Mind Body Medicine on the Katie Show
Author: bhi-admin
Mind Body Medicine on the Katie Show
BHI’s Dr. John Denninger and country legend Naomi Judd discuss the health benefits of Mind Body Medicine on Katie Couric’s Katie show.
Half Of A Drug’s Power Comes From Thinking It Will Work
THIS STORY WAS WRITTEN FOR NPR by RICHARD KNOX
January 10, 2014 2:38 PM
When you take a pill, you and your doctor hope it will work — and that helps it work.
That’s not a new idea. But now researchers say they know just how much of a drug’s effect comes from the patient’s expectation: at least half.
When patients in the midst of a migraine attack took a dummy pill they thought was a widely used migraine drug, it reduced their pain roughly as much as when they took the real drug thinking it was a placebo.
“There was no difference between the pharmacology of the drug in reducing pain and the placebo dressed up with a nice word,” study author Ted Kaptchuk tells Shots. “Basically we show that words can actually double the effect of a drug. That’s pretty impressive.”
And if it works when treating migraine headaches, it also might work for a wide variety of other ailments, from asthma to intestinal cramps to back pain, that involve the subjective experience of symptoms.
The findings, in this week’s Science Translational Medicine, have interesting implications for doctors and patients, because what physicians say about a medication appears to have a lot to do with its benefits.
Beyond that, it raises a question of whether drug companies should take subjects’ expectations into account when they test a new drug. (That question may explain why drug-maker Merck helped fund the study, along with the National Institutes of Health.)
The study is the latest in a series that’s helping to decipher the mysteries of the placebo effect. The research is conducted at a newly established Program in Placebo Studies and Therapeutic Encounter at Beth Israel Deaconess Medical Center and other Boston hospitals.
People reported changes in migraine pain after they were given an effective medication called Maxalt or a placebo pill. How the pills were labeled made a big difference.
• No treatment: 15 percent increase in pain.
• Known placebo: 26 percent decrease.
• Placebo labeled Maxalt: 25 percent decrease.*
• Maxalt labeled as placebo: 36 percent decrease.*
• Mystery pill (Maxalt or placebo): 40 percent decrease.
• Known Maxalt: 40 percent decrease.
*Note: These two values are not significantly different statistically.
The group has shown: that placebos rival the effect of active medication in patients with asthma; that even when patients know they’re taking a placebo, they can get relief from the cramps, bloating and diarrhea of irritable bowel syndrome; and that those subliminal suggestions can activate patients’ placebo response.
This time, Kaptchuk and colleagues decided to use migraines to untangle the placebo component of patients’ expectations.
“Migraine is ideal,” Kaptchuk says. “I can’t think of another instance in which a real disease happens and then disappears, and then comes back.” That allowed the group to test patients’ responses against themselves, by watching what happened during seven successive migraine attacks in 66 subjects — 495 attacks in all.
Another advantage is that there’s an effective drug,rizatriptan or Maxalt, that has been shown to work better than placebo pills.
The researchers asked all of their subjects to refrain from taking any medication for two hours after the onset of their first migraine. Then they were given six envelopes, each containing a pill to be taken during their next six migraine attacks.
Two of the envelopes were labeled “Maxalt.” Two indicated that the pill inside could be either Maxalt or a placebo. And two were labeled “placebo.”
Subjects rated their amount of pain two hours after taking each pill.
When subjects took no pills, they reported a 15 percent increase in migraine pain after two hours.
When they took a placebo that was accurately labeled, they reported 26 percent less pain. When they took a Maxalt pill that was properly labeled, they reported 40 percent less pain. And when they took a mystery pill that could have been either a placebo or Maxalt, they also reported a 40 percent decrease in pain.
When subjects took Maxalt that was labeled as placebo, their decrease in pain was statistically no different than when they took a placebo labeled as Maxalt.
“We were surprised that the efficacy of Maxalt mislabeled as placebo was not significantly better than the efficacy of placebo mislabeled as Maxalt,” the researchers write.
One striking thing in the findings is the power of uncertainty. Patients had just as much pain relief when they weren’t sure whether an envelope contained Maxalt or a placebo.
“There’s something going on here that we don’t understand,” Kaptchuk says. “But I think uncertainty engages you in a different way.” It might be analogous, he says, to how doubt can increase the faith of a religious person — it may strengthen the desire to believe.
