Although it's common knowledge now, as recently as the 1960s, it was heresy for a doctor to suggest that stress and disease were linked. In fact, nobody even linked diseases like hypertension to stress, even though the word "tension" is right there in the diagnosis.
Doctors knew that patients tended to run higher blood pressures when they visited the doctor's office—they called it "white coat hypertension." But somehow, nobody thought through the implications of the fact that visiting the doctor can be anxiety-provoking, and such stress resulted in a blood pressure elevation that dropped once the patients went back home and relaxed.
Curious about whether there could be a link between stress and high blood pressure, Harvard cardiologist Herbert Benson started discussing it with his colleagues, who mostly thought he was crazy for even suggesting it.
But Benson was dogged in his pursuit of the answers, and finding none, he started researching the topic himself. Inspired by the work of B. F. Skinner and Neal Miller on biofeedback and its ability to teach the body to control apparently "involuntary" physiologic phenomena, he started rewarding monkeys for increasing and decreasing their own blood pressures. He signaled success to them by flashing colored lights.
Eventually, he was able to train the monkeys to control their own blood pressure by simply signaling them with the lights. The monkeys were able to control their blood pressure with nothing more than brainpower alone.
The study, which was published in 1969, caught the attention of practitioners of Transcendental Meditation, which had been recently popularized by the Beatles, Mia Farrow and other celebrities. These practitioners, who had heard that Benson was studying monkeys, believed they were lowering their blood pressures when they meditated, but nobody had ever tried to prove it.
Already on shaky ground at Harvard for wandering into the territory of what ultimately would be called "mind-body medicine," Benson originally refused to get involved, but the meditation advocates were persistent. He then heard about another researcher, Robert Keith Wallace, who was studying Transcendental Meditation for his doctoral dissertation at the University of California, Irvine. The two decided to put their heads together and collaborate on a study.
Once they compiled the data, they were shocked. It was incontrovertible. Striking physiologic changes came with meditation—sharp drops in heart rate, respiratory rate and metabolic rate. In the initial study, the blood pressures of the study subjects didn't drop during meditation, but overall, the group that meditated had significantly lower baseline blood pressures than those who didn't.
Benson named the physiological changes that meditating people experienced the "relaxation response," the opposite of "stress response." He argued that, like the stress response triggered when a part of the hypothalamus is stimulated, the relaxation response is triggered when a different part of the hypothalamus is stimulated, as a safeguard intended to counterbalance the emergency alarm the body sometimes sounds.
A prescription for relaxation
Benson realized that the fertile breeding ground of the relaxation response might be harnessed to implant thoughts in the mind by visualizing an outcome you wish to achieve—such as raising your body temperature, lowering your blood pressure, fighting your cancer or alleviating back pain. He went on to study processes like these throughout his extensive career as a researcher.
Over the years, Benson studied thousands of patients and published scores of articles in medical journals. Through this research, he created a list of the conditions that respond to the relaxation response.
There are likely others, too, but he clearly proved efficacy in treating angina pectoris, cardiac arrhythmias, allergic skin reactions, anxiety, bronchial asthma, cough, constipation, mild to moderate depression, diabetes mellitus, duodenal ulcers, dizziness, fatigue, herpes virus, hypertension, infertility, insomnia, nausea and vomiting during pregnancy, nervousness, postoperative swelling, premenstrual syndrome, rheumatoid arthritis, side-effects of cancer, side-effects of AIDS, and all forms of pain—backaches, headaches, abdominal pain, muscle pain, joint aches, postoperative pain, neck, arm and leg pain.
In his 1975 book The Relaxation Response, Benson announced that he had discovered a counterbalance to the fight-or-flight response that physiologist Walter Cannon had described in the 1920s. Just as the body has a natural survival mechanism built in to help you run away from a wild animal, the body also has an inducible, physiologic state of quietude, which allows it to repair damage done by the fight-or-flight response.
Benson found four essential components that could reliably elicit the relaxation response: 1) a quiet environment; 2) a mental device, such as a repeated phrase, word, sound or prayer; 3) a passive, nonjudgmental attitude; and 4) a comfortable position.
Later, he discovered that only the mental device and passive attitude were necessary. A runner with a mantra and a passive attitude could be jogging down a busy street and elicit a relaxation response. The same was true for those doing yoga or qigong, walking, swimming, knitting, rowing, sitting, standing or singing.
As he continued his research, Benson found that the majority of medical problems were either caused or exacerbated by the chronic effects of the stress response on the body. Other studies showed that over 60 percent of doctor visits could be attributed to the stress response.
When the conscious forebrain thinks positive thoughts and feels things like love, connection, intimacy, pleasure and hope, the hypothalamus stops triggering the stress responses.
When you feel optimistic and hopeful, loved and supported, in the flow in your professional or creative life, spiritually nourished or sexually connected to another person, the relaxation response takes the place of the stress response.
