A History of the Mind-Body Connection

The Western concept of the Mind-Body Connection went through five different stages:

1. Natural Philosophies always start with the Physical,
2. The birth of Holism,
3. Interest in the Stresses of Modern Life,
4. Development of the Wellness Movement, and
5. Formulation of the complete Biopsychosocial Model of Health, Wellness, and Illness.

in its historical development.

Contents of a History of the Mind-Body Connection

"For centuries and long before the first glimmerings of modern science, physicians and non-physicians alike have acknowledged that the way people felt in their minds could influence the way they responded in their bodies. When prevailing medical theory denied the very possibility of such interactions, common experience and sometimes quite startling clinical encounters suggested otherwise."[32]

1. The Greek Period
2. The Greco-Roman Period
3. The 1500s--the Renaissance
4. Modern life begins between the 1870s and 1880s
5. Progressive Era of Health Care Reform (1890-1920)
6. The Next Millennium (2000-)
7. References

"The close relationship of emotions to disease [has] been ... central to the long history of medical practice."[33]

The Greek Period

Health could be maintained in the eyes of the ancient Greeks by adopting a temperate lifestyle of moderation. Health, beauty and happiness were the most important goals in life for the ancient Greeks. Physical fitness was seen by them as its own reward.

• {Start with the Physical}"This story begins as did so many other components of our culture, in Greek and Roman antiquity where medicine first emerged as a secular activity independent of religion. There Hippocrates (ca. 460 B.C.Bca. 370 B.C.) and his followers combined naturalistic craft knowledge with ancient science and philosophy to produce the first systematic explanations of the behavior of the human body in health and illness. ... They made the first attempts to understand emotions as mental phenomena which had surprising and complex connections to physiological order and pathological disorder."[34]
  • "Emotional factors played only a minor role in the subsequent development of classical medical thought because authors after Hippocrates continued to rely primarily on humoral-reductionism and did not actively pursue emotional causal elements."[34]
• {Start with the Physical}Plato, throughout his writings, emphasized the importance of bodily exercise for developing the mind. His ideal was the harmonious perfection of the body, mind, and psyche. Bodily exercise was one of the methods that Plato advocated in his Republic.

The Greco-Roman Period

The Greco-Roman culture encouraged the development of physical perfection.

• {Start with the Physical}Roman motto: Mens sana in corpore sano, A sane mind in a sound body.

The 1500s--the Renaissance

The humanistic revival of classical art, architecture, literature, and learning that originated in Italy and later spreads throughout Europe. "Ideas about the 'balance of the passions' were popular in the Renaissance and early modern periods."[34]

• {Holism}Paracelsus (1493-1541), the father of modern medicine, insisted on treating the whole being rather than merely the part displaying disease. Of course little else of Paracelsian medicine is desirable. His teaching emphasized toxic pharmaceutical preparations of poisonous metals like mercury, lead, arsenic and antimony. The human mind will eventually be viewed as being a part of the whole person. The concept of holism will evolve, beginning at the end of the 19th century, to include the notion that stress, or our mental states, has an impact upon our physical health.

The 1700s--the Colonies

The system of medicine prevailing in the Colonies in the years immediately preceding the American Revolution, was that of the Dutch physician and teacher Hermann Boerhaave (1668-1738). The Boerhaavian theory of disease explained it in terms of chemical and physical qualities, such as acidity and alkalinity, or tension and relaxation. The Boerhaavian system was increasingly being challenged in the second half of the 18th century by the theories of William Cullen (1710-1790), a Scottish physician and teacher. Cullen held that an excess or an insufficiency of nervous tension was the cause of all disease. Too much tension was often characterized by a fever, to be treated by a depleting regiment including bleeding, a restricted diet, purging, and rest and sedation. A cold or chill, on the other hand, indicated too much relaxation and called for restorative measures

.

