We all have an Uncle Paul …he’s that guy at the Thanksgiving table, the one whose political prognostications poison the potatoes and inspire suffering over the stuffing.  He’s loud, he’s brash, he’s opinionated and he makes you want to cower under the table cloth.

Yes, the holidays are the best of times, they are the worst of times.  And in this highly politicized climate, they can inspire no end to anxiety.

If you’re dreading the day, BHI’s Dr. Ellen Slawsby has some sage advice:

“Family dynamics are the number one stress factor for most people during the holidays,” Dr. Slawsby says.  “There are several ways to handle that stress so that you can make the most of your holidays and enjoy them yourself.”

1. The most important thing is self-care.
   The holidays are a very busy time of year; between parties, cooking, shopping and relatives from far flung places, its especially important to take time for yourself.Be sure to plan your time – fit in your daily exercise, schedule an afternoon break for a cup of tea or a few chapters of your favorite book.“We all feel a sense of obligation to our families, but we have an obligation to take care of ourselves,” Dr. Slawsby says.  “You need to literally make a list of the things that make you happy and schedule time to do them.  Even if it’s just for a few minutes, you need to stop, breathe and reflect.”
2. Brainstorm your responses in advance
   If you have a relative whose conflicting views on life, politics, fashion, etc… diverge from your own, don’t let yourself be goaded into an argument.  Think of what the conversational minefields may be and come up with some neutral comments that everyone can agree on.“If you have a toxic relative and you’re dreading seeing them, think in advance about what you have in common. Think of strategies for steering the conversation away from what might be divisive,” Dr. Slawsby said. “Think of a good memory that knits you all together and say to Uncle Paul, ‘remember that time I got lost at the amusement park you and found me and saved me?’”
3. Have an exit strategy
   If things tend to devolve over dessert, clear the table.  Go to the restroom.  Pop into the den and watch the football game if the gang in the living room is getting catty.  Take time for a mini meditation.Remember that you don’t have to commit for a full day – maybe you just come for dessert.  Perhaps you tell everyone you have to leave by 4 o’clock.“It’s healthy to set boundaries – decide how much time and energy you want to expend.  This is your family and you love them, but if the conversation is taking a toll on your emotions, you need to limit your exposure,” Dr. Slawsby said.
4. Host planning
   If you’re hosting the event and you want to avoid volatility, there are some easy things you can do to help set the right mood:

• Create a soothing playlist
• Dim the lights to set the mood
• Set place cards at the table to ensure conflicting parties aren’t seated side by side
• Create distinct conversational settings – place hors d’eouvres in different rooms so people of like minds can naturally congregate together
• Organize post-turkey walks around the neighborhood

“We all feel varying levels of stress about the holiday, but I really try to focus on what we have in common,” Dr. Slawsby said.  “The holidays are about gratitude, sharing and giving.  And if we think carefully about our interactions and take care of ourselves, there’s no reason the holidays can’t be joyful.”

The core belief of the Benson-Henry Institute (BHI) – that teaching patients mind body approach like meditation and yoga can reduce their stress and improve overall physical health – was proven correct in a preliminary study published this fall in the journal PLOS ONE.  The study found that patients who participated in BHI programs reduced their medical visits on average by 43% in the year after taking part.

The study was led by Dr. James E.  Stahl of the MGH Institute for Technology Assessment.  Dr. Stahl was previously affiliated with BHI and is Chief of General Internal Medicine at Dartmouth-Hitchcock Medical Center.

“Our study’s primary finding is that programs that train patients to elicit the relaxation response – specifically those taught at the BHI – can also dramatically reduce health care utilization,” Dr. Stahl said. “These programs promote wellness and, in our environment of constrained health care resources, could potentially ease the burden on our health delivery systems at minimal cost and at no real risk.”

The relaxation response was first described more than 40 years ago by Herbert Benson, MD, founder and director emeritus of the BHI and a co-author of the study. The physiologic opposite of the well-documented fight-or-flight response, the relaxation response is elicited by practices including meditation, deep breathing and prayer and has been shown to be helpful in the treatment of stress-related disorders ranging from anxiety to hypertension. The paper’s authors note that stress-related illnesses such as anxiety and depression are the third highest causes of health expenditures in the U.S. after heart disease and cancer, which also are affected by stress.

“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,” Dr. Benson said.  “This could improve patients’ overall health and reduce healthcare costs dramatically.  It’s time to integrate this approach into mainstream medicine.”

Other co-authors of the PLOS One paper include BHI Executive Director Dr. Gregory L. Fricchione, Director of Research John W. Denninger, MD, PhD, Medical Director Darshan Mehta, Researcher Michelle Dossett, MD, PhD, and Roberta Goldman; and Scott LaJoie, PhD, University of Louisville.

“The results are promising and it gives us hope that more rigorous study will bear out the findings of this report,” Dr. Fricchione said.  “We are committed to doing the rigorous study because we believe it is so important to the health of our healthcare system.”

