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The Mysterious 'Medication' of Meditation
Ancient Tradition Undergoes 21st Century Scientific Scrutiny
By Jeanie Davis
WebMD Medical News
May 30, 2000 -- The waves of pain are intense for Regina, the result of an auto accident that left her with neck and jaw injuries. Surgery brought no relief, and pain medications left her drowsy, with virtually no energy. She's had to quit her job as an on-the-rise Atlanta chef. "I didn't like the way they made me feel ... not like myself," the 35-year-old tells WebMD of the pain medication.
Seeking an alternative, she gave meditation a try. Now when the intense pain hits -- which happens at least five times a day -- she calms her thoughts, focuses on her breathing, and meditates it away.
Meditation -- an ancient spiritual tradition -- is for millions of people around the world a 15- or 20-minute daily ritual. While there are several forms of meditation, generally it involves focusing on the breathing, ignoring everyday thoughts, and repeating a word or phrase called a mantra. Relaxation, which is at the heart of meditation, has long been known to quiet a turbulent mind, reduce stress, and, as in Regina's case, provide pain relief.
During the past three decades, a handful of scientists have delved deeper into the mysteries of meditation, trying to understand how the mind affects the body. Studies show that daily meditation can indeed be medication -- creating long-lasting physiological effects that reduce high blood pressure and even help unclog arteries to reverse heart disease.
Harvard researcher Herbert Benson, MD, has studied and written about the physiologic effects of meditation over the past 30 years. Also president of the Mind/Body Institute at Beth Israel Deaconess Medical Center in Boston, Benson co-authored a recently published -- albeit small -- study mapping, for the first time, exactly what happens in the brain during meditation.
Five long-time meditation practitioners were involved in the study. Each had practiced Kundalini, an Eastern form of meditation, for at least four years. While meditating, each was given a brain scan called an MRI.
"There was a striking quietude across the entire brain which was documented through MRI," Benson tells WebMD. "The areas of the brain that became active from that quietude were those that control metabolism, heart rate, etc.," says Benson, who is also associate professor of medicine at Harvard Medical School. The results were published recently in the journal Stroke.
"We knew meditation caused a relaxation response, but we couldn't prove it. We knew that if you thought in a certain way, with repetition, that physiologic changes would occur in the body. Here now is proof that mind, in the form of repetition, is affecting the brain, which affects the body," says Benson.
Also studying meditation over the past 12 years are researchers at the College of Maharashi Vedic Medicine in Fairfield, Iowa. Many of the studies, sponsored by the National Institutes of Health, have focused on heart disease and its risk factors.
One study of transcendental meditation, another form of meditation, and its effects on black people with high blood pressure was published earlier this year in Stroke. The study was authored by Amparo Castillo-Richmond, MD, an assistant professor at Maharashi.
In the group that practiced transcendental meditation, there was an reduction in thickness of one of the arteries that supplies blood to the brain, a sign that blood flow is increasing, Castillo-Richmond tells WebMD. In the group that only followed diet and exercise recommendations, "the artery walls were getting thicker."
The transcendental meditation group also had significant changes in blood pressure as well as heart rate. "It's possible to reverse heart disease through meditation," reports Castillo-Richmond.
Another three-month study, published in the journal Hypertension, showed that transcendental meditation had a much greater effect on blood pressure than a widely used approach for relaxation, called progressive muscle relaxation.
"What we found was that conventional education had little or no effect in reducing high blood pressure, which is what doctors find most of the time. We tell our patients to change their diet, lose weight, avoid salt, avoid stress, get more exercise, but they just don't do it. It's hard to change your lifestyle," Robert H. Schneider, MD, director of the Center for Natural Medicine and Prevention at the College of Maharishi Vedic Medicine, tells WebMD.
The group that practiced progressive muscle relaxation showed a small change in blood pressure, which is consistent with other studies, he says.
However, "the transcendental meditation group had twice the change in blood pressure as the relaxation group" and had results similar to drug treatments, Schneider tells WebMD. "This is really critical because transcendental meditation is widely misunderstood. The original hypothesis 25 or 30 years ago was that all meditation approaches had the same effect. However, research in the past decade has disproved this hypothesis clearly."
