The Mind-Body Connect and Positive Psychological Health

Modern medicine, is largely founded on the Cartesian concept of duality of the mind and body [1], which says that the mind and body are two distinct unconnected entities. While this theory propounded by Rene Descartes was useful in the 17th century to fight religious dogma, it helped lay the path for the scientific and technological revolution that characterizes allopathy, which in turn has also led to a situation where the diagnosis and treatment of disease are disassociated from the individual suffering from that disease [2]. The focus of allopathy is and has been on the disease and the organ rather than the individual as a whole, which is in contrast to the philosophical basis and practice of Ayurveda, traditional Chinese medicine, homeopathy and many other forms of medicine that treat the person holistically rather than as a set of discrete organs and diseases.

For those interested in the art of war and battle, the way allopathic medicine has pretty much decimated most other traditional forms of medicine, is a classic example of a successful conquest, without overt bloodshed.

Having said that, if I were to get into an accident and have a fracture of the femoral neck that requires emergency treatment with surgery, then the singular focus on the hip and the surgical method for fixing the fracture to the exclusion of everything else, will help the doctor and the patient achieve the optimal technical surgical outcome - this is where modern medicine with its “Arjuna” like focus on the individual body part and disease process works best. But prevention of that fracture, rehabilitation after the fracture and getting back to normal life, all need the mind and the body to work in sync. It is not just the mind and body that are connected [3]…there is now clear evidence of a gut-mind-body connection too [4], which we will explore in a subsequent article(s).

Hippocrates is considered the “Father of Medicine”, but Hippocratic medicine [5] was holistic, treating the individual as a whole, rather than a set of body parts. This is also true of Ayurveda (and yoga), which derive from ancient Indian philosophies that are based on concepts of mind-matter or consciousness-matter dualism that consider the person as a whole [6].

Even Freud in his later days, talked of two forms of instincts, the Life Instinct (Eros) focussed on preservation of the life of the individual and the species and the Death Instinct (Thanatos) where people adopt behavioral patterns that hasten sickness and death [7].

Hence, when we fall sick, especially acutely, modern medicine with its focus on specific body parts and pathology works brilliantly. However, when it comes to healthfulness, the mind and body need to work as one to ensure that we lead a long and healthy life. For e.g. I mentioned in my piece on “moving” that the only known intervention that has been shown to reduce cognitive decline is physical exercise.

Vice versa, how our mind works, can significantly affect our health, including our cardiovascular health [3].

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In this context, the recent “Scientific Statement” from the American Heart Association (AHA) titled “Psychological Health, Well-Being and the Mind-Body Connection” is a welcome addition to our understanding of how the mind and body affect each other [8].

The “statement”collates the available evidence on the connection between the mind and cardiovascular health. While most studies of this nature are observational, the sum of all these studies yields enough evidence to support the final conclusions that I have summarized partly in this diagram, which in turn is adapted from the diagram published in this article.

Figure: The connection between the mind and cardiovascular health

Negative psychological health (stress, negative outlook to live, anxiety, anger & hostility and depression) affects cardiovascular health adversely, directly as well as by encouraging adverse behaviors such as smoking, physical inactivity, poor eating habits, weight gain and medication non-compliance. On the other hand, positive psychological health (happiness, a positive affect, emotional vitality, optimism, a sense of purpose, gratitude and mindfulness) directly improves cardiovascular health and leads to healthier behavioral patterns such as “moving”, sensible eating, adherence to medication, screening for disease and smoking cessation, which in turn also help with better blood pressure and blood glucose control. Changing negative behavioral patterns and the factors that cause negative psychological health can help improve our cardiovascular health at any time.

Even the “nocebo” effect of statins that I talked about a few weeks back that adversely affects the ability of the population at large to take statins when indicated, is a direct example of the mind-body connect.

So how does this matka affect us. If we have a positive psychological outlook, we will have better cardiovascular health, both directly as well as due to the likelihood of better behavioral patterns, such as “moving”, eating sensibly, not smoking, sleeping better, etc, most of which I have listed in a word-cloud in the very first MatkaMedicine article.

In our atmasvasth quest, good mental health is part of the 13-points guide that we need to follow to live long, healthy.

Footnotes:

1. https://en.wikipedia.org/wiki/Mind–body_dualism

2. Mehta N. Mind-body Dualism: A critique from a Health Perspective. Mens Sana Monogr. 2011;9(1):202-209. doi:10.4103/0973-1229.77436

3. https://nautil.us/issue/98/mind/that-is-not-how-your-brain-works?mc_cid=108c95fd12&mc_eid=0739f5b225

4. Panduro A, Rivera-Iñiguez I, Sepulveda-Villegas M, Roman S. Genes, emotions and gut microbiota: The next frontier for the gastroenterologist. World J Gastroenterol. 2017;23(17):3030-3042. doi:10.3748/wjg.v23.i17.3030

5. https://en.wikipedia.org/wiki/Hippocrates

6. en.wikipedia.org/wiki/Dualism_(Indian_philosophy)

7. https://www.verywellmind.com/life-and-death-instincts-2795847

8. Levine GN et al. Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association. Circulation. 2021 Mar 9;143(10):e763-e783. doi: 10.1161/CIR.0000000000000947. Epub 2021 Jan 25. PMID: 33486973.