Mind-Body: We Want Evidence, Don’t We?




Alternative Medicine CategoryI spend my days poring over medical research reports and databases, looking for high-quality evidence to build compelling arguments. And, when it comes to mind-body treatment modalities, I can’t find it. I’m not sure I want what it will take to get it, either.

I find small studies that lack control groups or testing for statistical significance. I find review articles that end like this: “More trials are needed” or “Future research… must be more rigorous in the design and execution of studies and in the analysis and reporting of results.”

MeditationThe lack of evidence doesn’t keep people from meditating, doing yoga, or practicing mindfulness. But it does relegate mind-body modalities to a second-class citizen status among treatment options. Medicine is evidence-based, so we should expect mind-body interventions to follow the rules of the game: large randomized controlled trials (RCTs) with rigorous statistical analysis.

The National Center for Complementary and Alternative Medicine, one of 27 divisions at the National Institutes of Health, is the US federal government’s lead agency for scientific research on complementary and alternative medicine (CAM). With a FY2008 appropriation of $121.5 million, it’s the largest single source for funding CAM-related research.

Browsing through the list of projects funded in 2007, I look forward to reading the reports of studies like these:

  • Neuroimaging acupuncture effects on human brain activity
  • Tai Chi mind-body therapy for congestive heart failure
  • Reiki and physiological consequences of acute stress
  • Mindfulness-based stress reduction for high blood pressure

My fear is that many of the results will be equivocal. By their very nature, CAM modalities consist of interventions that don’t fit the tightly-controlled mold of RCTs. How can you gauge the “effective dose” of reiki, for instance? Never mind whether it’s consistent across practitioners or patients or over time.

Even with controlled, consistent interventions, several studies are often required to create a clear picture of efficacy. The number of studies that NCCAM can fund with its minuscule annual appropriation (compare it to the National Cancer Institute’s proposed 2009 budget of $5 billion) isn’t enough to allow inconclusive or non-significant results to be balanced by other findings.

Trying to fit CAM into the RCT mold might actually jeopardize its transition to first-class citizen status.

  • When what is regarded as evidence tends to preclude a mind-body approach there is little chance of getting it.

    There is good evidence now for acupuncture’s effectiveness from a few studies.

  • When it comes to the mind or anything else to do with mental health for that matter there is usually very little money available. CAM’s research is definitely moving in the right direction, but obviously more funding is needed. I do hope that they make some progress with their studies because this is such an important topic.

  • My ideal relaxation is working on upholstry. I spend hours in junk shops buying furniture. I do all the upholstery work myself, and it’s like therapy.

  • Hey Kelly,

    As promised, I came over and read the article. You make some good points. Ill just copy and paste what I left on my site. Here you go!!

    I personally have not done any research in the style of like a clinical trial or anything. I just know that for me, personally, when I think more positively, I feel better… my life flows better.

    In my opinion, it’s like the Law of Gravity; some believe in it, and some don’t. However, whether you believe in it or not, it is still in effect. If I stand on the roof of a building with someone who doesn’t believe in the Law of Gravity and we both jump, we’re both gonna fall straight to the ground… both the believer and the non-believe it.

    I live my life by the “You reap what you sow” theory. I believe that when I plant apple seeds, Im going to get an apple tree that yields apples. I never expect to get a tree that yields oranges. Same is true for seeds of positivity. If I plant positive seeds, I will get a tree of positivity. Just my humble opinion and belief.

    Thanks for visiting TheNewLicious.com.

  • The problem comes after people survive the fall. Should the person just keep on not believing. And if some positive things don’t happen (and most lives in my experience contain some negativity) how much negative is enough to give up the belief in positivity? Just one fall should be enough to give up the disbelief in gravity; how many negatives ’til the belief in positivity is given up?

  • Cindi

    You visited my blog and asked me about evidence or proof that mind-body treatments actually work. The problem with studies that strive to look for such proof, is they are open to the interpretation of the data.

    Different people will see different things, just as different people will have different results.

    Studies are flawed from the very fact that the people studied are different. They have different body chemical make up, exercise, food intake, illnesses, lifestyles, beliefs, thoughts, expectations, and at least a hundred different things that make us unique.

    Just as it will rarely take one treatment, medication, remedy, and change of behavior that may heal or cure a disease, it takes more than one thing to make a person sick.

    You don’t get cancer simply because a cell in your body changes, just as you don’t die simply because you are in a car accident. Some people will have cell changes that if tested can indicate a pre-cancerous
    condition, it doesn’t mean they will get cancer. And not all people who have car accidents die.

    So to look for one or ten or hundred pieces of proof that alternative therapies work, is probably unlikely.

    They may work for some, and they may not work others. Just as Western medicine does. One person can have cancer and have surgery, radiation and chemotherapy and still die. And another person (me for example) can also have cancer and ignore conventional medicine and depend on crystals, color therapy, meditation and continue to live. Does that mean it works? It worked for me. But I can’t promise it will work for anyone else. Is that proof? No, and yes.

