Complementary Therapies in Cancer Care: Meditation
An ongoing series highlighting complementary therapies, adapted from The Complete Guide to Complementary Therapies in Cancer Care
by Dr. Barrie Cassileth PhD Laurance S. Rockefeller Chair and Chief of the Integrative Medicine department at Memorial Sloan-Kettering Cancer Center.
Meditation is among the most accepted complementary therapies in mainstream medicine. Its origins lie in the work of shamans, or early priests, who meditated while seeking guidance from the spiritual realm. Every major religion in the world has regarded and used meditation as a link to spiritual enlightenment. Hypnosis, especially self-hypnosis, may be seen as a deeper form of meditation. Both have ancient origins in magic and religion.
Meditation gained serious attention in Western cultures in the 1960s. As word spread of Eastern masters able to perform remarkable feats of bodily control and achieve altered states of consciousness, people in Western countries became increasingly fascinated by meditation. Health practitioners and researchers became interested in understanding how the mind could produce physiologic changes in the body. Meditation’s purported ability to achieve physical benefits was a natural springboard for the curiosity and the research activity that continues to this day.
What Is It?
Meditation has been described in varying, often extreme terms. Viewed by some as a means of maintaining attention pleasantly anchored in the current moment, it has also been canonized as a catalyst for world peace. As emphasized in most Asian traditions, mental control is the foundation of meditation, and mental control also lies behind the application of meditation as a complementary healing technique. Mental mastery is believed capable of producing physiologic and emotional change. The goal is to improve health in general and facilitate the healing of certain disorders.
Across its many varieties, meditation includes certain common procedures. The meditator sits or rests quietly, usually with eyes closed, in a peaceful environment devoid of distractions. Mental exercises geared to channel concentration and relax the body are performed. The aim is to stay relaxed yet alert. Typically, a point of concentration is selected. This can be an object, a word, a sound, a mantra, an action, or merely the rhythm of one’s own breathing. Many practitioners also adopt a passive, receptive attitude in which fleeting thoughts are disregarded without reflection. Saint Francis of Assisi likened these thoughts to birds flying overhead that should be observed without “letting them nest in the hair.”
What Practitioners Say It Does
Meditation is often lauded as a means of managing stress. Stress is now widely acknowledged as contributing to and exacerbating many health problems. Therapies such as meditation have many proponents because these approaches provide effective relaxation techniques that help patients deal with stressful situations.
During meditation people learn to redirect their attention to the present, reacting to neither memories of the past nor thoughts of the future. Preoccupation with past and future is believed to be a major source of chronic stress.
The mental training that meditation provides teaches individuals to be aware of what causes their stress, thereby giving them a sense of control. Control makes the difference between positive and detrimental stress. The benefits of relaxation and stress reduction, in turn, can reduce levels of stress hormones, improve immune function, diminish chronic pain, improve mood, and even possibly enhance fertility. Quieting the conscious mind is believed also to allow the body’s inner wisdom, or “internal physician,” to be heard. That is, meditation promotes the body’s ability to heal itself.
Further benefits attributed to meditation include enhanced immune function in individuals with chronic diseases such as cancer and AIDS. Practitioners also claim success with meditation included as part of the treatment of patients with hypertension and heart disease. It is also considered useful in assisting rehabilitative therapies for alcohol, drug, and other addictions.
Devotees say that with regular, long-term meditation, they experience personal and spiritual growth. They claim richer sensory experiences, greater alertness, and increased mental efficiency—as well as the ability to access deeper levels of awareness. Some even attest to a mystical sense of oneness with God or the universe.
Beliefs on Which It Is Based
The major foundation for the popularity of meditation, especially as a benefit to personal health, is the belief that the mind can cause changes in the body. Many cultures, particularly in Asia where meditative strategies have long been included in health regimens, have relied on this idea for millennia. A more recent underlying belief is the idea that stress itself has harmful effects on the body. Because meditation emphasizes mental training and relaxation and imparts a sense of control, it is considered a potent agent against stress and anxiety. That is part of the reason why meditation has gained widespread acceptance as a valid, beneficial medical therapy.
Research Evidence to Date
Many studies have documented the correlation between meditation and the reduction of stress, anxiety, and panic states. Research documents the relaxation response produced by meditation and prayer, a response involving decreased heart and respiration rates and eased muscle tension. Meditation has also been shown to help control negative thinking and assist people in managing potentially stressful situations in a calm fashion.