There are several forms of meditation, including transcendental meditation, and several types of relaxation therapies. Many clinicians believe that relaxation -- however it is achieved -- is the crucial factor.
"There are three basic kinds of meditation: concentrative, awareness, and expressive. Transcendental meditation and Kundalini are concentrative, focusing on a mantra; Vipassani is a mindfulness or awareness meditation, becoming aware of thoughts, feelings, and sensations as they arise; and expressive meditation is dance, twirling, shaking," says James S. Gordon, MD, director of Center for Mind-Body Medicine in Washington, D.C.
"Each may have slightly different physiologic effects, but that doesn't mean that one technique is better than the other. Different kinds of meditation are appropriate for different people at different times," Gordon tells WebMD.
Benson agrees. Meditation is but one form of relaxation that leads to a common set of physiologic changes, he tells WebMD. "There's nothing unique about meditation. Physiologically, it is called the relaxation response, and its opposite is the stress response. With the relaxation response there is decreased metabolism, heart rate, blood pressure, rate of breathing, slower brain waves. That's been proven repeatedly in studies."
Benson says yoga, tai chi, Lamaze breathing, and repetitive prayer such as the rosary can do the same. "They all share this common physiology," he says. "Repetition is key to creating the response. So it could be a mantra; it could be a prayer; it could be a repetitive muscular activity. The other feature is, when other thoughts come to mind when you do a repetition, simply let them go and come back to the repetition."
The bottom line is that any condition that's caused or exacerbated by stress can be alleviated, says Benson. "So with 60% to 90% of visits to physicians being in the mind-body, stress realm, you can see why this has such legion effects. Anxiety, mild and moderate depression, anger and hostility, hypertension, cardiac irregularities -- all forms of pain are made worse by stress. And that's why the relaxation response is useful."
Meditation-type exercises are "virtually curative of tension-related pain like tension headache. It's vitally important in PMS, infertility, hot flashes, insomnia," Benson says.
Regina's doctor, Stan Chapman, PhD, tells WebMD because all relaxation methods involve internal focus and putting distracting thoughts aside, "they can be effective in reducing pain." Chapman is a pain therapy specialist, psychologist, and professor at Emory University School of Medicine in Atlanta. "There's a lot of evidence in the research literature that pain tends to be worse when people are anxious, or when their muscles are tight."
Relaxation methods also help with sleep, a major issue for people with pain. "Many medications people use for sleep have untoward side effects, like carryover drowsiness during the day which affects their ability to function, remember, or drive, which is very critical to people," Chapman tells WebMD.
But in a busy world, if pain relief is not at stake, are people making time to meditate?
Schneider says that because meditation is a very natural activity, people easily adopt it as a routine. He reports that in his blood pressure study, 80% to 90% of people continued doing their daily meditation several months after the study.
"The jury is in on this; it's not even a question that it works," says cardiologist Paul Robinson, MD, of Emory University School of Medicine. But he has met some resistance.
Meditation has helped some of his patients, he says, but "they have to be agreeable to the technique and willing to go through what it takes to do meditation properly. That's one of the drawbacks, because in this country, many people don't understand it and don't want to take time to do it."
While meditation will reduce some risk factors, like blood pressure and excessive heart rate, you still have to watch cholesterol, diet, exercise, says Robinson.
Gordon tells WebMD that aside from the health benefits, meditation changes the way you look at the world, the way you live your life, and "that's quite important."
"If you live in the moment and are not preoccupied by the past or worrying about the future, you've made a profound change," he says. "It is true that meditation has important physiologic effects in terms of lowering blood pressure, decreasing heart rate, or decreasing levels of pain, and that's also important. Running may have similar effects, but it doesn't necessarily change your life in profound ways. Meditation has the capacity to do both."
Meditation can be an effective way to manage pain, relieve stress, lower blood pressure, and lower heart rate.
The three basic types of meditation are concentrative, awareness, and expressive, and they all induce a relaxation response, which is the opposite of the stress response.
For meditation to be effective, people must be agreeable to the technique and make the effort to do it properly.
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Have a great day guys!
Pain, Pain, Float Away
For people who suffer from chronic pain, meditation may be the first step to recovery.
