Mind and Body Connection

Prof. Dato’ Dr See Ching Mey

Universiti Sains Malaysia, Malaysia

Loh Guan Lye Specialist Centre

2nd Asian Neurofeedback Conference 2016

21-22 July, 2016

1. INTRODUCTION

Mind and Body

The mind is thoughts, emotions,

feelings, beliefs, attitudes, and

images.

The brain is the hardware that

allows us to experience these

mental states. Mental states can

be fully conscious, subconscious

or unconscious.

Eg: We can have emotional

reactions to situations without

being aware of why we are

reacting.

Mind and Body

Mind-body connection discusses mental

processes that affect our physical state.

Our thoughts, emotions, feelings, beliefs,

and attitudes can positively or negatively

affect our biological functioning. This

results in a complex interrelationship

between our minds and bodies.

Mind-body Therapies

Mind-body therapy focuses on treatments

that may promote health and wellness. Mind-

Body Therapies include:

(a)Cryotherapy - Localized or whole-body

exposure to subzero temperatures to

decrease inflammation, increase cellular

survival, decrease pain and spasms, and

promote overall health.

Mind-body Therapies

(b)Hydrotherapy - The healing power of water

is used to treat disease or maintain optimal

health through its different forms, including

steam or mineral baths, saunas, hot or cold

wet body wraps, aquatic physical therapy,

or whirlpools.

Mind-body Therapies

(c)Meditation - Simple and fast way to reduce

stress on the mind and body by refocusing

your attention on calming thoughts and your

breath. This may include mindfulness

meditation, repeating a mantra, or guided

imagery or visualization.

Mind-body Therapies

(d)Yoga - This ancient system of relaxation,

exercise, and healing. Yoga focuses on

physical poses, breathing technique, and

meditation, with the goal of achieving

relaxation, overall health, and improved

fitness.

Mind-body Therapies

(e)Massage - Using the principle that touch is

healing, massage involves rubbing the soft

tissues of the body, such as the muscles

and connective tissues, to release tension

or treat injury. There are over 80 different

types of massage; some gentle (like

Swedish massage) and others very active

(like Thai massage) or intense (like deep

tissue massage).

Mind-body Therapies

(f) Mindfulness Training - This structured

program trains you to focus on the present

moment and let go of thoughts from the

past or worries about the future. It is

remarkable in bringing about changes

ranging from improved sleep, greater

productivity, and both prevention and

treatment of chronic illness.

Mind-body Therapies

(g)Qi-gong - A traditional Chinese health care

technique that’s at least 4,000 years old,

the practice involves a series of postures

and exercises, including slow circular

movements. It combines relaxation,

meditation, and breathing exercises to

achieve a tranquil state of mind.

Mind-body Therapies

(h)Music Therapy is the clinical and evidence-

based use of music interventions to

accomplish individualized goals within a

therapeutic relationship by a professional

who has completed an approved music

therapy program.

Mind-body Therapies

(i) Neurofeedback – A technique in which we

train the brain to help improve its ability to

regulate all bodily functions and to take

care of itself. When the brain is not

functioning well, evidence of this often

shows up in the Electroencephalogram

(EEG). We can train our brain to function

better.

Mind-body Therapies

(j) Biofeedback - Sensors are attached to your

body to provide instant feedback on things

like heart rate, blood pressure, skin

temperature, and muscle tension. After

reviewing the results on a monitor, the

biofeedback therapist then teaches the

clients mental and physical exercises to

control those functions.

Mind-body Therapies

(k)Acupressure - This ancient Asian technique

is similar to acupuncture—without the

needles. Practitioners use their hands or

tools to apply pressure to various acupoints

on the body to open energy flows, release

tension, and promote emotional balance.

Mind-body Therapies

(l) Acupuncture - A key component of

Traditional Chinese medicine, acupuncture

is practiced by inserting extremely thin

needles through the skin at strategic

acupoints on your body. The goal is to re-

balance the flow of energy or life force

known as chi.

Mind-body Therapies

(m)Aromatherapy - Aromatic essential oils

from plants are extracted, distilled, and

typically mixed with other substances like

oil, alcohol, or lotion, then applied to the

skin, sprayed into the air, or inhaled.

