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Integrative Fitness: The New Science of Body-Mind Medicine

by Pamela Peeke, MD, MPH, FACP on Jun 01, 2007

The latest research confirms the truth behind the adage mens sana in corpore sano, or “a sound mind in a sound body.”

Most fitness professionals have realized by now that their mission as teachers and mentors is not just about helping clients achieve hard bodies. Instead, engaging and training the mind to achieve optimal body-mind performance has become the new challenge. There’s lots of talk about maximizing mental and physical fitness by “making the body-mind connection.” But if you’re like the many other personal fitness trainers, coaches and movement therapists struggling to reach this goal, you’re in for a surprise: There is no body-mind connection. There never was.

That said, here is the latest research-based news on the topic:

  • The mind is the body and vice versa.

  • The mind and body are changeable, or plastic, throughout the entire life span.

  • The healing process is one of psychobiological regeneration.

  • Mental, physical and spiritual self-care practices are all part of what is known as integrative fitness, the only path to the achievement of optimal holistic wellness.

Fitness is no longer limited to the physical part of our beings; rather, the physical elements must become fully integrated with the mental and spiritual elements if we are to function properly. This article will explain the latest cutting-edge scientific findings about harnessing the extraordinary power of integrative fitness to achieve optimal functioning of the entire mind, body and spirit.

A Brief History of Science

For the better part of history, the individual was viewed as a totality of mind and body. Then things got a bit more complicated. In the 17th century, the scientist René Descartes became the voice of a movement called iatromechanism (from the Greek iatros). The doctors and biologists who spearheaded this movement viewed the body as a machine made up of countless smaller machines. Descartes proclaimed that the body was made of measurable physical matter, but the mind lacked physical substance. This belief system was further supported by 19th- and early 20th-century physicists who embraced the Newtonian model of a physical world of measurable matter.

This line of thinking came to a crashing halt with the emergence of Albert Einstein’s concept of matter as a dynamic flow of energy. Einstein’s innovative line of reasoning created the perfect transition for the emergence in 1980 of a new field of body-mind research that is now known as psychoneuroimmunology (PNI), or the study of the effect of mind on body function and vice versa.

Leading the charge were maverick bioscience pioneers Candace Pert and Michael Ruff, who presented the groundbreaking new concept of a “psychosomatic network,” a network that extends to every one of the approximately 75 trillion cells in the brain and body (Williams & Herrup 1988). This network is composed of neuropeptides (short chains of amino acids) and their corresponding receptors; these neuropeptides communicate the organism’s physical and emotional reactions and responses to life events. The network, then, acts as a living system, dynamically processing and exchanging cellular information based on changes in the organism’s internal and external environment. The outdated Cartesian model was replaced after Pert’s discovery that the “feel-good” opioid neuropeptide and its receptors were located in the brain (the limbic or emotional center) and in most body cells. Other scientists later confirmed that most neuropeptides had receptors located in the limbic brain.

All of these scientific discoveries led to the conclusion that our emotions are the language of the body and mind as a whole entity, meaning there is no separation of the body and mind. The body-mind entity allows for a free and continual flow of information as we adapt and adjust to life’s ever-changing environment.

Going With the Flow

How does this free and continual flow of information take place in the body-mind? By way of example, imagine that you are suddenly frightened. Within nanoseconds of your feeling the “fight-or-flight” response, neuropeptides are secreted and connect to receptors on cells throughout your brain and body. Once the connection is made, the receptors trigger a message to be sent to each cell’s command central, or nucleus. The neuropeptide then tells the cell to prepare for the stress response. This process, known as transduction, leads to a change in gene expression, which results in the cell increasing or decreasing the production of proteins that regulate its function. These proteins influence everything from increasing the inflammatory response (so your arthritis pain increases when you are under stress) to suppressing the immune response (so you get the flu while cramming for final exams).

Another example of the flow of information might be feeling queasy when you are scared. That manifestation occurs when the neuropeptide receptors that line the gut, from the mouth to the colon, quickly respond to the surge of stress-induced neuropeptides and hormones. Under stress, the neuropeptide known as cholecystokinin (CCK) activates in both the brain stem and the gut, causing a variety of gastrointestinal distress symptoms.

