Spirituality and Healing in Medicine
Introduction

Herbert Benson, MD

This course centers on how the integration of mind/body and spirituality has changed within traditional medical settings. The practical applications are seen in physician and therapists' offices, hospital and nursing home institutions. It also opens the possibilities for use in hospice and home health care settings.

The course offering emphasizes the positive effect of using the two major strengths available to patients:

1. Healthcare and spiritual care providers and support groups;
   
2. Patients' inner strength and willingness to collaborate for optimum healing.

For more than 30 years laboratories at the Harvard Medical School have systematically studied the benefits of mind/body interactions. The research established that when a person engages in a repetitive prayer, word, sound, or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. There is decreased metabolism, heart rate, rate of breathing and distinctive slower brain waves. These changes are the opposite of those induced by stress and have been labeled the relaxation response.

Elicitation of the relaxation response has been demonstrated to be an effective therapy in a number of diseases that include hypertension, cardiac rhythm irregularities, many forms of chronic pain, insomnia, infertility, the symptoms of cancer and AIDS, premenstrual syndrome, anxiety and mild and moderate depression. In fact, to the extent that any disease is caused or made worse by stress to that extent evoking the relaxation response is an effective therapy.

This work led to consideration of the healing effects of spirituality, since research later established that people experienced increased spirituality as a result of eliciting the relaxation response regardless of whether or not they used a religious repetitive focus. Spirituality was expressed as experiencing the presence of a power, a force, an energy, or what was perceived of as God and this presence was close to the person. Furthermore, spirituality was associated with fewer medical symptoms.

There is also an increased body of literature on the role spirituality and religion play in patients' lives: in coping with illness, suffering and stress, in recovery and in improving quality of life. Physicians and other healthcare providers are increasingly recognizing the significance of spirituality in the healthcare setting. This is evidenced by the tremendous explosion in medical school courses and continuing medical education programs that train physicians and other healthcare providers how to address patients' spiritual needs as well as their own. It is now an appropriate time to bring these findings into fuller contact in contemporary healthcare settings.

Other new data on spirituality and healing and the power and biology of belief, including the hypothesis that the relaxation response promotes the activation of constitutive nitric oxide, will be presented. In addition, the course will strive to identify future empirical research on the healing aspects of spirituality in medicine. This course has continuously evolved and is different from our previous fourteen courses of the same title.

Two Basic Steps Necessary to Elicit the Relaxation Response

• The repetition of a word, sound, prayer, thought, phrase or muscular activity
• The passive return to the repetition when other thoughts intrude

Different Techniques Eliciting the Physiologic Changes of the Relaxation Response

Conditions in Which the Relaxation Response Has Been Demonstrated to Be Effective

• Hypertension
  
• Cardiac Arrhythmias
  
• Chronic pain
  
• Insomnia
  
• Side Effects of Cancer Therapy
  
• Side Effects of AIDS Therapy
  
• Anxiety
  
• Hostility
  
• Depression
  
• Premenstrual Syndrome
  
• Infertility
  
• Preparation for Surgery and X-Ray Procedures
  
  

References

1. Wallace RK, Benson H, Wilson AF. A wakeful hypometabolic physiologic state. Am J Physiol 1971;221:795-9.
   
2. Benson H, Beary JF, Carol MP. The relaxation response. Psychiatry 1974;37:37-46.
   
3. Beary JF, Benson H. A simple psychophysiologic technique which elicits the hypometabolic changes of the relaxation response. Psychosom Med 1974;36:115-20.
   
4. Benson H, Epstein MD. The placebo effect--a neglected asset in the care of patients. JAMA 1975;232:1225-7.
   
5. Benson H, McCallie DP Jr. Angina pectoris and the placebo effect. N Engl J Med 1979;300:1424-9.
   
6. Hoffman JW, Benson H, Arns PA, Stainbrook GL, Landsberg L, Young JB, Gill A. Reduced sympathetic nervous system responsivity associated with the relaxation response. Science 1982;215:190-2.
   
7. Benson H, Lehmann JW, Malhotra MS, Goldman RF, Hopkins J, Epstein MD. Body temperature changes during the practice of g tum-mo (heat) yoga. Nature 1982;295:234-6.
   
8. Kass JD, Friedman R, Leserman J, Zuttermeister PC, Benson H. Health outcome and a new index of spiritual experience. J Sci Stud Religion 1991;30:203-11.
   
9. Benson H. The relaxation response. New York: Morrow, 1975.
   
10. Benson H. Beyond the relaxation response. New York: Times Books, 1984.
    
11. Benson H, Stuart E, Staff of the Mind/Body Medical Institute. The wellness book. New York: Carol, 1992.
    
12. Benson H. Timeless Healing: The Power and biology of belief. New York: Scribner, 1996.
    
13. Stefano GB, Fricchione GL, Slingsby BT, Benson H. The placebo effect and the relaxation response: neural processes and their coupling to constitutive nitric oxide. Brain Res Rev, 2001; 35:1-19.

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