Kaptchuk says a doctor’s (or researcher’s) manner or words had no effect because patients were only influenced by the words on the pill-containing envelopes.
“What’s exciting is that all we did is change one or two words on an envelope,” the Harvard researcher says. “There was no doctor-patient interaction after the first meeting.”
But in one significant way the placebo didn’t beat the real drug. When the researchers asked patients if they were totally pain-free 2 1/2 hours after taking the pills, patients said Maxalt was almost four times better — 25.5 percent versus 6.6 percent.
That’s consistent with previous placebo studies, Kaptchuk says. For instance, the asthma study showed that asthma inhalants open patients’ airways while placebos don’t. But placebo inhalers reduce patients’ perceived symptoms of asthma.
Being free of migraine pain is a yes/no question, whereas there’s more “wiggle room” in being asked if pain is lessened. “That’s a judgment call,” Kaptchuk says. “Being pain-free is not a judgment call.”
Kaptchuk says the results shouldn’t be seen as undermining the effectiveness of Maxalt. “It’s a really good drug. If I had migraines, I’d take this drug, too,” he says. “But I’d want a physician to understand that every word counts.”
Compassionate Care for Cancer: Why We Need It
The Democrat and Chronicle recently published this essay, written by BHI patient Nila Webster. Read it for her view on the importance of compassionate care, and how it helped her heal and grow.
The Science of Relaxation- Yoga Journal
Curious about the scientific benefits of yoga? Yoga Journal has an interesting current issue, which focuses on scientific research on relaxation techniques such as yoga. For the full link, visit http://www.yogajournal.com/health/2638
Located in one of the best academic medical centers and in one of the most doctor-friendly cities in the country, the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital is well poised to train new doctors to incorporate mind-body techniques into their practice. Its founder and director emeritus, Dr. Herbert Benson, pioneered research on the relaxation response as a powerful antidote to the stress response; he was also one of the first to illustrate that meditation changes metabolism, heart rate, and brain activity as a result of the relaxation response. This commitment to research is still what makes the institute stand out: Benson and his colleagues recently published a landmark study illustrating some of the changes in gene expression that can come from practices that elicit the relaxation response, including meditation and yoga.
Physicians at the institute help treat patients for everything from heart disease to diabetes to infertility. Individual therapeutic yoga instruction is offered as an adjunctive approach for a wide variety of conditions, both physical and mental. Darshan Mehta, the institute’s medical director and director of medical education, says that along with maintaining its commitments to research and patient care, the Benson-Henry Institute is dedicated to educating medical students and residents in integrative medicine. “Boston is famous for training leaders in medicine,” Mehta says. “We need to expose the next generation of doctors to the benefits of mind-body medicine. My hope is that after studying at the Benson-Henry Institute they’ll be able to at least recognize value in it and perhaps add it to their practices in some way.”
Study finds Relaxation Response Triggers Genomic Changes
Meditation, yoga, deep breathing and prayer are all ways to evoke a physiologic state of deep rest known as the relaxation response. New research published in the journal PLOS ONE finds that eliciting this response triggers immediate changes in gene expression that can affect the body’s immune function, energy metabolism and insulin secretion.
The study was a joint effort between the Benson-Henry Institute for Mind Body Medicine at the MGH and Beth Israel Deaconess Medical Center.
“The relaxation response is like the opposite of the fight-or-flight response, which is the body’s natural reaction to stress,” says Herbert Benson, MD, director emeritus of the Benson-Henry Institute and co-senior author of the report. “Previous studies have shown that people experience beneficial changes to their brain while eliciting the relaxation response. And now – for the first time – this study identifies key physiological hubs through which these benefits might be induced.”
The study analyzed the gene profiles of 26 healthy adults who had no experience with the relaxation response. After being taught the relaxation response and following the routine for eight weeks, their profiles were analyzed again. Researchers found significant changes in the expression of several important groups of genes within as little as one relaxation response session. They also found more pronounced changes in those who practiced the response over longer periods of time.
“When you elicit the relaxation response, your energy usage is lowered, your heart beats slower, your muscles relax and your blood pressure decreases. If practiced regularly, it can have lasting effects,” Benson says. “People have been engaging in these practices for thousands of years, and our finding of this unity of function on a basic-science, genomic level gives greater credibility to what some have called ‘new age medicine.’”
