As a Mind/Body Consultant at the Dana Farber Cancer Institute, and Harvard and Tufts Medical Schools in Boston, Ramel Rones has worked to improve the quality of life for cancer patients with techniques from Tai Chi, Qigong, Yoga, and meditation.

As this country and, indeed, much of the world undergoes fundamental reevaluation of methods and goals of health care and questions how to better approach patients with cancer, there has never been such open mindedness to expanding our concepts and methods of treatment. The wisdom and experience of the Eastern healing traditions of, accumulated and enriched over thousands of years, added to the growing recognition that good nutrition and exercise are essential to health maintenance and the amelioration of disease, have expanded the scope of healing in nearly revolutionary proportions. Perhaps, most importantly in the West, we are learning humility about limits as well as the genius of Western scientifically-based medical techniques and drug usage.

A tremendous interest by cancer patients, their health care providers, and their families has created a demand for additional treatments to complement their medical needs. This interest inspired institutions around the country to study and research different “alternative” approaches which deal with prevention and creating awareness while empowering people to take more responsibility in their journey towards better health. This school of thought has gathered momentum, not only among individuals but also among governments, businesses, hospitals and educational facilities.

Recognized institutions are publishing results and implementing the benefits of holistic approaches which weave together the physical, mental, and spiritual elements of our being. For example, the Arthritis Foundation in the USA recognizes that regular exercise reduces pain, fatigue, and depression, especially through the ancient art of Tai Chi. Stability and balance outcomes with Tai Chi have been demonstrated at Emory University in Atlanta, Georgia. Studies at Tufts University in Boston, Ma. are showing that people can benefit from general aerobic conditioning (walking, biking, swimming), strength and endurance building exercises, and range-of-motion exercises (gentle movements to the limits of each joints motion to improve flexibility). Studies at Ohio University, has shown that in low stress populations (vs. high stress populations) a significant increase of Killer Cells (KC) existed in the immune system. Dr. Herbert Benson in Boston has shown positive health responses to relaxation. It is clear that western science has begun to realize the benefits of integrating nutrition and exercise, mind and body, and east and west when dealing with improving quality of life and having an affect on immune function.

Eastern Arts

In order to explain how a modified mind/body approach evolved, it is necessary to understand some of the basic philosophy and principles which compromise the eastern arts. If we look at the 2500 year old art of Chi (energy) Kung (study), for example, we find that it embodies a total “scientific” system of physical, mental and spiritual exercises which deal with the promotion of health. It also strives for balance and harmony among the building blocks of our being: body, breathing, mind, energy and spirit.

Tai Chi, a form of Chi Kung, was born and designed to serve as a form of health and martial arts. Tai Chi is Chi Kung, but Chi Kung is not necessarily Tai Chi. Tai Chi, emphasizes following the natural flow from one thing to the next while balancing between action and reaction, yin and yang. Yoga, which means union or to join (body, mind, and spirit) focuses on calming the fluctuations or thought waves in the mind. Integrating relevant principles and techniques from these three arts results in a customized mind/body approach for cancer patients which compliments western medical treatment by helping to prevent symptoms and side-effects of conventional treatment, increase physical performance, strengthen the immune system and improve the quality of life.

Personal Experience

My 20 years of studying with masters of the eastern arts has provided me with a unique array of mind/body tools to draw upon when dealing with health and healing of cancer patients. Utilizing the relevant principles and techniques from the eastern arts during my years of involvement with various forms of cancer has proven to me how mind/body/spirit arts, such as Tai Chi, Chi Kung, and Yoga, can target, alleviate, and possibly reverse the physical and mental affects of the debilitating processes associated with cancer. Based on the dramatic benefits and results which I have witnessed I was encouraged to modify and translate the eastern health model into a mind/body approach which easily fits into the lives of cancer patients.

As I began addressing the needs of cancer patients, I observed how quality of life and independence is affected by physical and mental obstacles such as depression, lack of energy, fatigue, stress, anxiety, low self esteem, bone loss, pain, shrinking of soft tissue, loss of muscle mass (sarcopenia), loss of lung capacity, and a weaker immune system. After recognizing these challenges, I began to implement mind/body techniques (based on the principles of Chi Kung, Tai Chi, and Yoga) which are practiced while lying, sitting, standing, and moving slowly, depending on ability. From years of experience, I have developed and customized this unique mind/body approach and I have witnessed how this approach helps patients improve their physical performance and their quality of daily living by improving sleep, concentration, overall functioning of the body, and self esteem, managing stress, pain and anxiety, increasing circulation, decreasing fatigue and depression, controlling weight, building bone density, preventing further decline and injuries, and most importantly empowering individuals, their families, and their physicians to play an active role in their health care.