Antebellum America--Age of Romanticism

"By the mid-nineteenth century, however, a place was secured for emotions in connection with disease even as post mortem anatomy and cellular pathology advanced. Already in the eighteenth century William Cullen had noted that patients with certain major disorders -- 'insanity', for example -- did not always show the expected organic lesions upon post mortem dissection. ... Cullen and Robert Whytt were two of the many physicians who turned to the nervous system to find a physiological connection between emotions and disease. ... By the 1840s and 1850s, functional disorders of the nervous system (also called "neuroses") and the emotional causes that precipitated them had become a major area of clinical study."[34]

• 1800s>{Medicine}"Intellectuals and lay people alike were strongly committed to these ideas in the seventeenth and eighteenth centuries. While certain philosophical fashions within the medical community changed to reflect the Scientific Revolution going on around it, much medical practice remained traditional and fundamentally unaltered. Consideration of the role of the imagination and of strong emotions in the onset and course of illnesses continued into the nineteenth century."[34]
• 1840s-1850>{Medicine}"By the 1840s and 1850s hysteria was a serious subject in medical textbooks and in separate, often massively detailed studies."[35]

Americans who lived through the second half of the nineteenth century experienced the most fundamental changes in how people experienced reality since the start of Western civilization.

Postbellum America

Health care is centered on the individual practitioner, rather than on the institution or in science.

• 1859>{Science}Charles Darwin publishes his On the Origin of Species, in London A growing loss of faith and an acceptance of the authority of Science accompanied Darwinism. "In this turbulent [American] society, which stressed individualism over community, the psychologist [would soon] replace the priest, as people sought respite from their confusion and unhappiness."[17]
• 1865>{Medicine}The Civil War comes to an end. "In the post-war period, physicians developed an interest in war-induced stress, and soon identified similar syndromes in the normal population."[17]

Modern life begins between the 1870s and 1880s.

The pace of life begins to speed up. People began to notice how the acceleration of the perception of the duration of time and the apparent shortening of physical distances was inducing stress in them. Americans who lived through the second half of the nineteenth century experienced the greatest, most fundamental changes ever experienced by mankind: electricity, telephone, telegraph, and the railroad.[1] Western notions of stress was a direct consequence of theses technological accelerations that began to really take off during the second half of the 19th century. People in our modern times have to do more things, with less and less time to do them in.

• 1869>{Modern Stress}George Beard, MD, a neurologist, wrote: Neurasthenia, or nervous exhaustion, an article published in a medical journal. Neurasthenia, or Nervous Exhaustion, was defined as a condition of general malaise, and was attributed by Beard to the stresses of modern life. Beard completed his pre-med studies at Yale in 1862, and received his medical degree from New York's College of Physician's (now known as Columbia University) in 1866. He became a member of the College of Physicians and Surgeons of New York in 1886. Beard, a real physician, was one of the most important American electrotherapists of the 19th century. His contemporary critics referred to him as the �P.T. Barnum of medicine.� Beard's nervous exhaustion of neurasthenia would eventually develop into the modern concepts of Chronic-Fatigue-Syndrome, Fibromyalgia and Multiple Chemical Sensitivities.[2],[13]
• 1876>{Faster is Better?}Alexander Graham Bell patents the telephone.
• 1876>{Faster is Better?}Wind-up alarm clocks were first introduced by Seth Thomas.
• 1881>{Modern Stress}George Beard, MD wrote American Nervousness. Neurasthenia was first described as American nervousness. Beard saw a significant correlation between American social organization and nervous illness. Beard wrote: "American nervousness is the product of American civilization." Unlike other countries, America offered its inhabitants the possibility of unlimited freedom which resulted in unlimited ambition among the populace. Beard wrote: "It has long seemed the especial province of Americans to abuse their nerves from the cradle to the grave." A deficiency in nervous energy was the price exacted by industrialized urban societies, competitive business and social environments, and the luxuries, vices, and excesses of modern life. "The chief and primary cause of ... [the] very rapid increase of nervousness is modern civilization, which is distinguished from the ancient [civilizations] by these five characteristics: steampower, the periodical press, the telegraph, the sciences, and the mental activity of women." American nervousness was alarmingly frequent "among the well-to-do and the intellectual, and especially among those in the professions and in the higher walks of business life, who are in deadly earnest in the race for place and power."[14]
• 1881>{Faster is Better?}Frederick Taylor (1856-1915) introduces time-motion studies, where workers' movements are dictated in order to maximize efficiency and boost speed.
• 1884>{Modern Stress}George Beard, MD, wrote: Practical Treatise on Nervous Exhaustion (Neurasthenia). It was one of the first books to express the concept that your mental life can have a profound negative impact upon your physical health.[15]
• 1884>{Wellness} Julia Anderson Root published the Healing Power of the Mind.