Read more articles from the 05/10/13 Hotline issue
Survey examines Americans’ use of and satisfaction with homeopathic medicines
While few report using homeopathy, many of those who do find it helpful in addressing common health problems
A new survey finds that homeopathic medicines are primarily used by a small segment of the U.S. population for common, self-limited conditions such as the common cold or back pain. The report published in the American Journal of Public Health also finds that homeopathy users, particularly those who also report visiting homeopathic practitioners, find the use of these products helpful and that they tend to use a greater variety of complementary and integrative medicine (CIM) modalities than do users of supplements and other CIMs. This is the first detailed report on the use of homeopathy in this country.
“The information provided by this survey is important to regulatory officials at the FDA (Food and Drug Administration) and the FTC (Federal Trade Commission), both of which have inquired about the public use and perception of these products,” says Michelle Dossett, MD, PhD, MPH, of the Benson-Henry Institute at Massachusetts General Hospital, lead and corresponding author of the paper. “Since most people purchase these products over the counter without physician guidance, it is reassuring to see that most use them for non-serious, self-limited conditions.”
Homeopathy is a 200-year-old system of medicine based on the principal of similars – that highly diluted substances can be used to treat symptoms similar to those that would be caused by large doses of those substances in healthy people. While it is controversial because of the extremely diluted nature of homeopathic medications, interest in homeopathy has increased in recent years. Although homeopathic medicines are usually stocked near supplements on drug store shelves, the authors note they are regulated differently from supplements, going through formal approval by the Homeopathic Pharmacopoeia Convention of the United States and conforming with FDA guidelines for good manufacturing practices.
The study analyzed data from the National Health Interview Survey, which is conducted annually by National Center for Health Statistics of the Centers for Disease Control and Prevention. The 2012 survey included a number of questions about participants’ use of CIM and was completed by more than 34,500 adults. The study authors – based at Beth Israel Deaconess Medical Center, where Dossett was a research fellow at the time of the survey – divided respondents into four groups: those who used homeopathic products during the preceding 12 months, those who used supplements but did not use homeopathy, those who used other forms of CIM but not homeopathy or supplements, and those who did not use CIM.
The respondents who reported using homeopathy were more likely to be white, female, married, highly educated, aged 30 to 44 and live in the western U.S. than were CIM users who did not use homeopathy. They also were more likely to report using other types of CIM, except for chiropractic or osteopathic manipulation, and to have used several different types of CIM.
While two-thirds of the 718 respondents who used homeopathy ranked it among their top three CIM therapies, only 140 or 19 percent reported seeing a homeopathic practitioner during the preceding year. One third of homeopathy users – both those who did and did not consult practitioners – reported using homeopathy to address specific health conditions, most commonly head and chest colds. Those who did see a practitioner were significantly more likely to report that homeopathy was very important to maintaining their health and that it had helped their health problem ‘a great deal.’
“We were a bit surprised to see how few homeopathy users reported seeing a practitioner, but I don’t think that is concerning since most use is for conditions that will resolve on their own and homeopathic medicines are generally very safe,” says Dossett, who is an instructor in Medicine at Harvard Medical School. “Our data suggest that the likelihood of people using these products for serious conditions without input from a healthcare professional is low, and data from other groups suggest that most CIM use is in addition to, not in place of, conventional treatment.”
While she agrees that the data from this report helps meet the interest of the FDA and FTC for information on the use of homeopathy, Dossett adds that additional, more detailed information on homeopathy users and studies of homeopathic products would provide additional helpful information.
Additional co-authors of the AJPH report are Roger David, ScD, Ted Kaptchuk and senior author Gloria Yeh, MD, MPH, all of the Beth Israel Deaconess Department of Medicine. Support for the study includes National Institutes of Health grant 1UL1 TR001102-01 and Institutional National Research Service Award T32 AT000051 from the National Center for Complementary and Integrative Health.
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $800 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine. In July 2015, MGH returned into the number one spot on the 2015-16 U.S. News & World Report list of “America’s Best Hospitals.”
Friends & Family Honor the Life and Legacy of Vicci Recckio with Gifts to BHI
Whenever Vicci Recckio encountered a friend or confidante, her first question was always, “How are you?” She was someone who could make the person she was talking to feel like the center of the universe. Even though she often had the most pressing news or concerns – when she was dying of cancer, for example – she was an “enough about me, how about you?” type of person.