And the body remembers this stress. Columbia University’s Nobel Laureate Eric Kandel has suggested that these cellular receptor changes are the molecular basis of memory as well as learning (Kandel et al. 1986). If memory storage is taking place in the brain and the body, then the unconscious mind is found not only in the brain structures but also in the spinal cord, organs and immune system. No wonder some people break out in a skin rash in the same place whenever they are under mental stress!

The Stress Reaction Revealed

Have you ever wondered what happens when you are in a stressful situation, such as speaking in public? The usual stress response kicks in, with the resulting increase in blood pressure, heart rate and stress hormones, such as endorphins. Meanwhile, at the cellular level, the information flow triggered by the fear results in the rise of natural killer cells (NKCs) that spread out and destroy stressors, such as viruses or bacteria.

That system works fine for short-term stress.

However, when stress becomes chronic (as in a bad marriage), NKC production is actually suppressed, leading to immune suppression and significant vulnerability to disease. Additionally, the body reacts by producing the hormone cortisol and suppressing production from the thymus gland, which generates disease-fighting T cells. A real-world example of this response is the longtime caregiver who forgets to eat or exercise while caring for someone else. People in this situation tend to become sick more frequently and die earlier than those who lead a more balanced life.

Harnessing Hope

Hans Selye, a physician and budding scientist, never expected to stand out as one of the great pioneers in stress research. But thanks to his clumsiness in the laboratory, he became one of the godfathers of early body-mind science. In the 1930s, while injecting rats for an experiment, Selye constantly fumbled and dropped them. Consequently he spent most of his time, broomstick in hand, chasing them around his lab. After months of these mishaps, he was amazed to find that each of the mishandled rats ended up with a peptic ulcer, enlarged adrenal glands and a shrunken thymus (Sapolsky 1994). Fascinated, Selye constructed an experiment in which he deliberately dropped and stressed one group of rats and didn’t touch the others. Sure enough, the first group showed anatomical signs of chronic stress (Sapolsky 1994).

In later experiments, Selye found that if the stressed rats were petted and held after each stressful session, the physical nurturing reversed or minimized the physical manifestations of chronic stress (Sapolsky 1994). The gentle touching transformed the animal’s perception of hopelessness, helplessness and defeat into one of hope. The neuropeptides of hope flowed through the body’s network, modulating and potentially eliminating the toxicity of the physical stress.

And, in fact, studies of breast cancer patients have demonstrated that women who scored the highest on measures of helplessness and hopelessness were much more likely to relapse and die than women who felt more hopeful (Jacobs & Bovasso 2000).

Hope flows from choice. How you deal with life’s stressful events—perceiving them with hopelessness or hope—is your choice. It is choice, then, not stressful events, that determines the final mental and physical outcomes you experience from day-to-day living.

Toxic Stress Alterations

My own research has demonstrated that chronic feelings of anxiety, withdrawal, depression and rage result in what I refer to as toxic stress alterations in the body-mind’s functions. These alterations include chronic increases in opioids, which suppress NKCs, leading, in turn, to immune suppression and increased disease vulnerability. Classic studies undertaken by Sheldon Cohen, PhD, and colleagues demonstrated a direct relationship between the amount of stress experienced and the risk of contracting a cold after being inoculated with a rhinovirus (Cohen, Tyrrell & Smith 1991).

The stress of chronic emotional suppression can also erode immune function. This was illustrated in brilliant work done by Steve Cole and his colleagues, who found a direct association between how rapidly HIV disease advanced and whether or not the patient’s gay identity was concealed (Cole et al. 1996a; Cole et al. 1996b). Other researchers have found that immune function significantly improved in people who used journaling to express their deepest feelings about past traumas (Pennebaker, Kiecolt-Glaser & Glaser 1988).

Many people with heart disease spiral into major depression when feelings of anxiety, anger and hostility are combined with chronic feelings of hopelessness; there is generally a breakdown in the person’s ability to adapt and adjust. Cardiologist Dean Ornish addresses this head-on with his multiplatform treatment intervention, which includes meditation, imagery, group therapy, personal insight–oriented psychotherapy, a low-fat diet and consistent physical activity. The end result is the generation of the best healing each individual can produce, and the hope that the individual can restore a new and healthy homeostasis going forward.

