Mind-body Interaction Research Articles

Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trial

Background Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind–body interaction should be tested to enhance the mental health of older adults. Objective To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status. Design Cluster randomized trial. Settings Eight senior activity centers, southern Taiwan. Participants A sample of 139 participants was recruited, and 128 of them completed the study. Inclusion criteria: (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 ± 6.23 years, and the average number of chronic illness was 0.83 ± 0.90. The average BI score of the participants was 99.92 ± 0.62, and the mean SPMSQ score was 9.90 ± 0.30. Methods Participants were randomly assigned into either the experimental ( n = 62) or the control ( n = 66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group. Results Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p < .05). Conclusions After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.

Mind, Introspection, and "The Objective"

Abstract In this sequel to his essay "Ayn Rand and The Objective'" (JARS, Fall 2007), the author warns against "the seduction of 'the basic"' and uses ideas by Efron, Peikoff, and Aristotle to argue that introspection and mental data (including mind) are objective and that causal efficacy of mind and mind-body interaction only make sense if mind is conceived of not as an attribute, but as an entity (viz., the conscious human brain). None of this, however, implies Epiphenomenalism or that consciousness is irrelevant to human history.

Mind, Introspection, and "The Objective"

Abstract In this sequel to his essay "Ayn Rand and The Objective'" (JARS, Fall 2007), the author warns against "the seduction of 'the basic"' and uses ideas by Efron, Peikoff, and Aristotle to argue that introspection and mental data (including mind) are objective and that causal efficacy of mind and mind-body interaction only make sense if mind is conceived of not as an attribute, but as an entity (viz., the conscious human brain). None of this, however, implies Epiphenomenalism or that consciousness is irrelevant to human history.

Body and spirit in psychodynamic therapy: Eastern contributions to non-verbal psychotherapeutic paradigms

This paper looks at dilemmas concerning psychodynamic therapy with patients practicing Eastern psycho-spiritual disciplines that involve physical regimens. Psychoanalytic approaches to questions of body–mind interactions are reviewed. Taoist and Buddhist therapeutic traditions are used to contextualize contemporary psychodynamic practice relating to bodily perceptions and to pre-verbal reality and communication. Case studies from the author's work as a psychodynamic therapist and body-psychotherapist are presented to illustrate the use of an integrative body-based approach, with the patients in point, within a psychodynamic context. Theory and practice with patients whose modes of relating and frames of reference are linked with psychosomatic experiences, that challenge accepted nomenclature, are discussed.

Menstrual-cyclic fluctuation of autonomic nervous system activity among women with different degrees of premenstrual symptoms

