SLBMI Psychology and Religion Program>> Psychology and Religion Resource Center>> Articles of Interest

The Mind-Body-Spirit Connection: An Essential Paradigm
Ryan M. Niemiec, Psy.D.

This is the first of two articles addressing a concept essential to the enhancement of health, the understanding of our existence as a whole person. The present article will address the meaning of the mind-body-spirit connection, the key concepts that support the holistic understanding of health, and practical ways to put it into practice in daily life. A later article will focus specifically on one particular mind-body-spirit approach, mindfulness meditation, a rapidly emerging, dynamic process now being used in clinics and hospitals around the country.

"To optimize the function of the healing system, you must do everything in your power to improve physical health, mental/emotional health, and spiritual health"
-Andrew Weil, M.D.

Limitations of the Medical Model
I am sure there are few who have not been introduced to Rene Descartes’ dualistic perspective on mind and body. Although this dualism provided some practical advantage to scientists of the time, and notwithstanding the many advances to which it lead, this dualistic perspective has been largely discarded by reputable scientists and clinicians. In common culture, however, it is a perspective so deeply embedded that it is employed widely and unconsciously. Often unknowingly, Western culture embodies the often maligned “medical model.” It is evident in our desire to have our symptoms “cured” and in our reflexive preference for “real medicine,” usually in the form of pills or surgery. This preference is understandable really; the body seems so much more substantial than the mind. There is a greater sense of control, however illusory, when we can initiate chemical interactions or manipulate body parts. It is tempting to imagine that one can “fix” the body like one can fix a machine. One sometimes hears the complaint, “if we can land a person on the moon, why can’t we cure cancer,” as if curing cancer were at all analogous to the complex but ultimately mechanical process of a NASA mission.

In fact, this approach does work very well in the case of acute, circumscribed physical problems, such as a broken leg or a bacterial infection. It has even been productive in addressing severe psychiatric disease, such as debilitating depression or schizophrenia, although the medications are much more effective when the psychological and spiritual dimensions of care are also considered. On the other hand, it has been of very limited utility in addressing chronic physical disorders, such as chronic back pain, headaches, and gastrointestinal disorders. In such cases, the medical or surgical treatment often succeeds only in mitigating or temporarily interrupting the symptoms, perhaps even “covering up” the deeper but more amorphous problem that is expressed in the medical disorder.

Unhappily most health problems are of the latter variety. Research suggests that 70% or more of all visits to primary care physicians are due to stress-related and/or lifestyle problems. Recent research at the National Institute of Health has noted that at least 50% of all U.S. deaths have significant social and behavioral causal factors. The top four leading causes of death in this country (heart disease, cancer, stroke, and respiratory conditions) are stress-related. This is not to say that stress is the only or the direct cause of these diseases, but it is true that psychological and spiritual distress play a large role in making our bodies more vulnerable to such problems. Chronic psychological distress can trigger disorders of the body and mind, exacerbate existing conditions, or inhibit the psychological and physical response to the disorder or to medical treatments.

The good news is that a change is underway in our culture, and it has been gaining momentum for the last two decades or so. You, a person taking the time to read this article, have almost certainly been affected by this change. Survey research and clinical experience demonstrate that you are not alone. More than 50% of Americans are patronizing the various types of non-traditional health clinics that are springing up in every major city across the country. Top medical schools have opened their curriculums to courses that examine the research and many of these same schools have established clinical and research teams to develop and refine integrated models of health care. This is the wave of the future. Although some persons reject mainstream medicine altogether, the gathering strength lies with those who seek to integrate the new and the old in the search for the best possible care of any given person.

Important Mind-Body-Spirit Principles
That is the segue to some important definitions of terms. There has been an evolution of phrases used to describe holistic medicine and that evolution mirrors perfectly the evolving understanding of the field. “Alternative medicine” was an early phrase; it implied that this approach to health stood apart from (and perhaps in competition with) mainstream medicine. Then “complementary medicine” came into vogue. The implication was that holistic medicine might well work synergistically with the medical model, but clearly the practitioners would be operating separately from mainstream medical practitioners. More recently, “integrative medicine” has entered the lexicon. This phrase clearly implies that any practitioner can adopt a holistic perspective of the individual and utilize widely varying approaches to care, with the same goal of helping the person heal. Integrative medicine embodies a perspective that carries great promise.

An “integrative” approach to health and health care is informed by a common set of underlying principles, whatever the professional identification or the treatment armamentarium of the particular practitioner. Let’s take a moment to consider the main ones.

1) We consider the human being as a “whole.” If the human is a whole, then all the aspects of that whole—biological, psychosocial, spiritual—must be considered in understanding disease and undertaking treatment. The interaction among these aspects is such that change in any will lead to change in all. This is a very powerful concept, embodying our multiple roles—listener, caretaker, detective, asserter—with our selves. The human being is comparable, as best-selling medical/spiritual writer, Larry Dossey puts it, to “a glorious composition, a part of God’s oeuvre: the Great Tone.”