Progressive Era of Health Care Reform (1890-1920)

"The late 19th century spawned the psychoanalytical enterprise, the shift from priest to therapist, and the abnegation of personal responsibility in the face of social turmoil. By medicalizing neurosis, the early psychologists and physicians initiated a disturbing trend that has now reached crisis proportions."[17] "By the turn of the 20th century, neurasthenia had become a medical phenomenon on both sides of the Atlantic and neurologists found themselves sharing authority over the illness. Homeopaths, eclectics, general practitioners, and gynecologists in Europe and America tried their hand at treating the condition, each putting their discipline's own spin on the illness. ... Cases of neurasthenia reached a peak near the turn of the 20th century, and by the 1930s fewer and fewer physicians were diagnosing the disease. There are a number of explanations for this decline, including modern medicine's abandonment of the 'nervous energy' model of health and the rise of Freud's psychoanalysis as a way of explaining and treating psychosomatic disorders."[4]

• {Biomedicine} During the Progressive Era, medicine chose to look to the biological roots of disease rather than to the illness as experienced by the patient. The basic structures of twentieth-century American medicine--its focus on biomedical science, its reliance on technologically based hospital care, and its systems for medical education and training--were firmly in place by the end of the Progressive Era.[5]
• 1890s>{Faster is Better?}The popularity of new sports governed by the clock, like football and basketball, grows dramatically.
• 1893>{Psychoanalysis}Sigmund Freud and Josef Breuer publish their paper On the Psychical Mechanism of Hysterical Phenomena in Europe, marking the beginning of the psychoanalysis movement. Hysteria was thought to be caused by undischarged emotional energy.
  • "The next major stage in the unfolding of the relationship between emotions and disease began with the deeper exploration of one of the neuroses: hysteria. This complex disorder was long known in medicine but not until the seventeenth and eighteenth centuries was it seriously associated with the nervous system or emotional causation."[35]
• 1902>{Wellness} William James in his The Varieties of Religious Experience wrote: "The Religion of Healthy-Mindedness has recently poured over America and seems to be gathering force every day."[8]
• 1909>{Mind-Body Connection}Richard Cabot, MD (1868-1939) publishes his Social Service and the Art of Healing and wrote: "I found myself constantly baffled and discouraged when it came to treatment. Treatment in more than half of the cases...involved an understanding of the patient's economic situation and economic means, but still more of his mentality, his character, his previous mental and industrial history, all that brought him to his present condition in which sickness, fear, worry, and poverty were found inextricably mingled."[6]
• 1909>{Psychoanalysis}The psychoanalysis movement first receives public recognition in the United States when Sigmund Freud and Jung were invited to give a series of lectures at Clark University in Worcester, Mass.
• 1920s-1930s>{Medicine}"In the 1920s and 1930s conversion hysteria gained popularity as a general medical notion, as psychoanalysts joined internists and other physicians in exploring the meaning of hysterical symptoms."[35]
• 1920s>{Psychosomatic Medicine} Walter Bradford Cannon coined the phrase fight or flight response when he discovered the relationship between the stress of perceived danger and neuroendocrine responses in animals.[18]
• 1936s>{Psychosomatic Medicine}Hans Selye coined the phrase General Adaptation Syndrome where stressors like cold and heat produce a generalized response in biological organisms as they respond with automatic somatic reactions.[23]