Research evidence shows that meditation helps decrease chronic pain. Meditation performed regularly over an eight-week period reduced participants’ pain by as much as 50 percent.
There’s Meditation and Then There’s Transcendental Meditation
During the rise in popularity of meditation in the 1960s, Maharishi Mahesh Yogi, a physics scholar from India, developed a version of the practice called transcendental meditation (TM). TM is based on ancient Indian practices and is similar to other forms of meditation such as Zen, yoga, progressive relaxation, and other means of eliciting deep relaxation, but promotional materials claim that TM also teaches mastery of the forces of nature, enabling students to become invisible, walk through walls, fly unassisted, and develop “the strength of an elephant.” Devotees claim that TM is the vehicle for enlightenment and even world peace.
Accepting these beliefs is not prerequisite to benefiting from the practice of TM. Its physiologic benefits, which are shared by other types of meditation and are not unique to this particular approach, are well documented. But flying through the air? Becoming invisible? These aspects likely don’t make sense to most of us.
What It Can Do for You
The relaxation, stress reduction, and pain relief benefits of meditation are well documented. It has been found to reduce lactic acid, which is associated with anxiety. Mainstream medical practitioners often recommend meditation as an adjunct to conventional treatment or as a preventive health measure.
Meditation can ease muscle tension, lower oxygen consumption and heart rate, and, with practice, decrease blood pressure. Therefore it is often recommended for patients with hypertension or heart disease in conjunction with dietary and other positive lifestyle changes. Regular practice of meditation can enhance one’s sense of control and improve self-esteem. Meditation can also promote spiritual growth, calm, and serenity.
Where to Get It
Assistance with meditation is available from practitioners, including psychiatrists and other mental health professionals, stress reduction experts, yoga masters, and clinics at many major medical centers and local hospitals.
Many organizations offer related services and information as well as audio recordings that teach meditation. A relatively recent recording called The Eight Minute Meditation was a popular success, and it introduced many people to the benefits of meditation. You can also teach yourself meditation with self-paced online tutorials and programs and attend classes to learn the relaxation response.
In 1975 Dr. Herbert Benson, a professor at Harvard University, published a book called The Relaxation Response in which he described meditation for relaxation and decreased stress and offered instruction in the practice. Dr. Benson’s books, lectures, and classes remain popular for people of all types, healthy and ill. Most have found his teaching helpful and rewarding, and for many it has been life-changing. The Benson-Henry Institute for Mind Body Medicine courses at Harvard Medical School remain an important focus of research and education.
Laura Kupperman, a cancer survivor and yoga instructor, has experienced first hand the value of meditation during treatment and beyond. “Meditation is so important,” Kupperman stresses. “There is such an intricate link between the state of your breath and your emotional state. Anything you can do to tap into a relaxed state gives the body a chance to rebuild. Research supports that when the body is relaxed, the immune system is stronger, and when the body is stressed and worn down, the immune system is compromised. It is important to maintain a calm state.”
Meditation generally involves techniques designed to control and discipline the mind so that it is not overrun with useless thoughts, fantasies and fears. Often, newcomers to meditation misunderstand the technique and believe that the purpose is to clear their mind totally, becoming frustrated when they are unable to make their mind blank. But this is impossible. The mind can never be blank, but it can be trained.
The options for escape in our society are unlimited: television, Internet, video games, exercise and more. However, the problem with all of these escape tools is that they only provide temporary relief from real anxiety. And because what we resist usually persists, ignoring our fears and anxieties only causes them to escalate. Hours in front of the television won’t eliminate anxiety; it will simply prolong it.
For this reason, the typical escape tools are useless in the face of cancer. The unique sense of anxiety and fear that cancer perpetuates cannot be placated with a few hours of escape. Instead, this anxiety requires something entirely different: our attention.
With this in mind, it’s time to turn inward and utilize our own resources to quiet the mind and create a sense of calm. We all possess two invaluable tools for tapping into peace: the mind and the breath. Rather than fostering a sense of escape, these tools offer a chance for an “inscape” and a chance to truly slow down and release anxiety.
“Our brainwaves are usually on a beta frequency, for example, when we’re talking or doing something,” Crist explains. “The theta frequency, on the other hand, is slower and wider apart. Meditation helps us to reach that theta frequency.”