2) We emphasize healing rather than cure. Healing is an interactive, relational concept that values acceptance of limitations as much as breaking through them. To a generation inspired by the slogan, “know no boundaries,” and to a culture informed by a “can do” attitude, this principle may be discomforting. Yet, clearly, healing is the universal gift; cure may be limited, but healing is always possible. Whether in the elimination of a tumor, the reconciliation of old enmity or the breaking down of self-protective aloofness, healing is the natural end of all that that is human.

3) We understand the human being as simultaneously fragile ecosystem and resilient spirit of life. Human beings are fragile in that a small change in one aspect, even unnoticed or apparently inconsequential, has the potential to being a process that leads to devastating consequences. Humans are resilient spiritual beings because in and even through the instances of neglect and assault that occur each day, the natural course is recovery and even strengthening. If we understood only a fraction of what is happening each and every day in our world, we would be taken up in awe, confidence and joy.

4) We believe the human being is greater than the sum of the parts. Because humans are whole, it is not possible to truly understand or treat any individual by way of any single aspect. Further, it is not even possible to understand the human person by considering all aspects in an additive fashion. We are “more” than body, mind and spirit, and that “more” cannot be articulated definitively. Ultimately, anything we say is already insufficient. The scientist may grasp some part; the poet may suggest the whole; we all stand humbly before that which cannot be wholly grasped.

5) Therefore, anyone who holds the office of healer must invite any person who seeks healing to be an active collaborator in the process of maintaining and restoring health. Since no healer can hold the entire truth of the matter, each human person must make active decisions regarding diagnosis and treatment. Clinical experience suggests that people who take an assertive role in their healthcare and who have confidence in their capacity for inner healing live longer and enjoy greater quality of life. Passivity and helplessness lead ultimately to negative thoughts and emotional distress and these, in turn, feed disease. Norman Cousins said it well, “belief becomes biology.”

Implementing a holistic approach to health
Just as there are principles that underlie the integrative perspective of health, so are there principles that underlie its successful application. Although the impetus to heal is innate, there are many obstacles to letting it work. The principles outlined below help you to set free the healing that is yours.

1) Everything begins with awareness, and awareness itself is a journey. Most of us walk through life as if asleep. There is so much that we “do not know that we know.” This knowledge nags at us—of problematic life style habits, of dysfunctional thoughts, of turning away from prayer, of incipient disease—but we brush away the hints as we might a troublesome dream or a paranormal experience. Only when disease develops does the human being snap to attention. Even then, the lessons are too often soon forgotten. Medical treatment places the symptom in remission, and we live again “as if” we had never been woken.

What keeps us blind? For some it is lack of education, for others a closed mind. Some mistake cynicism for wisdom, yet others cling to the familiar. Almost everyone sacrifices complexity for a sense of clarity, even if the “answer” obtained is clearly an oversimplification. Almost everyone prefers to think of the goal rather than living the journey. It is hard to be confused or feel stuck, yet these are part of our natural condition.

2) Healthy awareness is a balance of taking in and letting go. Self-awareness may be described as a continuum. Somatic awareness, for example, ranges from those who are hyper-vigilant (responsive to any cue and likely to interpret it adversely) to those who are blissfully ignorant (unaware of most cues and likely to explain away those that are perceived). Research suggests that a balance between self-focus and external-focus, between action and acceptance will lead to optimal health care.

3) Awareness must be complemented by skills. Some of the most important skills to be achieved are those that enhance the capacity for self-regulation. Some are very simple, others are more complex. Some are quieting, others are activating.

Quieting responses have in common the four components (defined by Dr. Herbert Benson over 30 years ago)—quiet environment, comfortable body position, some constant stimulus, and a passive response to that stimulus and to any distraction. Quieting responses free the body from unnecessary demands imposed by the countless, useless anxieties that mark most human lives. The scientific literature is replete with the benefits of quieting exercises to mind, body and spirit.

Activating exercises are less well studied, but they hold great promise for those who are particularly unfamiliar with their bodies. T’ai Chi (a unique form of the martial arts, done slowly with the goal of “stillness in movement”) and yoga (in its most basic form, a gentle stretching of the body paired with breathing) serve as “wake-up calls” for the somnolent. With greater attention to the body comes enhanced interior communication among all aspects of the whole.

4) No skill will have an impact unless it is employed. Most of us know the importance of the four pillars of health: sleep, nutrition, exercise, and relaxation; practicing what we know is a different issue. It is beyond the scope of the present article to attempt any kind of complete list of excuses. In any case, you know your own. Putting aside the content of the excuse, what all excuses have in common is lack of readiness to make a change.