• 1937>{Mind-Body Connection}Joseph Pilates publishes his Your Health where he writes about achieving a "balance of mind and body" and "the natural development of coordinated physical and mental (normal) health and the prevention, rather than the cure of disease." In 1945 he wrote Return to Life where Pilates wrote for the first time about the the stresses of modern life. Pilates was ahead of his time in his booklets on a number of different issues, such as the mind-body connection, wellness, the benefits of mind-body exercise, and functional exercise.[6]
• 1938>{Psychosomatic Medicine}Dr. E Jacobson in his Progressive Relaxation book developed a relaxation technique that claimed anxiety is caused by skeletal muscle contractions.
• 1940s>{Psychosomatic Medicine}"World War II accelerated the growth of psychosomatic medicine even further."[35]
• 1940s>{Psychosomatic Medicine}Henry Beecher coined the phrase placebo effect. He discovered during World War II that pain experienced by wounded soldiers could be controlled with saline injections. Subsequent research will soon show that up to 35 percent of a therapeutic response to any medical treatment could be attributed to the power of belief.[19]
• 1940s>{Wellness}During the 1940s the self-help movement became increasingly more psychologically oriented and was devoid of religious overtones.[9]
• 1940s>{Psychosomatic Medicine} Harold G. Wolff moved from Cannon's fight-or-flight self-defense disease model to a more generalized notion of stress and disease where people respond to stressful situations or events.[20]
• 1950s>{Psychosomatic Medicine} Medicine started to abandon all ideas derived from psychoanalysis (i.e.., role of unconscious emotions, early childhood experiences, etc.).[21] Psychotherapy was replaced by stress reduction and increased reliance on the drug therapy of biomedicine.[22] The public, however, sought to fight off the effects of modern stress in two different basic ways. Either normal people sought out psychotherapy for help or they turned to the wellness movement. One famous example of the psychotherapy approach is the film director Woody Allen
• 1950s>{Psychosomatic Medicine} Hans Selye became the best known proponent of the role played by stress in psychosomatic theory.[24] Selye published forty books and over 1,700 scientific papers in the course of his career. He wrote for the public books like The Story of the Adaptive Syndrome (1952), The Stress of Life (1956 and 1976), and Stress Without Distress (1974).[25]
• 1950s>{Wellness}"However fashionable psychosomatic medicine became, it was by no means the only way Americans pursued their interest in the relationship between emotions and disease. A long-standing tradition of mental self-help, not directed by physicians and concentrating on overt and positive rather than covert and negative feelings, began in the late nineteenth century and was still strong in the 1950s and 1960s. This tradition had consistently focused attention on proactive ways people could become more positive and optimistic about life, master their moods, and fix their physical ills without taking medications. People could align their thoughts and constructively adjust their attitudes. Because mind and body were assumed to be closely interconnected ... it was taken for granted that harmonizing one's emotions in a positive way would, unquestionably, improve one's physical well-being."[36]
• 1950s>{Wellness}Halbert Dunn, a physician, began using the phrase high level wellness in the fifties, based on a weekly series of thirteen lectures at an Unitarian Universalist Church in Arlington, Virginia, in the United States.[11]
