A conversation with BHI’s Director of Research.

Q: What drew you to the field of mind-body medicine research?
Denninger:

Well, I’ve always been interested—even back when I was in high school—in the mind, brain and behavior, but it wasn’t until I went to China on the Boston-Hangzhou Sister City program right after I graduated from Boston Latin School that I had any exposure to what we think of now as mind-body medicine. While studying at Hangzhou University, we had daily sessions with a tai chi master. Although my 18-year-old self was a little thick about the focus on breathing, intentionality and chi (I think I had been expecting something a little more martial arts and less meditation), I like to think that I internalized some of the wisdom in that practice and have carried it with me since.

When I was getting my MD/PhD at the University of Michigan, my dissertation work focused on the kind of science where we looked at one protein—one enzyme—at a time in a test tube. After my psychiatry training here in the MGH/McLean Psychiatry Residency Training Program, I decided that I really wanted to shift my research to something that would be more directly applicable to helping patients. I spent four years at MGH’s Depression Clinical and Research Program, doing both clinical and research work with patients struggling with depression. Coming to BHI, I was excited by the idea of being able to integrate research on mind-body medicine at a number of levels—from public health to individual patients to understanding the molecular details of how mind-body approaches work.

At BHI we are clinician-researchers, so we combine expertise in developing and delivering mind-body programs with expertise in conducting scientific research. Both of these areas inform and complement each other so that we can improve both over time. One example of this is our current work to identify outcome measurements that will be most useful for future mind-body medicine research.

It’s also tremendously exciting to be able to work collaboratively with a some of the top researchers in the field, whether in genetics, neuroimaging or in the clinical application of the work. There are over 600 integrative medicine researchers at Harvard alone who are making tremendous advancements in the field, and Boston continues to evolve into a truly international hub for this work.
Q: What areas of research are leading to new understandings in the field?

Denninger: I’m always excited by research into the biology underlying the approaches that we teach. Being able to say something very specific on a molecular level about what happens when people practice meditation is important to me, to the institution and to the field in general. It’s some of the most exciting work that we do.

For the past several years, we’ve been exploring with Dr. Towia Libermann and Dr. Manoj Bhasin, our partners at Beth Israel Deaconess Medical Center, the effect of the relaxation response and BHI’s mind-body intervention on how genes are turned on and off. We’ve already established that the regulation of NF-B, an important molecule in the immune system, is altered by the mind-body approaches. Our focus now is on higher level questions; for example, can BHI’s resiliency program improve patient outcomes and potentially prevent development of disease by directly affecting physiology.

Along with collaborators here at MGH, at Dana Farber Cancer Institute, Beth Israel Deaconess Medical Center and Newton-Wellesley Hospital, we are about halfway through a study of patients who have conditions that are precursors of multiple myeloma (a cancer of plasma cells—a type of white blood cells—which accumulate in the bone marrow) to see whether the BHI’s mind-body program can help these patients become more resilient in the face of the stress of having these conditions’ physiology and possibly—and this would be the home run—alter gene regulation in a way that might help slow the progression of these conditions.

In the larger field, there have been great strides in neuroimaging and meditation. The October 2014 Scientific American magazine does a nice job of summarizing some of that exciting research.

We’re also starting work to get at costs—answering the question of how much our program can save money for the system. That’s important research to do, but it takes time and can be difficult to do well.

The reality is that we still have a long way to go in the research arena before policymakers and planners are ready to recommend mind-body approaches to patients with the same universality that they recommend exercise and eating right. But I think that day will come: The fact is that the science continues to lead us toward further integration into mainstream healthcare. It’s an incremental process, but eventually, as I see it, mind-body medicine will be widely perceived as an effective tool in the healthcare tool belt.
Q: Do you have a personal practice?

Denninger: Yes, but it’s taken me a while to really integrate it into my life. I came to BHI attracted by the science; over my years here I’ve fallen in love with the practice. Now my daily meditation—okay, almost every day—is one of the things I look forward to most.