The Mind/Body Approach

This mind/body approach relies on the theory that physical exercise alone is not enough to solve the discomfort associated with cancer. The power of the mind can affect a persons outlook on life, and his or her ability to deal with pain and sickness. The mind/body approach recognizes the importance of confidence, faith and determination when dealing with cancer, so that a thorough approach to healing must stem from a balanced program of mental, physical, and spiritual exercises while, at the same time, seeking and working with 40%, 60%, and 80% effort (depending on the goal). The method uses props and tools while performing stretching, strengthening, cardiovascular, “energetic” and visualization exercises.

This mind/body approach tries to harmonize and regulate the body, breathing, mind, energy, and spirit (until regulation is not needed).

Regulating until Regulating is not Needed

When I talk about “regulating until regulating is not needed,” the goal is, with sensitivity and awareness, to create a mind/body journey towards better health by striving for the maximum potential of our physical and mental body in order to function as designed. In order to achieve this physical and mental state we must embark on a mind/body journey that emphasizes regulating body, breathing, mind, energy, and spirit. As we regulate each of these five elements, we “sew” a thread through all of them and try to harmonize them, while later continuing the thread into other “relevant factors” (nutrition, faith, etc.) which have been developed and observed from “human experience,” or proved by science to lead to a healthier, holistic approach which culminates in a stronger universal sense of being and prosperity.

Science has been talking about the placebo effect (one limited explanation for the success of holistic approaches) and its health outcomes, but there is no real knowledge about what awakens that effect. Is it the mind, the body, or the spirit? Since the mind/body approach targets all elements of our being, body, breathing, mind, energy and spirit, then awakening the placebo effect may not be a random incident but rather a clear path or formula. By regulating all five elements, we have a higher chance of igniting the placebo effect.

Regulating the Body

In order to reach the maximum physical potential design of our body we must first learn how to recognize and isolate areas which have regressed or lost functioning. The ability to recognize, reach, and affect muscles, tendons, ligaments, bones, joints, the ten internal organs (or twelve, in Chinese medicine), spine, vertebrae and ribs is essential when regulating the body. To isolate means to recognize the movement or function of a specific physical body part or system and be able to isolate movement or stimulation in the desired body part, directly or indirectly. Once isolation is possible, creating balance between strength and flexibility, while aligning the bones is the next goal. It is important to first align the bones, and then “ask” and teach the muscles to develop according to an ideal skeletal structure (aligning bones and achieving an optimal range of motion in the joints), as opposed to allowing the muscles to develop irrespective of that ideal.

Once we have invested time and effort into the above goals, then maintaining or even increasing range of motion in the joints while stretching or relieving inflammation in the fascia is next step. Then massaging internal organs through movement and self-massage. The organ area (which symbolizes strength in China) is a very important factor in our health care, since most deaths occur because of organ failure (not considering accidents), and not because of biceps or triceps problems (a “funny” measure of strength in the west). And finally, to regulate the body, harmonizing all the physical elements and trying the create “space” while releasing physical stress on the different soft tissues, skeletal, nervous and muscular systems, lungs and other organs. Our goal is to reverse the process of “shrinking” caused by cancer and chemotherapy.

Working with people on physical, emotional, mental and spiritual levels, I have read and found that traumas may affect or be “stored” in the different soft tissues or physical areas of the body. Due to this fact, working on regulating the body results not only in reaching our maximum physical potential but also affects the release of physical and emotional traumas which are stored in our physical body. Since there is a need to analyze the process of “releasing” and its manifestations the Mind/Body approach offers the theory and actions of regulating the mind, the next step, since the body and mind cannot be separated.

Regulating the Mind

The mind/body approach recognizes that we metaphorically have two minds. One is the horse mind, which symbolizes wisdom, and the second is the monkey mind, which symbolizes the emotions. It is said, “Obtain the horse, seize the monkey.” For example, when you go to sleep you tell yourself that you will get up early the next morning and practice. “It is healthy for me!” That is your wisdom, or horse, mind.

