Herbert Benson and William Proctor: Relaxation Revolution: The Science and Genetics of Mind Body Healing
Scribner, New York, London, Toronto, Sydney; 2011, 288 pages
A Review by Barry Blackwell
This is a tardy review of a book with multiple meanings for the INHN website, not least because Herbert Benson died at the age of 87 on February 3, 2020, the day before our founder, Tom Ban’s sudden death. Tom would have been fascinated by the book’s findings and its implications for the history of neuropsychopharmacology.
Benson spent his entire career at Harvard beginning in 1961 as the Mosby Scholar. As a junior faculty member, he soon became involved in research focused on stress working in the lab where Walter B. Cannon discovered the fight-flight response. Benson’s interest and contributions focused on “The Relaxation Response” and in 1975 he, along with Miriam Z. Klipper, published his first book with that title. In the 1970s he had garnered extensive Foundation support - amounting to $300,000 ($1.5 million today - to study Transcendental Meditation). His 1975 book also announced a wider interest in the new field of Mind Body Medicine. Despite a promising career, Benson’s work created tensions with his mentors and fellow faculty at Harvard.
Benson discusses this schism openly and frankly in the current book. The problem lies in the fact that the Relaxation Response is “characterized by extremely complex mind-body interactions that cannot be measured in reductionistic terms. Harvard Medical School Science has been and still is almost exclusively reductionistic.” In practical terms this meant, “a real cure for serious illness is possible only through drugs, surgery or some physical procedure.” Any treatment apart from these physical responses is “unscientific and will probably be ineffective.”
In an attempt to resolve this dilemma Benson’s boss and the Chief of Medicine at Harvard convened a review panel of non-Harvard academics to assess whether Benson’s body of research had “an adequate scientific basis.” The panel report was ambivalent but led to compromise with two criteria: Benson had to publish his research in a highly respectable journal whose criteria observed rules of “vigorous reductionistic science” and he was also required to obtain a “National Institutes of Health competitive grant.”
Benson fulfilled both criteria and was allowed to continue research at Harvard. He eventually moved off campus, first in 1988 to his Mind/Body Medical Institute in Boston and eventually, in 2006, to the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital.
Harvard now advocates for transactional research based on cross-disciplinary linkages. In Part 11 at the end of this book Benson discusses “The Limits of Reductionism” and “Why the Whole may be Greater.”
But the full force and validation of his career is in Part 1: The Science of Mind Body Healing. The “Response” became a Revolution when in 2008 he and seven colleagues published Genomic Counter-Stress changes induced by the Relaxation Response. Its conclusion is that “Mind Body Strategies can actually ‘Switch on’ and ‘Switch off’ gene activity or expression associated with disease.”
This led to the conclusion that, “Mind body science has now reached a stage where it should be accepted as the third major treatment and preventative option, standing equal alongside drugs and surgery in the clinical medical pantheon.”
The methodology and outcome of this groundbreaking study are on display in Part 11: Planning Your Personal Mind Body Health Strategy. Here details of the two features of the Relaxation Response are provided: the relaxation itself and the mindfulness strategy designed to invoke the hope, optimism and cognitions associated with a placebo response.
Sections 7 and 8 in Part 11 provide details of the many Mind Body Treatments currently available with detailed and scrupulous analysis of these approaches (p. 109-208). He begins with an understanding and appraisal of medical treatments provided by the treating physician, including contributions to improvement and side effects, then notes and assesses any contribution of stress to the patient’s symptoms. If patient and treating physician approve explain and teach both phases of the Relaxation Response and its Mindfulness Component. Benson lists the 16 conditions and disorders most likely to respond to a Mind Body approach, particularly those known to show a placebo response or a stress component (p. 200).
In addition to the clinical benefits of Mind Body Medicine Benson draws attention to its low cost once the patient has acquired the requisite skill. This contrasts with the physician’s choice of drugs or surgery, quick but expensive procedures that inflate cost, reinforced by the drug manufacturers profit. “We have entirely too much to lose in terms of excessive cost and impaired personal health if we stand in the way of this Revolution.”
Relaxation Revolution provides a unique view of the philosophical, scientific, clinical, practical and economic aspects of Mind Body Medicine.
Benson H, Miriam Z. Klipper. The Relaxation Response. HarperCollins; 1975.
Dusek JA, Otu HH, Wohlhueter AL, Bhasin M, Zerbini LF, Joseph MG, Benson H, Libermann TA. Genomic counter-stress changes induced by the relaxation response. PLoS One 2008;3(7):e2576.
February 2, 2023