  • Hi Cindi,

    The problem as I see it with the ‘everybody’ is different line is that it is also true that ‘everybody is the same’ and ‘every body is the same’. Even the alternative therapies have standard procedures and protocols. From where to put the pins in acupuncture to greeting rituals or ways to tune in for channelers.

  • M

    Thanks for visiting my blog and letting me know about your site. You wouldn’t know it from what you visited, but I have great interest in the brain:) The site you visited is mainly about theology though, so my concern isn’t scientific inquiry.

    Yet, my former profession involved working with cognitive training and also using mind/body techniques like brain gym (www.braingym.org), so I will be back to check out your interesting articles!

    There is a spiritual element to mind/body technologies that “work” but science won’t probably be able to validate such things…

    Ah well.

  • Future science will show there is more to a man than physical properties. Some of the electromagnetic knowledge is known now. We have a great deal to learn, that is obvious. When something seemingly tragic may happen or already has happened, God Forbid, these are certainly times to pray, and without delay. Turn to God and beseeched Him to heal family and friends who are beset with illness. Be God’s partner and direct His divine energy into those who wish to be restored in mind, body, and spirit. You eventually may be able to help Heal people wherever they may be. Understand much of our everyday experience involves the transfer of energy over long distances — satellite dishes are just one example. There are energies all about us traveling great distances in short amounts of time such as radio waves and TV signals. But the directing of Divine energy in Healing is a bit different. Its easier as it is not necessary for the energy to “travel” anywhere. “God fills all the world with His glory” (Isa. 6:3). Its just a matter of Invoking this energy. Its never far away. God has even given the body and the mind has the innate ability to heal itself, but it requires some effort on our part sometimes to help it along. Just note what happens when you cut your finger or sprain a ligament. It heals itself; it needs no intervention. All it needs is a healing environment like keeping the wound clean or resting the sprain. The needed powers are inherent. Sometimes the body just needs a little push. Healing with Divine energy is a very natural process. All the organs of the body, its fluids and its nervous system construct a intangible energy field in “super” consciousness. At times a medicine may be helpful, but God is able to send his healing energy into even bread or water. So eat for your health. Most people in their life eat many times. They may even do this more than anything else. Even 3 times a day. So Shouldn’t this behavior be constructively directed. Eat a balanced diet so to refine and harmonize your body. You will feel better, have more energy. Every one can use this. Don’t eat too much of sugar, fat, oil, or animal proteins. Don’t cause yourself to die of cancer or some other painful degenerative disorder. Avoid pesticides, preservatives, and artificial additives. The bugs won’t even eat the pesticides, they don’t want to die. How about you ? Health is a balanced state of energy. Illness is an imbalance and healing is the process of rebalencing. Illness arises from the misalignment of the energies and healing come about by aligning our distorted energy patterns with the perfect Divine pattern that was intended. Its something like tuning a piano, but more complex. Imbalances could have a host of causes which would generally include physical or emotional trauma and stress. The source of our stress, illness and emotional problems many times is the failure to live in the moment. You can’t let circumstances of any kind take control, preoccupy your mind. Know it is your mind. Take control and be here now !.
    concerning proof, Here is a start:

    Each Hebrew letter corresponds to a number.

    People ask why? Simply because it all adds up as we will see:

    1=?

    ? =2

    ? =3

    ? =4

    ? =5

    ? =6

    ? =7

    ? =8

    ? =9

    ? =10

    ? =20

    ? =30

    ? =40

    ? =50

    ? =60

    ? =70

    ? =80

    ? =90

    ? =100

    ? =200

    ? =300

    ? =400

    For example let us start with the word Torah or in Hebrew ???? = 611 this is the same numerical value as the phrase “specifically the mountain” ?? ??? alluding to Sinia. Torah itself is like a mountain being hard to climb but from its highest levels one can see as no other. The phrase “in Torah” is equal to 613 . All the sages say there are exactly 613 commandments in the Torah. The phrase “all the mitzvot of Yhv’h ” equal 612 we are allowed to add 1 for the phrase itself and then it equals 613 which are “all the mitzvot of Yhv’h ” ?? ????? ???”? . Isn’t that amazing. And if that is not enough Covenant or in Hebrew ???? also equals 612 and if we add 1 for the word itself it equals 613, the number of all the commandments in the Torah. The Phrase “Specifically the light” ???? ?? also equals exactly 613. Referring of course to Torah which is called light. 613 is also the numerical value of The phrase “moses our teacher” or in Hebrew ??? ?????

    http://godssecret.wordpress.com

  • Pingback: carnival of healing #143()

  • You asked me to visit your blog post regarding pharmacists and I found my way to this blog posting— Given that I the co-author of the American College of Physician’s Evidence Based Guide to Complementary and Alternative Medicine, I could not resist responding to this post. Briefly put- we are at the beginning of a long and eventful journey into researching the mind’s healing effects (and it’s limitations). What do we know? We know with certainty that there is a mind-body connection—

    #1: Placebo response is a mind-body connection: let’s start with the placebo effect which by definition means that the person is effected in a positive way by the ‘belief’ that they are receiving a real treatment for a health issue. People undergoing knee surgery, fake bypass surgery, epidural steroid injections — each receiving a ‘sham’ procedure and each showing a healing response. The NIH is increasingly interested in this topic area and actively funding projects.

