In a dimly lit utility room at Mercy Hospital in Chicago, Cathy Heckla crouches onto the floor, stuffing a pillow beneath her knees. Reclining on a sticky green yoga mat, she stares at the tile ceiling, shifting restlessly as instructor Michele Madison cues a chime music cassette.
Sitting cross-legged, Madison leans toward Heckla and begins her soft-spoken incantation: “You can do it in the car. You can do it when you have an altercation with someone. You can do it when you want to sleep.”
For the first time in her stress-filled life, Heckla is learning the proper way to breathe.
“Bring all of your attention to the breath,” Madison commands gently. “It may be cooler in the nostrils, warmer as it exits.”
Heckla sinks into a dreamy rhythm of deep breathing from her diaphragm. Her eyes ease shut. Her shoulders go limp. Her belly swells and shrinks like a balloon.
She lies still as if floating, exhaling the day’s aggravations. The office manager from the Southwest Side is not trying to reach nirvana, only to save her heart. On her doctor’s referral, Heckla is enrolled in Mercy’s cardiac risk modification program to control high cholesterol.
She reclines for 15 minutes until Madison leads her back to alertness.
Smiling, shaking off her drowsiness, Heckla exclaims: “I feel great! I could feel my legs, down to my toes, tingling. It was like a wave coming over me. I felt all of my stress melting away.”
While experiences like Heckla’s might seem more apropos in an ashram than a hospital, they have become commonplace at Mercy and a few other medical facilities across the country. They herald a movement founded and forwarded by some of the nation’s most respected doctors and medical resarchers, known as mind/body medicine.
Cliches like “mind over matter” oversimplify this branch of behavioral medicine, not quite three decades old though its roots go back thousands of years. Proponents claim–and offer studies to back it up–that mind/body therapies represent a missing link in Western medical science.
“I think this is the future of medicine,” said Dr. Herbert Benson, an associate professor at Harvard Medical School and president of the Mind/Body Medical Institute at New England Deaconess Hospital in Boston, which he founded in 1988.
“Consider our awesome cures of the last century: penicillin, vitamins, surgery,” Benson said. “They’re astounding. We’ve come to believe they influence all illnesses. But they don’t work on stress-related disorders.”
What works better, judging by the Boston institute’s track record, is a program that includes not only a physician and a cardiac nurse, but also a pastoral care chaplain, a dietitian, an occupational therapist, a social worker–and a consultant humorist.
Mercy’s mind/body program (the first of five national affiliates and now in its third year) also includes Madison, a therapist in the Japanese Reiki method, who serves as the institute’s administrator.
Together, the faculty teaches a program that combines elements of yoga, biofeedback, creative visualization and comedy in helping patients regain stress hardiness.
“Our participants are people who realize that their lives are out of control, and are looking for ways to get their body, mind and spirit into balance,” Madison said.
The aims and methods of mind/body medicine may sound suspiciously New Age, yet they make as much sense as anything tossed around in the health care debate of the ’90s, advocates argue.
Mind/body’s cornerstone, as Heckla discovered, is a physiologic state of deep rest called “the relaxation response.”
Studies suggest that when patients learn and practice the response, especially with other mind/body disciplines, a host of medical evils can be controlled, from hypertension and insomnia to headaches and stomach cramps.
In one study of 100 patients at the Boston institute, 78 percent reduced their high blood pressure medication and maintained that reduction over five years; 20 percent eliminated it.
“There is no magic pill, no magic doctor,” Madison said. “More and more people are realizing that they have to take control. But they don’t know how to do that, or what the steps are.”
A startling discovery
Enter a Harvard researcher, a few stubborn meditators and a roomful of stressed-out monkeys.
The year was 1968, and Benson was studying whether primates could learn to lower their blood pressure through reward. His work excited several young devotees of Transcendental Meditation, which was gaining fame at the time thanks to the Beatles and Maharishi Mahesh Yogi.
The Boston area meditators approached Benson. “They said essentially, `Why are you studying animals? Why not study us?’ ” Benson recalled.
Benson balked at their proposal several times, thinking the Harvard establishment would find it “beyond the pale.” Perhaps unfazed because of their daily TM ritual, the would-be guinea pigs ignored him and kept coming back. Benson finally agreed.
As it turned out, the subjects led Benson to what he called “a startling discovery.”
Benson knew from previous work by Harvard researchers that acute stress–and the perception of danger accompanying it–could increase a person’s heart rate, blood pressure, sensitivity to pain and adrenalin flow to unhealthy levels.
TM, he found, could produce and sustain an opposite response in the body. In his experimental group, metabolism (as measured by heart rate, breaths per minute and other factors) dropped 16 to 17 percent soon after the meditators began chanting their mantras.
Benson labeled this phenomenon the relaxation response, and went on to demonstrate how other techniques could produce the same calm state.
“Some want to use prayer, some want to use yoga, some want to use meditation,” Benson said.
Benson documented his findings in a series of books beginning in 1975 with “The Relaxation Response” and most recently in “The Wellness Book” (1992) written with nurse Eileen Stuart. Benson outlines two steps to illicit the body’s stress-fighting capacity.