The Science of Neuroplasticity

Hope and other emotions do indeed affect our very cellular core and its ability to trigger life-saving immune responses. This is because the body-mind connection is changeable, or “plastic.” Scientists have long abandoned the notion that the only brain neurons we will get and use for life are the ones we were born with. Instead, the brain is constantly turning over cells and adding new ones as we are exposed to new experiences and wonders in the world.

Scientists have known for a while that the body possesses an extraordinary ability to change in response to environmental challenges, and that, if necessary, most of the body’s organs and tissues can regenerate within limits. The latest news is that the brain can do the same.

Fred “Rusty” Gage, PhD, and his colleagues at the Salk Institute in La Jolla, California, laid down the foundation for the new science known as neuroplasticity. Gage’s research found that the brain can undergo neurogenesis, or the formation of new cells (Gage et al. 1998). The hippocampus, the area of the brain that regulates memory, is known to be shrunken in people suffering from depression; whether this shrinkage leads to depression, or depression causes the shrinkage, is unknown. However, Gage and his team found that after administration of either Prozac or Zoloft, this area of the brain experienced the growth of new cells, which was also associated with a decrease in the symptoms of depression (Gage et al. 1998). On the other hand, chronic toxic stress decreases the ability of the hippocampus to generate new cells in response to the environment. It is no surprise, then, that memory is suboptimal under chronic stress.

Exercise Those Brain Cells

Brain weight and volume decrease approximately 5% every 10 years after the age of 40 (Williams & Herrup 1988). But most of that loss affects just the supporting tissue and nerve fiber insulation. The number of brain cells remains mostly intact throughout life, with the notable exception of cells within the hippocampus, the center of memory, learning and emotional expression.

Loss of brain cells in general is due primarily to decreased oxygen and glucose metabolism resulting from the slowing of blood flow associated with sedentary lifestyles. Much of this damage can be reversed through daily cerebral and physical activity. This teaming of the body and mind stimulates new cell growth and also activates the production of neurotropic (nerve growth) brain proteins that protect neurons against injury and death. Encouraging people to stay mentally and physically active is a win-win-win scenario for the mind, body and spirit.

The body-mind is constantly adapting and adjusting its psychosomatic network as it monitors the living environment, in terms of both physical challenges and psychological stresses. Physical regeneration occurs optimally when we keep our bodies well nourished and maintain excellent physical fitness, and when we keep our brains in shape by continuously taking on challenges, such as learning a new dance step or tackling a sudoku puzzle. Using these strategies can minimize most age- related brain losses.

The Body-Mind Healing Process

Healing is a continuous, lifelong process in which cells are constantly and dynamically responding to physical, psychosocial, emotional, nutritional and physiological challenges. Disease occurs when there is a significant enough disturbance in this homeostasis. The question is, How can the healing process be optimized throughout the life span?

The old answer was to rely on the power of “positive” emotions to carry us through challenges. But all the emerging science now shows we need to draw from all of our primary emotions—including anger, fear, grief, sadness and joy—to augment our immune function and maximize physical resilience and neuroplasticity.

Remember, our emotions help carry valuable information to cells throughout the body, mind and spirit. If we get bogged down in feelings of chronic hopelessness or unresolved grief, we don’t create the ideal environment for healing. For example, researchers who studied patients with melanoma found that those who responded well to a psychosocial intervention (including learning better coping skills) actually experienced a significant reduction in recurrence and a threefold reduction in mortality over 6 years when compared to a control group (Butow, Coates & Dunn 1999). One reason for the difference is that the psychosocial intervention generated hope.

Here it is important to mention the power of words. Desperate people are constantly seeking for signs of hope to sustain them through a life crisis. They will hang on every word from those they trust to help them in their crisis. This is no small thing: Once hope is perceived through a written or stated word, it sets into motion a psychobiologic information flow, activating the emotional brain to produce neuropeptides that will decrease an out-of-control stress response and support a powerful immune reaction. The body, mind and spirit can then begin the healing process.