Z Z Z … 6 am. Your alarm goes off. You are tired. You hit the snooze button, and say to yourself, “I will train tomorrow.” That is your monkey mind taking over. Here we have an example of the horse mind making a decision, and the monkey mind sabotaging that resolution. Since both minds exist within us, we cannot ignore the monkey mind. We must learn how to seize, cultivate, and focus the strong energy that the emotional, monkey mind generates, and use it to improve our health. A person who is controlled by the monkey mind may experience a scattered mind, living in an illusion, with fear, jealousy, hate, painful love, disappointment and depression, as opposed to a balanced horse/monkey mind which may result in a person who is focused, loving, successful, yet considerate, knowledgeable, highly motivated, yet loyal and humble; a balance between wisdom and emotion. A balanced person. Recognizing which of the two minds is making decisions, is a big step that can help one cope better with different life “experiences,” while reducing emotional and mental stress. Regulating the mind is a key element to achieving a stage of optimum health. It is easy to say and hard to do; to recognize the emotional mind and learn to lead that strong source of energy into constructive rather than destructive actions. That is why, in order to capture the monkey mind, wisdom sometimes is not enough. One also needs a banana! What is the banana? The breath.

Regulating the Breathing

The breath is a tool which serves many purposes. There are many books which try to explain and teach what is called in the east, the Science of Breath. Breathing is the tool to capture and quiet the monkey mind and obtain the horse. Breathing helps quiet the mind, allowing it to rest and rejuvenate. Just as any other muscle in the body that needs rest, so does the mind. That restful state is called a “place of thoughts with no thoughts. That place is also a “place” which is believed to be a state of deep relaxation that has all kinds of positive hormonal responses (Herbert Benson, Deaconness Medical Center in Boston, MA.) once an individual is able to easily reach this “place,” inner tranquillity and healthy living may occur.

Breathing also needs to be balanced. Inhalation and exhalation must be equal; long, deep, quiet inhalations balanced with long, deep, peaceful quiet exhalations. It is believed that heat (Lee = fire in Chinese) and cold (Kan = water in Chinese) in the body can be regulated through working with the breath.

Relaxation

Before continuing with regulating the energy and the spirit, relaxation must be discussed. The positive response to relaxation has been shown by Herbert Benson. But if we look at the eastern models for achieving “enlightenment,” or translated into modern language, good health and higher quality of life, we can see that relaxation is just a “doorway” to a temple full of rooms - mental, physical and spiritual actions and exercises. The direction and guidance to which room to go to first, needs to be in the hands of a qualified guide; a “qualified” mind/body expert, or Chi Kung master.

It is said, “It may take you ten years to become a qualified teacher, but it may take you twenty to find a “real” one.” Even relaxation is divided in to three levels. The first level is to look relaxed. It may be that it is just looks, but not real. The second level is to feel relaxed. Here, we can have the scenario of a person on vacation slouching on a chair on a beautiful island beach. Mentally they feel relaxed, but on a physical level, the internal organs are compressed, the spine is collapsed, and the central nervous system is stressed. This exemplifies mental relaxation only. But if we look at the deeper level of relaxation, the third level, it is to sense relaxation; aligning the bones while in certain postures, lying, sitting or standing, while creating space for organs, reducing stress off of the spine, nervous system, skeleton, and the different soft tissues in our body until a sense of physical transparency is experienced and a place of thoughts with no thoughts is reached - this is mind/body relaxation.

Looking at the eastern model >relaxation > balance > center > roots > chi > enlightenment. It is very hard to understand which action needs to be taken. But if I translate this philosophy into a western model we can see how relaxation is just the first needed step in an array of mind, body, spirit exercises which need to be learned and practiced to achieve our potential physical and spiritual health. Once, and only when we truly relax, can we find balance, which means working with “the up and down forces” of our body. First we realize how physically we are unbalanced. One arm is stronger than the other, one hamstring is tighter than the other, our heart is not in the middle, and the left and right lungs are not equal in size. Physically, we are ot perfectly symmetrically designed or balanced.

Recognizing and experiencing this through a mind/body journey is very important. The next step is to take this physical feeling of unbalance and mentally create balance. If you push a car, you push equally from both hands, even though one hand is “different” from the other. When you walk, mentally you feel balanced; there is no interference from unbalanced quadriceps, hamstrings, or even a limp. If a person with a limp walks and watches the scenery, the scenery does not “rock” because of the limp. This is a good example of how even though physically that person is not centered, mentally he or she is.

Even though there is not a physical center, there is a mental center. Once you have established this mental center, you can better understand and cope with your surroundings which leads to a strong sense of self esteem and confidence, and a focused clear mind, symbolized in the eastern model as roots > chi, which describes a state of a vibrant life force and a higher quality of life, all through a mind, body, spirit connection.

Once you achieve a clear, focused mind there is still the choice to be made by every individual between doing good or evil. To remind a focused clear minded individual to be humble, there is a Chinese saying, “The higher the bamboo grows, the lower it bows.”