OBJECTIVE: Premenstrual syndrome (PMS) comprises psychophysiological symptoms in the luteal phase of the menstrual cycle and abates after menses starts. Despite its near omnipresence in reproductive-age women, we do not yet understand the etiopathogenesis of PMS. In this study we looked at how autonomic nervous system (ANS) activity—vital in orchestrating human homeostasis—changes during the menstrual cycle of women with different degrees of premenstrual symptoms.DESIGN: A within- and between-subjects study.MATERIALS AND METHODS: This study involved seventy-six women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. We also measured salivary chromogranin A (CgA), which reflects sympathoadrenal function, as a psychological stress marker. The Menstrual Distress Questionnaire evaluated psychosomatic and behavioral symptoms of the subjects’ menstrual cycles. The subjects were categorized into four groups depending on the severity of premenstrual symptoms: Control, Low-Molimina (L-Molimina), High-Molimina (H-Molimina), and PMS.RESULTS: No intramenstrual cycle difference in HRV parameters was found in the Control and L-Molimina groups, with zero and a small increase (9.7±0.7%) in premenstrual symptoms, respectively. In contrast, Total power and high-frequency (HF) power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the luteal phase from the follicular phase in the H-Molimina group with moderate increase (24.8±0.7%) in premenstrual distress. Luteal-phase reduction in Total and HF power was also detected in the PMS group with more severe symptoms (67.6±8.1%). In addition, all HRV components in both phases decreased markedly in the PMS group compared to that of the other groups. CgA in the PMS group increased in the luteal phase from the follicular phase, and the value was greater than that of the other groups.CONCLUSIONS: This study provides intriguing findings that the altered functioning of the ANS in the luteal phase might relate to diverse psychosomatic symptoms appearing premenstrually. The study further implies that noninvasive evaluation of ANS activity—reflecting mind-body interaction—with electrophysiological and biochemical indexes could contribute to monitoring and promoting women's physical and mental health. OBJECTIVE: Premenstrual syndrome (PMS) comprises psychophysiological symptoms in the luteal phase of the menstrual cycle and abates after menses starts. Despite its near omnipresence in reproductive-age women, we do not yet understand the etiopathogenesis of PMS. In this study we looked at how autonomic nervous system (ANS) activity—vital in orchestrating human homeostasis—changes during the menstrual cycle of women with different degrees of premenstrual symptoms. DESIGN: A within- and between-subjects study. MATERIALS AND METHODS: This study involved seventy-six women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. We also measured salivary chromogranin A (CgA), which reflects sympathoadrenal function, as a psychological stress marker. The Menstrual Distress Questionnaire evaluated psychosomatic and behavioral symptoms of the subjects’ menstrual cycles. The subjects were categorized into four groups depending on the severity of premenstrual symptoms: Control, Low-Molimina (L-Molimina), High-Molimina (H-Molimina), and PMS. RESULTS: No intramenstrual cycle difference in HRV parameters was found in the Control and L-Molimina groups, with zero and a small increase (9.7±0.7%) in premenstrual symptoms, respectively. In contrast, Total power and high-frequency (HF) power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the luteal phase from the follicular phase in the H-Molimina group with moderate increase (24.8±0.7%) in premenstrual distress. Luteal-phase reduction in Total and HF power was also detected in the PMS group with more severe symptoms (67.6±8.1%). In addition, all HRV components in both phases decreased markedly in the PMS group compared to that of the other groups. CgA in the PMS group increased in the luteal phase from the follicular phase, and the value was greater than that of the other groups. CONCLUSIONS: This study provides intriguing findings that the altered functioning of the ANS in the luteal phase might relate to diverse psychosomatic symptoms appearing premenstrually. The study further implies that noninvasive evaluation of ANS activity—reflecting mind-body interaction—with electrophysiological and biochemical indexes could contribute to monitoring and promoting women's physical and mental health.

Dissociation and Psychosis: Conceptual Issues

SUMMARY The relationship between dissociation and psychosis is not a topic of serious study and research in the psychosis field, though it has received attention in the dissociation literature. A number of conceptual problems must be solved before the role of dissociation in schizophrenia and other psychoses can be a central issue in diagnosis, research and treatment. These include problems with: the model of mind-body interaction accepted in psychiatry, definitions of dissociation and psychosis, the concept of pseudo-hallucinations, DSM criteria for schizophrenia, research measures for dissociation and psychosis, the sociology of psychiatry, the drug industry, assumptions about etiology of dissociation and psychosis, and assumptions about treatment. These problems are discussed and recommendations are made for DSM-V and future research.

Conceptions of health, illness and treatment of patients who use homeopathy in Santos, Brazil

Objective To investigate the conceptions of health and illness, the reasons for seeking homeopathy and continuing treatment, compliance and the meaning of the relationship between religiosity and health for patients who adhere to homeopathy. Methods A qualitative study of 20 adult patients in Santos (Brazil) treated by homeopaths in the public and private sector for at least 2 years. Semi-structured interviews, organized by predefined thematic categories, the content of the interviews was analyzed. Results The conceptions of health and illness of the interviewed patients are related to the idea of vital balance/imbalance mediated by body–mind interaction. Dissatisfaction with conventional treatment, family influence and suggestions of others were the reasons for seeking homeopathic treatment. Patients continued homeopathic treatment due to positive therapeutic results, cure without being aggressive to the organism, the holistic integrated approach, the preventive nature of the treatment and low prices of medicine. For these patients, the availability of homeopathy in the public health sector extends the possibility of access. The need for a wider dissemination of homeopathy and the difficulties in following the prescription are the main problems involved in continuing treatment. Faith is an important component. We found a correlation between the conceptions of health and illness and the principles of homeopathy, assimilated through a strong bond between patients and the homeopathic practitioners. Conclusion To investigate the beliefs, values and meanings that patients attribute to homeopathy helps to understand subjective aspects that may interfere with treatment compliance.