By Karen Hopkin, PhD
WebMD Medical News
Medically reviewed by Dr. Jeannie Brewer
Aug. 28, 2000 -- Pick up a raisin. Look at it -- really look at it -- like you've never seen a raisin before. Roll it between your fingers. What do you notice about its texture, its color, its heft? Hold the raisin to your ear. Squish it a bit. Does it make a sound? Bring it to your lips. Take note of any stray thoughts you might have, but always come back to the raisin itself. Place it on your tongue. When you finally swallow it, appreciate the fullness of its flavor. Now imagine that your body is exactly one raisin heavier.
Sound like an odd exercise? Then consider this: For thousands of people who suffer from chronic pain, spending quiet time with a raisin has proven to be the first step to recovery -- or at least to learning how to cope with their pain.
The raisin contemplation serves as an entree to the practice of meditation -- an approach that is gaining in popularity among people in pain. In 1997, Americans made more than 100 million visits to alternative practitioners for relaxation therapies such as meditation, according to a study by David Eisenberg, MD, that was published in the Nov. 11, 1998 issue of the Journal of the American Medical Association. Just how meditation relieves pain is not entirely clear, though researchers are beginning to enumerate and examine potential mechanisms. What is clear is that for millions seeking treatment for headaches, arthritis, and many other conditions, meditation seems to work.
Benefits for Mind and Body
"It changed my life," says Imogene Benson, who signed up for the stress reduction program at the University of Massachusetts in Worcester after a bad fall left her with neck and back injuries and who also suffers from a chronic, painful condition called fibromyalgia. "I've learned to relax and be more in control of my body, instead of having my body controlling me," she says. An avid runner before the accident, Benson says that the pain kept her from working for months at a time and made negotiating even a short flight of stairs a nightmare. Meditation has not only given her a sense of inner peace, she says, it has improved her physical condition as well. "I have less pain, my muscles are more relaxed, and I have much better mobility," she says.
Over the past 20 years, thousands of individuals have sought help at the U. Mass. Stress Reduction Clinic, which has pioneered methods for teaching meditation techniques to people with pain. Their symptoms vary -- from headaches and back pain to anxiety and eczema -- but their stories are remarkably similar. "Most of the people we see have had long experiences with pain clinics, doctors, and medications," says Elana Rosenbaum, a social worker at the clinic. "But nothing has relieved their suffering." Before coming to the clinic, Benson tried medication, physical therapy, and a device that electrically stimulates muscles to reduce pain: none offered more than temporary relief.
And then she tried meditation. "It's just wonderful. No matter how stressed you feel before, afterward you feel relaxed, calm, and filled with energy," says Benson. Since graduating from the program nine months ago, Benson sets aside some time each day, wherever she is, to practice her techniques. Closing her eyes, she stretches and does a body scan, slowing her breathing and gradually moving her attention to each part of her body. Meditation doesn't always require a mantra or mystical music; for Benson, the key thing is finding a quiet place to focus for half an hour.
Scientists Weigh In
According to one early study by Jon Kabat-Zinn, director of the Stress Reduction Clinic, 65% of the patients who spent 10 weeks in his program reported that their pain was reduced by one-third or more. (The study was published in the April 1982 issue of General Hospital Psychiatry.) Their mood improves and they experience significantly fewer overall symptoms, says Shreyas Patel, MD, a neurologist who trained with Kabat-Zinn before joining the Marino Center for Progressive Health in Cambridge, Mass. Indeed, an independent technology assessment panel, convened in 1995 by the National Institutes of Health (NIH), confirmed that behavioral approaches -- including relaxation techniques and hypnosis -- can be quite effective in the treatment of chronic pain.
But how might meditation work to relieve pain? First off, the relaxation that's at the heart of meditation relieves the muscle tension that most certainly contributes to pain, says Howard Fields, MD, of the University of California, San Francisco, who sat on the NIH technology assessment panel. And the anxiety involved in anticipating pain -- or thinking it will never leave -- causes additional muscle tightening, says Patel. Relieving that anxiety is another way meditation may make people better able to cope with physical sensations.
In addition, meditation most likely alters a person's emotional response to pain. Remember, pain is more than just a physical sensation -- it is an experience steeped in emotion. "I'm still in constant pain," says Benson. "But meditation makes the pain more bearable. It's taught me how to live with it and to find ways to better manage it."
