The Shambhala Sun: Your first work on the mind/body connection was a study in the early seventies of the effects of Transcendental Meditation. At that time, neither the scientific community nor the spiritual community took TM’s claims very seriously, yet you did.
Herbert Benson, M.D.: Well, I had seen in animal studies how high blood pressure was related to stress. The transcendental meditators claimed that they could lower blood pressure by practicing stress-alleviating techniques, and that just made sense to me, once I got over the hesitation of going into something so relatively unexplored. I studied transcendental meditation and found that it evoked a response that was physiologically opposite to the stress response. Another way to describe the stress response is the so-called fight-or-flight response, and as historical accident would have it, the room where we studied people practicing TM was the very room where sixty years before Walter B. Cannon had first described the fight-or-flight response.Then, it made no sense to say that TM was the only way to evoke this quieting response, so I looked for the basic steps that made up Transcendental Meditation. Ultimately, I felt there were two: Step one was repetition, of a sound, a word, a prayer, a phrase, or a muscular activity. The second step was that when thoughts came to mind, you tacitly disregarded them and returned to the repetition. When I looked for these two steps in the religious and secular literatures of the world, I was astounded to find that in every single culture of man that had a written history, these two steps were described.
You are describing the elements of all basic mindfulness meditation, in which you return from discursive thought to a simple object of mindfulness, such as the breath.
Exactly, which is still repetition. So at that point we had a mind/body technology, because we chose other words, sounds or prayers and found the same physiology that occurred with TM. That meant this was a mind/body technology, which I have called the relaxation response. If you meditate in a certain way, measurable, predictable, reproducible physiological changes occur. So this is science.
I find the next step that you took even more interesting. That was to look with fresh eyes at what the medical profession usually dismisses as the placebo effect. Rather than dismissing it, you looked at the placebo effect as important proof of the mind/body connection and as a demonstration of the healing power of belief.
The so-called placebo effect is extraordinarily powerful. We in medicine denigrated it because we didn’t understand it, and it got in the way of our pharmaceutical ideas, you know, "Placebo is dummy pills," and "It’s all in your head," and so on. Early on, people criticized the relaxation response as nothing more than the placebo effect, which led me to ask, just what is the placebo effect? That led to some thirty years of study of the placebo effect.
When you think about it, it’s astounding that the medical profession could just dismiss something as "the placebo effect" when they knew it had a significant positive impact on many cases.
The whole thing is so turned on its ear. Here we are ridiculing one of our most powerful assets, rather than saying, let’s have a look at it. I could never understand that.
Your thesis is that the power of belief, as demonstrated by the placebo effect, allows us to access what you call "remembered wellness."
We are wired: all our memories, all our thoughts, are constellations of various connections in our brains, which are extraordinarily complex. So you can be wired to a certain configuration of your brain’s connections that will produce a headache. If I were in front of you saying, "Headache, headache, headache," you would be reminded of a headache and indeed a headache would be produced. Similarly, you have wirings of being without a headache. So if you take a pill, if you believe it will work, even though it’s nothing but a sugar pill, you will then turn on that wiring of being without a headache and the headache will disappear. You have remembered what it was to be without a headache. You have remembered wellness.
Is meditating one of the ways to access that?
It’s different, but immediately after you elicit the relaxation response your mind is quieter, and it’s easier then to remember wellness.
From a Buddhist point of view, the sense of basic healthiness is found at the absolute, non-ego level, beyond relative phenomena such as the wiring of the brain. Is it your belief that our most basic experience of wellness is found at the level of biology or neurology, or is it beyond that?
That’s unanswerable now. Certainly, you can do experiments and see whether such influences do occur. For example, if you have an effect from intercessory prayer, when you do not know you’re being prayed for, then it can’t be your belief system. It has to be, if you will, this other power, force, energy operating in your system. Are you with me?
Yes, we’ve talked to Larry Dossey about this at length.
Right, so it’s studied. And if it does occur, then science will have to be redefined in terms of explaining this. There is no current framework in which to accept it.
Now you combine meditation technique, which you call the relaxation response, with the power of belief into what you call the "faith factor" in health. Let’s talk more about the belief aspect.