History of Psychology: Recurring Errors among Recent History of Psychology Textbooks

Five recurring errors in history of psychology textbooks are discussed. One involves an identical misquotation. The remaining examples involve factual and interpretational errors that more than one and usually several textbook authors made. In at least 2 cases some facts were fabricated, namely, so-called facts associated with Pavlov's mugging and Descartes's reasons for choosing the pineal gland as the locus for mind-body interaction. A fourth example involves Broca's so-called discovery of the speech center, and the fifth example involves misinterpretations of Lloyd Morgan's intentions regarding his famous canon. When an error involves misinterpretation and thus misrepresentation, I will show why the misinterpretation is untenable.

The effect of choral music on emotions, immune parameters and lung function during physiotherapy treatment of pneumonia and bronchitis

Introduction: Music, processed by the brain, has a strong impacton the emotions and health. The Magnificat in D major of JS Bach communicates not only a positive emotion of happiness but also motivational behaviour. Infectious lung conditions are often associated with negative emotions which develop due to physiological changes. The hormonal action of the hypothalamuspituitary-adrenal axes (HPA) could be negatively affected by emotions of anger and depression. This will result in a disturbance of the mind-body inter-action. Music therefore can exert a powerful influence on therapeutic benefits by changing the psychological status and the immune endocrine functions. The purpose of this study was to determine the effect of music, during respiratory physiotherapy treatment on a) theemotional status, b) neuroendocrine responses, c) immune functions and d) lung functions of subjects with infected lung conditions.Method and Materials: Forty subjects attending physiotherapy treatment was selected according to set criteria and randomly assigned to an experimental and control group. The parameters (Profile Of Mood State [POMS]; CD4:CD8 cell ratios; Cortisol; the Cortisol: DHEA ratio; PF; FEV1; FVC and FEV1/FVC %) were measured on day 1before the treatment and on day 3 after the treatment. Data were analysed with Statistica (Statsoft) using the RepeatedANOVA tests. Results: Results indicated that the intervention of music had a positive effect on the immunological parameter (CD4+:CD8+ cell ratios) and on the cortisol and cortisol:DHEA ratio levels. At the same time the psychological status as measured by Profile of Mood States (POMS scale) improved with a significant improvement in the lung functions.Conclusion: The research provided sufficient scientific evidence that music affects both the biomedical and psycho-somatic aspects of infectious lung conditions.

Protective and damaging effects of stress mediators: central role of the brain

The mind involves the whole body and two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms. Stress is a condition of the mind-body interaction, and a factor in the expression of disease that differs among individuals. It is notjust the dramatic stressful events that exact their toll, but rather the many events of daily life that elevate and sustain activities of physiological systems and cause sleep deprivation, overeating, and other health-damaging behaviors, producing the feeling of being "stressed out." Over time, this results in wear and tear on the body which is called "allostatic load," and it reflects not only the impact of life experiences but also of genetic load, individual lifestyle habits reflecting items such as diet, exercise, and substance abuse, and developmental experiences that set life-long patterns of behavior and physiological reactivity. Hormones associated with stress and allostatic load protect the body in the short run and promote adaptation by the process known as allostasis, but in the long run allostatic load causes changes in the body that can lead to disease. The brain is the key organ of stress, allostasis, and allostatic load, because it determines what is threatening and therefore stressful, and also determines the physiological and behavioral responses. Brain regions such as the hippocampus, amygdala, and prefrontal cortex respond to acute and chronic stress by undergoing structural remodeling, which alters behavioral and physiological responses. Translational studies in humans with structural and functional imaging reveal smaller hippocampal volume in stress-related conditions, such as mild cognitive impairment in aging and prolonged major depressive illness, as well as in individuals with low self-esteem. Alterations in amygdala and prefrontal cortex are also reported. Besides pharmaceuticals, approaches to alleviate chronic stress and reduce allostatic load and the incidence of diseases of modern life include lifestyle change, and policies of government and business that would improve the ability of individuals to reduce their own chronic stress burden.