Crist has been meditating regularly for over 30 years. In fact, meditation has become an integral part of her psychotherapy practice. She introduces the technique to many of her patients and even offers a free weekly meditation for anyone interested in meditating. She believes that a daily meditation practice provides an important opportunity for balance.
“If you focus on the breath, you’ll hear your heartbeat. Every day, if I check in and focus on my heart, then I don’t get too off balance,” Crist says.
For cancer patients, daily facing the challenges of physical and emotional stress that their illness brings, this balance can seem an especially tough challenge and achieving it an incredible blessing.
How Do You Meditate? Let Us Count the Ways
There are countless meditation techniques, some of which have been passed down through ancient traditions. Every technique has value; however, you don’t need any special tools to meditate. All that is required during meditation is to sit still and enter into the quiet space in the mind that most people typically try to avoid by engaging in an endless stream of activities.
The first step, then, for most of us, is to pause. Take a step back and make a conscious decision to take the time to be still. Or, as meditation practitioners and self-help gurus like to say, “Sit with it.” However, it’s not as easy as it sounds. In a culture where more is better, sitting runs contrary to our lifestyle. Sitting is a start, but it will take more than sitting to quiet the mind, especially a mind overcome with fear of cancer.
Once you’ve made the decision to take time out and sit quietly, the next step is to notice your breath. The mind and the breath are inextricably linked. The breath is the pathway to relaxation and this relaxation is the pathway to the mind. By focusing on your breath, you can quiet your mind and enter a state of calm.
“There are many different meditation techniques, but they all share one common theme: the breath,” Crist says. “There are all sorts of little tricks to help keep the mind on the breath, but it doesn’t have to be too complicated. I just try to get people to breathe in and down and exhale up and out.”
Some meditation practitioners simply take time to breathe and get quiet, while others find it helpful to use imagery and visualization tools. (See our sidebar describing several visualization techniques.)
“Imagery is huge,” says Ame Onofrey, a yoga instructor in Vail, Colorado , who works with students from all walks of life on healing what ails them. “I teach my students to see themselves in a posture, see themselves as healthy and whole, and choose to walk the path of life, not the path of death.”
While the combination of breathing and imagery are enough to transport some people to peace, others recommend another step: the use of a mantra, which is a word or phrase repeated over and over to focus the mind. A mantra does not have to be a Sanskrit or holy word; it can be any word or phrase that has meaning for you. For example, cancer patients might benefit from repeating the phrase “I am healthy.”
Any advocate of meditation will tell you that it doesn’t matter how you do it, it just matters that you do it. By sitting quietly and focusing on the breath, you’ll tap into a state of peace that you probably didn’t know was there.
Crist suggests a consistent meditation practice. “Most people get overwhelmed when they think they have to sit for 20 or 30 minutes. Five minutes is great. Consistency is important. Five minutes every day is better than 20 minutes once a week,” she says.
Furthermore, Crist recommends creating a ritual of sameness to a meditation practice. “Sit in the same place, on the same cushion, ring the same bell, smell the same smell. It’s like Pavlov’s dogs….after a certain time, all you have to do is just sit on that cushion and you’re there,” she says.
And where is “there”? It’s that place of peace inside each of us, a place that cancer can’t touch, a place where all you have to do is sit still and breathe.
Barrie R. Cassileth, MS, PhD*, is Laurance S. Rockefeller Chair and chief of the Integrative Medicine department at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City. She has an extensive medical leadership career and is a recognized authority on complementary therapies and integrative medicine in oncology. Her work includes more 170 publications in medical literature, more than 40 medical textbook chapters, and 22 books for physicians, patients, and families. She was a founding member of the Advisory Council to the US National Institutes of Health Office of Alternative Medicine, now the National Center for Complementary and Alternative Medicine; she previously served on the National and the NY-NJ Regional Boards of the American Cancer Society and on multiple national and international committees. She is a staunch opponent of cancer quackery. She is founding president of the Society for Integrative Oncology. Since joining MSKCC in 1999, Dr. Cassileth has established prototypic research, education, and clinical programs in integrative medicine. Her most recent book, The Complete Guide to Complementary Therapies in Cancer Care: Essential Information for Patients, Survivors and Health Professionals, was published in 2011 by World Scientific Publishing Company.*
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