| | Modality | Description | Use by the general public (%) [10] |
| | Meditation | (i) A mental training that is a state of being more than a task. Practices incorporate self-observation and awareness, emotional and attentional regulatory strategies, and the cultivation of an attitude of acceptance.
(ii) Many forms exist, share some distinctive features but vary in purpose and technique.
(iii) Most widely researched forms include transcendental meditation and mindfulness meditation.
(a) Transcendental meditation: a silent word or phrase (a mantra) is repeated in order to reduce mental activity.
(b) Mindfulness meditation: practitioners cultivate an open, nonjudgmental awareness of both internal experiences (thoughts, emotions, and bodily sensations) and external experiences (sights, sounds) in
the present moment. Has been formalized for clinical intervention with mindfulness-based stress reduction, a program that is an amalgam of several mind-body techniques, including mindfulness meditation, breathing exercises, yoga postures, and relaxation techniques. | 9.4 |
| | Yoga | (i) Incorporates physical postures, breathing, meditation into a multifaceted approach to physical/mental wellbeing.
(ii) Many different practices of yoga, each varying in focus.
(a) Hatha yoga is typically gentle with an emphasis on poses and breathwork.
(b) Ashtanga and Vinyasa yoga are more physically demanding, moving from posture to posture
without stopping.
(c) Iyengar yoga is most concerned with precision of poses, encourages prop use to attain correct alignment.
(d) Bikram Yoga is practiced in a heated room (typically 105°F).
(e) Kundalini yoga incorporates an added emphasis on the breath in conjunction with physical poses.
(iii) Like meditation, the practice of yoga cultivates a way of being rather than performing a task, although, Western practices that focus on exercise and physical health rather than awareness, insight, or spirituality have emerged. | 6.1 |
| | Hypnosis | (i) Relaxed state of focused, inward attention in which peripheral awareness is reduced.
(ii) Attaining alteration of consciousness involves absorption, dissociation, and suggestibility.
(a) Absorption: deep immersion in an internal experience.
(b) Dissociation: disconnect from peripheral events that would normally be conscious (perceptions, thoughts, emotions, or sensory activity).
(c) Suggestibility: suspension of conscious editing (not asking “why?”), respond to suggestion more readily.
(iii) Therapist may use guided imagery or hypnotic suggestion to help the person to understand behavioral patterns and envision making desired change.
(iv) Self-hypnosis techniques can be used at home, reducing the cost of therapy and encouraging self-efficacy. | 0.2 |
| | Biofeedback | (i) Electrodes placed on the body provide feedback to the patient about peripheral physiological markers like heart rate, breathing rate, muscle tension, or electrodermal activity.
(ii) Neurofeedback uses scalp electrodes to measure EEG activity.
(iii) Information relayed with visual or auditory cues; patient can attempt to change thoughts, emotions, or behaviors in order to control physiological reactions, such as slowing the heart rate or relaxing certain muscles.
(iv) Strategies are developed and refined with a practitioner, then utilized in real time outside the therapeutic encounter.
(v) Portable biofeedback devices available to enhance relaxation.
(vi) Individualized treatment goals depend on the specific condition being addressed. | 0.2 |
| | Relaxation | (i) Reduces reactivity to physical, psychosocial, and environmental stressors by reducing sympathetic nervous system arousal and enhancing parasympathetic response [16].
(ii) The physiological counterpart of the fight-or-flight, response [17].
(iii) Jacobson’s progressive muscular relaxation technique and autogenic training are formalized relaxation techniques, all the mind-body therapies initiate some kind of relaxation response.
(iv) Often incorporates breathing techniques that create awareness of breathing rate, rhythm, and volume.
(v) Voluntary control of breathing patterns influences autonomic nervous system functions: heart rate variability, cardiac vagal tone, and CNS excitation as indicated by EEG and MRI [18].
(vi) Relaxation training enhances awareness of nervous system activation; patients can employ techniques at any time to reduce reactivity. | 15.6 |
| | Imagery | (i) Most prominent forms are guided imagery and motor imagery.
(a) Guided imagery: involves visualization and imagination, goal of evoking a state of relaxation or
a specific outcome (visualizing the repair of myelin, or one’s white blood cells attacking a tumor).
(b) Motor imagery: patient relives the sensations of undertaking a skilled movement without actually doing the movement [19]. Physiologic similarities between physically executed and imagined movements have been noted in motor evoked potentials, MRI, PET, and EMG studies [20–24].
(ii) Can engage visual, tactile, kinesthetic, olfactory, gustatory, or any combination of these senses.
(iii) Imagery typically developed and refined with a therapist, then practiced regularly outside the therapeutic encounter. Motor imagery is used in addition to physical therapy or exercise and not as an isolated treatment.
(iv) Tailored to condition and abilities, it should be practiced in patient’s own context to be meaningful for their progress. | 2.2 |
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