Basic knowledge in psychodermatology

The authors try to define the framework of this approach, what should be acquired by "well-informed" dermatologists and what is required to be a pyschodermatologist. To better define the necessary knowledge to practice psychodermatology. 1) The first level is dermatology psychology: there is a psychotherapeutical implicit effect of the dermatological consultation with a goal that is not psychological change. This effect can be improved by acquiring better communication skills and information. The second level needs a possibility to change the emotional individual process and the relational context in a continuum between counselling and psychotherapy. To practice this level a complete psychotherapeutic education with some specificity is needed. This can be reached by a dermatologist also being a psychotherapist or by a team consisting of both dermatologist-psychotherapist. 2) The psychodermatological patient is characterized by alexithymia. He/she needs to be understood through the body language he/she presents. This kind of patient is coming from families where the theme of loss seems to dominate the histories and be associated with deep emotional experiences of separation anxiety. These characteristics must be known together with the different psychodermatological disorders and the mind-body interaction to handle these patients. 3) Taking all of this complexity into account, the psychodermatologist or the psychodermatological team should be able to integrate the different points and adapt attitudes to the patient's difficulty during the whole therapeutic process. 4) The evaluation of the problem should be done using psychological tools here described. The European Academy of Dermatology and Venereology (EADV) together with the European Society for Dermatology and Psychiatry (ESDaP) are able to provide the specific education for dermatologist and psychotherapist. In the future, they could be responsible for the recognition of these special abilities and treatments on a governmental and European political level.

BUSY LIVES

Click to increase image sizeClick to decrease image size Notes 1. Quotations from the Descartes–Elisabeth correspondence are from John J. Blom's translation of Descartes: His Moral Philosophy and Psychology ( 1978 Descartes , René . 1978 . Descartes: His moral philosophy and psychology . Translated and introduced by John J. Blom . Hassocks : Harvester Press . [Google Scholar] ). For biographical information on Princess Elisabeth of Bohemia, I am indebted to the excellent biography of her mother by Carola Oman (1938 Oman, Carola. 1938. Elizabeth of Bohemia, London: Hodder & Stoughton. [Google Scholar]). For additional biographical sources on Elisabeth, see Beatrice Zedler (1989 Zedler, Beatrice. 1989. Three princesses. Hypatia, 4(1): 28–63. [Crossref] , [Google Scholar]). 2. For a discussion of the philosophical merit of Elisabeth's specific objections to Descartes's treatment of mind–body interaction, see Daniel Garber (1983 Garber , Daniel . 1983 . Understanding interaction: What Descartes should have told Elisabeth . Southern Journal of Philosophy 21 ( Supplement ). [Google Scholar]). 3. When all Descartes's works are taken into account, however, there are good grounds (despite his reputation as a dualist) to see him as taking very seriously the ramifications of embodiment for human thinking. For such a reading, see Amélie Rorty's excellent ‘Descartes on Thinking with the Body’ (1992 Rorty , Amélie . 1992 . Descartes on thinking with the body . In The Cambridge companion to Descartes , edited by John Cottingham . Cambridge : Cambridge University Press .[Crossref] , [Google Scholar]). 4. Thomas Wartenberg (1999 Wartenberg , Thomas . 1999 . Descartes's mood: The question of feminism in the correspondence with Elisabeth . In Feminist interpretations of René Descartes , edited by Susan Bordo . University Park : Pennsylvania State University Press . [Google Scholar]) has explored, more fully than I can here, the bearing of the correspondence on issues of the gendered ‘contextualization’ of philosophy. 5. The ethical implications of Elisabeth's responses to Descartes, which I do not develop here, have been discussed by Andrea Nye (1996 Nye , Andrea . 1996 . Polity and prudence: The ethics of Elisabeth, Princess Palatine . In Hypatia's daughters , edited by Linda Lopez McAlister . Bloomington : Indiana University Press . [Google Scholar]). 6. Descartes (1991 Descartes , René . 1991 . The philosophical writings of Descartes . Vol. 3. Translated by John Cottingham, Robert Stoothoff, Dugald Murdoch, and Anthony Kenny . Cambridge : Cambridge University Press .[Crossref] , [Google Scholar]), pp. 383–4. 7. A full evaluation of the philosophical importance of Elisabeth's responses to Descartes would, of course, need to address the relevance of the fact that she produced no philosophical treatise of her own. For an illuminating discussion of issues of genre in relation to the correspondence, see Lisa Shapiro (1999 Shapiro , Lisa . 1999 . Princess Elisabeth and Descartes: The union of soul and body and the practice of philosophy . British Journal for the History of Philosophy 7 ( 3 ): 503 – 20 . Reprinted in Genevieve Lloyd, ed., Feminism and history of philosophy. Oxford: Oxford University Press, 2002: 182–203 .[Taylor & Francis Online] , [Google Scholar]).