First: Using slow, regular breaths, the subject should close his eyes and repeat a prayer, relaxing phrase or mantra such as “The Lord is my shepherd.”
“The second step is that when other thoughts start to intrude, you just passively disregard them,” Benson said. As fears, long to-do lists or other distractions pop into consciousness, the rule is simple: Return to the breath, return to the phrase.
Debating the benefits of bliss
About 2,500 years before Benson, the Hindu Upanishads counseled spiritual seekers to breathe and pray in unison to achieve transcendence. A similar process was described in the 13th Century by an anonymous English monk in “The Cloud of Unknowing.” And some Tibetan monks can chill out at five breaths a minute, without turning blue.
Even humor plays a role. Mercy’s clinic employs Denise Williams, a leader of stress management seminars nationwide, who moonlights at Chicago area comedy clubs, Madison said. Williams teaches clinic participants about the physiological benefits of laughter–how it produces endorphins, the body’s natural mood elevators.
While meditation and laughter may offer a path to spiritual bliss, some experts still doubt they have anything to do with good health. Some of mind/body’s biggest skeptics, it turns out, work right in Benson’s back yard.
“It’s an area where there are strong feelings and limited, sometimes questionable data,” said Dr. Edward Campion, deputy editor of The New England Journal of Medicine. “There’s more enthusiasm than science.”
Benson bristles at that suggestion, citing study after study where subjects saw their conditions improve: a 75 percent cure rate for insomniacs, a 36 percent reduction in doctor visits for chronic pain patients, a 59 percent improvement rate for women with premenstrual syndrome.
Other supporters suggest that Western medicine has a lot to learn from Eastern healing traditions, where peace of mind and health go hand-in-hand.
“The mind and the body cannot be divided,” said Dr. Subhash Shah, director of Mercy’s mind/body program. “Spiritual needs are important. You need to be happy inside.”
An internist, geriatrician and rehabilitation specialist, Shah speaks from professional and personal experience. He learned medicine in the West, and meditation as a child in India.
Mind/body medicine has also won over some traditional physicians who, in trying to preserve their own health, tried it for themselves.
“I was pleasantly surprised with how practical they made it, how easy it was,” said Dr. Dennis Gates, an orthopedic surgeon at Mercy, who completed the mind/body cardiac program last spring.
Six years ago, Gates suffered a bout of hepatitis from which he never fully recovered his strength. After practicing the stress prevention techniques and dietary changes taught by the clinic, his energy rebounded–meanwhile, his cholesterol count dropped from 230 to 198, his body fat from 29 percent to nearly 20 percent, and he lost 18 pounds.
“Since doing the course, I called each of the medical schools in Chicago to see if they were teaching anything like this,” Gates said. “The answer was no. Hopefully, that will change.”
As past president of Mercy’s medical staff and current secretary general of World Orthopedic Concern, Gates’ endorsement carries some weight. Yet he finds many colleagues still resist the ideas behind mind/body medicine.
“It’s because of the way we were trained,” Gates said. “We were trained to treat disease, not promote health.
At least one high-profile lawyer presents his own case for the merits of the mind/body course.
“It’s given me the ability to get outside myself and not be so impressed with the problems of me,” said Philip Corboy.
Corboy, 70, founder of Chicago’s Corboy Demetrio Clifford law firm, cuts an imposing legal profile. Experts rank him as one of the nation’s top trial lawyers, but for all his skill at winning multimillion-dollar awards in personal injury cases, Corboy pays a price. “I’m under constant pressure,” he said. “If I don’t do all that’s required of me, my client’s cause is going to fail.”
Corboy entered a shorter version of the clinic two years ago, Mercy’s “Less Stress” class. Corboy said he benefited “almost immediately.”
Benson admitted that he himself took much longer to learn that lesson. He spent 15 years singing the praises of the relaxation response before he tried it.
Early signs positive
Before enrolling in the Mercy program, Cathy Heckla had watched her stress level rise over the past few years with relationship changes, increasing job demands, digestive surgery in December and the discovery of high cholesterol just before going under the knife.
“Even traffic can do it to you,” Heckla said.
She dropped out after four weeks because of scheduling conflicts and the deaths of three close friends. But she said Friday that what she had absorbed in the program helped her through that rough time.
“The class was super; the things I learned stuck with me,” she said. “In fact, I have taught the message to other people: Breathe.”
Heckla reports that the mind/body techniques led to a lower cholesterol count, a 16-pound weight loss and a stress hardiness she lacked before.
And now, when people cut her off on the road, Heckla leans on her breath instead of the horn. In. Out. Relax. Let go.
“It works,” she said.
———-
The Mercy Mind/Body Medical Institute operates two classes. The Cardiac Risk Modification Program–for patients with high blood pressure, diabetes, elevated cholesterol or chronic health problems–meets in 12 weekly two-hour sessions. The Less Stress program concentrates more on stress management and meets over five weeks. Less Stress, which is not covered by most insurance programs, runs $99. Call the institute at 312-567-2600.
