A mantra a day can keep the doctor away. Diane Goldner explains why to try a dose of meditation with your meds.
At least 30 minutes each day, Jeffrey Allen sits cross-legged on a cushion on the floor of his Brooklyn apartment -- spine erect, eyes closed -- and follows the rhythm of his breath. He breathes in and he breathes out. In. Out. In... Sometimes he repeats his mantra, a phrase that focuses his attention inwardly. Often his experience is exceedingly mundane. "I'm just sitting there watching my thoughts float by," he says. At other times, he finds himself in "a really expansive state." The 40-year-old PWA began meditating only a few weeks after he tested positive in November 1986, when his CD4-cell count was already below 200. "I was told that I had a year to live," he recalls pointedly. As it turns out, however, predictions of his death were greatly exaggerated. With 54 CD4s and on permanent disability, he has been sick only once, with a mild case of pneumocystis carinii pneumonia in 1995, and has all but skipped antiretrovirals, except for a two-month stint in 1998.
Allen believes his daily dose of meditation is one reason he's relatively healthy -- 14 years of HIV and counting -- and researchers back him up, reporting that meditation can subtly but definitely enhance HIVer health. These deep-relaxation techniques (by which you relax your body -- one part at a time -- until breathing is balanced) work on both mind and body and allow practitioners to harness the powerful but mysterious link between them. Some say that because it creates a peaceful state, meditation also has a spiritual effect (see "Keep the Faith"). "As an anti-stress discipline," Ann Webster, PhD, director of the Mind/Body HIV/AIDS program at Beth Israel Hospital in Boston, says unequivocally, "meditation is useful for people with HIV."
There's a mountain of research on meditation and even a category in the National Library of Medicine's computer database. But only a few studies have tackled the question of its effects on HIVers. One study completed last year at the University of Miami School of Medicine comparing depression and the quality of life of 450 HIV positive women found that those who got stress-management training, including progressive relaxation and group therapy for 10 weeks, were significantly "less depressed" than the control group. This still-unpublished study also found that the stress-addressed group had better adherence to their meds. And a previous Miami study of 21 HIV positive gay men trained in stress management -- including moderate exercise, guided relaxation and positive affirmations -- found that those who maintained these practices after two years were less likely to be in denial about their diagnosis and had lower rates of progression to disease and death. According to Beth Israel's Webster, meditation can also reduce AIDS symptoms caused or made worse by stress, such as headaches, gastritis, insomnia and neuropathy. (A University of North Carolina study reported that even one major chronic-stress factor doubles the risk of progressing from HIV to AIDS.) But, Webster cautions, "No one can claim that meditation will prevent AIDS symptoms."
Meditation is widely viewed as an ancient Asian import, although disciplined contemplation is a feature not only of Hinduism and Buddhism but of virtually all religious traditions. The practice entered U.S. pop culture with a bang in the late '60s when the Beatles and other icons made long hair, bare feet and yogi consults faddish. In the '70s, TM, or Transcendental Meditation, was to the nation's collective consciousness what Earth Shoes were to its feet. Since then, along with the advent of Chinese medicine and other complementary treatments, meditation techniques of body and mind have been adopted by many doctors to help patients decrease anxiety and depression and promote a sense of physical well-being. Herbert Benson, MD, a cardiologist at Boston's Beth Israel Hospital and a pioneering researcher in the field, coined the phrase the relaxation response in the early '70s to describe the physiological effects of meditation. The process is simple: Anxiety causes your breathing to become shallow, while depression makes it heavy. By bringing a gentle focus to the breath, you can literally shift your emotional state.
But better moods are not the only advantage of controlled, focused breathing. According to Benson, meditation reduces the rate of oxygen consumption by 10 to 20 percent (compared to sleep's measly 8 percent), and this induces a slowed-down, restful condition called hypometabolism which allows your immune system to recharge. (Other studies show that even after several weeks of practice meditation lowers the heart rate, reduces blood pressure and increases the brain's alpha rhythms and its ability to relax and focus.) "Meditation is a far deeper physiological relaxation than even the best sleep," says Jeff Leiphart, PhD, a psychologist at the Shanti Project, an ASO in San Francisco, who teaches progressive relaxation. "The immune system works best at deep rest."
But note: Meditation can pose the occasional problem. One study shows it can induce psychotic episodes in schizophrenics. And several studies show that even meditators without psychological challenges sometimes experience anxiety during a session. Experts say such results are expressions of preexisting mood disorders. "If you're meditating and a powerful feeling comes up or you get teary, it's OK," says Webster. "You need to talk about those things." For that reason, meditation is usually taught in a setting where there is also some group therapy. Says Alan Brown, instructor at the Learning Immune Function Enhancement (LIFE) program in San Diego: "The meditative work is helpful," he says, "With HIV, it's important that people have a range of resources."
Meditation may work wonders, but what if you're too busy tofind a teacher? Diane Goldner and HIVer Michael McColly make a housecall.
Meditation 101: Sit in a straight-backed chair with yourspine erect, feet on the floor and hands on thighs, or sit cross-leggedon a cushion on the floor. Close your eyes. Slowly breathe in and out.
Michael McColly: I sit on mat and a small pillow.Sometimes I put on instrumental music such as Japanese flute music,Indian chants or even Beethoven or Bach. I think it's important toestablish a clean, orderly space in my home to meditate, no matter howsmall. If my meditation space is disorganized, it's harder for me tofocus. I wear sweats or loose clothes, and if I'm really feeling aunaturel, I meditate naked. It makes my body feel alive. Some daysthat's essential.
Basic Meditation With Mantra: Choose a word or phrase torepeat silently with each inhale and exhale to help stay focused onyour breathing. A simple Sanskrit mantra is Ham-sa, which means I am that. Or try peace or one, on the in breath. Or you can adopt a phrase from a prayer -- such as Hail Mary, full of grace, or Allah, or shalom, which means peace in Hebrew -- and repeat the phrase as you breathe in and breathe out.
McColly: I chant Om -- which means "beginning and end" -- in a pronounced, prolonged way: Ahh ohh mmm.The sound heightens my awareness and resonates in the air. Iconcentrate on my inhaling and exhaling, which is a sort of a metaphorfor give and take. To me, that's what life is all about.
Full Body Scan: Variations of this technique are taught inmany progressive relaxation and Hatha yoga classes. Lie on your backwith your spine straight and legs and arms relaxed, palms up. Slowlybring your awareness to your left foot and relax it, then to yourankle, your calf...knee...thigh...and hip. Then do the same with yourright side. Next focus on your pelvic area, stomach and chest. Focus oneach organ and muscle as you go. Then move to your left hand, arm andshoulder, and repeat this on your right side. Then relax your neck,face, mouth, eyes and head. Visualize light moving through your body.Let all of your tension release and allow any emotions held in yourbody to surface. Feel your body sink. Once you're fully relaxed, bringyour attention back to your breathing.
McColly: Sometimes I just sit quietly instead of thinkingabout whether I'm doing all of the physical stuff correctly. I neverwant meditation to feel like another chore or another thing on my to-dolist. In life, I'm constantly measuring myself against what I feel Ishould be achieving. I use meditation to slow down and enjoy life. WhenI do it, it's a breath of fresh air.