Vicci Recckio was a special part of the Benson-Henry Institute family; she joined an 8-week BHI Mind Body Program for Cancer group in fall 2013, when she was first diagnosed with colon cancer. From the outset, she bonded with the six other women in her group to form they dubbed the “the Benson Babes,” a tight-knit coterie that shared triumphs and tragedies as well as a recycled wool coat that became a sort of talisman to be passed back and forth depending on the severity of the members’ illnesses.
“We learned that we have no control over what happens to anybody else, and you have to figure out what is really important to you and look at life like that,” said Cynthia Thomas, a member of the group.
Vicci embraced the BHI philosophy; she found ways to relax her mind and body and to live for what truly mattered – the people she loved. She fought valiantly against the cancer and at times seemed to triumph, but died shortly after her 50th birthday in September.
Yet it is the connections she made and the vision she had that remain, and many of her friends and family have taken up her mantle.
Vicci had always wanted to own her own business, and she found inspiration in her cancer treatments: she hated the utilitarian chemo bag she was forced to lug around with her for 46-hour periods. It was drab and depressing. So she designed a functional and funky bag for the chemo patient on the go – and this year, she launched cosmedicdesigns.com, the online store that sells her customizable shoulder bag.
As she grew sicker, Vicci was determined to see her dream to fruition. She managed her own marketing campaign, chose the photos and web designs, and gathered testimonials. She lived to see the business launched; and she was proud to have accomplished her goal and to have helped others who would tread the same road.
“She was not militant, not the person who always wanted to speak out, she was a person who want to act,” said her friend, Cécile Garcin. “Everyone who knew her, before she was diagnosed and after, could just see from her how life can positive if you take it in a positive way. Her life was full of joy, hope and love.”
As her friends and family came to terms with having lost the charming, witty and elegant Vicci, they could not let her dream go with her. On November 1st, Cecile and her husband, Fred Chereau, ran the New York Marathon, an achievement for any athlete. On their chests they wore their numbers, on their backs a picture of Vicci and a message thanking their supporters for donating $10,500 to the Benson-Henry Institute in her memory.
“I said I would do my best, and this would be a legacy for her,” Cécile said. The race “was hard on my body and very often I was like, ‘Vicci can you help me?’ and I could see her face smiling. She was with me, I’m sure.”
Vicci’s sister, Donna Recckio, has felt a similar need.
“I felt a strong desire to move forward with Cosmedic Designs, to carry on her legacy,” she says. “She has touched so many people all over the world – from here to Hong Kong – people call and email and have said the most beautiful things about my sister. It means so much to know that she touched so many lives.”
The first shipment of Benson Bags sold out within weeks this fall; Donna Reckio is working with the Massachusetts-based artisans who make each special component of the bags to offer a new line of products in early 2016. She’s taking orders now, and hoping that her sister’s sense of style will bring some small comfort to cancer patients. Cecile’s marathon efforts will be used to grow mind body programs for cancer patients and others at BHI.
“This is what she would have wanted,” her friend Cécile says, “The story is not over, it hasn’t ended yet. Her legacy lives on with others.”
To learn more about Cosmedic Designs and The Benson Bag, click here.
For a link to the Boston Globe Magazine story about “The Benson Babes” and their shared coat, click here.
BHI Newsletter
Current Issue:
Fall 2013: Resilient Warrior, Learning to be home again
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We are pleased to share the The Mind Body Connector, a new resource to help you stay current with the latest news from the Benson-Henry Institute for Mind Body Medicine.
Sign up online to get future issues of The Mind Body Connector by email. Questions about the newsletter? Contact Nan Doyle, Director of Development or call her at 617-726-2200.
Past Issue:
Spring 2013, Mind Body Medicine and Multiple Myeloma: A Promising New Approach
Summer 2012 – Aging Without an Expiration Date
Fall 2011 – Mind Body Medicine and Your Genes
Summer 2011 – Mind Body Medicine Has Heart!
BHI Hosts Historic 2015 CME Conference
Two “prophets of Mind-Body Medicine” appeared together on the same stage to open the Benson-Henry Mind-Body Institute’s (BHI) annual CME Conference. Herbert Benson, MD and Jon Kabat-Zinn, PhD earned a standing ovation November 5th after discussing their groundbreaking work and experiences over 40+ years advocating for mind body health.
“It is such an honor to have two prophets of mind-body medicine here to talk about the work they have been advocating for for so long,” said BHI Executive Director Gregory L. Fricchione. “The world is catching up to their vision, and this is a historic occasion.”