Psychosomatic medicine: A new psychiatric subspecialty in the U.S. focused on the interface between psychiatry and medicine

Background and Objectives: In the past, Psychosomatic Medicine (PM) has had ambiguous connotations, and there have been many other names for this specialized fields, including Consultation-Liaison Psychiatry. The objective of this report is to briefly review the background, the history and current status of PM, which recently was recognized in the U.S. a psychiatric subspecialty. Methods: Historical review and review of the literature. Results: PM has a rich history. Psychoanalysts and psychophysiologists pioneered the study of mind-body interactions, and crucial events in the development include the funding of PM units in several U.S. teaching hospitals by the Rockefeller Foundation, and the training grants and a research development program funded by the National Institute of Mental Health. By the 1980s, all psychiatry residency programs were requiered to provide substancial clinical experience in the field, and as of 2005 there were 32 fellowship programs in the Academy of Psychosomatic Medicine's (APM) directory. In 2001, The Academy of Psychosomatic Medicine (APM) applied for the recognition of PM as a subspecialty of psychiatry, and formal approval was granted by the American Board of Medical Specialties (ABMS) in March 2003.The foundation of PM is a specialized body of scientific knowledge regarding psychiatric aspects of medical illness. This has been articulated in contemporary textbooks, journals and regular scientificic meetings of national and international societies A cadre of scholars and researchers has emerged, and important contributions have occurred. A major goal of the PM field is to improve the psychiatric care of patients with complex medical conditions. There are a number of obstacles and challenges ahead in pursuing optimal integration of PM services into existing service delivery systems of care, but anticipated expansion of accredited fellowship programs in PM will hopefully help address this shortfall. In the past 20 years an international PM network has developed with increasing scientific exchanges, and the US paradigm is regarded as important for the development of PM as a subspecialty internationally. Conclusion: Formal recognition as a subspecialty in the U.S. has and will strengthen PM and will enhance its growth internationally.

The cybersemiotic model of communication: An evolutionary model of the threshold between semiosis and informational exchange

The present paper discusses various suggestions for a philosophical framework for a transdisciplinary information science or a semiotic doctrine. These are: the mechanical materialistic, the pan-informational, the Luhmanian second order cybernetic approach, Peircian biosemiotics and finally, the pan-semiotic approach. The limitations of each are analyzed. The conclusion is that we will not have to choose between a cyberneticinformational and a semiotic approach. A combination of a Peircian-based biosemiotics with autopoiesis theory, second order cybernetics, and information science is suggested in a five-levelled cybersemiotic framework. The five levels are 1) a level of Firstness, 2) a level of mechanical matter, energy, and force as Secondness, 3) a cybernetic and thermodynamic level of information, 4) a level of sign games and 5) a level of conscious language games. These levels are then used to differentiate levels of information systems, sign and language games in human communication. In our model, Maturana and Varela's description of the logic of the living as autopoietic is accepted and expanded with Luhmann's generalization of the concept of autopoiesis to also cover psychological and socio-communicative systems. Adding a Peircian concept of semiosis to Luhmann's theory in the framework of biosemiotics enables us to view the interplay of mind and body as a sign play. I have in a previous publication (see list of references) suggested the term 'sign play' pertaining to exosemiotics processes between animals in the same species by stretching Wittgenstein's language game concept into the animal world of signs. A new concept of intrasemiotics designates the semiosis of the interpenetration between the biological and psychological autopoietic systems as Luhmann defines them in his theory. I am suggesting a cybersemiotic model to combine these approaches, defining various concepts like thought-semiotics, phenosemiotic and intrasemiotics, combining them with the already known concepts of exosemiotics, ecosemiotics, and endosemiotics into a new view of self-organizing semiotic processes in living systems. Thus a new semiotic level of description is generated, where mind-body interactions can be understood on the same description level. This is the direction suggested to work in to create a broad philosophy of information, cognitive, and communication science that makes it possible for us to see the different approaches not as mutually exclusive, but rather as mutually complementary in accepting an ontology where reality do have structures and processes, but the foundation is hyper. complex and therefore not to be reduced by any knowledge system.

