Leslee Kagan, MS, FNP, is Director of BHI women’s health programs and co-director of the BHI Stress Management and Resiliency Training Program. Here she shares a body scan meditation

Stress and the Relaxation Response: The Fundamentals of Mind Body Medicine

This interactive 4-week course provides valuable, evidence-based insights on the basic principles of mind body medicine. Enhance your clinical practice by helping your patients understand the science of how stress impacts health.

The course provides an overview of mind/body interactions and a deeper understanding of how mind body therapies decrease stress and enhance well-being. It strengthens your knowledge and clinical skill set for recognizing early warning signs, weighing the relative risks of various conditions, and ultimately helping your patients alleviate stress and either prevent or relieve medical conditions.

This is the first in BHI’s three-part online course catalogue and a requirement for participation in a SMART Implementation Training.

Next online course begins: April 3, 2017

It also features interactive discussion boards and weekly call-in hours with world-renowned faculty from the Benson-Henry Institute for Mind Body Medicine, including Mind Body Medicine pioneer Dr. Herbert Benson. Research shows that stress is a contributing factor in many common conditions and diseases, such as obesity, type 2 diabetes mellitus, hypertension, pain and fatigue syndromes as well as mood disorders. Engage faculty with questions about your clinical challenges and cases, and bridge the gap between the science underlying the principles of mind body medicine and applying that evidence to clinical practice to help patients tackle their serious health issues.

Course assignments include online lectures, recommended readings, interactive discussion forums, and weekly conference calls with faculty and all participants. The course content is 100% mobile-friendly so you can participate whenever your schedule allows. New course assignments are released each week, and you can finish the preceding week’s materials at any time to unlock the next week’s materials.

This four-week online course, “Using Mind Body Techniques in Your Health Care Practice” provides CME/CE credits, and is appropriate for both beginners and those with some experience in eliciting the relaxation response.

The course provides both a broad and deep look at the many methods to elicit the relaxation response. Participants learn how to build their own meditation practice along with effective approaches for instructing their clients/patients to do the same. 

Donna attended the Stress Management and Resiliency Training program after a friend suggested she learn more about the Benson-Henry Institute. Her reasons for attending the program were “chronic stress and medical problems.”

“In the program I learned how to meditate after never having meditated a day in my life.  I also learned how to restructure my negative thoughts into more positive thoughts that serve me.”

“After meditating daily I felt a difference in my world view.  I began to look at my life through a wider lens and things began to open up for me.”

“Participating in the program allowed me to accomplish several personal goals, including becoming an adult bat mitzvah and climbing 4,300 feet to the top of Mt. Pierce in New Hampshire.”

The program, Donna says, helped her change her outlook on the world and on life. “When you’re in that negative place, it’s all about you. This program teaches you that there is a world out there to explore and your life is bigger than me, myself and I.”

“I think when people are hurting, they are reluctant to try new therapies. In my case, I had no other options.” She advises others to be open to try something new.“It might really help to change your outlook,” she says.

About program leader and BHI Director of Clinical Programs Peg Baim she says, “Peg is a wonderful, compassionate and extremely knowledgeable teacher. She provides her patients with a sense of unconditional support. She presented the latest research with such enthusiasm we all could not help but be wowed. Peg is a very special person to me and I credit her for inspiring me to lead the life I was meant to live.”

Donna has maintained her daily meditation practice that she started at BHI, and credits the program with relieving her medical symptoms, and helping her personal and professional life take a different turn.

… Thanks for sharing your story, Donna!

February is American Heart Health month- which reminds us of the history of mind-body medicine and its power to support healthy hearts.

As a young cardiologist in the 1960s, BHI founder and current director emeritus Herbert Benson noticed a strange phenomenon. His patients’ blood pressure levels were often higher in the office than medication seemed to call for. He began to suspect that simply being in his office was creating artificially high blood pressure.

While this may seem an obvious observation now, it was a time before doctors knew about ‘white coat hypertensive syndrome’ – that is, the stress of seeing a doctor’s white coat in a clinical setting leading to elevated blood pressure.

His observations were confirmed, and got him to thinking that if stress could lead to higher blood pressure, perhaps the reduction of stress could lead to lower blood pressure. This line of inquiry led him to conduct the first studies of the effect of meditation on blood pressure. Doing so was a courageous act, as noone in the field was studying the influence of stress, and virtually all of his colleagues saw meditation and other mind-body approaches as flaky… “woo-woo”… definitely not medicine.

And yet, results showed that eliciting what Benson dubbed the relaxation response could offset the effects of the fight-or-flight response to stress, resulting in decreases in heart rate and respiration, blood pressure and the metabolic rate.  This initial work launched Benson on a path that would establish him as a pioneer in the field of Mind Body Medicine, conducting some of the first evidence-based research in this area, and thus transforming the field from being considered “alternative” health care to one that is now increasingly recognized as an essential component of health care.