Altering Emotions and Sensations
This makes sense, physiologically speaking, because the sensations and the emotions associated with pain are processed by different parts of the brain, says Catherine Bushnell, PhD, of McGill University. So relaxation techniques, including meditation and hypnosis, might allow people to tolerate pain they would ordinarily describe as unbearable. In her studies of hypnosis, Bushnell has found that people can be taught to reinterpret painful sensations, regarding them as "warm and pleasant" rather than "burning and unpleasant."
"So it's not just that people are being trained to ignore pain" when hypnotized or meditating, says Bushnell. She's concluded that relaxation techniques can alter the way the brain responds to a painful sensation and the way a person feels about it.
Further, meditation may also change the neural pathways that control the physical sensation of pain. Perhaps it works like morphine, says Bushnell, dampening pain by stimulating the inhibitory nerves that extend from the brain to the spinal cord, where they block the sensation of pain.
A raisin might not always be a substitute for morphine, but it appears that meditation can help people control their response to pain -- and their outlook on life. "The raisin exercise makes you aware of sights, sounds, scents, and tastes," says Benson. "Now I relax, slow down, and take time to appreciate things around me -- a bird or a cricket, the wind in the trees. Meditation makes my life a little more peaceful. It's made me a better me."
Why Meditate? Because It's Good Medicine
Meditation is a quiet, simple technique that belies an extraordinary power to boost disease resistance and maintain overall health.
By William Collinge, M.P.H. Ph.D.
WebMD Medical News
When it comes to alternative therapy, there's one method that's leading the pack, at least in terms of popularity of use. According to research conducted by Dr. David Eisenberg and his colleagues at Harvard Medical School, mind/body medicine is the most widely used alternative. And it's no wonder, when you look at the medical evidence piling up to support its role in promoting health. At the heart of mind/body medicine lies the age-old practice of meditation, a quiet, simple technique that belies an extraordinary power to boost disease resistance and maintain overall health.
Meditation: More Than Just a "Feel-Good" State
Meditation -- focusing the mind continuously on one thought, phrase or prayer for a period of time -- naturally leads to the "relaxation response," changes in the body that are deeply restorative and which quicken healing. These changes include reductions in heart rate, blood pressure, respiratory rate, oxygen consumption, blood flow to skeletal muscles, perspiration and muscle tension, as well as an improvement in immunity. The relaxation response works much like pushing a "reset" button, enabling your body to return to a state of optimal balance. Many studies have been done that show the effectiveness of meditation in treating a number of health conditions.
Some remarkable benefits are possible for women who meditate regularly. One study found that women with PMS (premenstrual syndrome) reduced their symptoms by 58 percent. Another study found that women going through menopause could significantly reduce the intensity of hot flashes.
Even those women struggling with infertility can benefit: In a study of a 10-week group program that included meditation (along with exercise and nutrition changes), the women had significantly less anxiety, depression and fatigue, and 34 percent became pregnant within six months.
Researchers have also found that new mothers who use meditation with images of milk flowing in their breasts can more than double their production of milk.
The Healthy Heart
The heart has been the focus of hundreds of studies of meditation worldwide. Regular practice of meditation has been found to significantly reduce blood pressure in people with hypertension. These reductions can endure over the long term: In one study, the reductions achieved during an eight-week program were still in place three years later.
Other studies have focused on meditation in relation to heart disease. For example, patients with coronary-artery disease who meditated daily for eight months had nearly a 15-percent increase in exercise tolerance. Patients with ischemic heart disease (in which the heart muscle receives an inadequate supply of blood) who practiced for four weeks had a significantly lower frequency of premature ventricular contractions (a type of irregular heartbeat).
Patients undergoing heart surgery can also reap the rewards of meditation. In one study, angioplasty patients who used meditation had significantly less anxiety, pain and need for medication during and after the procedure. In another, those having open-heart surgery were able to reduce their incidence of postoperative supraventricular tachycardia (abnormally high heart rate).