Belief can be translated into physical reality in the body. One can turn on a whole host of symptoms and diseases by simply believing them, and similarly they can be relieved. There is a whole list of diseases where belief has been shown to play a major role and it’s a remarkable list, angina, asthma, all forms of pain, skin rashes, duodenal ulcers, rheumatoid arthritis, congestive heart failure, and on and on. One could even die because of belief.
But you talk not only about health beliefs, but also the power of spiritual beliefs.
According to the work of Dr. Jared-Kass, people experience spirituality when, first, they feel the presence of a power, force or energy guiding them, and second, that presence is close to them. When those two components are there, people say it’s a spiritual experience. For 95% of Americans, the most powerful belief is belief in God. If you want them to have the healing power of belief, their most powerful belief is the belief in something beyond themselves.
Then is the positive impact of spiritual belief on health the result of hope that people can get from religion, or is it from belief in a larger reality that allows them to be non-attached to a specific outcome?
It could be both, or either. You see, if you believe, in one extreme, in a sugar pill, that belief can help you heal. It almost doesn’t matter what you believe in, in a religious belief, in your doctor, in nature itself. We all have a belief in something and we have to tie in the power of the body to heal with what we believe in, which may be different from person to person.
How do you differentiate this power of belief from what we might just call the will to live, or love of life?
That’s part and parcel of it. Or look at the numerous examples of people who stayed alive for a wedding and anniversary, or willed themselves to die with the loss of a loved one.
How does a medical doctor have this kind of discussion about belief, which was traditionally the province of ministers or therapists, with a patient?
It’s so easy in this context: Let’s go back to the relaxation response, which will work whether you believe in it or not. It’s like penicillin. You carry out those two steps and you’ll have these physiological changes. Now, when you are teaching a person a relaxation response, you have to have them choose a word, a sound, a prayer, or a phrase. You ask them, do you wish it to be secular or religious, and they will make a choice.
And they’ll choose something of meaning to them.
Exactly. What they believe in. So the teaching of the relaxation response then gets you into a dialogue about beliefs. It becomes very natural.
And the technique produces not only the physiological effect, but helps them make a more powerful contact with their spiritual beliefs.
Exactly. Then you have the relaxation response plus the power of belief. That’s the combination I have called the faith factor.
So should this technique be brought into every MD’s practice?
To the extent that stress causes or exacerbates any disorder, the relaxation response is appropriate. If you look at the number of physician encounters that are due to stress or other mind/body interactions, it’s an impressive number: 60 to 90 percent. Therefore, patients should be taught to elicit the relaxation response. In the vast majority of encounters between physicians and patients, the relaxation response is a most appropriate intervention.
Some of your literature is aimed at convincing HMO’s of the efficacy of such mind/body techniques. I wonder if they might look at your work and decide to charge religious and non-religious people different rates.
No, no, no. It is helpful for a person to be in touch with their beliefs, but to discriminate on the basis of what the belief is would be a gross misinterpretation of my work.
I understand that. But I wonder whether the insurers will look at the epidemiology and say, well, you go to church, you’re more likely to be healthy, so you’ll be less expensive to us.
There happens to be much data supporting that.
Finally, having pioneered this mind/body field, how do you feel now that interest in it is so widespread?
Looking over these thirty years, it’s so gratifying that I’ve been able to be around to see the corner turned.
Yet you are clear about the limits of the mind/body approach, while there are many extravagant and unproven claims now being made for it. How do you feel about the current state of the field?
It’s virtually impossible to control what happens with a therapy; it will be used and it will be abused. We do that with medicines; we do that with surgery. But I think we can explain so much more by understanding the power of belief; for example, if we bring clarity to how some alternative medicines work. They may not be working because of the herb or what have you, and isn’t it nice to be able to come to an understanding of what would otherwise appear to be mysterious mechanisms? What I find very, very pleasing is that our work has been able to narrow the artificial separations that have been created between spiritual belief, healing and medicine. I truly believe that although there will be offshoots that are not particularly desirable or useful, ultimately this synthesis will be the most meaningful. People can use their own inherent capacities, combined with the awesome healing powers of our medicines. I’m rather optimistic.