Brain–gut connections in functional GI disorders: anatomic and physiologic relationships

Understanding the neural regulation of gut function and sensation makes it easier to understand the interrelatedness of emotionality, symptom-attentive behavior or hypervigilance, gut function and pain. The gut and the brain are highly integrated and communicate in a bidirectional fashion largely through the ANS and HPA axis. Within the CNS, the locus of gut control is chiefly within the limbic system, a region of the mammalian brain responsible for both the internal and external homeostasis of the organism. The limbic system also plays a central role in emotionality, which is a nonverbal system that facilitates survival and threat avoidance, social interaction and learning. The generation of emotion and associated physiologic changes are the work of the limbic system and, from a neuroanatomic perspective, the 'mind-body interaction' may largely arise in this region. Finally, the limbic system is also involved in the 'top down' modulation of visceral pain transmission as well as visceral perception. A better understanding of the interactions of the CNS, ENS and enteric immune system will significantly improve our understanding of 'functional' disorders and allow for a more pathophysiologic definition of categories of patients currently lumped under the broad umbrella of FGID.

Burton's ‘Turning Picture’: Argument and Anxiety in The Anatomy of Melancholy

Burton's Anatomy is built around a coherent analysis of melancholy. It presents a consistent explanation of the properties and pathology of melancholy, relating these to a lucid model of mind–body interaction which also accounts for the disease's self-propagating nature. Furthermore, Burton differentiates between those who are merely disposed to, and those who have become habituated to, melancholy, and that distinction makes good sense of the relationship between the Anatomy's preface and the treatise proper. At the centre of this work is an aetiological analysis which roots the causes of melancholy in ethical decisions. Hence, Burton accords primary therapeutic significance to the management of Galen's so-called six ‘non-naturals’. Against this Galenic regimen is set, though, a recurrent anxiety that melancholy may be intractable. That disquiet is reflected in Burton's use of copia as a device, first, for ‘confining’ melancholy (by recording its every facet), and then for overwriting the anxious fear that it cannot be thus confined (because its mutations are infinite). Uneasiness is further reflected in the constant oscillation between Burton's ‘own’ and ‘Democritus Junior's’ persona, an oscillation which dramatizes Burton's sense of the instability of his own sanity. These stylistic features, then, stand in opposition to the rationalist argument.

Placebos and painkillers: is mind as real as matter?

Considerable progress has been made in our understanding of the neurobiological mechanisms of the placebo effect, and most of our knowledge originates from the field of pain and analgesia. Today, the placebo effect represents a promising model that could allow us to shed new light on mind-body interactions. The mental events induced by placebo administration can activate mechanisms that are similar to those activated by drugs, which indicates a similarity between psychosocial and pharmacodynamic effects. These new neurobiological advances are already changing our conception of how clinical trials and medical practice must be viewed and conducted.

