition to self-help. A book like this is a wonderful adjunct in some cases, or it may be enough by itself, but it's always a good idea to ask for professional help if you have questions.
My own journey of healing began some forty years ago and is still in progress. I hope that my experiences and those of the patients I have learned from and shared with will help you along your way. You may find the precepts of the book challenging, but they are a guidepost for how we become fully alive and compassionate human beings. I wish you all the best on your journey to healing and peace of mind. It's what you were born for.


CHAPTER 1
The Science of Healing
Early in my career, when I was an assistant professor at the Tufts University School of Medicine in Boston, I watched a Chinese film demonstrating acupuncture anesthesia. As assistants twirled a few needles, a surgeon incised a patient's chest, cracked the ribs, and removed a lobe of the lung—all while the patient, his head demurely hidden behind a sheet, talked amiably and sipped tea. I was viewing the film with immunologist Dr. Miroslav Borysenko, and we were both astounded by what we saw. We asked an anesthesiologist who had been seated nearby what he thought about the remarkable demonstration. "It's nothing," our colleague said dismissively. "Just hypnosis." As if that, in itself, would not have been equally remarkable.
Until the last few decades, scientists were often in the position of having to deny what they were seeing, simply because the underlying mechanisms were not understood. Science is a search for explanations, a complex structure built of small, measurable units, yet some things that happen to real people in the real world just don't fit inside the well-established categories.
A subject under hypnosis raises a very real blister on her skin, even though the "hot iron" the hypnotist says he is touching her with is, in reality, an ordinary pencil. In a clinical test, one-third of women receiving placebos instead of chemotherapy still lose their hair. A person with metastatic cancer, who has been told that she has just weeks to live, suddenly rallies and ultimately beats the disease. The latter is a very rare event, but still it happens. How can this be?
Two thousand years ago a woman who had suffered prolonged uterine bleeding approached Jesus of Nazareth. Coming up to him in a crowd, she touched the hem of his garment and was instantly healed. Jesus turned to her and explained that it was her faith that had made her whole. After centuries of slow progress toward rational explanations of the physical world, even scientists can at last begin to appreciate the truth of his assessment. We are entering a new level in the scientific understanding of mechanisms by which faith, belief, and imagination can actually unlock the mysteries of healing.
Today sophisticated neuroimaging techniques, such as positron-emission tomography (PET) scans or functional magnetic resonance imaging (MRI), allow the brain to be scanned while research subjects are studied in a variety of different conditions. In one such study, volunteers received mild electric shocks—with or without the application of an "anesthetic" salve that was actually a placebo. Not only did they feel less pain when they believed that they were anesthetized, but brain areas responsible for the experience of pain were also less active. In a similar type of study, researchers at the University of Wisconsin in Madison found that when study volunteers were exposed to an unpleasant heat stimulus, their belief that they had control over how long the heat would last (even though they really didn't) reduced both their perception of pain and activity in the three brain areas most consistently associated with the experience of pain.
In other words, beliefs may start in the mind, but they end in the body. Any woman who has ever given birth understands something about how context alters pain tolerance. In labor I discovered that discomfort was a euphemism, akin to calling Niagara Falls a gentle shower. Yet still, I endured pretty well. Had the pain been due to something frightening, however—say, a burst appendix or a gunshot wound—the same pain would have seemed completely unbearable. Likewise, what stresses one person is an exciting challenge to another. Again, it's the attitude that makes the difference in how they respond to the same event. Through a web of subtle interconnections involving nerve pathways, neurohormones secreted by the brain, and hormones like cortisol and adrenaline secreted by the adrenal glands, attitudes can affect every cell in the body. For better and for worse.

Brain, Mind, and Molecules

My roots are in laboratory research, and for many years I studied the effects of stress—which often involves a perceived lack of control—on health and immunity. The immune system (the body's front line of defense against disease), the cardiovascular system, and the brain and nervous system—all have been explored independently. In recent years, however, neuroscientists working with psychologists and immunologists have forged a new scientific discipline with the tongue-twisting name of psychoneuroimmunology, or PNI, a field that explores the body's most subtle interconnections.
Stress often begins with how you think. And how you think determines how you feel—both emotionally and sometimes physically as well. When your thoughts create strong emotions—whether positive or negative—your brain releases hormones that spread the emotional news to every system of the body. Called neuropeptides, these hormones are informational molecules that telegraph messages to any cell in the body that has receptors for them. Neuroscientist Dr. Candance Pert has been in the forefront of demonstrating that emotions are a powerful link between mind and body through these informational molecules. Neuropeptides make their way into the bloodstream, where they are distributed throughout the body, binding to surface receptors on a multitude of diverse cells. In the twinkling of an eye, then, an emotion that begins in the brain can trigger subtle and complex cellular reponses throughout the body. In turn, neuropeptides manufactured by the immune system, or by different organs, can also affect the brain and emotional state.
What researchers are documenting is a rich and intricate multidirectional communication system linking the brain, the mind, the immune system, and potentially all other systems of the body from the heart, to the lungs, to the skin. This is the pathway through which our emotions and our hopes, fears, and beliefs can affect the body's ability to defend itself and to function optimally in response to the continually changing moment-by-moment demands of life.

