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Psychologist describes mind/body program
(June 2006 Issue)

A recent Boston Globe article trumpeted the news that placebos actually do make people feel better.

Isn't that rather obvious? Isn't that what, by definition, a "placebo" does? It may seem strange in this day and age to have this information make headline news. Then again, it's only recently that society has begun to accept the idea that our mental health can have a direct positive and/or negative effect on our physical health.

Although it's not a new field, New England Psychologist's Catherine Robertson Souter took the opportunity to speak with Ann Webster, Ph.D., director of the program for cancer patients at the Mind Body Medical Institute in Chestnut Hill, Mass., and an instructor in medicine at Harvard Medical School, about the strides that the field of mind-body medicine has taken in the last two decades.

Q: First, tell us about the Mind Body Medical Institute.
A: The Mind Body Medical Institute was started by cardiologist Herbert Benson 30 years ago. We basically offer our patients self-care techniques, things they can do to prevent themselves from getting sick or to help them heal and get better.

One of the things our clinic is famous for is helping people elicit the relaxation response, a state of quiet in the mind and the body, through meditation, progressive muscle relaxation, self-hypnosis, visual imagery, prayer and yoga.

Another big component is what I call "change your mind, change your mood," paying attention to your negative thoughts when you are upset and seeing that your thoughts create your moods. We teach how to challenge those negative thoughts and come up with more rational ways of thinking.

We also have exercise and nutrition as a part of what we teach.

An important distinction is that we are not giving medical treatment. We are not prescribing. The things we are teaching people are things that they can do themselves.

Q: How is this so different from standard therapy? These are not new techniques you are teaching.
A: It's really the whole package. I don't think many psychologists are trained in relaxation techniques and that is absolutely the foundation of everything we are doing. I think of it as the earth we stand on and the air we breathe. That foundation makes therapy much simpler.

A lot of therapists don't use the cognitive restructuring model that we use. They just do talk therapy. There's a whole model that goes along with this that is different from standard psychotherapy. Also, standard psychotherapy doesn't take into consideration a lot of other components of people's lives such as nutrition, sleep and rest, healthy pleasures, spirituality, humor.

Q: Why do you think, historically, this type of treatment is disregarded by Western medicine?
A: Well, that's their training and we need that. But it is changing rapidly. We have this Harvard course that we give three times a year on mind/body medicine and about 80% of the people who attend now are physicians. Before, maybe we'd have 10%. Everybody is seeing the wisdom of what we do, the health benefits, the cost savings, everything. We are not taking people away from traditional Western medicine, just supplementing it.

Q: These recent studies talking about pain-killers working even though they are placebos are obviously nothing new to you.
A: Dr. Benson has been talking about the placebo effect for three decades. It's not new. It's the power of belief. Mind/body medicine is so powerful. We teach people things and they believe that by practicing they can make change…and lo and behold, they do. Many of them don't want to take medication. They would much rather do this themselves. There is a very powerful belief system at work.

Placebo means "I shall please" in Latin. It's been around since the beginning of time. Centuries ago, you would go to a shaman or faith healer or a priest. Just the power of belief would help people get well.

Q: What is it about belief that changes them physically, medically?
A: Optimism. If you are hopeful it will change the chemistry of your brain. It changes your thinking. You change your thinking and things actually alter in the brain, nerve growth and chemical changes. We know that stress and upset diminishes immune functioning so the opposite would have a positive effect. Studies have proven that. I've seen cancer patients who had doctors tell them all these horrible side effects they are going to have from their chemotherapy and they do. Other patients believe they are going to sail right through it and they do.

Q: Then of course, not everyone does. We can't totally control our health this way…otherwise we could conceivably live forever just by willing it so.
A: People are very individual, but if you were going through some kind of scary diagnosis, you would feel that you had an edge if you had all these tools and were optimistic and hopeful and then that would show up physically.

Plus, I suppose even if you were not able to change the outcome, it's better to live out your life in peace and happiness rather than in stress.

Q: How would a psychologist incorporate some of these techniques into his or her own practice?
A: Well, you get the training. There are a lot of places where you can learn relaxation techniques and cognitive therapy, nutrition and positive psychology. Then just put it in your practice. What's interesting is that my practice has changed enormously since I've incorporated all these things rather than just doing talk therapy, which is so boring. And people get better. It's great.

If people are going to do this work, it's best to have an abundance of techniques because you don't know what one person is going to experience. When the only tool you have is a hammer, you treat everything like it's a nail. But having tons of tools makes me a better therapist.

Q: What does the future hold?
A: The future of mind-body medicine is just soaring. I first came to the Mind Body Medical Institute 20 years ago and when I started I would go out and give talks and people would scoff at what we were doing. That's changed enormously. Now everyone wants to learn what we are doing. There are all these books out there. It's just huge. It's an exciting field to be in.