Mind-body medicine uses the power of the mind to promote healing in the body. Some forms of mind-body medicine — specifically, affirmation and visualization — are active, using mental exercises to change physical health. Other more indirect forms of mind-body medicine acknowledge that stress and traumatic events have a negative impact on both the immune system and the body in general. These approaches work to control mental and emotional stress. For example, helping people deal with the stress of being HIV positive may benefit their immune function and reduce their risk of illness. Meditation, Tai Chi, yoga and stress management programs are indirect forms of mind-body medicine. An emerging field of conventional medicine, psychoneuroimmunology, studies the links between stress and immune function.

Affirmations

Affirmations are positive statements about health and identity. They are always spoken in the first person and in the present tense. "I am strong and healthy," is an example. PHAs use affirmations to maintain control over their lives. Some people may read them aloud or memorize them for repeated use. Others prefer to listen to them as they are read aloud by a friend or played on a recording device: they find that this method makes it easier for them to concentrate on the words. Hundreds of books and tapes offer affirmations to enhance health and self-esteem. Choose one that is meaningful to you or create your own affirmations. If you are worried about T-cell numbers, you might try an affirmation like, "I am a healthy human being. I am not defined by any T-cell number." Jon Kaiser's book Immune Power offers affirmations specifically for PHAs.

Guided Imagery (Visualization)

Anyone who has salivated over a recipe knows that what is imagined can have a physical effect, such as making you hungry. Guided imagery aims to mobilize the imagination to promote physical and holistic healing. Many PHAs feel powerless in the face of their illness. Guided imagery is used to direct thoughts to an environment where you have total control within your own mind. It is used to relieve the anxiety that accompanies illness and the pain that may be a symptom of illness. Several studies suggest that guided imagery effectively controls anxiety and pain. With some guided imagery, you imagine yourself in a relaxing time or place (your grandmother's kitchen or a sandy beach). Other forms encourage you to visualize your immune system destroying HIV. Guided imagery is used to reinforce the ability of the immune system to resist HIV. Studies have produced mixed results, since the effectiveness of guided imagery may be influenced by such things as receptiveness to hypnosis and the ability to accurately imagine what is happening in the body. Some AIDS service organizations offer guided imagery sessions. Tapes may also be used to guide visualizations. Tapes that focus on HIV or the immune system are available and can be purchased at many bookstores.

Meditation

The art of meditation involves becoming aware of your thoughts, observing them and eventually achieving mastery over them. Meditation means listening to your body and the workings of your own mind and spirit. Many forms of meditation teach awareness of the subconscious act of breathing. When you are in sync with your breathing, you enter a different realm of consciousness. Doing so may help you relax and make you feel more rested than after the deepest sleep. It may also give you a sense of calm, peace, joy and efficiency. Some people use meditation to get a clearer view of reality.

With practice and discipline, meditation is used to cultivate mindfulness. Meditation can be associated with specific spiritual beliefs and is a part of many culture-based approaches to healing, including Ayurveda, First Nations healing traditions and traditional Chinese medicine. Some forms of meditation require that you maintain specific postures or repeat specific sounds or phrases. Other forms are much more casual. Many people meditate when they paint, write or watch a sunset.

PHAs use meditation to help themselves relax and deal with stress and anxiety. Like they use guided imagery, PHAs use meditation to increase feelings of control over their lives. Meditation is also used to strengthen sense of self since it may be understood as a way of listening to your internal voice. At least one study links participation in prayer or meditation to better overall health for PHAs. Many different spiritual traditions teach meditation. Look for one that is meaningful to you. Local AIDS service organizations may offer programs that teach meditation outside specific systems of religious beliefs or they may be able to refer you to an organization that provides such programs.

Stress Management

Stress management programs are used by PHAs to constructively cope with stress. These programs identify the ways you currently cope with stress and teach new mental and emotional techniques for dealing with these issues. Stress management often involves a physical component, such as a breathing exercise, meditation or physical exercise. It may also incorporate counselling sessions or massage work or both. Most PHAs who take advantage of these programs feel the sessions improve their day-to-day life experiences.

A number of small studies confirm that stress management programs lead to relief from anxiety and improvements in quality of life. Since it has been shown that stress has a negative effect on the immune system, many people believe that their immune systems have benefited from stress management programs. But study results have been mixed, partly because the definition of a stress management program varies widely. One study demonstrated an improvement in herpes outbreaks in HIV-positive men after a stress management program. Another showed increases in the number of CD4+ cells.

Many Canadian AIDS service organizations run stress management programs for PHAs, and the programs are usually free. Call your local AIDS service organization (ASO) for more information. If no such workshops are available to you, your local ASO may be able to recommend counsellors or psychotherapists who do this kind of work and are experienced working with PHAs. In some cases, this therapy may be covered by a provincial health plan. Your local organization should be able to tell you more. Further, branches of the Canadian Mental Health Association (CMHA) often run stress management workshops and provide materials about coping with stress. These workshops are not specific to PHAs but they may be sources of useful information. Look up the local branch of the CMHA in the phone book. For individuals, CMHA workshops usually cost around $50.

Tai Chi

Tai Chi is related to qigong (see section on traditional Chinese medicine) and the Chinese martial arts tradition. Like qigong, Tai Chi combines physical movement and meditation. The movements emphasize being aware of your own Chi, or Qi, and the Chi of others. Tai Chi's slow, rhythmic movements have made it a popular form of exercise in Canada, but the mental and physical discipline that it teaches also helps those who practise it to deal with stress. Tai Chi is related to the spiritual teaching of Taoism. There are a number of different forms of Tai Chi, and several are practised in Canada.

Yoga

Yoga is union with the self or divine truth. Although many people think of it primarily as an exercise program, the stated purpose of yoga is liberation: to help an individual achieve longevity, rejuvenation and self-realization. It may also be used to heal and prevent illness.

There is more to yoga than stretches and postures, but these components are usually the first ones that people learn. Yoga contains eight components, which can be incorporated as a person progresses. These eight stages combine mental, emotional and physical aspects. They are yama (abstentions), niyana (observances), asana (postures), paranayama (life force control or breathwork), pratyahara (sense withdrawal), dharana (concentration), dhyana (meditation) and samadhi (contemplation and state of perfect equilibrium).

Yoga is used to establish a sense of relaxation and awareness. It may also increase oxygen consumption and reduce stress. Doing yoga on a regular basis builds muscle strength and flexibility. It is used to manage insomnia too.

Yoga is also said to massage the body internally, stimulating the circulatory and endocrine systems and strengthening the lungs and digestive organs. PHAs who practise yoga have experienced benefits such as improved stamina and reduced fatigue as well as a general feeling of well-being, sometimes referred to as connectedness.

There are many different schools of yoga and many different approaches and techniques. Look for instructors who are registered with a specific school and are experienced at working with PHAs. At least one school has developed a video of postures specific to PHAs. See the section on resources for details.