The Big Three Negative Emotions: Depression, Anxiety, and Anger

Depression, anxiety, and chronic anger are uncomfortable emotions in themselves—reason enough to want to minimize them. But in addition, we know that they can also have profound effects on physiology and health.2 Prospective studies (these are the scientific gold standard because they follow people who are well for years to understand how and why illnesses may eventually develop) show that depression—the most common psychiatric disorder in America—takes a significant toll on health. Depressed people have an increased incidence of coronary heart disease, and for those who already have heart disease, depression can aggravate it, leading to increased disability. Depression makes pain more difficult to cope with, worsens most medical conditions, and can create its own set of physical symptoms—from headache and body aches to neurological and digestive disturbances. Prolonged depression may even be a risk factor for the development of cancer. Depression's cousins, anxiety and hostility, can also increase the risk of coronary heart disease, and anger has been shown to speed up age-related decline in lung function.
Without going into too much detail, there is a particular kind of neuropeptide, called a cytokine, that regulates the body's immune response. Cytokines signal the immune system to gear up after injury or infection. But if those signals don't turn off in time, inflammation—the increased immune response that initially shows up as heat, swelling, and redness around a cut—damages the body. Chronic inflammation leads to frailty and can lead to a multitude of disabilities associated with aging, such as osteoporosis, type 2 diabetes, arthritis, some cancers, and even Alzheimer's disease.
We know that both depression and anxiety gear up cytokine production, as do physical stress and chronic emotional stress, such as the difficult task of caring for a loved one with Alzheimer's disease. Poor health habits—obesity, smoking, and a sedentary lifestyle—also increase cytokine production. Although easier said than done, it's best, then, to try to free ourselves from the big three—or at least to make them less prevalent in our lives.

The Stress and Relaxation Responses

In the 1940s, Swiss physiologist and Nobel laureate Walter Hesse experimented on the cat brain and discovered that he could produce two diametrically opposed energy states simply by stimulating different areas of the animal's hypothalamus. One state was a kind of "passing gear" for heightened activity; the other was a state of very low energy expenditure characterized by deep rest and relaxation—the bodily equivalent of "neutral."
In the 1970s, Dr. R. Keith Wallace and Dr. Herbert Benson documented a similar state of profound rest in humans who practiced transcendental meditation. Benson's subsequent studies proved that this state could be elicited through any form of mental concentration that distracted individuals from their usual cares and concerns and focused their minds. He termed this innate, hypothalamic mechanism the relaxation response.
When the relaxation response is called upon, heart rate and blood pressure drop. Breathing rate and oxygen consumption decline because of the profound decrease in the need for energy. Brain waves shift from an alert beta rhythm to a relaxed alpha or theta rhythm. Blood flow to the muscles decreases, and instead, blood is sent to the brain and skin, producing a feeling of warmth and rested mental alertness. It was by learning to induce the relaxation response that I began to reverse symptoms of stress that were severe enough to send me to the emergency room.

Genre:

  • "An elegant and credible blend of modern psychology and medical science that allows us to get in touch with our higher self to experience the field of infinite possibilities and brings us healing and wholeness in our busy world."
    —Deepak Chopra, author of Buddha: A Story of Enlightenment
  • "Joan Borysenko is the smartest woman I've ever known. I urge you to drink in her wisdom. This book is a classic."
    —Wayne W. Dyer, author of Change Your Thoughts-Change Your Life: Living the Wisdom of the Tao
  • "Whether you're a young person who hopes to live a healthy, vital, and happy life; an older person who is trying to age well and maintain your energy level and physical function; a stressed-out person yearning for balance; or someone with an acute or chronic illness that you'd like to address on all levels-body, mind and spirit-this book can help you. It's practical, easy to understand, and based on solid research that you can trust. Furthermore, Minding the Body, Mending the Mind is an inspiring exploration of what it means to be fully human-present in each moment with an open mind and an open heart. In the last analysis, that may be one of the best definitions of well being and what it means to live your best life."
    —Andrew Weil, M.D., from the Foreword
  • "Dr. Borysenko's groundbreaking first book about the interdependency of the mind and body and the power of meditation to heal is as relevant and intriguing today as it was twenty years ago when it was first published. Her scientific perspective, clear language, and sincere appreciation for the healing journey of the body and spirit make this book a practical and heartfelt guide for all people on a path of self-discovery. . . . Minding the Body, Mending the Mind is intelligent, easy to read, experiential and in-depth, but above all, what I appreciate most is Dr. Borysenko's understanding of the human spirit and the challenges involved in the process of healing. It is this compassionate consideration that makes this a necessary read for all interested in living a happier, healthier, and more integrated life."
    —Seane Corn, Yoga Instructor, National Yoga Ambassador for Youth AIDS and co-creator, "Off the Mat, Into the World"
  • "Dr. Joan Borysenko is a venerated pioneer in behavioral medicine and psychoneuroimmunology. In her brilliant best selling primer, written in 1987, she described how to use the mind body connection for healing and wholeness. In these times of increased stress and anxiety, the now classic Minding the Body, Mending the Mind, beautifully updated, is more important than ever. We owe it to ourselves and our patients to stay current with the latest evidence-based advances in healing. Joan has made that easy with this superb new edition."
    —Janet F. Quinn, PhD, RN, FAAN, Associate Professor, Nursing, University of Colorado
  • "Offers a practical approach to relieving stress and anxiety."—Curve

On Sale
Nov 13, 2007
Page Count
272 pages
Publisher
Da Capo Press
ISBN-13
9780786750054

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Joan Borysenko

About the Author

Joan Borysenko, Ph.D., is the author of seventeen books, including the New York Times bestseller Minding the Body, Mending the Mind; It’s not the end of the World: Developing Resilience in Times of Change; and Your Soul’s Compass: What is Spiritual Guidance? She lives with her husband Dr. Gordon Dveirin and their two standard poodles in Santa Fe, New Mexico—the Land of Enchantment. 

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