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.