Mind-Body Techniques in Wound Healing
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The Mind-Body-Spirit Relationship
Conventional medicine has a long history of breaking down physical and mental function into a mechanistic model. The emergence of a new paradigm, holistic medicine as a complement to conventional medicine, has lead to the acknowledgment of a so-called "ghost in the machine"1 - the role of human spirit or consciousness in the healing process. The placebo effect is an example of this theory. Without tangible explanation, the placebo transcends patient confidence in the caregiver and treatment into biochemical changes.2 Growing research in the field of psychoneuroimmunology suggests that the neuropeptide network is not linear in transmission, but rather numerous, spontaneous interconnections between ganglia, organs, immune system and skin.3 Thus, research is beginning to reveal communications between the nervous, endocrine, and immune systems.4 Although the immune system is still considered central, virtually all biological systems are considered part of the healing process, including the mind and emotion.3 The emergence of psychoneuroimmunology has been able to significantly demonstrate biochemical changes in the body that can be traced to emotion and/or repressed memories locked in the mind-body network.5 Often, this repression becomes the long-term coping strategy of the individual3; therefore, the manner in which human beings handle stress and form coping behaviors has a significant impact on their overall health. Likewise, it is inferred that the degree of stress on the immune system can be correlated to the quality of wound repair.5
Research by Marucha et al6 involving dental students demonstrated that examination stress resulted in a 40% slower healing rate of punch biopsies taken from the hard palate. Perhaps most interesting is that examinations for students at this level are relatively mild and predictable stressors to which they have become well accustomed. Despite this fact, examination stress was found to have statistically significant consequences for healing.6 Another study found that anxiety and depression have a distinct relationship to delayed wound healing.7 In addition to the possible psychoneuroimmunology explanation, the authors point out that indirect factors such as self neglect, disturbed sleep, and poor appetite also may be contributing to the delayed healing findings.
Various authors and researchers have explored the connection between physical ailments and a lack of self worth.8,9 These symptoms often are compounded by feeling overwhelmed and helpless in the face of illness.9 The loss of personal control and lack of self worth are described as paramount emotions linked with delayed wound repair.8-10
An ever-increasing body of knowledge points to the effect of stress on the body. More often than not, physical symptoms are not the first signs of an illness, but rather the last. Emotions and faith are being explored in their direct relation to healing. Stress stimulates the sympathetic nervous system; thus, inducing vasoconstriction, decreased tissue profusion, the release of glucose from the liver, and hormonal changes in the levels of cortisol.11-13 The secretion of cortisol, a glucocorticoid, will promote further constriction of arteries, inhibit inflammation, decrease the release of lymphocytes, and suppress the proliferation of fibroblasts.13 Although a study by Braden13 was not able to draw a causal relationship between cortisol and pressure ulcer formation, stress-induced negative thinking is believed to contribute to a diminished wound repair.
1. Seaward BL. Health of the Human Spirit. Boston, Mass.: Allyn and Bacon; 2001.
2. Cousins N. Anatomy of an Illness as Perceived by the Patient. New York, NY: W.W. Norton Co.; 1979.
3. Pert CB, Dreher HE, Ruff MR. The psychosomatic network: foundations of mind-body medicine. Altern Ther Health Med. 1998;4(4):30-41.
4. Brehm BA. Stress Management: Increasing your Stress Resistance. New York, NY: Longman; 1998.
5. Kiekolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995;346:1194-1196.
6. Marucha PT, Kiecolt-Glaser JK, Favagehi M. Mucosal wound healing is impaired by examination stress. Psychosom Med. 1998;60:362-365.
7. Cole-King A, Harding KG. Psychological factors and delayed healing in chronic wounds. Psychosom Med. 2001;63:216-220.
8. Hay LL. You Can Heal Your Life. Carlsbad, Calif.: Hay House, Inc.;1987.
9. Astin JA, Shapiro SL, Lee RA, Shapiro DH. The construct of control in mind-body medicine: implications for healthcare. Altern Ther Health Med. 1999;5(2):42-47.
10. Borysenko J, Borysenko M. The Power of the Mind to Heal. Carlsbad, Calif.: Hay House, Inc.; 1994.
11. Ennis WJ, Meneses P. Growth factors, extracellular matrix, and wound healing. In: Kloth LC, McCulloch J. Wound Healing Alternatives in Management, 3rd ed. Philadelphia, Pa.: F.A. Davis Co.; 2002:75-76.
12. Sussman C, Bates-Jenson BM. Wound Care A Collaborative Practice Manual for Physical Therapists and Nurses, 2nd ed. Gaitherburg, Md.: Aspen Publishers, Inc.; 2001:44.
13. Braden B. The relationship between stress and pressure sore formation. Ostomy/Wound Management. 1998;44(3A)Suppl:26S-37S.
14. Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing and Health. 1988;11:235-244.
15. Stotts NA, Wipke-Tevis DD. Co-factors in impaired wound healing. In: Krasner DL, Rodheaver GT, Sibbald RG (eds). Chronic Wound Care: A Clinical Source Book for Healthcare Professionals, 3rd ed. Wayne, Pa.: HMP Communications; 2001.
16. Surwit RS, van Tilburg MA, Zucker N. Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care. 2002;25:30-34.
17. Myss C. Why People Don't Heal and How They Can. New York, NY: Three Rivers Press; 1997.
18. Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality and medicine: implications for clinical practice. Mayo Clin Proc. 2001;76:1225-1235.
19. Gawain S. Creative Visualization. Novato, Calif.: Nataraj Publishing; 1995.
20. Terrels P. Reduce Stress and Create Health through Meditation, Creative Visualization and Sound. Complimentary and Alternative Medicine 2001: Reinventing Health Care: Toward a New Model of Health and Healing. Conference presentation in West Chester, Pa.; October 5-7, 2001.
21. Benson H. The Relaxation Response. New York, NY: Avon Books, Inc.; 1975.
22. Byrd R. Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Medical Journal. 1988;81(7):826-829.
23. Dossey L. Reinventing Medicine. San Francisco, Calf.: HarperCollins Publishers; 1999.
24. Aviles JM, Whelan SE, Hernke DA, et al. Intercessory prayer and cardiovascular disease progression in a coronary care unit population: a randomized controlled trial. Mayo Clin Proc. 2001;76:1192-1198.
25. Dossey L. Keynote address. Complimentary and Alternative Medicine 2001: Reinventing Health Care: Toward a New Model of Health and Healing. Conference presentation in West Chester, Pa.; October 5-7, 2001.
26. Weil A. 8 Weeks to Optimum Health. New York, NY: The Ballantine Publishing Group; 1997.