The Immune Response
There's also evidence that meditation has immune-enhancing effects. For example, medical students who meditated during final exams had a higher percentage of "T-helper cells," the immune cells that trigger the immune system into action. Nursing-home residents trained in meditation had increased activity of "natural-killer cells," which kill bacteria and cancer cells. They also had reductions in the activity of viruses and of emotional distress.
Cancer patients have also experienced the benefits of meditation. In one study, patients with metastatic (spreading) cancer who meditated with imagery regularly for a year had significant increases in natural-killer cell activity.
Though a variety of meditation techniques exist, there are basic elements that anyone can master. Doing as little as 20 minutes per day is enough to begin to see benefits.
1. Sit or lie in a comfortable position with your eyes closed.
2. Focus your attention on the repetition of a word, sound, phrase or prayer, doing this silently or whispering. An alternative is to focus on the sensation of each breath as it moves in and out of your body.
3. Every time you notice that your attention has wandered (which will occur naturally), gently redirect it back, without judging yourself.
How Meditation Works
: Studies have shown that meditation (in particular, research on Transcendental Meditation, a popular form of meditation practiced in the West for the past thirty years), can bring about a healthy state of relaxation by causing a generalized reduction in multiple physiological and biochemical markers, such as decreased heart rate, decreased respiration rate, decreased plasma cortisol (a major stress hormone), decreased pulse rate, and increased EEG (electroencephalogram) alpha, a brain wave associated with relaxation. Research conducted by R. Keith Wallace at U.C.L.A. on Transcendental Meditation, revealed that during meditation, the body gains a state of profound rest. At the same time, the brain and mind become more alert, indicating a state of restful alertness. Studies show that after TM, reactions are faster, creativity greater, and comprehension broader.
: A laboratory study of practitioners of Maharishi Mahesh Yogi's transcendental meditation (TM), carried out by Benson and Wallace at Harvard Medical School towards the end of the 1960s, provided the first detailed knowledge of the many physiological changes that go with meditation.
: Some of the meditators, whose ages ranged from seventeen to forty-one, had been meditating only a few weeks, others for several years. All recorded changes associated with deep relaxation.
: The fall in metabolic rate was the most striking discovery. This was indicated by a dramatic drop in oxygen consumption within a few minutes of starting meditation. Consumption fell by up to twenty per cent below the normal level; below that experienced even in deep sleep. Meditators took on average two breaths less and one litre less air per minute. The meditators' heart rate was several beats less per minute.
: During meditation, blood pressure stayed at 'low levels', but fell markedly in persons starting meditation with abnormally high levels.
: The meditators' skin resistance to an electrical current was measured. A fall in skin resistance is characteristic of anxiety and tension states; a rise indicates increased muscle relaxation. The finding was that though meditation is primarily a mental technique, it soon brings significantly improved muscle relaxation.
: Meditation reduces activity in the nervous system. The parasympathetic branch of the autonomic or involuntary nervous system predominates. This is the branch responsible for calming us.
: During anxiety and tension states there is a rise in the level of lactate in the blood. Lactate is a substance produced by metabolism in the skeletal muscles. During meditation blood lactate levels decreased at a rate four times faster than the rate of decrease in non-meditators resting lying on their backs or in the meditators themselves in pre-meditation resting.
: The likely reason for the dramatic reduction in lactate production by meditators was indicated when further studies of meditators showed an increased blood flow during. Benson and Wallace found that there was a thirty-two per cent increase in forearm blood flow. Lactate production in the body is mainly in skeletal muscle tissue; during meditation the faster circulation brings a faster delivery of oxygen to the muscles and less lactate is produced.
: The two investigators summed up the state produced by their meditating subjects as wakeful and hypometabolic. The physiological changes were different in many ways from those found in sleeping people or those in hypnotic trance states. Meditation, they said, produces 'a complex of responses that marks a highly relaxed state'. Moreover, the pattern of changes they observed in meditators suggested an integrated response, mediated by the central nervous system.
: "Through meditation we can learn to access the relaxation response (the physiological response elicited by meditation) and to be aware of the mind and the way our attitudes produce stress," says Dr. Borysenko, author of 'Minding the Body, Mending the Mind". "In addition, by quieting the mind, meditation can also put one in touch with the inner physician, allowing the body's own inner wisdom to be heard."
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