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Duke Health News

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Contact: Renee Twombly
(919) 684-4148
twomb001mc.duke.edu

DURHAM, N.C. -- The Duke University Medical Center will hold
a two-day conference exploring the connections between medicine
and the mind, body and spirit Friday and Saturday, Oct. 4 and
5. The symposium will take place at the Omni Europa Hotel in
Chapel Hill.

The conference, "Integrating Mind, Body, and Spirit in
Medical Practice," is regarded by the physicians who organized
it as the first of its kind sponsored by an academic medical
center. It seeks to introduce health care providers nationwide
to the concepts of utilizing the mind and spirit to bolster the
therapeutic value of traditional medicine.

Among the topics being explored are stress management,
visualization therapy, behavior modification, hypnosis in
primary care, the healing power of compassion, the role of
humor in health, spirituality and addiction, and the use of
sensitivity and compassion in medicine.

"It is becoming increasingly evident that lifestyle and
psychosocial factors play an important role in both the origin
and management of chronic illness in this country," said Duke
cardiologist and conference organizer Dr. Martin Sullivan. "We
will examine how we can broaden medical practice to include an
integrated psycho-spiritual approach to patient care."

Techniques discussed at the conference are designed to help
health care providers give patients comprehensive treatment and
attention, Sullivan said in an interview. "Not only does this
help patients, giving them the best care possible, but it
addresses the needs of physicians and nurses, who are sometimes
frustrated with medical approaches that treat symptoms without
addressing the patient's illness in a larger biopsychosocial
context."

The conference features five experts on mind-body medicine
from around the nation as well as 17 from Duke University
Medical Center, which is a leader in the scientific evaluation
of how the mind and body interact to promote, or to impede,
physical health. The National Institutes of Health alone
sponsored $5.8 million in research in behavioral psychiatry in
1995-96.

Therapies that reduce stress and improve the medical
experience of patients are known as complimentary medicine.
Many of these complimentary practices are now in use at Duke
Medical Center.

For example, about a thousand times a week, Duke health care
professionals provide relaxation techniques and guided imagery
sessions to both inpatients and outpatients. Such encounters
are aimed at reducing stress, pain, and discomfort associated
with medical procedures. Additionally, Duke patients with heart
disease are being taught lifestyle modification and stress
reduction techniques aimed at improving their symptoms and
reducing chances of future heart attacks. And in various
outpatient settings, Duke professionals teach workshops on yoga
for patients with chronic illnesses, on mind-body approaches to
reducing acute pain, and on techniques for managing anger and
hostility.

Such therapies have evolved from a wide body of scientific
research conducted at Duke showing that mental stress has
measureable effects, both positive and negative, on physical
health. Decades of research conducted by Dr. Redford Williams,
James Blumenthal, Norman Anderson and dozens of others at Duke
have shown that mental stress caused by factors such as racism,
parenting, working, marriage, watching violent movies and
simply having a hostile personality can all increase the risk
of heart disease by raising blood pressure, heart rate and
stress hormone production. An excess of stress hormones can
suppress the immune system and over time can damage the
cardiovascular system by increasing blood pressure, heart rate,
and blood flow to the muscles, according to Duke
researchers.

Among the Duke physicians speaking are:

Williams, director of the behavioral medicine research
center, who will discuss two decades of his research showing
that psychosocial factors such as hostility, depression, social
isolation and even marriage can increase the risk of heart
disease via biological mechanisms. He will also highlight
interventions that can reduce a person's biological and
environmental risk factors and thus the health-damaging effects
of such behaviors.

Dr. Harold Koenig, director of the Duke Program on Religion,
Aging and Health, who has scientifically evaluated the impact
of religious practices on the mental health of hospitalized
patients. He has found, for example, that older people who
attend religious services are both less depressed and
physically healthier than those who worship at home.

Sullivan, director of the Healing the Heart Program, who has
published research showing that a comprehensive
lifestyle-modification retreat program that uses the principles
of mind-body medicine can reduce health risks among patients
with coronary artery disease.

Dr. Larry Burk, associate professor of radiology, who will
discuss anodyne imagery, which is a combination of relaxation
techniques that includes visualization. Nurses, physicians and
technicians use this technique to increase patient satisfaction
and decrease the use and amount of pain medication.

Joan Tetel-Hanks, director of Duke's standardized patient
program, who uses choreographed dramas to depict a range of
situations that medical students, residents and other health
care professionals will likely face in treating patients. This
interactive method of teaching, which calls on hired actors as
well as students to participate, addresses a range of topics,
from compassionate treatment of patients to uncovering hidden
cases of domestic violence.

The conference also features nationally known experts who
will deliver keynote addresses. Included are:

John Kabat-Zinn, University of Massachusetts Medical Center,
who will talk about the meditative practice known as
mindfulness, a technique to focus one's mind on the present,
ignoring distracting thoughts of the future or past. For the
health care worker, this practice means concentrating on the
patient being treated instead of the next appointment or
meeting, using inner resources to focus on the task at hand,
and providing an empathetic, sensitive demeanor. Kabat-Zinn
will describe the applications and potential value of
mindfulness in medical practice for both patients and medical
practitioners.

Joan Borysenko, author and former director of the Mind/Body
Clinic at Boston's New England Deaconess Hospital, who is
speaking about "the wisdom of the heart: integrating medicine,
science and the spirit." She will discuss, among other topics,
how health care providers can best interact with dying patients
and how positive emotions such as love can contribute to the
healing process.

Loretta Laroche, an instructor at Deaconess Hospital in
Boston, who will discuss the role of laughter in healing. She
conducts a workshop, which has been attended by more than
10,000 people, to explain why the age-old remedy of humor can
contribute to a strengthened immune system. (A corresponding
body of research at Duke, conducted by Susan Schiffman, has
shown that pleasurable tastes and smells can boost the immune
system in elderly individuals. Schiffman has also found that
unpleasant odors, such as those from commercial hog farms, can
cause major mood disturbances that diminish physical and mental
well-being.)

Elmer Green of the Life Sciences Institute of Mind-Body
Health in Topeka, Kan., who will talk about methods to access
the unconscious through visualization training and alpha-theta
brain wave biofeedback.