Now, more than ever, mind-body exercise programs are hot.

From 1998 through 2002, yoga and tai chi participation increased by 95 percent in the United States, according to American Sports Data (ASD) Inc. (ASD 2003a). By 2002, an estimated 11.1 million Americans were practicing tai chi or yoga and 4.7 million were doing Pilates (ASD 2003b). New participants are attracted partly by savvy marketing but also by the lure of programs that might offer them peace of mind as well as fitness gains.

In the midst of all this growth and excitement, is it clear what mind-body exercise really is? We think that it includes yoga and tai chi, but not weight training or swimming. Are we justified in making that distinction?

A Little History

The term mind-body exercise comes to the fitness industry from the field of mind-body medicine. According to the Mind/Body Medical Institute in Chestnut Hill, Massachusetts, mind-body medicine is based on the “inseparable connection between the mind and body—the complicated interactions that take place between thoughts, body and the outside world.”

Today’s strong focus on mind-body medicine had its beginnings as early as the 1940s and 1950s, when Hans Selye, MD, popularized the concept of stress and the “fight or flight” response in modern medicine. The field has evolved steadily since the early 1970s, which saw the emergence of body therapies, along with pioneering studies on the psychological impacts of exercise. That same decade, Herbert Benson, MD, from Harvard University, coined the term
relaxation response to describe how changes in states of mind could effect changes in the body. Benson’s research documenting the relaxation response was based on studies of people who
engaged in transcendental meditation. His findings provided
research-based evidence that mental changes resulting from meditation could bring about beneficial physiological changes.

Since then, medical evidence for the support of mind-body medicine, which includes mindful exercise techniques, has been growing. Research has shown that mind-body practices can benefit both the nervous system and the immune system by restoring balance after the stress response has been aroused. People with borderline hypertension, in particular, have experienced remarkable benefits from engaging in mindful techniques and, in some cases, have even been able to discontinue drug therapy.

When such techniques involve physical movement—as is the case with yoga and tai chi—researchers find that participants also experience improvements in physical conditioning, such as cardiovascular conditioning, muscular strength and endurance, flexibility and balance. However, the primary reason for practicing these physical activities was traditionally not to achieve fitness gains, but rather to develop harmony of mind, body and spirit.

Labeling these techniques as mind-body activities was not meant to imply that conventional exercise was not mindful. In contrast, the term indicated that what was quintessentially important about such activities was that they were rooted in the category defined as “mind-body” by the medical research community.

Defining Mind-Body Exercise

In the 1990s, in keeping with this background, the IDEA mind-body fitness committee defined mind-body exercise as “physical exercise executed with a profoundly inwardly directed focus.” According to Ralph La Forge, MS, former chair, the committee identified five characteristics of mind-body exercise: inner mental focus; concentration on muscular movements; synchronization of movements with breathing patterns; attention to form and alignment; and a belief in the “life energy,” such as prana or chi, that is part of ancient Eastern disciplines. The committee noted that any mind-body style of exercise typically has one or more of these qualities.

But can’t a runner run with inner mental focus? Doesn’t a weightlifter pay attention to breathing and form? How is a mindful swimmer any different from a mindful tai chi practitioner?

The difference seems to lie, ultimately, in the particular state of mind that practitioners bring to— and develop from— mind-body practices. This state is something more than concentration or mental attention but is not easy to define, just as a meditative state is not easy to describe in words. The lack of vocabulary, however, does not mean the state of mind does not exist. Technologies today can measure alterations in brain patterns and changes in blood levels of cortisol, showing that a change in state of mind can lead to physiological changes.

“Until we have a better understanding of precisely what the ‘mind-body focus’ consists of, how will we incorporate it [into conventional fitness activities]?” asks La Forge. “At this point, I am not entirely sure that there is a measurable health-related value to incorporating a mind-body focus in conventional fitness activities. It sounds very logical and impressive, but what is the outcome?”

Others, however, question the notion of a separate mind-body category. Clinical and sport psychologist Jim Gavin, PhD, who teaches at Concordia University in Montreal, says, “I think it is misleading to even speak about mind-body exercise as if it is something qualitatively different from other forms of exercise. It makes more sense to consider all exercise forms as representing degrees of emphasis along a continuum ranging from ‘integrated to unintegrated.’ A weightlifter can be very mindful (focusing breath, concentrating, clearing her mind), and someone doing yoga can be quite ‘unintegrated’ in thinking about his date last evening as he ritualistically goes through his asanas.” Others would reply, however, that an “unintegrated” yoga practitioner would not be practicing yoga in the way it was intended, so the question arises: Would that person have an authentic practice? By contrast, an “unintegrated” weightlifter would still be practicing legitimate weight training. In other words, the mindful component is not essential to the authenticity of weight training.

Keeping an Open Mind

Clearly, we still need to learn more about the “mind-body state of mind.” In 2000,
researchers at the Stanford University Prevention Research Center reviewed existing studies of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly and found “a dearth of randomized controlled research conducted in the U.S.” Researchers concluded that “there is a lack of studies with which to determine appropriate dosage and understand the mechanisms by which many of the practices work. Anecdotal evidence, some controlled research, clinical observation, as well as the cost effectiveness and lack of side effects of the mind-body treatments make further investigation a high priority.”

La Forge, moreover, points out that “one contaminant in research evaluating the addition of a mind-body component to conventional exercise is that when exercise is somewhat hard, perhaps approaching lactate threshold, the subject produces a number of metabolites, such as lactic acid, and other substances that ‘wash out’ some of the potential cognitive effects of a mindful or meditative component.” This is a significant point, since mind-body exercise, by its very definition, is inseparable from its cognitive component, which is the key to creating the beneficial physiological effect.

“It needs to be acknowledged that all action involves some form of mental activity—and therefore can be hypothesized as having ‘major to minor’ impact on cognitive/psychological processes,” argues Gavin. “If deliberate and intentional focusing of mind (while exercising) on breath, body scans, mantras or immediate experience can be seen as a key ingredient to mind-body exercise, then we need to stop creating a hierarchy of ‘more’ or ‘less’ mind-body exercises, and begin teaching people what to do with their minds in whatever they are doing.” Perhaps, as we learn more about exactly what they should be doing, that will happen more. This assumes, however, that all people seek a mind-body integrative experience, which may or may not be the case.

Coming Together

The future for teaching professionals of both mind-body and conventional exercise is particularly exciting. Researchers continue to unravel and identify with greater precision the exact relationship of our mental state to our physical well-being. At the same time, researchers are discovering more about the importance of physical activity for our mental well-being. The time for a true understanding of the complexity of the merger of mind and body is upon us. In the words of Zen Buddhist philosopher D.T. Suzuki, “Body and mind are not two and not one.”