Mind-body Therapies

(n)Craniosacral Therapy - This gentle form of

massage therapy, used by chiropractors,

massage therapists, and naturopaths,

involves finger pressure to manipulate the

bones of the skull, lower spine, and pelvis.

Mind-body Therapies

(o)Hypnotherapy – The induction of a state of

consciousness where the client becomes

responsive to suggestions/directions.

Hypnosis is widely promoted as a treatment

for various long-term conditions such as

phobias, anxiety, sleep disorders,

depression, stress, post-trauma anxiety,

grief and loss. Hypnosis also might be used

to help with pain control and to overcome

habits, such as smoking

or overeating.

Mind-body Therapies

(p)Visual Imagery - The ability to create

pictures in our mind that become mental

images. This therapy can evoke all the

senses such as taste, sound, touch, and

your sixth sense intuition such as creativity

and abstract thinking skills. It has a

positive impact on mental and physical

health, wellness, and performance.

2. BIOFEEDBACK

Biofeedback

The Association for Applied Psychophysiology

and Biofeedback (AAPB), (2016) define

Biofeedback as:

A process that enables an individual to learn

how to change physiological activity for the

purposes of improving health and performance.

Precise instruments measure physiological

activity such as heart rate, breathing, muscle

activity, and skin temperature.

Biofeedback

Biofeedback can be used to treat a variety of

medical and other physiological conditions.

Biofeedback and has been shown to be an

effective treatment for migraine and tension

type headache, urinary incontinence, high

blood pressure, anxiety, and a number of other

conditions (Yucha & Montgomery, 2008).

The goal of Biofeedback is long-term benefit

and control over the symptoms that are being

treated.

Effects of Biofeedback

(a)Ratanasiripong et.al (2012) investigated the

impact of biofeedback intervention program

on nursing students’ levels of stress and

anxiety during their first clinical training.

− Results indicated that the biofeedback

group was able to maintain the stress level

and had a significant reduction in anxiety;

while the control group had a significant

increase in the stress level and a moderate

increase in anxiety over the 5-week period

of clinical training.

Effects of Biofeedback

(b)Knox (2011) examined changes in anxiety

and depression in 24 children and youths (9-

17 years old) referred for treatment for

anxiety.

− The eight-session biofeedback intervention

included psychoeducation (identification of

triggers and signs of anxiety).

− The intervention group reduced anxiety and

depression scores on standardised tests.

3. NEUROFEEDBACK

Neurofeedback

Neurofeedback training offers additional

opportunities for rehabilitation through

directly retraining the electrical activity

patterns in the brain to reduce symptoms

from ADD/ADHD, a stroke, head injury,

uncontrolled epilepsy, cognitive dysfunction

associated with aging, depression, anxiety,

obsessive-compulsive disorder, and autism.

Hammond (2011)

Effects of Neurofeedback

(a)Gapen et. Al. (2016) showed that

neurofeedback significantly reduced PTSD

symptoms (Davidson Trauma Scale scores

averaged 69.14 at baseline to 49.26 at

termination), and preceded gains in affect

regulation (Inventory of Altered Self-

Capacities-Affect Dysregulation scores

averaged 23.63 at baseline to 17.20 at

termination).

40 sessions of neurofeedback training two

times per week at either T4-P4 or T3-T4.

Effects of Neurofeedback

(b)Choobforoushzadeh, Neshat-Doost, Molavi &

Abedi (2015) evaluated the effectiveness of

neurofeedback in treating depression and

fatigue in persons with multiple sclerosis.

− Results from the study demonstrated that

both depressive symptoms and fatigue were

significantly reduced among the multiple

sclerosis patients receiving neurofeedback

compared to the control group receiving

standardized treatment

Effects of Neurofeedback

(c)Steiner et. al (2014) evaluated sustained

improvements 6 months after a 40-session

using neurofeedback or cognitive training

(CT) administered to 104 children (7-11-year-

olds) with attention deficit hyperactivity

disorder (ADHD).

− Neurofeedback participants made more

prompt and greater improvements in ADHD

symptoms than did CT participants or those

in the control group.

Effects of Neurofeedback

(d)Reddy et. al. (2009) was to examine

neurofeedback training to enhance verbal

and visual learning and memory in a patient

with traumatic brain injury (TBI).

