Tuesday 5 July 2016

The (Very Real) Power of Mind-body Medicine Techniques



I recently met with a good friend who had major surgery two days before our visit.

As we sat there chatting, I realized how amazingly well she was doing after such an invasive procedure. She was totally lucid, in little to no pain, describing in detail how great she had been feeling for the last two days.
When I asked why she thought she was recovering so well, said that she believed it was because of how much mental and emotional preparation she had done with guided imagery and meditation before and after the surgery.
I found myself, once again, inspired and surprised by the power of mind-body medicine techniques. I shouldn’t be, really, because I have been practicing and teaching these modalities for many years, but I am still amazed by how radically they can impact someone’s experience of health and healing. In fact, my decision to become a Professor in Holistic Health Education and a teacher of mind-body medicine, meditation and health behavior change was in part because of a terrible surgical healing experience I had many years ago. My healing process from that surgery was in stark contrast to what I was witnessing in my friend.
The extent of the incisions and tissue removal in my friend’s surgery were intensive. Yet, during her healing process, she took much less pain medication than the doctors said she would need and her incisions were healing very quickly, as if her recovery had been fast-tracked. In comparison, my recovery from a minimally invasive Uterine Fibroid Embolization (UFE)—just two tiny incisions, and no removal of tissue—had been truly awful. The surgery itself went well, but my post-surgical healing did not.
This minor surgery usually requires just two to three days of down-time afterwards, but I was totally out of commission for three full weeks before I could return to work and then I could only work part-time. I was very sick with issues of wound healing, the need for large amounts of pain medication, infection, and negative reactions to the pain medications. For weeks, I could barely eat, threw up multiple times a day and developed a stomach ulcer. The negative healing experience and chemical reactions in my body caused me to sink into a depression the likes of which I had never experienced. It was as if my whole body shut down after this minor surgery. In fact, the surgical team was baffled and said they had never seen anything like it.
So, what can account for the difference between my experience and my friend’s?
Well, I can say with a fair amount of certainty that it has to do with the different ways that my friend and I prepared our minds and bodies for surgery. My friend was nervous about the surgery (understandably) and so she decided to be very proactive by listening to guided visualizations and meditating regularly for several weeks before her surgery. She visualized the surgery going well and the doctors and nurses doing an amazing job. She imagined that her body had all the resources it needed and would heal quickly and easily. She even went to a Yin yoga class the night before her surgery and dedicated that yoga practice to a good surgical outcome.
I was in a very different mental and emotional state when I went for my UFE. My father had died from cancer several months prior to me undergoing this surgery. For the 15 months before he died, I had been his primary caregiver. I was grieving, in the process of settling his estate, selling his house and preparing to move to California to attend graduate school. I was literally “squeezing” this surgery in amidst everything else I was juggling. I didn’t prepare for it and I was incredibly stressed. I certainly didn’t take any time to practice any mind-body medicine techniques and I didn’t even really think about the surgery much until the night before. As a result, I came out on the other end unprepared to heal and miserable. It was one of those terrible experiences that makes you really stop and think about yourself, your life and the bigger picture. I started to dig around for information on why my recovery had been so hard. I mean, I knew I was stressed, but could it really have made that much of a difference? The answer was a resounding, yes!
Research shows that using mind-body medicine techniques, such as guided imagery and meditation, for surgical preparation and recovery can dramatically decrease pre-operative stress and anxiety, blood loss, post-operative pain, length of hospital stay and medication use and increase wound healing, recovery speed, and post-operative well-being. This isn’t just from anecdotal stories; these were results of multiple double-blind, placebo-controlled research studies (Dreher, H; Disbrow, et al; Tusek, DL, et al; Laurion, S, and Fetzer, SJ).
In fact, because of this research, medical institutions such as the Mayo Clinic, Kaiser, Johns Hopkins and UCSF, among others, are not only using these mind-body techniques, but many of them are offering them to patients for free because they have found them so effective (and, let’s be honest, it saves them money).
So, how does mind-body medicine work to reduce stress and increase positive surgical outcomes?
Well, it works for two reasons; the first has to do with the effect that relaxation has on our body. When we are stressed, our body perceives that we are in danger (even if that’s not actually the case) and it shuts down a lot of the systems that we normally need to function, such as digestion, reproduction and our immune system. Our body’s stress response, also called the fight-or-flight response, is built to protect us from real danger, such as being robbed on the street, when we would have to marshal all of our energy to either run or fight our way out of that situation. To gather all the energy to fight or flee, the body diverts all of its energy away from these important functions (this is also why we may experience things like stomach upset when we are stressed). The problem is that many things that are not actually threatening our survival also trigger the stress response, like getting into a fight with our partner or missing a deadline at work. While our survival is not really being threatened in these situations, if our mind and body perceives the situation as dangerous in some way, our body still shuts down those systems that it doesn’t need in do-or-die situations.
Here’s the good news—you can actually shut off the stress response if it gets turned on at the wrong time, and activate what’s called the “Relaxation Response.” During the Relaxation Response, a term coined by Dr. Herbert Benson (2000), the body not only turns on all of the systems that are turned off during the stress response, but it actually shifts the body into optimal functioning. In a state of relaxation, our body receives all the signals and chemicals that it needs to help our immunity, and other systems, go into action. So, what does this mean for surgery? It means that if you are more relaxed before, during and after surgery, your body can heal faster, your immune system is in the best possible state to prevent infection, increase your body’s natural pain relief chemicals and direct all of its energy toward wound healing, re-stabilizing the body and increasing the overall “feel-good” hormones that we need to heal and move forward.
The second way that many mind-body techniques, and specifically guided imagery, work is that the mind cannot tell the difference between something real or something imagined. Take a second and imagine biting into a juicy, tart lemon. Think about how that lemon smells and the feel of the lemon in your mouth as the juice fills your mouth and washes over your tongue. When reading that, I bet you felt your mouth pucker and fill with saliva as if you were actually eating a lemon. Right? You can use this same approach to help your post-surgical healing. By giving the mind images on how you would most like your surgery and recovery to go, it’s like giving the body a blueprint to follow. The clearer the imagery you provide and the more often you do it, the easier it is for your body to follow the guidance you are giving it.
If you have surgery, or any other medical procedure, coming up consider using some mind-body medicine techniques, such as meditation and guided imagery, to help your body and mind prepare. General relaxation is fantastic for overall well-being and having your body in a receptive state for healing. And specific guided imagery and meditation for health and healing post-surgery can go a long way to support a positive surgical and post-surgical experience.


References:
Dreher H. Mind-body interventions for surgery: evidence and exigency. Advances. 1998 Summer;14(3):207–22.
Disbrow EA, Bennett HL, Owings JT. Effect of preoperative suggestion on postoperative gastrointestinal motility. West J Med. 1993 May;158(5):488–92. [PMC free article] [PubMed]
Ashton C, Jr, Whitworth GC, Seldomridge JA, et al. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J Cardiovasc Surg (Torino) 1997 Feb;38(1):69–75. [PubMed]
Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997 Feb;40(2):172–8. [PubMed]
Laurion S, Fetzer SJ. The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients. J Perianesth Nurs. 2003 Aug;18(4):254–61. [PubMed]
Benson H, Klipper MZ. The relaxation response. 2000. HarperTorch.

Author: Nina Fry-Kizler
Image: Monica H/Flickr
Editors: Emily Bartran; Caitlin Oriel


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