And perhaps no condition can benefit more from mind body medicine approaches as cardiovascular disease. The single greatest health-related cause of death in this country, cardiovasvular disease is a devastating source of suffering, leading to over 600,000 deaths per year, and is also the most expensive health care issue in the country. According to the Center for Disease Control, in 2010, cardiovascular diseases in the United States cost $444 billion. Treatment of these diseases accounts for about $1 of every $6 spent on health care in this country.

Nearly 5 decades after Benson’s observation that stress influences blood pressure levels, it is now universally recognized that stress is a major contributor to cardiovascular disease, and that no pharmaceutical approach effectively treats stress.

At the same time, dozens of studies have confirmed the beneficial effects of mind-body approaches such as meditation, yoga and tai chi in reducing blood pressure, and ultimately, the need for expensive pharmaceuticals and procedures. In fact, in 2009, the U.S. Center for Medicaid and Medicare Services (CMS) formally compared outcomes from the BHI Cardiac Wellness Program with data on matched patients from their database who had had traditional cardiac rehabilitation services.  Their research found a statistically significant reduction in cardiovascular hospitalizations and a dramatic decrease in mortality over the course of the three-year review, as well as striking improvements in blood pressure, lipid levels, weight, and frequency of symptoms in male and female participants.

BHI is committed to more widely disseminating this proven approach to heart health to many more people in the coming years. And so, it is fitting that as we launch into February- heart health month- we are able to announce our upcoming one-day CME conference “Mind Body Medicine and Cardiovascular Health,” to be held May 5 in collaboration with the Osher Center for Integrative Medicine. This event will cover the most exciting new research in the field and provide attending health care professionals an introduction to how they may apply techniques in their health care practices.

For those interested in a simpler approach to maintaining heart health, try out this issue’s monthly dose of relaxation, as well as others in our archives.

Whether you are among the nearly half of all Americans who make New Year’s Resolutions, or are among those who don’t because you think they won’t last, the topic is worth a bit of reflection.

Recent studies on the success of New Year’s Resolutions- and yes, there actually are such studies- showed that only about 8% of people successfully fulfilled their resolutions over the long term. And just what are these resolutions? The top five include:

1- losing weight
2- getting organized
3- spending less, saving more
4- enjoying life to the fullest
5- staying fit and healthy

All worthy goals, and most of us can stick with them for at least the first week. But by the first month, only about 60 percent are keeping up with them, and by six months the percentage drops to less than half.

To improve our chances for success, it’s worth looking at why resolutions typically fail.
When we initially set goals, we are filled with enthusiasm and determination. If the goal is, say, to lose weight, we steadfastly deny treats or seconds and choose healthy alternatives for meals throughout those early days. But life has its ups and downs, and when the world seems overwhelmingly stressful and we feel we’ve lost control of circumstances, it becomes increasingly difficult to stick with the plan.

So what’s the secret ingredient to help us more effectively carry out admirable resolutions towards improved health and happiness?
The answer does not involve trying to control our circumstances or even setting lower or shorter-term goals. Rather, we must work with the one thing that we can control: our own reactions to life’s challenging situations.

Here are two ways BHI teaches people to shift responses to stressful circumstances:

1. Shifting mental reactions. There are many stress-based responses we can have to any given situation. Say you miss your train to work. An all-or-nothing thinker might say, “Why does this always happen to me?” A perfectionist might say, “I can’t believe I was stupid enough not to set my alarm 10 minutes earlier.” A  catastrophizer would think, “This is going to be the worst day ever!” and so on… Coming to understand your personal stress response habits is an important first step in shifting towards more helpful thinking. Using the example above, more helpful responses might be, “This gives me the opportunity to be out in the fresh air while I wait 20 minutes for the next train,” or “I’ll remember to set my alarm clock a bit earlier from here on,” or “It’s not that big a deal. I’ll catch the next train and check my email in the meantime.”

2. Shifting physical reactions. At BHI, we teach people a wide variety of techniques to elicit the relaxation response (RR), which is experienced as a state of profound rest that directly counteracts the physiological stress response (sometimes called the fight-or-flight response). When practiced regularly, eliciting the RR can help prevent the nervous system from overreacting when stressful situations arise. There are dozens of ways to practice eliciting the relaxation response, including various types of seated meditation, as well as moving meditations like yoga and tai chi, and prayer. We encourage people to find the techniques that work best for them, though all involve focusing the mind with a repetitive word, sound, phrase or action, and keeping a sense of mindful openness while letting go of everyday concerns. Learning to meditate has been scientifically shown to beneficially shift gene expression, and long-term practitioners are increasingly resilient to stress, and better able to adapt to challenging life situations over time.

So, even though New Year’s Eve has passed, why not strengthen  your resolution with these practices that will likely enhance your chances of success in the year to come.

Presented by Elyse R. Park, PhD, MPH

Childrens’ gastrointestinal illnesses are on the rise.