• 1961>{Wellness}Halbert Dunn published High Level Wellness. Wellness comes to mean a new concept of health where there is more to health than a mere absence of disease. Wellness now refers to a healthy balance of the mind-body and spirit that results in an overall feeling of well-being. The modern concern with wellness did not, however, become really popular until the 1970's.[11],[12]
• 1969>{Psychosomatic Medicine}Neil E. Miller, a pioneer in biofeedback research, showed that it was possible to apply the principles of operatant behavior shaping towards altering internal bodily functions, like heart rate. Miller's Visceral learning would later come to be known as biofeedback. Miller established that man could learn to control his involuntary or autonomic nervous system.[37]
• 1970s>{Modern Stress} It was becoming increasingly clear to the public that the stresses of modern life, the work place, and your home life could adversely affect your health. More researchers were also starting to introduced biofeedback as a practical method of managing hypertension and a variety of other health conditions without the use of drugs.[30]
• 1972>{Psychosomatic Medicine}George Engel coined the phrase conservation-withdrawal as an alternative to the current stress model. He conceptualized psychobiological threats to an individual�s well-being in terms of losses and deprivations that caused the organism to become withdrawn, depressed and shut-down with depressed physiological functions that created a pathway to illness and death.[26]
• 1974>{Mind-Body Connection} Meyer Friedman and Ray Rosenman published Type A Behavior and Your Heart.[28]
• 1974>{Mind-Body Connection}Herbert Benson coined the phrase relaxation response.[29] And publishes a book on it in 1975 which promoted it as a counter to modern stress. Benson viewed the relaxation response as being opposite to the fight-or-flight response. Both of these responses involved physiological changes in the brain's hypothalamus. The fight-or-flight response provokes feelings of anxiety and increased levels of blood-lactate. While the relaxation response was presented as a method, more practical than biofeedback, that effectively counters inappropriate elicitation of the fight-or-flight response.[31] Patients could elicit the relaxation response through what he called "a non-cultic psychological technique," which was a form of concentration meditation. According to Benson, four basic components were necessary to elicit the relaxation response: 1)a quiet environment, 2)a mental device, 3)a passive attitude, and 4)a comfortable position. And, he offered a choice of 3 different mental devices: 1)concentrating on breathing, and repeating 2)a mantra or 3)an affirmation.[31]
• 1977>{Mind-Body Connection}George L. Engel, MD (1913-1999) first proposed the biopsychosocial model of health, wellness, and illness. The simplistic biomedical model (mentioned above) assumes that all disease is caused by structural anatomic or biochemical abnormality. The physician's responsibility is limited to finding the abnormality to be cured. But without an easily discovered abnormality, as in the functional gastrointestinal disorders, the simplistic biomedical model fails. In contrast, the complex biopsychosocial model is concerned with illness, the subjective sense of suffering or reduced capacity to function. The biopsychosocial model is a much more complex, systems theory approach to health, wellness, and illness. It does not look for single, specific causes for illness, but sees health, illness and healing as resulting from the interacting effects of events of very different types, including biological, psychological, and social factors. All of these are seen as systems that affect on another and interact with one another to affect individual health. In the past decade, even as medical technology has advanced rapidly, there has been an increased appreciation of the value of the mind-body connection systems approach to managing both functional disorders and chronic disease.