At the core of this healing process is the organism’s ability to manage all that life throws our way. In my book Fit to Live, I note at the outset Charles Darwin’s now famous quote: “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

The Role of the Spirit

Another, more controversial, element—the spirit—has been purported to support the healing process and self-protection. Few would deny that the body-mind is inhabited by some core essence of the individual. How often have we heard the phrase, “He may have passed on, but his spirit stays with us”?

The psychologist Rollo May defined spirit as “that which gives vivacity, energy, liveliness, courage and ardor in life” (Dreher 2003). Many have tried to grasp the essence of this integral piece of the self. Investigators have attempted to understand, measure and expand on the potential power of spiritual practices, from energy medicine to prayer therapy.

Spirit is unique to the individual, whereas the term spirituality seems to imply a connectedness to another, or a community of others. As Herbert Benson, MD, discovered in his early research at Harvard’s Benson-Henry Institute for Mind Body Medicine, a significant, direct association exists between the strength of an individual’s belief system and his or her medical outcomes (Benson & Stark 1996). The belief system could be personal or could reflect that of an organized religious or spiritual community. Population studies have demonstrated that people who regularly attend religious services of any denomination live longer and have a reduced risk of disease (Benson & Stark 1996).

While studies of prayer rituals have been fraught with difficulty in execution and interpretation, scientists are fascinated with the potential to measure the body’s energy fields and their effect on body-mind function. From acupuncture to yoga, researchers continue to pursue the quest to measure the elusive qi (energy). I predict that one day we will have a better understanding and appreciation of the role of spirit and spirituality in the body-mind paradigm.

Integrative Fitness

The body-mind entity represents an integrated system of living cells in constant communication, vigilantly relaying every emotion through a wide array of neuropeptides that freely flow throughout the body’s endless networks and feedback loops. Integrative fitness, then, is the optimal functioning of that whole entity—the body, mind and spirit.

From the molecular to the muscular, fitness must be defined by the success of the organism to operate at the highest levels of mental, physical and spiritual performance to achieve optimal quality and quantity of the life span.

That’s where you come in. Fitness professionals are now challenged with an expanded role. You become the body-mind guide for the clients who come to you with an immediate need to improve the physical, but a real need to be enlightened about the whole body-mind entity. These people need to be taught to appreciate how their life circumstances, from jobs to relationships to living environments, affect their mood, body composition, physical and mental performance, immune function, disease risk and ultimate longevity. They’ll learn from you that they’ll be lifting mental as well as physical weights, pumping up both their brain and their brawn.

In his book A Path with Heart, psychologist and Buddhist monk Jack Kornfield, PhD, noted: “After 10 years of focusing on emotional work and the development of the heart, I realized that I had neglected my body. . . . I learned that if I am to live a spiritual life, I must be able to embody it in every action: in the way I stand and walk, in the way I breathe, in the care with which I eat. All my activities must be included. To live in this precious animal body on this earth is as great a part of spiritual life as anything else.”

So we come full circle. The quest was never about making the body-mind connection. Instead, the ultimate goal is to accept and put into practice the body-mind-activity connection.

As fitness professionals, your work is to patiently encourage and support your clients’ efforts to sail through life’s challenges by promoting physical and mental fitness. Your very words can generate life-giving hope. That hope then leads to smarter lifestyle choices that further augment immune function and well-being. In the end, by honoring the body-mind as a whole, you give each client the precious gifts of self-empowerment and the ability to generate optimal self-healing for life.

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IDEA Fitness Journal, Volume 4, Issue 6

© 2007 by IDEA Health & Fitness Inc. All rights reserved. Reproduction without permission is strictly prohibited.

About the Author

Pamela Peeke, MD, MPH, FACP

Pamela Peeke, MD, MPH, FACP IDEA Author/Presenter

Pamela Peeke, MD, MPH, FACP, is a Pew Foundation Scholar in nutrition and metabolism and an assistant professor of medicine at the University of Maryland. She serves as chief medical correspondent for...