BEHAVIORAL
MEDICINE
What is Behavioral Medicine?
by Stephen I Sideroff, Ph.D.
The earthquake on January 17 not only shook up
the LA area, it sent a collective jolt through the psyche of
its residents. Insomnia, nightmares, anxiety and the emergence
of deeper feelings were just a few of the reactions found to
be consequences. At the same time, headaches, flu like symptoms
and general "disease" have also increased during this same period.
The earthquake, in fact, has heightened the impact of our constant
companion stress and has demonstrated what we all intuitively
know: emotional problems and trauma frequently turn up as physical
manifestations.
Behavioral medicine is the study and treatment of behavior that
affects physical symptoms. Behavior can refer to high risk behavior,
such as smoking or excessive use of alcohol or other drugs,
or to poor eating habits, resulting in overweight, high cholesterol
levels or a lack of necessary nutrients. It can also refer to
the antecedents of these behaviors; in other words, the emotional
conflicts that lead to overeating or the use of drugs. Finally,
behavioral medicine can refer to dealing with emotions that,
in themselves, cause body tension or hyperactivity of the nervous
system, resulting in stomach disturbances, headaches, backaches
and neck aches, TMJ, and even elevated heart rate and blood
pressure.
In scientific terms, we say that these emotional factors influence
the "hypothalamic pituitary endocrine axis" of the body. We
are rapidly learning how these systems in the body translate
emotional upsets or stress into neurochemical impulses, which
can alter the functioning of any system in the body, including
the immune system.
Behavior is not always seen, as in smoking or even the expression
of anger. There is "covert" or internal behavior, such as our
thoughts. If, for example, a friend or relative has not returned
our call, and we begin to get upset, it is probably because
we think, "he or she does not care about me, or is angry with
me." These thoughts will trigger anxiety or anger, which in
turn creates tension and worry. Tension and worry can become
a pain in the neck or a headache. It can become thoughts at
night that cause sleeplessness. It can aggravate an already
painful ulcer.
There are many goals of behavioral medicine that were designed
to alleviate physical symptoms. By helping people change how
they think about a situation or how they interpret a. situation,
we can reduce the tension and worry that trigger physical symptoms.
In the example given above, if we interpret the lack of response
by the friend or relative in a more neutral way, saying, "he
or she is probably -very busy," we can avoid the tension and
worry. By avoiding these emotional reactions, we reduce the
body's physical reaction, as described above, and thereby minimize
the potential physical symptoms.
Emotions and behavior not only trigger physical symptoms, but
also can be the result of physical symptoms. For example, prolonged
pain and disability are typically accompanied by depression
and insomnia. This, in turn, can cause additional tension and
heightened pain sensitivity. In this case, behavioral medicine
techniques are used to disrupt this cycle. Biofeedback can,
for example, help teach the patient to be aware of and then
reduce this body tension. By accomplishing this, patients are
better able to relax as well as feel a sense of control over
their bodies. This, in turn, can reduce the perception of pain.
In many respects, we tend to ignore the signals from our body
until they turn into more serious symptoms or pain. Behavioral
medicine treats the relationship between mind and body and helps
bring them back into harmony.
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