Regulating Energy and Spirit

It is interesting to see how different cultures and religions from remote places and various times in the world, reached the same “sense” of an existing force. A force which is greater than just us. A force that shows itself randomly, or maybe not. A force which is believed to be able to be tapped and utilized through different means.

That force is expressed in different cultures with different words: In India that force is called Prana, while in China it is called Chi. Japan named it Ki, and the American Indians refer to it as The Great Spirit. In Hebrew, Neshama means spirit or soul. And interestingly enough, breath (Neshima) and soul (Neshama) in Hebrew has the same root. The same as luck (mazal) and leak (nazal). Does this mean if you know when to be and where to be there is no luck? Does luck leak from the heaven at certain times in certain areas? If so, maybe that is why some cultures do not believe in luck, but in destiny!

We all agree that a strong spirit is recognized as alert, focused, present, stimulated, inspiring and has spark in the eyes, while a weak spirit tends to reflect as a bored and discouraged person, bent spine, tends to get sick easily, fatigued and depressed. Both spirits could change from one to the other. And both can be cultivated for bad and for good purposes (like Darth Vader vs. Luke Skywalker in Star Wars). What is important for cancer patients, and is one of the principles of the mind/body approach, is to utilize mind, energy and spirit as healing tools. The mind is the general, the energy or thoughts, are the soldiers, and the spirit is the morals. It is said, “You are your biggest enemy. If you can conquer yourself, you can conquer anything.”

Meditation

Meditation is not relaxation. But relaxation is essential for meditation. Meditation is the key to fully understanding and experiencing the connection between body, mind, and spirit. A good mind/body teacher will emphasize meditation in all postures of our being; lying, which sometimes is referred to as relaxation or sleep, sitting, recognized as meditation or recreation, standing, sometimes recognized as Chi Kung or prayer, moving slowly, referred to as Tai Chi or walking, and moving fast, as Kung Fu or running.

As you can see, a meditative mind, or focused clear enlightened mind, should be emphasized at all times. Until we do not need to say “I meditate two times a day,” but instead, “I live a meditative life.”

Which means, I fully experience at every moment the connection between body, mind, and spirit, earth, heaven and human in order to achieve a richer, healthier, spiritual life.

Conclusion

This thread through body, mind, and spirit does not end at that point, however, but should continue through the rest of our life. Awakening sensitivity leads to awareness, which may aid in prevention of sickness and diseases. This thread should be carried into our daily activities. The mind, body, spirit approach should be emphasized at the work place, for example, in order to find the correct, healthy posture as we sit, stand, or lift. This thread can continue into times of recreation, as well, mixing fun with practice.

This approach can also be a constructive tool in decision making and relationships. Recognizing the monkey mind and the horse mind can make life smoother and clearer. And finally, this thread or bridge should continue to grow between western and eastern medicine. Eastern medicine can be a great source of mind/body “prescriptions,” or sets of exercises, routines, to compliment western medical treatments.

Taking this approach could reverse the debilitating effects of cancer and its treatment, or at least ease symptoms and side effects. Disease can be like a negative snowball if the right actions are not taken. If an individual decreases his or her ability to achieve daily goals and tasks, independence is reduced so that assistance is required. The stage of losing independence has been shown to have the highest number of depression cases (M. Geil del Real, Spain). Negative emotions arise which result in a poor physical and mental quality of life.

The array of physical and mental challenges can be alleviated or eliminated through an effective mind/body exercise program. Not only that, but a mind/body approach is ideal for cancer patients since they have both the time and the need but also, unlike western medical exercises which emphasize high impact aerobics to build muscle mass and improve cardiovascular functioning (which is not suited for the cancer patient), the mind/body approach achieves those goals without abusing the lungs, heart, joints, bones, or the immune system which are important considerations when dealing with cancer.

The learning of proper use of the mind and the body with minimum effort is appropriate for persons with cancer so that daily tasks can be performed easily and efficiently. Mind/body exercises can readily be performed by the fragile, wheelchair and bed-bound, while at the same time, prove challenging to the younger, stronger patient if necessary. The mind/body program highlights the role of the mind and spirit as healing tools, teaches the importance of integrating mind/body exercises with daily living, and emphasizes the individual’s journey (rather than results), all missing factors in current health maintenance and promotion modalities. A mind/body approach can save health costs and perhaps prevent a great deal of physical and mental misery. A mind/body approach could easily be integrated into conventional cancer treatment approaches, clinics, and especially our own homes. But most importantly, a mind/body approach empowers individuals to play an active role in their journey towards better health.