Several clinician-researchers have offered a conceptual structure of the change process. Five stages have been suggested. Stage 1 (Precontemplation) denies even the need for change. Stage 2 (Contemplation) involves greater receptivity to the idea, but without a plan of action. Stage 3 (Preparation) is the resolution to take action according to some plan. Stage 4 (Action) is the beginning of action, which includes the experience of some positive (or negative) effects. Stage 5 (Maintenance) occurs only after a period of time (perhaps six months or more) of continuous action.

Obviously, we are in and out of these stages as they have to do with various aspects of our lives. Even with a given issue we may have many “Stage 4s” before we establish a new routine. What seems to be most important in making a change is perseverance. Stay with it, and you are likely to reach your goal.

5) It is easier to maintain health than to restore it. The old adage, “an ounce of prevention is worth a pound of cure,” holds a great truth. If you can find the depth of understanding and the intensity of motivation necessary to value and carry out those actions that promote health without having to experience disease, more power to you. However, even if you are not living at that level of awareness, it is still possible to apply prevention. Catching disease when it is still treatable and changing lifestyle to promote the healing are no mean feats. These are the “happy faults” that many of us can use to wake us and change us. Even if we have waited too long to resolve the disease, remembering that healing always possible, a holistic response to the disease can change lives in powerful and unexpected ways.

One way we do it at SLBMI
The integrative approach to health is the perspective that guides much of our work in the Program for Psychology and Religion. One very clear clinical example is the “Body-Mind Group.” Members utilize three modes of learning: input, discussion, and experience. Each group session employs all three modes in varying proportion. The latter two are especially important for sustaining change. Interpersonal sharing and real experience trump “expert opinion” every time.

Topics may include any dimension of integrative health care; some examples are therapeutic benefits of laughter, importance of body awareness, emotions and the body, healthy aging, and physical responses to forgiveness. Discussion focuses on assessing the stage of change that characterizes each member and forming a plan that realistically takes into account that stage of “readiness” for change.

Group members hear how others have coped. They may discuss stress in community or family, symptom management in more public settings such as ministry, or obstacles to change. Stories of successful change, by members or others they have known, are “witness stories” that encourage members when spirits are flagging. Much time is given to noticing subtle changes, positive or negative, and learning to respond effectively or to let them go.

Experiential exercises comprise the beginning and the ending of each group. These exercises not only build new skills, they also help members let go of distractions as the group begins and consolidate learning as the group ends. Experiential exercises are also a way to practice vicariously responses to a particular situation under discussion. In these vicarious responses the members recall and employ the principles and skills underlying successful change. Techniques may include yoga, t’ai chi, meditation, progressive-muscle relaxation, guided imagery, self-hypnosis, somatic awareness, autogenic training, or positive visualization.

These physical and mental exercises often awaken memories and build confidence. Members are empowered to encounter the issues they have tried to ignore or work around. They find the support and courage to explore themselves and their circumstances. They open themselves to the many voices within, seeking harmony and consensus among all parts of the self rather than settling for the benign dictatorship that passes for “adjustment” in so many lives.

So many members, on completing the program, have told us how much more aware they are. They had not recognized how much life was passing them by. They were struck by how little attention they had paid to the physical, psychosocial and spiritual events swirling in and about them. They had not perceived how much their body “embodies” the experiences of each day, whether recognized or not. They had not appreciated how much they might influence thereby their health. They come to see the “oneness” among body, mind, and spirit and learn to enhance those inter-connections in the moments of their lives.

Suggested Reading

I am placing emphasis on and listing the following authors who are renowned experts in their respective area. Each has written several books so it will be easier for you to generalize your search this way. I have listed each author's area of expertise in parentheses and follow with suggestions to get you started.

Herbert Benson, M.D. (relaxation): Timeless Healing; The Relaxation Response

Joan Borysenko, Ph.D. (mind/body connection, spirituality): Guilt is the Teacher, Love is the Lesson; Minding the Body, Mending the Mind

Norman Cousins (laughter, mind/body connection): Anatomy of an Illness; Head First

Larry Dossey, M.D. (prayer, alternative medicine): Reinventing Medicine; Meaning and Medicine; Be Careful What You Pray For

Jon Kabat-Zinn, Ph.D. (meditation, awareness) Wherever You Go, There You Are; Full Catastrophe Living

Daniel Goleman, Ph.D. (emotions, science of meditation): Healing Emotions; The Meditative Mind

Stephen Levine (spirituality, healing): Healing into Life and Death

Marty Rossman, M.D. (imagery): Healing Imagery

C. Norman Shealy, M.D., Ph.D. (holistic health, alternative medicine): Miracles Do Happen; Sacred Healing

Bernie Siegel, M.D. (healing, positive attitude): Love, Medicine, and Miracles; Prescriptions for Living

Andrew Weil, M.D. (nutrition/herbs, integrative medicine, body/mind/spirit wellness): Spontaneous Healing; 8 Weeks to Optimum Health, Eating Well for Optimum Health