Dr. Fricchione, you are the Associate Chief of Psychiatry at the MGH, Director of its Division of Psychiatry and  Medicine, and Director of its world-renowned Benson-Henry Institute for Mind Body Medicine. Tell us more about your clinical and research interests, and what guided you into the field of Mind Body Medicine in particular?

Dr. Fricchione: I’ve been lucky in that I was drawn to a subspecialty called Psychosomatic Medicine and benefitted from training here at MGH in the early 80’s in this field.Psychosomatic Medicine allows you to reside in the borderland between the brain and the body and to stage forays into the land of the body and into the land of the mind across the bridge of the brain, all the while understanding at a very deep level that mind, brain and body are really one country. The age-old mind body question that has vexed philosophers and scientists surfaces in almost every patient you see when you deal with the symptoms and the suffering a psychiatrist deals with on the medical and surgical wards.

So, it is very interesting and it has led to many researchable questions. The catatonic syndrome, for instance, is an amazing natural experiment that has a lot to teach us about the relationship between motivation and movement. Patients who have implantable cardioverter defibrillators are benefited by protection from lethal atrrhythmias but subject themselves to the risk of developing PTSD if their device fires. Researching this will help us understand anxiety disorders. With the dawning of a revolution in our understanding of epigenetics – how the environment can activate and de-activate certain genes – we are discovering ways that mind approaches like meditation, cognitive skills and positive psychology can predispose to a healthier brain and body. I’ve been fortunate to lead the Benson-Henry Institute for Mind Body Medicine here at MGH and we are doing these epigenetic studies as well as clinical and biomarker outcome studies.

What is the Relaxation Response? Tell us about the doctor who had coined the term, and please share with us what you know about its many health benefits.

Dr. Fricchione: Dr. Herbert Benson, a cardiologist, first described the relaxation response. He started as a hypertension researcher and then did the first studies on transcendental meditation back in the late 60’s and early 70’s. He came to the realization that the stress response physiology was counter-regulated by a relaxation response physiology that could be elicited through the use of a variety of meditative techniques, the core features of which are the emptying of one’s mind of everyday concerns combined with a repetitive thought, word, phrase or prayer. When someone is successful in integrating a relaxation response practice into their daily lives, for as little as 10 minutes a day, health can be promoted and stress related illnesses like hypertension, functional bowel diseases, pain syndromes etc. can be prevented. By reducing blood pressure, heart rate, respiratory rate, oxygen consumption, as well as inflammatory response, learning to elicit the relaxation response can help with primary, secondary and tertiary prevention.

Do you think that a ‘mind-body approach’ may be used for dementia prevention and related diseases? If so, what kinds of research and/or clinical programs would you envision for our community?

Dr. Fricchione: There is research to suggest that those with “distress prone personalities” may be more at risk for developing dementia. There is also research implicating a persistent inflammatory response syndrome, perhaps related to amyloid or tau as irritants, in the etiology of Alzheimer’s and oxidative stress in the development of neurodegenerative diseases in general. If reducing stress through relaxation response and enhancing resiliency through mind body approaches plus nutrition, exercise and sleep hygiene, can reduce oxidative stress and the inflammatory response syndrome, perhaps dementia can be prevented or at least delayed by these mind body approaches.

We would like to collaborate with the MGH Dementia Center to put this hypothesis to the test by offering our Benson-Henry Institute approach to the normal elderly and to those with mild cognitive impairment and monitoring them longitudinally for effects on cognitive functioning. In addition given the stress we know that dementia family caregivers experience, we want to begin offering caregiver stress management and resiliency programs to this ever-growing population.

What advice would you give to someone who wants to work in your field?

Dr. Fricchione: Whether you are an internist, a neurologist or a psychiatrist, first become the best traditional clinician you can be. Then focus extra study on how the mind, brain and body are integrated and how this understanding can help you synthesize your practice into what is being called whole person care. Whole person care recognizes the addition of patient self-care as an essential component of health and well being to the traditional components of pharmacotherapy and procedures. Mind body approaches form the foundation of modern self-care. Along the way the engrossing mystery of how the mind, brain and body interpenetrate will be a constant companion.

Lastly, tell us what you like to do during your ‘down-time’? What sustains your enthusiasm and energizes you for all the work that you do for your patients?

Dr. Fricchione: My family is really the most sustaining dimension of my life. I have a wonderful wife of 36 years and 3 great children all living exciting, interesting lives, and also an awesome retired Seeing Eye retriever named Yuma. I like to shovel snow in the winter and swim in the summer and read and hike all year round. And, of course, I try to do my meditation.

Thank you so much for your time, Dr. Fricchione. 

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.”

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 50^th 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 1^st, 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.

Current Issue:

Fall 2013: Resilient Warrior, Learning to be home again

Please register using the form to the right in order to receive our e-newsletter.

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!

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 5^th 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.