The Next Millennium (2000-)

• 2003>{Wellness} The economist Paul Pilzer in Wellness Revolution writes that the wellness industry is already a 200 billion-dollar business, with most of its revenue coming from vitamin sales and health club memberships.[16]

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References

1. Stephen E Ambrose, Nothing Like It in the World: The Men Who Built the Transcontinetal Railroad 1863-1869. New York: Simon & Schuster, 2000.
2. Schafer ML. [On the history of the concept neurasthenia and its modern variants chronic-fatigue-syndrome, fibromyalgia and multiple chemical sensitivities] Fortschr Neurol Psychiatr. 2002 Nov;70(11):570-82. Review. German. PMID: 12410427 [Abstract]
3. Your Health, Published by Jospeh Pilates, 1934.
4. Schuster, DG. Neurasthenia and a Modernizing America. JAMA. 2003;290:2327-2328.
5. Rosenberg CE. The Care of Strangers: The Rise of America's Hospital System. New York: Basic Books, Inc.; 1987.
6. Cabot RC. Social Service and the Art of Healing. New York: Moffat, Yard, and Company; 1909.
7. Ramsey P. The patient as person. New Haven: Yale University Press; 1970.
8. William James, The Varieties of Religious Experience (New York: Longmans, Green, and Co., 1902), p. 94.
9. Donald Meyer, The Positive Thinkers (New York: Pantheon Books, 1980), pp. 177-194, 259-289.
10. Nesse R., and Williams G. Why We Get Sick: The New Science of Darwinian Medicine, Vintage Books. 1996.
11. http://www.seekwellness.com/wellness/reports/2000-12-29.htm
12. Halbert L. Dunn, High Level Wellness, Beatty Press, Arlington, VA., 1961.
13. George Beard, Neurasthenia, or nervous exhaustion. Boston Medical and Surgical Journal, 1869; 80: 245-259.
14. George Beard, American Nervousness, With its Causes and Consequences. New York, NY: GP Putnam's Sons; 1881.
15. George Beard, Practical Treatise on Nervous Exhaustion (neurasthenia), its symptoms, nature, sequences, Treatment. New York, 1884.
16. Paul Zane Pilzer, The Wellness Revolution : How to Make a Fortune in the Next Trillion Dollar Industry, Wiley, 2003.
17. Mark Pendergrast & Melody Gavigan, Victims of Memory, Sex Abuse Accusations and Shattered Lives, Upper Access, 1996, Chapter 11.
18. Cannon WB. The Wisdom of the Body. New York, NY: Norton; 1932.
19. Beecher H. Measurement of Subjective Responses. New York, NY: Oxford University Press; 1959.
20. Harold G. Wolff, Stress and Disease (Springfield IL: Charles C. Thomas, 1953).
21. Chase P. Kimball. Conceptual developments in psychosomatic medicine: 1939-1969. Ann Intern Med. 1970 Aug;73(2):307-16. Review. No abstract available. PMID: 4916763
22. Nathan G. Hale, The Rise and Crisis of Psychoanalysis in the United States (New York: Oxford University Press, 1995), p. 322.
23. Hans Selye, "The Evolution of the Stress Concept," American Scientist, 61 (1973): 692-699.
24. Quoted in John W. Mason, "A Historical View of the Stress Field," Part I, Journal of Human Stress, 1 (March, 1975): 10.
25. Y. Tache, "A Tribute to the Pioneering Contributions of Hans Selye: An Appraisal Through His Books," Experientia, 41 (1985): 567-568.
26. George L. Engel and Arthur H. Schmale, "Conservation-Withdrawal: A Primary Regulatory Process for Organismic Homeostasis," in Physiology, Emotion & Psychosomatic Illness, Ciba Foundation Symposium 8, ns (Amsterdam: Elsevier-Excerpta Medica, 1972), pp. 57-85.
27. E Jacobson, Progressive Relaxation. Chicago: University of Chicago Press, 1938.
28. Meyer Friedman and Ray Rosenman, Type A Behavior and Your Heart (New York: Alfred A. Knopf, 1974), Chapts. 16 & 17.
29. Herbert Benson, The Relaxation Response (New York: Morrow, 1975).
30. Lee Birk, ed., Biofeedback: Behavioral Medicine (New York: Grune and Stratton, 1973).
31. Benson H, Beary JF, Carol MP. The relaxation response. Psychiatry. 1974 Feb;37(1):37-46. PMID: 4810622
32. National Library of Medicine (NLM), History of Medicine Division (HMD), Emotions and Diseases in Historical Perspective
33. NLM, HMD, Emotions and Diseases, Exhibition Directors' Statement
34. NLM, HMD, Emotions and Diseases, The Balance of Passions
35. NLM, HMD, Emotions and Diseases, Psychosomatic Medicine.
36. NLM, HMD, Emotions and Diseases, Self-Healing, Patents, and Placebos.
37. Neil E. Miller, "Learning of Visceral and Glandular Responses." Science 163 (1969):434-445.