The four-day conference at Harvard Medical School provided more than 400 integrative medicine practitioners from across the globe an opportunity to explore cutting edge research, share best practices and discover new strategies for treating patients.
Held annually since the late 1970s, the conference was especially salient this year as it follows on the heels of the publication of an exciting preliminary study published in October by James E. Stahl, MD, of the MGH Institute for Technology Assessment and a team of Benson-Henry Institute researchers. The study found that patients who participated in BHI programs reduced their medical visits on average by 43% in the year after taking part. Previously affiliated with the Benson-Henry Institute, Dr. Stahl is now Chief of General Internal Medicine at Dartmouth-Hitchcock Medical Center.
“Studies show that 60 to 90 percent of all medical visits are stress-related. This research proves that we can greatly improve the lives of our patients by integrating stress reduction into our healthcare delivery model,” said Dr. Benson, a co-author of the study. “This could improve patients’ overall health and reduce healthcare costs dramatically. It’s time to integrate this approach into mainstream medicine.”
Dr. Kabat-Zinn, who founded the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School, said that participatory medicine will be the prescription for public health in the coming decades.
The conference featured two keynote speakers, Anthony Biglan, PhD, senior scientist at the Oregon Research Institute and co-director of the Promise Neighborhood Research Consortium; and Ichiro Kawachi, MD, PhD, professor of Social Epidemiology and chair of the Department of Social and Behavioral Sciences at Harvard School of Public Health.
The four-day course had a robust schedule, with lectures and workshops covering a number of topics from changing the healthcare delivery model to stress reduction in children and the effects of stress on gastroenterology and inflammatory bowel disease. Participants were offered small group lectures and question and answer sessions on establishing a mind body clinic, the benefits of mind body medicine and sleep and working with youth to build resiliency, among other topics.
Click here for preliminary information about the 2016 CME Course.
Back-to-School Strategies that Promote Positivity and Cultivate Resilience
The first sight of a yellow school bus can cause excitement and anxiety. The best way to prepare students for back-to-school is to do just that – prepare them.
“Children thrive with routine; it’s important that as we get back to school, we get back into those routines that kids can rely on – going to bed on time, eating healthy, limiting screen time,” said Marilyn Wilcher, Director of the Resilient Youth (RY) program at the Benson-Henry Institute for Mind Body Medicine (BHI) at Massachusetts General Hospital.
Rana Chudnofsky, MEd, is a former Massachusetts school teacher who works with students, educators and families through the Resilient Youth and Resilient Schools programs. Back-to-school worries can vary according to children’s age and interests, but the one constant should always been open lines of communication, she says.
“A new year can mean a lot of new experiences and anxiety, so communication is key: talk to your child about their expectations, answer their questions and reach out to the school. Whatever the age, kids need to know that their parents are there for them, that they will support them, and that they love them,” Chudnofsky said. “We want to instill and foster resiliency in children, and we can do that by maintaining open lines of communication.”
Back-to-School Tips
- Establish a routine: set standard times for going to bed and waking up, for meals, schoolwork and free time. The sooner you put the routine into practice, the better; that way, waking up early on the first day of school is not a shock to your child’s system.
- Minimize anxiety: everyone gets butterflies before the big day, but if kids feel their parents are anxious for them, they will feel justified for their worries. Talk to your children about their concerns and let them know these are normal feelings; share your own first day worries. Help your child relax by going to the school beforehand, so s/he gets the lay of the land; this alleviates worries about being able to navigate around school. Meet up with friends from school before school starts, plan back-to-school outfits and lunches, and buy your school supplies early so that your child is excited for new opportunities and has a comfort level of what to expect.
- Build excitement: help your child get pumped up for school by talking about great experiences from last year and listing new opportunities the new year will afford. Promote positivity by helping plan what types of clubs, teams or activities your child will join. Going to school should be looked at as an exciting time by the whole family.
- Set healthy limits: going back to school means shedding some of the freedom of summer. Begin the school year with established expectations about the amount of time children will devote to schoolwork, extra-curricular activities, social interactions and family time. Limiting screen time (TV, phones, video games and computers) now will serve you well through the rest of the year. The American Academy of Pediatrics recommends that parents limit children’s daily screen time to no more than one or two hours per day, as well as turning off screens during dinner and prohibiting screens from children’s bedrooms.