    #2: Effective mind-body therapies such as yoga, tai chi, meditation, relaxation response, etc. There are dozens of randomized clinical trials showing evidence of benefit for select conditions– while these trials don’t cure cancer they provide preliminary (or even more robust) evidence for benefit for a range of conditions including depression, fall risk, osteoporosis, high blood pressure, and more.

    You might also visit my blog from time to time where I catalogue the results of clinical trials in this domain.

    PS– i disagree with some of your viewers comments that these therapies cannot be evaluated in the clinical trial setting. On one hand, finding an ‘adequate’ sham/placebo may be difficult- agreed but given this limitation, you can certainly focus on the outcomes and whether the therapy has positive results. The key is for research organizations to let go of the notion that all research must have reductionist logic– sometimes you need to allow the therapy to occur in it’s ‘natural environment’ and measure outcomes comparing this group with another group (usual care or perhaps another widely used therapy).

  • #1: Placebo response is a mind-body connection: let’s start with the placebo effect which by definition means that the person is effected in a positive way by the ‘belief’ that they are receiving a real treatment for a health issue. People undergoing knee surgery, fake bypass surgery, epidural steroid injections — each receiving a ‘sham’ procedure and each showing a healing response. The NIH is increasingly interested in this topic area and actively funding projects.

    #2: Effective mind-body therapies such as yoga, tai chi, meditation, relaxation response, etc. There are dozens of randomized clinical trials showing evidence of benefit for select conditions– while these trials don’t cure cancer they provide preliminary (or even more robust) evidence for benefit for a range of conditions.

    You might also visit my blog from time to time where I catalogue the results of clinical trials in this domain.

    PS– i disagree with some of your viewers comments that these therapies cannot be evaluated in the clinical trial setting. On one hand, finding an ‘adequate’ sham/placebo may be difficult- agreed but given this limitation, you can certainly focus on the outcomes and whether the therapy has positive results. The key is for research organizations to let go of the notion that all research must have reductionist logic– sometimes you need to allow the therapy to occur in it’s ‘natural environment’ and measure outcomes comparing this group with another group (usual care or perhaps another widely used therapy).

  • MoiMoi

    simple…those things do really happen. End.

  • Westy

    “#1: Placebo response is a mind-body connection: let’s start with the placebo effect which by definition means that the person is effected in a positive way by the ‘belief’ that they are receiving a real treatment for a health issue. People undergoing knee surgery, fake bypass surgery, epidural steroid injections — each receiving a ’sham’ procedure and each showing a healing response.”

    Er, are you familiar with the revealing work on placebo effect sizes (or lack of them) by Hróbjartsson and Gøtzsche? The existence of a significant placebo/nocebo effect can no longer be taken for granted, which is a serious problem for the mind-body connection advocates.

  • Hi,great post mind-body therapies do work that is for sure but consistency needs to be maintained,even faith and the mindset plays an important role,if a person has no faith in the treatment it will not effect him as much.All ailments start in the mind and then travel to the body.

  • But the problem thus far with any approach has been to prescribe rather than ask what the best is for the body – who do we ask than the body itself? It is time that a shift occurs in giving away power to any professional (of any modality) and taking control of your own health status.

  • Just found your blog and am enjoying browsing through.
    I have to say that most of the reason for the fact that alternative medicine research is not as prolific as research into main stream drugs would appear to be to do with funding. The drug companies fund the drug research; they have the money to do it. Having said that it would seem that there is a lot more attention being paid to alternative therapies and so we will see more and more reliable scientific studies in the near future, so long as the funding issue is overcome.

  • Estie

    The Isscheem Foundation is doing a lot of research into alternative medicine. They are by far the most regarded by the scientific community. So as far as money is concerned, there is money – but only for credible healing systems, i.e. those that get results. The so-called placebo effect ones are being sorted out very quickly from the ones that are getting results.

  • Estie

    Sorry misspelling – it is spelt ISSSEEM:

    The International Society for the Study of Subtle Energies and Energy Medicine (ISSSEEM) is an international non-profit interdisciplinary organization dedicated to exploring and applying subtle energies as they relate to the experience of consciousness, healing, and human potential. ISSSEEM is in a unique position, acting both as a bridge builder between communities and a leader in the field, offering a community with a widespread appreciation of the energetic component within many disciplines including quantum physics, therapeutic modalities, healing, psychology, consciousness, psi and the understanding of our multidimensional existence.

  • Lyn Murphy

    Alternative therapies are gaining ground and have a great deal of merit from an anecdotal point of view. The mainstream medical entities have nothing to gain from researching alternatives and have the power of the almighty dollar to scream the loudest. Smart health care consumers are getting more persistent in researching all options which over time will make inroads.

Jennifer Green, MS

Jennifer Green, MS, is a freelance health care writer. A former nurse and college professor, she now writes about health care for clients around the world. She's particularly interested in research into the mind-body connection.
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