ISSN: 2940-3243

Editorial I

The Physiological Basis of Mind-Body Medicine

by Maja Figura1 and Tobias Esch2

1Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Institute and Polyclinic of Occupational and Social Medicine, Health Sciences/Public Health, 01069 Dresden, Germany

2Institute for Integrative Health Care and Health Promotion, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany

Cite as: Figura, M. & Esch, T. (2023). The Physiological Basis of Mind-Body Medicine. THE MIND Bulletin on Mind-Body Medicine Research, 2, 1-4.

Mind-body medicine (MBM) is a modern form of stress medicine (Esch & Stefano, 2010; Esch & Stefano, 2022). It was developed by the American cardiologist and professor of medicine at Harvard Medical School, Herbert Benson (M.D.). As a counterpart to Walter B. Cannon's discovery of the body’s “fight or flight” response  (Cannon, 1915), Benson coined the term relaxation response (RR), a physiological response reaction of the body to stress (Cannon, 1915). Techniques that elicit a RR are the basis of virtually all MBM interventions (MBI) (Esch et al., 2018). Together with Integrative Medicine, MBM forms Complementary and Integrative Health (Esch & Brinkhaus, 2020). According to the approach of salutogenesis, the self-healing potential is used to build up and facilitate individual resources (Esch, 2020). Thus, MBM offers the opportunity to make an important contribution to individual health care by helping people to help themselves (Dineen-Griffin et al., 2019).
Based on the idea that thoughts and emotions have an impact on health, MBM effects manifest, e.g., at the psychoneuroimmunological level (Magan & Yadav, 2022). Psychoneuroimmunology is an interdisciplinary field of research that focuses on the role of neuro-immune interactions in coping with stressors (Ader, 2007; Godoy et al., 2018). Stress results from an interplay of biological and adaptive processes (Godoy et al., 2020). These processes involve a variety of different brain areas that can interpret events as real or potential threats. This is followed by a rapid activation of the autonomic nervous system via the sympathetic-adreno-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis (Figure 1) (Stefano et al., 2005).

Figure 1. The stress response simplification based on Godoy et al. (2018).

SAM = sympathetic-adreno-medullary axis, 

HPA = hypothalamic-pituitary-adrenal axis


In addition to the classical stress mediators cortisol and (nor-) adrenaline, a wide range of neuroendocrine signaling molecules areinvolved. These lead to an adaptation of the cardiovascular system such as increased heart rate, blood pressure and immune response. Short-term stress seems to increase the ability to perform. Problems arise when permanent and/or excessive stress occurs (Chrousos & Gold, 1992; Esch et al., 2002; Esch & Stefano, 2010). Chronic stress can lead to suppression of protective immune responses and exacerbation of pathological immune responses (Dhabhar, 2014).

The balance between type 1 and type 2 cytokines changes and chronic inflammation is induced. The number, transport, and function of immune protective cells increases. By suppressing type 1 cytokines and protective T cells and increasing function of defensive T cells, susceptibility to certain cancers may increase (Esch et al., 2002). The body’s physiological stress response is also suspected to have negative effects on the disease progression of viral infections such as SARS-CoV-2 (Peters et al., 2021).
How the effects of chronic stress can drive aging processes is evident at the molecular genetic level, as seen, e.g., in our chromosomes (Dobos & Paul, 2019). In a study by Mathur et al. (2016), a minimal association was found between perceived psychological stress and a decrease in telomere length.

Telomeres are regions of repetitive nucleotide sequences associated with specialized proteins at the ends of linear chromosomes. They protect the end regions of chromosomal DNA from progressive degradation and ensure the integrity of linear chromosomes via preventing DNA repair systems from confusing the outermost ends of the DNA strand with a double-strand break (Jacobs, 2013). Hence, telomeres are non-coding DNA segments that serve a protective role during DNA transcription: A small number of base pairs at the ends of a chromosome are lost during each transcription, resulting in an overall shortening of the chromosome after many duplications. Telomeres thus have a function as a bumper that prevents functional coding segments from being truncated during duplication. This buffer grows shorter during the lifetime of a cell, and its cycles of transcription and replication. Hence, although telomeres are routinely replenished by telomerase, their gradual attrition over the lifespan may contribute to aging and disease (Esch et al., 2018; Mathur et al, 2016). Thus, short-term, and chronic stress can have an impact on cell aging and chromosomal integrity. At the cellular level, this may favor age-related diseases such as Alzheimer’s, cardiovascular disease, type II diabetes or even general muscular atrophy (Esch et al., 2018; Ludlow et al., 2013; Stefano et al., 2005).
It has been shown that telomere length is influenced not only by individual genetic predisposition, harmful noxae, and oxidative or psychological stress, but also by the individual’s own health behavior (Bär & Blasco, 2016). At the same time, the probability of the occurrence of mental and somatic illnesses is increased (Esch, 2003). Especially the use of MBIs has proven to be particularly effective in stress reduction in this context (Bhasin et al., 2013; Black et al., 2013; Esch, 2020; Esch & Stefano, 2022; Niles et al., 2014).
MBIs contribute to the restoration of the balance between sympathetic and parasympathetic nervous system. In the process, the catecholamine and cortisol hormone equilibrium is adjusted. While psychological stress declines and a positive state of mind is re-established, both conditions, as described, are associated with an effect on telomeres (Epel et al., 2004). The length of telomeres appears positively changed already over short periods of time (Ornish et al., 2013; Puterman et al., 2015). Moreover, recent study results suggest that lifestyle interventions also have a positive effect on mitochondrial bioenergetics, insulin secretion, and a reduction in inflammatory processes (Stefano at al., 2019). Dysfunctional mitochondrial processes thus lead to impaired energy translocation in the brain and neuropsychiatric symptoms (Büttiker et al., 2022). Therefore, lifestyle interventions and MBIs include RR as a parameter of metabolic “correction”, thus also causing cognitive and mental “awareness” (Stefano at al., 2019).
Taken together, the mind affects the body – and this may happen even on cellular, chromosomal, and mitochondrial levels.



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