− The training incorporated video feedback to

increase the frequency of alpha waves (8-12

Hz); and to decrease theta waves (4-7 Hz).

− Results indicated improvement in both verbal

and visual learning memory in patient.

4. EFFECTS OF

NEUROFEEDBACK AND

BIOFEEDBACK

Both biofeedback and neurofeedback are

holistic therapies, based on the recognition

that changes in the mind and emotions

affect the body, and changes in the body

also influence the mind and emotions.

Biofeedback and neurofeedback

emphasized training individuals to self-

regulate, gain awareness, increase control

over their bodies, brains, and nervous

systems, and improve flexibility in

physiologic responding.

(a)Shaw et.al (2012) evaluated the efficacy of

a biofeedback and neurofeedback training

program to improve gymnasts’ balance

beam performance in competition.

− Ten sessions of HRV and

theta/sensorimotor rhythm training were

conducted two times per week for 5 weeks

to 11 female gymnasts.

− Results of this uncontrolled study indicated

that competition scores and scores from an

independently judged video assessment

improved throughout the training.

(b)Deborah and Martha (2010) applied two

newer forms of neurobiofeedback, EEG

biofeedback and hemoencephalography

biofeedback were combined with thermal

handwarming biofeedback to treat 37

migraine patients in a clinical outpatient

setting.

− Of the 37 migraine patients treated, 26

patients or 70% experienced at least a 50%

reduction in the frequency of their

headaches which was sustained on average

14.5 months after treatments were

discontinued.

5. FOUR DIFFERENT AXES

TO DEMONSTRATE THE

CONNECTION BETWEEN

THE MIND AND THE BODY

1. Hypothalamic Pituitary

Adrenal (HPA) Axis

The hypothalamic-pituitary-adrenal (HPA)

axis plays important roles in maintaining

alertness and modulating sleep.

Dysfunction of the HPA axis play a causative

role in some clinical sleep disorders, such

as insomnia and obstructive sleep apnea

(OSA).

2. Heart Rate Variability (HRV)

Axis

Heart rate variability (HRV) is a measure of

the beat-to-beat changes in heart rate.

The heart and brain are connected

bidirectionally. Efferent outflow from the

brain affects the heart and afferent outflow

from the heart affects the brain.

Heart Rate Variability (HRV)

Axis

(a)Kudo, Shinohara & Kodama (2014) examined

the effectiveness of heart rate variability

(HRV) biofeedback intervention for reduction

of psychological stress in women in the early

postpartum period.

− Results indicated that postpartum women

who implemented HRV biofeedback after

delivery were relatively free from anxiety

and complained less of difficulties sleeping

at 1 month postpartum.

Heart Rate Variability (HRV)

Axis

(b)Kim et. al (2013) determined if individuals

with brain injury can modify HRV through

biofeedback and, if so, enhance its pattern

to improve emotional regulation and

problem-solving ability.

− Results demonstrated an association

between regulation of emotions/cognition

and HRV training.

3. Gut Brain Axis (GBA)

Gut Brain Axis (GBA)

The changes in the biological processes in

the gut may effect the brain chemistry.

A dysfunction in the gut–brain axis is linked

to neuropsychological, metabolic, and

gastrointestinal disorders (Zhou & Foster,

2015).

Gut Brain Axis (GBA)

It is suggested that the gut microbiota

affects the brain via the humoral and neural

mechanisms of the gut–brain axis, with

particular attention on the vagus nerve.

Though several links between altered gut

microbiota and depression have been

established in animal models, few clinical

studies have been conducted.

Gut Brain Axis (GBA)

Naseribafrouei et. al. (2014) studied the

potential correlations between human fecal

microbiota (as a proxy for gut microbiota)

and depression.

− Results demonstrated several correlations

between depression and fecal microbiota.

4. Muscle Brain axis

All types of movement from locomotion to

fine manipulation require an interplay

between sensory input and motor output

that is controlled by the central nervous

system.

Failure within the muscle brain axis causes

tension, stress and pain.

One of the evidenced based

stress management

techniques is

progressive muscle relaxation.

6. CONCLUSION

Biofeedback and neurofeedback do provide

evidence-based practice in health care.

Understand the mind and body connection.

Hence, managing the mental and physical

state results in health and wellness.

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THANK YOU