The Importance of Trust for Ethics, Law, and Public Policy

The importance of preserving trust in physicians and in medical institutions has received widespread attention in recent years. Primarily, this is due to the threats to trust posed by managed care, but there is a general and growing recognition that trust deserves more attention than it traditionally has received in all aspects of medical ethics, law, and public policy. Trust has both intrinsic and instrumental value. Trust is intrinsically important because it is a core characteristic that affects the emotional and interpersonal aspects of the physician/patient relationship. As an instrumental value, trust is widely believed to be essential for effective therapeutic encounters. It has been hypothesized or shown to affect a host of important behaviors and attitudes relating to care, including seeking care, disclosing private information, complying with treatment, and being satisfied with care. Moreover, trust may be a mediator of measurable clinical outcomes and a key factor in the mind–body interactions that underlie placebo/nocebo effects and the effectiveness of alternative medicine. It is no surprise, then, that preserving, justifying, and enhancing trust is the fundamental goal of much of medical ethics, and is a prominent objective in healthcare law and public policy. Discussions of trust and related concepts were commonplace in professionally based medical ethics prior to the 1970s.This research was supported in part by the Robert Wood Johnson Foundation, under its Patient-Provider Relationship Initiative. Several colleagues contributed to the development of these ideas, including Elizabeth Dugan, Ph.D., Douglas Levine, Ph.D., Beiyao Zheng, Ph.D., Raj Balkrishnan, Ph.D., and Charles Rawlings, M.D. This article is based in part on a prior article and book chapter.Hall MA. The ethics and empirics of trust. In: Englehardt TH, Bondeson W, eds. The Ethics of Managed Care: Professional Integrity and Patient Rights. Amsterdam: Kluwer;2003:109–26.Hall MA. Law, medicine and trust. Stanford Law Review 2002;55:463–527.

Genomic Profiling of Neutrophil Transcripts in AsianQigongPractitioners: A Pilot Study in Gene Regulation by Mind–Body Interaction

The great similarity of the genomes of humans and other species stimulated us to search for genes regulated by elements associated with human uniqueness, such as the mind-body interaction. DNA microarray technology offers the advantage of analyzing thousands of genes simultaneously, with the potential to determine healthy phenotypic changes in gene expression. The aim of this study was to determine the genomic profile and function of neutrophils in Falun Gong (FLG, an ancient Chinese Qigong) practitioners, with healthy subjects as controls. Six (6) Asian FLG practitioners and 6 Asian normal healthy controls were recruited for our study. The practitioners have practiced FLG for at least 1 year (range, 1-5 years). The practice includes daily reading of FLG books and daily practice of exercises lasting 1-2 hours. Selected normal healthy controls did not perform Qigong, yoga, t'ai chi, or any other type of mind-body practice, and had not followed any conventional physical exercise program for at least 1 year. Neutrophils were isolated from fresh blood and assayed for gene expression, using microarrays and RNase protection assay (RPA), as well as for function (phagocytosis) and survival (apoptosis). The changes in gene expression of FLG practitioners in contrast to normal healthy controls were characterized by enhanced immunity, downregulation of cellular metabolism, and alteration of apoptotic genes in favor of a rapid resolution of inflammation. The lifespan of normal neutrophils was prolonged, while the inflammatory neutrophils displayed accelerated cell death in FLG practitioners as determined by enzyme-linked immunosorbent assay. Correlating with enhanced immunity reflected by microarray data, neutrophil phagocytosis was significantly increased in Qigong practitioners. Some of the altered genes observed by microarray were confirmed by RPA. Qigong practice may regulate immunity, metabolic rate, and cell death, possibly at the transcriptional level. Our pilot study provides the first evidence that Qigong practice may exert transcriptional regulation at a genomic level. New approaches are needed to study how genes are regulated by elements associated with human uniqueness, such as consciousness, cognition, and spirituality.

Human Cognition and 1/f Scaling.

Ubiquitous 1/f scaling in human cognition and physiology suggests a mind-body interaction that contradicts commonly held assumptions. The intrinsic dynamics of psychological phenomena are interaction dominant (rather than component dominant), and the origin of purposive behavior lies with a general principle of self-organization (rather than a special neurocognitive mechanism). E.-J. Wagenmakers, S. Farrell, and R. Ratcliff (2005) raised concerns about the kinds of data and analyses that support generic 1/f scaling. This reply is a defense that furthermore questions the model that Wagenmakers and colleagues endorse and their strategy for addressing complexity.