Solving the Mind/Body Puzzle
U of L researcher explores the connection
For most of his adult life, Michael Hollifield has been trying to solve a complex puzzle that has intrigued scientists for centuries: How do the brain and body work in tandem to affect our health?
By Denise Fitzpatrick
Hollifield, a psychiatric and family medicine researcher who joined U of L last year, has devoted his career to exploring that connection, which is now known to play a significant role in a variety of mental and physical ailments.
Grasping how the mind and body actually work together will lead to significant new improvements in health care, he believes.
"Many times clinician-scientists are so focused on the body that they forget to look at the interactions between mind and body," Hollifield says. "How do mental processes affect the patient's physical condition? How do thoughts and feelings alter the functioning of the brain and the rest of the body?
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"You often have to take all that into account to really figure out what's going on."
Hollifield, medical director of the biobehavioral oncology program at U of L's James Graham Brown Cancer Center and director of a new Anxiety Disorders Program in U of L's Department of Psychiatry and Behavioral Sciences, has received more than $1.3 million in federal and private research grants to study the effects of trauma and anxiety on health and has another $3.5 million in grant proposals under review. His work, much of it funded by the National Institutes of Health, has led him to explore a myriad of bio-behavioral topics.
"There's a common theme that runs through everything I do. I look for how things out there," he says, stretching his arms away from his body, "get in here," he says as he brings them back and points to his head.
Straddling Disciplines
Hollifield sees himself as a connector who works to draw people of all backgrounds together to pursue a common cause. That task can be challenging since modern medicine has evolved into an array of highly focused specialties.
"Specialists tend to see a problem from a focused perspective," he says. "This can make for overlooking the bigger picture. We need specialists, but we also need generalists."
In a way, Hollifield is both. He earned a bachelor's degree from Hanover College in 1979 with a double major--biology and theology--and completed pre-medical studies. Ten years later, he finished a doctorate of medicine from the University of Washington School of Medicine in Seattle.
For the next five years, he did a combined residency in psychiatry and family practice at the University of New Mexico School of Medicine in Albuquerque. He continued on as a faculty member at UNM through 2004, also serving as an adjunct assistant professor of international health and development at Tulane University's School of Public Health and Tropical Medicine from 1998 to 2002.
He has taught courses about humor in medicine and has studied (and been quoted in the New York Times about) the ins and outs of psychosomatic illness. The grandson of two ministers, he uses his vacation time to visit Africa, where he is helping create a trauma treatment center for the children victimized by a 10-year civil war in Sierra Leone.
Hollifield joined U of L last year through a dual appointment as medical director of the cancer center's biobehavioral program and as an associate professor in psychiatry at the university's School of Medicine. He also works with a research team in the family and geriatrics medicine department, who are looking at how to best integrate mental health training into primary care.
"I have had to learn how to straddle disciplines," he says.
Mind-Body Medicine
Acceptance of complementary and alternative medicine as a valued area of research is growing by leaps and bounds, particularly in mind-body studies. Hollifield cites Oregon Health and Science University in Portland as an example of the trend.
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Researchers there clarified the relationship between prolonged stress and vulnerability to serious illness, discovered the relationship between light and the biological clock, and created new therapies using light and melatonin to alleviate sleep and mood disorders.
"Many prominent universities are looking at new, complimentary approaches to medical care," Hollifield says.
Federal funding for mind-body research has soared over the past decade, he adds. The National Center for Complementary and Alternative Medicine, one institute of NIH, awarded only $2 million in research funding in 1992. By 1999, that number had climbed to $50 million. This year, it reached $123 million.
As medical director of the biobehavioral program, Hollifield's job is to further develop a model of cancer care and research that adds value to current biomedical standards of care.
"I want to help build an interdisciplinary approach to helping cancer patients that combines biological, behavioral, psychological, social and spiritual factors," he says. "Cancer affects so much of the person's life that we need to always view treatment as a holistic enterprise."
Hollifield recently implemented a psychiatry oncology program for cancer patients who suffer fatigue, anxiety, panic attacks or sleep disorders. Also, a mind-body medicine program is beginning to offer therapies such as yoga, massage, acupuncture, relaxation imagery, cognitive behavioral therapy and some herbal medicine. This builds on the behavioral oncology program that has been operating since 2002.
 Dr. Michael Hollifield, medical director of the biobehavioral oncology program at U of L's James Graham Brown Cancer Center, recently implemented a psychiatric oncology program for cancer patients who suffer fatigue, anxiety, panic attacks or sleep disorders. |
"All cancer patients are going to be stressed," he says. "We need to ask, 'What's needed when and with whom?' It's going to be different depending on the patient."
The biobehavioral lab facilities are where researchers conduct basic and translational research on how psychological, psychiatric and social conditions affect the biology and behavior of people who have cancer.
The biobehavioral core researchers include Hollifield; Carla Hermann, who used an NIH grant to study quality of life in advanced lung cancer patients; Sandra Sephton, who is researching the effects of the biological clock on tumor progression; Jamie Studts, who is examining behavioral responses to cancer screening and factors that affect physician-patient communication; and multiple collaborators including Paul Salmon, Mark Pheifer and medical and surgical oncologists.
Hollifield is now awaiting word from NIH on whether he will receive $275,000 funding for a research project on adverse outcomes. The study is aimed at learning whether difficult childhood experiences of cancer patients influence their symptoms and ability to cope with the illness late in life.
In another recent project, Hollifield led a team of researchers in developing a scale to measure the extent of trauma suffered by war refugees. Articles about this work have appeared in the Journal of the American Medical Association and in Comprehensive Psychiatry. He was also recently invited to write a commentary in the medical journal, The Lancet.
Hollifield's team found that refugees endure a far greater range and extent of trauma than previously was thought.
"Assessing the effects of war-related trauma in refugees is something that has been understudied," he says. "Being able to accurately assess the problem should help clinicians do a better job caring for refugees and make it easier to document human rights violations," he adds.
Hollifield also has conducted research about post-traumatic stress disorder.
"War and other traumatic events appear to be here to stay," he says, adding that a high prevalence of post-traumatic stress disorder, physical symptoms and physical disability has been moved to soldiers returning from Iraq. "If we don't have the capacity to prevent war, then we have a collective responsibility to better understand and treat its psychiatric and medical consequences."
Other examples of Hollifield's research include how sexual assault victims can benefit from consciously trying to change the ending of their nightmares and studying how to relieve sleep-disorded breathing in people who have been evacuated from fires.
His long-term goal is to develop a National Institute of Mental Health-funded mind-body medicine center where researchers can pinpoint the links between stress and physical health.
"I want to be a part of changing the mindset so people will look at the bigger mind-body picture."
