Nonconventional Therapies Gain Broader Acceptance

Until recently, the U.S. medical establishment's response to chronic illness was mainly drugs or surgery. But in 1999, the National Institutes of Health created a new National Center for Complementary and Alternative Medicine, which studies nonconventional treatments. This year, the institute has a $108 million budget for research on approaches such as yoga for people at risk for diabetes; music imagery exercises aimed at decreasing fatigue and anxiety -- and improving overall mood -- for leukemia patients on chemotherapy; and the prospect of "distant" healing for brain tumors -- that is, prayer directed at the patient from afar.

Most proponents of mind/body techniques and spiritual wellness acknowledge they can't cure chronic diseases. But many believe the approach can alleviate symptoms, make patients feel better and give them more strength to cope. "Can it cure cancer? No," says Herbert Benson, an associate professor of medicine at Harvard. "But can it alleviate the stress-related aspects of cancer, the symptoms that are not coming from the cancer, the insomnia, the worries ... ? Yes." Dr. Benson is also director of the Mind/Body Medical Institute in Boston.

Some clinicians, like Richard Sloan, a professor of psychiatry at Columbia University, argue that physicians should steer clear of spiritual guidance of any sort. He says it's fine for patients to pray or meditate if it makes them feel better, but doctors should stick to what they were trained to do. Dr. Sloan says much of the data that links prayer and religion to improved health are flawed and there is no convincing evidence that spiritually based therapies are truly effective.

"Living Well," a Los Angeles program for people newly diagnosed with MS, which was launched in 2002, has a waiting list for its spring course. Patients are referred by neurologists, pastors, rabbis, physical therapists or by word of mouth to the 12-week program in education, exercise, diet and spiritual wellness. A shorter program, "Exploring Your Spiritual Self," offers more individualized guidance.

Debulyn Salinas said the program "changed my life." Diagnosed in 1993, Ms. Salinas, of Los Angeles, said she'd become an angry "hermit" who perceived herself as "damaged goods." Chronic pain and multiple medications made her depressed, she says, and she became withdrawn and celibate, and contemplated suicide. After joining the program, she began to meditate, and says she started thinking about her illness not as a punishment, but as merely an event to be examined in the greater context of her life.

"I now have a boyfriend, I'm putting makeup on every day, and I'm seeing life through different eyes," she said. "The symptoms aren't as painful. After 11 years, I finally learned that it's time for me to accept MS."

Carolyn Roberts, a Los Angeles psychologist who was diagnosed with MS 28 years ago and acts as spiritual director of the Living Well program, says one goal is to restore a sense of balance to patients reeling after their diagnosis. "Your life is never going to be the same," she says. "We address the fear, the grief, the shock, the denial."

Dr. Roberts begins her sessions by trying to help participants develop a greater consciousness about where they have tension in their bodies and helps to develop internal methods for dealing with stress that can trigger an attack. "When people engage in the process, they get a clearer sense that they are more than just their illness and they find meaning," she says.

Sister Bridget Haase, director of the five-year-old spirituality and wellness program at the Boston Home, a residential care center for people with chronic neurological diseases, says there was a "hunger" among residents for spiritual guidance beyond organized religion. Her program encourages group discussions, rituals and prayers among residents, as well as yoga tailored for people in wheelchairs. Although none of the residents can walk and many are cognitively impaired, she said, "they still want to know that their lives have meaning and know they've made a difference."

About 150 patients with heart disease, immune-system disorders, breast cancer and other diseases are enrolled in one of the multiweek courses at the Mind/Body Medical Institute, double the number of three years ago, says Dr. Benson. One big reason enrollment is up is that the institute now makes it easier for health insurers to cover the classes.

The programs, tailored to specific disorders, emphasize what Dr. Benson calls, the "relaxation response" -- repeating a single word, phrase, prayer or movement in an effort to slow the heart rate, reduce blood pressure and other stress-induced reactions. Sessions also include advice on nutrition, exercise and "cognitive restructuring" in which participants are encouraged to reassess the meaning and goals of their lives in the context of their illness.

Traditional doctors, and even the administrators of Medicare, the government program for seniors, are investigating the therapeutic and financial benefits of these mind/body techniques. HIP, the big New York HMO, will soon start using Dr. Benson's techniques for its heart-disease patients.

Christina Puchalski, associate professor of medicine and director of the George Washington Institute for Spirituality and Health is trying to incorporate "spiritual histories," as part of the routine medical history taken by doctors. She says by asking broader questions, patients often open up about important issues, like tension in a marriage or despair over a disability that can help physicians offer more comprehensive care.

Write to Rachel Zimmerman at rachel.zimmerman@wsj.com²