The Mind-Body-Spirit connection in the healing process is paramount. Integrative Medicine pursues an equilibrium state of health, combining conventional medicine with complementary modalities that are safe and beneficial in promoting health and healing. It seeks to prevent disease, promote health and vitality, manage symptoms, and allow patients to strive toward inner peace.
Implicit in the foundation of Integrative Medicine is an emphasis on self-coping methods and a philosophy of empowerment toward one’s care. This is especially important for children, who may experience multiple areas of impairment when faced with a chronic, life threatening, or recurrent illness, including physical, emotional, social, behavioral, academic, and recreational dimensions. The impact on the family is also multidimensional, extending beyond the medical and emotional to include financial constraints and coordination of care for the patient and the extended family. The role of the patient’s community and cultural background is an essential element in this overall approach.
The use of Integrative Medicine techniques (also called Complementary and Alternative Medicine, or CAM) is growing. A study published by the National Center for Complementary and Alternative Medicinein 2008 found that 38% of adults and nearly 12% of children used some form of CAM. The pediatric literature also demonstrates that a significantly higher percentage of patients with chronic and/or recurrent illnesses use some form of CAM ; some estimates are as high as 72%. Furthermore, worldwide surveys of pediatric oncology patients estimate CAM use between 31% and 84%. This reflects CAM’s use not only in alleviating symptoms of the disease but also easing the side effects sometimes associated with the treatments rendered.
Indeed, more than 33% of pediatricians have reported use of some form of CAM therapy, administered either by themselves or by a patient’s family member. The number of CAM providers in the United States increased by approximately 88% between 1994 and 2010. This is in contrast with the 16% increase in the number of allopathic physicians. Interestingly, the number of U.S. medical schools offering CAM has increased from 75 in 1998 to 98 in 2002-2003 (out of a total of 125 U.S. medical schools).
From a personal perspective, I have been interested in Mind-Body techniques for many years. I first glimpsed their importance when, as a pediatric hematology oncology fellow, I had the honor of witnessing the “Mind-Body connection.” One of my patients, who had acute lymphoblastic leukemia, sang a beautiful church hymn during a busy clinic afternoon. This event caused the entire clinic, including staff, patients, and their families, to stop, breathe, and take in the grandeur and privilege of the moment. To this day when I think of this lovely patient I feel great joy and honor in having been present to witness such an experience. That was a long time ago, but it continues to inspire me to strive to incorporate this alignment of mind, body, and spirit into every medical encounter.
Currently, I am interested in learning how to help children with acute and chronic pain conditions by combining pharmaceutical and integrative modalities to ameliorate pain. The need is great—data from the American Pain Society reveals that in 2010, 20% of U.S. children ages 5-17 suffer from chronic headaches, 20% of U.S. children have stomach discomfort at least three times per week for at least three months, and at least 6% of school children suffer from fibromyalgia. Moreover, 1.5 million U.S. children who undergo surgery do not have adequate pain relief, and in 20% of these young patients the pain becomes chronic. It is further estimated that as of 2010, 1 in 1,000 children in the U.S. are survivors of cancer, some of whom endure chronic or intermittent pain as a result. And beyond the physical pain that these children suffer, many develop fears and anxiety due to their medical condition and its treatment. This affects not only their emotional and physical health but also may impede sleep, school performance, self esteem, social relationships and cause countless other complications.
Finally, I also feel a very personal connection to the impact of chronic pain. My mother suffered from a chronic leg pain lymph drainage condition which caused extreme pain and swelling in her left leg. As a young child I often used distraction to attempt to minimize her discomfort. She encouraged me to utilize massage, breathing and meditation as well. Though I unknowingly understood the Mind-Body connection at a young age, it took many years for me to rediscover and embrace it in my personal and professional life. It is perhaps for this reason that I am now so adamant in promoting its value.
Integrative medical programs can offer a myriad of options for prevention and wellness, as well as for coping with and alleviating anxiety and pain. Some strategies include promoting healing through implementing relaxation techniques, enhancing self coping strategies, biofeedback, guided imagery, focused attention/hypnosis, pre- and post-operative hypnosis, guided imagery, and pediatric massage.
These approaches help our youngest and most vulnerable patients and their families – people from all socioeconomic, cultural, and religious backgrounds – experience wellness, and regain control of their lives, rather than being defined by a disease or circumstance.
Ana Maria Verissimo, MD, MA
Attending Physician
Department of Pain and Palliative Medicine
Connecticut Children’s Medical Center