Dr. Daniel Monti’s Lecture at Kochi Symposium
May 10, 2011
School of Medicine, Kochi
A one-day symposium on integrated healing titled Mind, Body and Soul – An Integrated Healing Approach was organized at Amrita’s Health Sciences campus on April 30, 2011.
Dr. Daniel Monti, Head of Integrated Medicine and Associate Professor of Psychiatry and Human Behavior at Thomas Jefferson University, United States, was the invited chief guest. With broad expertise in several areas of integrated medicine, particularly mind-body medicine and integrative oncology, Dr. Monti is the recipient of a substantial research grant from the National Institute of Health (NIH), USA.
Dr. Monti’s talk was based on the effects of a novel stress reduction intervention technique developed by his research team. Below are some excerpts from his lecture.
Exploration of the mind-body relationship led me into integrated medicine. I became very interested in clinical trials and researching how the mind and body affect one another with an emphasis on stress, biology of stress, understanding how stress affects the different organ systems and when the body is physically stressed, how that affects the mind.
Integrative approach is ground into the principles of medical science. In addition to simply focusing on the biology, we also think about what is going on in the person’s mind and what is going on in their social network in terms of, do they have support from the community, so on. If people do not have any kind of connection that gives them a sense of progress or meaning in life, then that is going to affect their health as well.
Integrated model of care teaches people the need to be proactive about health. I think people need to be empowered with the tools to be an active participant as well as the knowledge about what will enhance health versus what will take them down the road of illness.
Often times, when we are talking to people, we help them understand that genes are not everything. Multiple things can affect the expression of genes. The expression of many of our genes is largely environmentally determined. So everything that you are exposed to; the food that you eat, the stress that you have, toxins you are exposed to, is all part of the environment. The combination of genes and the environment really determine your phenotype.
In fact, after the age of 40, the environment determines up to 75% of health and the majority of chronic diseases that have become epidemic are really diseases of environment. Look at type II diabetes. It is a disease of life style.
Psychosocial support for cancer has been well known for a couple of decades now. Cancer patients who have adequate psychosocial support have better overall health outcomes. This is a fact. The goals of psychosocial support are to minimize stress and to improve quality of life. Stress affects everybody but it is not just the stress that we have, it is how we perceive stress and cope with it. It depends on the state of our mind. There is no state of mind that does not have an effect on the body.
States of the mind has their reflection in the body and its biology. This is proven science. Patients with cancers have their own unique levels of stress. Being cancer patients, they have existential crisis that occurs at the time of the cancer diagnosis, like what does this mean for me, what is going to happen to my children, how much time do I have and if there is a truncated period of time, how is that to be dealt with.
Stress can manifest in a variety of psychological and physical symptoms. This is well known and there is a detailed neurobiology of stress. We know what stress is doing, how it is affecting the body and our emotions.
Mind-Body therapy falls into the category of complementary therapy where we are utilizing techniques that are outside the realm of our regular medical science. It includes meditation techniques. Everybody can relate to the concept of stress. People like learning a technique, learning a set of tools that will empower them. We are not promising a cancer cure but outcomes can be better by utilizing stress reduction techniques.
For example, studies in a laboratory on some groups around the world have shown that cancer cells or tumors grow more quickly in an environment of stress chemicals. So the idea of looking at stress and stress reduction is important and the evidence supports that.
The idea of a perceived threat to your well being put you in a ‘fight or flight’ mode. The sympathetic nervous system gets activated. But sometimes you are never out of that ‘fight or flight’ mode which is how many peoples’ lives have become. The parasympathetic nervous system when activated can cause the complete opposite; restoration and recuperation. That is what happens when we relax, meditate or breathe. That is why we need to constantly keep a balance in the nervous system.
Psychosocial factors can activate the sympathetic nervous system and keep you in sympathetic overdrive, which is a problem. When it happens, every cell in the body feels it. Being in high stress mode can affect everything from blood sugar to hypertension but not just that; there are further downstream effects. Immunity goes down. Several studies show that populations of people who have high levels of stress, anxiety and depression are more vulnerable to infections.
We can think about self recognition in terms of how well people cope and adapt to stressful situations. In a self-recognition model, there is objective representation such as this is your diagnosis, this is your lab results. There is subjective representation in emotional terms, i.e., how a person emotionally responds to that objective information. Then there is a schema that forms around that objective and subjective information.
Using self recognition as a model, the goals of the types of interventions that we have been talking about would be to modulate the autonomic nervous system to a more parasympathetic mode, to replace automatic responses with chosen responses and to change the locus of control so that one is no longer a victim of external influences.
One model that we utilized is mindfulness meditation. Through mindfulness we change the way we perceive the outside world. We call our particular intervention mindfulness-based art therapy. We take the content of the schema and integrate a process of attentiveness through mindfulness.
The way a person perceives themselves after they integrate skills of meditation and other stress reduction skills really changes a whole lot. Remember, improving all those things affects the entire biology.