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, was once a rarity among children, but now may affect as many as 80,000 kids in the U.S., an increase of more than 50 percent in the last decade. These diseases can damage the tissue of the small and large bowels through chronic painful inflammation.
Irritable bowel syndrome (IBS), which occurs in as many as 15 percent of adolescents, can cause cramplike pains and bouts of diarrhea and/or constipation.

The causes of IBD and IBS are not well understood, but research suggests that influential factors may include genetic and/or immune system dysfunction, overuse of antibiotics, diet, lack of exercise and stress.

Stress may also be an important factor both in the severity and likelihood of flare-ups for these conditions. Kids are particularly sensitive to stress and emotional upsets. Because nerves in the colon are linked to the brain, stress and conflict (things like family problems, moving, taking tests, going on vacation, and trauma) can affect how the GI tract functions in a myriad of ways. By countering the stress response with the elicitation of the relaxation response we can prevent or reduce severity of flare-ups and possibly even help stave off disease onset.

This January, BHI is very pleased to partner with the Mass General pediatrics GI department in leading Stress Management and Resiliency Training programs for kids with chronic gastrointestinal issues. Given the critical importance of parents’ abilities to support their children in having success with the program, BHI also will host a corresponding program for parents of patient participants.

“With the initiation of this program, we will bring a much needed resource to a group of patients for whom Mind Body Medicine will be highly beneficial,” says Mark Salvatore, MD, a pediatric gastroenterologist at MGH.

This interactive, engaging research-validated program will provide teens, ages 12-18, and their parents, the self-care skills they need to reduce physical symptoms and move through life’s physical and emotional challenges with greater resiliency by learning:
•    How stress affects thoughts and feelings
•    Meditation techniques to reduce symptoms and improve physical health, such as deep breathing, mindfulness and imagery
•    How to foster positive thoughts and attitudes

Enrollment is still open for this eight-session program, which begins January 21st. Sessions will be held Wednesdays from 3:30 – 5:00 p.m. at the Benson-Henry Institute, 151 Merrimac Street, 4th floor, Boston, MA.
Cost: $300 per participant
Leadership: This program is led by Leslee Kagan, MS, FNP, and Rana Chudnofsky, Director of the BHI Education Initiative, and Mark Salvatore, MD, Pediatric GI.

Parent Group: Parents have the option to participate in a separate stress-reduction and resiliency building program while their children’s program is in session. Cost: $200 for one or both parents.

For more information, or to sign up, please contact Laura Malloy at lmalloy@partners.org or (617) 643-6061 or Marilyn Wilcher at 617-643-6035 or mwilcher@partners.org.

An annual survey by the American Psychological Association (APA) in 2013 identified today’s teens as the “most-stressed generation” in the United States. Nearly half of the teens surveyed said that they had stress but couldn’t manage it.

This stress—be it academic, parental, peer, environmental or health-related—is associated with increased incidence of academic failure, physical illness, insomnia, depression and violence. Sadly, suicides among adolescents have quadrupled since the 1950s. A recent survey of seventh graders showed that only 36 percent of students agreed with the statement, “I am happy with my life.”
Not surprisingly, excessive stress in childhood is firmly associated with unhealthy adult behaviors such as abuse of alcohol, tobacco and drugs, and unprotected sex. It is also associated with an increased incidence of autoimmune and cardiac diseases, and mental illness.
In his remarks introducing the APA study, APA Chief Executive Officer Norman B. Anderson, PhD, said, “In order to break this cycle of stress and unhealthy behaviors as a nation, we need to provide teens with better support and health education at school and home, at the community level and in their interactions with healthcare professionals.” He adds, “Parents and other adults can play a critical role in helping teens get a handle on stress by modeling healthy stress management behaviors.”
The BHI has 25 years of experience teaching resiliency in school settings through its Education Initiative (EI). By learning resiliency, children can “rise above” or “bounce back” from situations that create uncertainty, such as illness, adolescence, or academic or peer pressure.
The EI regularly measures the effectiveness of the program using validated assessment tools, which examine pre- and post-program changes in stress levels, self-esteem, grades, coping strategies, locus of control and lifestyle behaviors. The EI’s controlled studies demonstrate that students who participate in the curriculum have:
* higher grade point averages
* increased self-esteem
* decreased psychological distress
* better work habits
* better attendance
Classroom teachers are the primary focus of the EI’s resiliency-enhancement program, via a “train the trainer” model. Experience shows that teachers who develop their own resiliency skills are much better equipped to impart those skills to students. Teachers know their students’ daily concerns well, and are often in the best position to help. And with each new academic year, trained teachers can pass this work on to a new class, multiplying the positive mindset so that it soon becomes part of the school culture.
Teacher training can also be augmented with training for parents, as well as BHI-led programs for students.
In 2014 alone, the program served more than 2,000 teachers, students and counselors. To find out about upcoming programs in your area, or for more information on how to set up a program for your child or school, please click HERE