The sympathetic nervous system shuts off. Cortisol and adrenaline levels drop. The parasympathetic nervous system takes over. The immune system flips back on. And the body can go about its natural self-repair process, preventing illness and taking its stab at treating disease that already exists.
As a result, disease is more likely to be prevented in well people, and disease may even be treated in sick people. Voilà! Your thoughts lead to self-healing. The mind has healed the body, and it's not some New Age metaphysical thing. It's simple physiology.
You don't have to follow Benson's prescription for eliciting the relaxation response. Other forms of meditation offer great health benefits, which have been well documented. All forms of meditation, to some degree, activate the parasympathetic nervous system, decrease stress-related cortisol, reduce respiration and heart rate, reduce the metabolic rate, increase blood flow in the brain, increase activity in the left prefrontal cortex (which is observed in happier people), strengthen the immune system and lead to a state of relaxation.1
Meditation also reduces work stress, anxiety and depression, promotes cardiovascular health, improves cognitive function, reduces alcohol abuse, improves longevity, promotes healthy weight, reduces tension headaches, relieves asthma, controls blood sugar in diabetic patients, alleviates premenstrual syndrome, reduces chronic pain and improves immune function.2
Lest you, like Benson's colleagues, suspect this might all be due to the placebo effect, take note that one study even studied sham meditation and found that it wasn't as effective at improving health variables as real meditation.3
I know you've heard before that meditation is a good idea, but it's not just good for your mind, it's a critical technique for countering the effects of chronic stress in your life and in your body.
Other ways to elicit the relaxation response
It's not just meditation that shuts off the stress response and calms the body. Creative expression, sexual release, being with people you love, spending time with your spiritual community, doing work that feeds your soul and other relaxing activities such as laughter, playing with pets, journaling, prayer, napping, yoga, getting a massage, reading, singing, playing a musical instrument, gardening, cooking, tai chi, going for a walk, taking a hot bath and enjoying nature may also activate your parasympathetic nervous system and allow the body to return to a state of rest so it can go about the business of self-repair.
This is vital for every single one of us, not just as treatment for illness but for the prevention of it and extension of our lives. In one study, nearly 75 percent of people surveyed said their stress levels were so high they felt unhealthy.4 But the relaxation response can serve as a counterbalancing response.
Back when I was seeing 40 patients a day in my very stressful job as an OB/GYN, I would spend 12 hours a day practicing medicine and then come home to my art studio, where I'd paint until bedtime. I always said, "Medicine is my hemorrhage, but art is my transfusion."
What I didn't understand was that I was naturally prescribing treatment for my stressful life. While my physician job triggered my stress responses all day long, my painting elicited relaxation responses.
Although I wasn't ready to quit my job and I wasn't meditating, I was still giving my body medicine, calming it into a state of rest and self-repair for up to 40 hours per week in my spare time, allowing myself to slip into a state of creative flow, during which hours passed without my awareness of the passage of time.
Parasympathetic nervous system activation is the chill-out state of the mind and body. When the relaxation response is induced, the parasympathetic nervous system is in the driver's seat.
Only in this relaxed state can the body's natural self-repair mechanisms go about the business of fixing what gets out of whack in the body, the way the body is designed.
The relaxation response also improves mood. It's hard to feel anxious or depressed when the parasympathetic nervous system is in charge.
The relaxation response may even alter how your genes are expressed, acting like a Band-Aid for the stressed-out body and reducing the damage of chronic stress at the cellular level.5
How to shut down the stress response
(From Herbert Benson's The Relaxation Response)
1) Pick a focus word, short phrase or prayer that is firmly rooted in your belief system, such as "One," "Peace," "The Lord is my shepherd," "Hail Mary, full of grace," "Shalom," or "Om."
2) Sit quietly in a comfortable position.
3) Close your eyes.
4) Relax your muscles, progressing from your feet to your calves, thighs, abdomen, shoulders, head and neck.
5) Breathe slowly and naturally, and as you do, say your focus word, sound, phrase or prayer silently to yourself as you exhale.
6) Assume a passive attitude. When other thoughts come to mind, simply say to yourself, "Oh, well," and gently return to your repetition.
7) Continue for 10 to 20 minutes.
8) Continue sitting quietly for a minute or so, allowing other thoughts to return. Then open your eyes and sit for another minute before rising.
9) Practice the technique once or twice daily. Particularly good times for it are before breakfast and before dinner.
A shortcut to the Relaxation Response
In his latest book, Timeless Healing: The Power and Biology of Belief, Herbert Benson provides a simplified method to elicit the relaxation response.
All you need to do is the following:
• Repeat a word, sound, phrase, prayer or muscle activity
• Passively disregard everyday thoughts that inevitably come to mind and return to your repetition
This can be done while exercising, making art, cooking, shopping, driving . . . in fact, whenever.
Excerpted from Mind Over Medicine by Lissa Rankin (Hay House, 2020)
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