Posts Tagged ‘active ingredients’

Isolating the 8 Active Ingredients of Tai Chi

Perhaps what makes Tai Chi so special is that it is a holistic, multi-component exercise that impacts us at physical, psychological, social, and philosophical levels.

Based on his research and 35 years of Tai Chi training, Peter Wayne, PhD, Research Director for the Osher Center for Integrative Medicine jointly based at the Harvard Medical School and Brigham and Women’s Hospital, has put into words what he describes as the 8 Active Ingredients of Tai Chi.

“Like the components of a multidrug combination to lower cholesterol and blood pressure, each ingredient has a unique impact on the physiology of the body,” says Wayne.

“However, in Tai Chi, there are many more components, and each of these factors is inseparable from, and synergistic with, each other.”

In a recent blog Dan Kleiman, a fellow Tai Chi instructor in the Boston area, discussed the concept of 8 Active Ingredients with Wayne.

Here are some excerpts from that interesting discussion between the two Tai Chi instructors:

The concept of isolating active ingredients is common in other medical research. But does it really make sense to think of Tai Chi within this framework?

Great question…..and I think absolutely so.

Part of why I chose this language is to bend the ear of my medical colleagues—to try to communicate in their language.

Even if we see positive clinical effects in Tai Chi trials, without plausible mechanisms–– that is, being able to attribute clinical health effects to specific ‘active ingredients’, research results often have little traction in the medical community.

Mechanisms are part of what we call the totality of evidence.

Additionally, by using this language, we’ve been able to emphasize Tai Chi’s richness—that it includes not just one active ingredient—but many—including those related to neuromuscular control, breathing, cognitive processes, etc.

This may explain why it’s helpful for so diverse a set of health issues.

Finally, as a teacher, thinking in terms of active ingredients has helped me shape a curriculum that tries to maximize the ‘dosage’ of essential Tai Chi principles in as short a period of time as is possible.

This is key for teaching in clinical trials which are often constrained in length due to funding limitations; but also relevant to community-based classes where we want people to get a real taste of deep Tai Chi as quickly and efficiently as possible.

Living in the research world and the Tai Chi world at the same time allows Peter to apply lessons from one to the other. Here he explains how his scientific education influences the way he understands teaching Tai Chi:

My formal academic training was in evolutionary biology and ecological modeling, and my research for the first 15 years was with plants.

So shifting to medical research 12 years ago was a big change for me.

Consequently, I bring a somewhat unique perspective to the teams of medical researchers I work with.

My training to think ecologically, in terms of systems, is more like Chinese Medicine in that it focuses on ecological interactions within the body—how systems interact to create a complex whole that is greater than the sum of its parts.

In contrast, Western medicine has traditionally emphasized reductionist thinking, focusing on smaller and smaller parts, often at the cost of not seeing the whole person.

Interestingly, systems biology is being increasingly appreciated in medicine, and Tai Chi research fits beautifully into this more ecological framework of health.

Can you give an example?

Sure…breathing is a really important element in our Tai Chi and qigong training.

But there’s no way you can substantially change your breathing without changing your posture and how you hold your structure.

And your breathing deeply affects you nervous and cardiovascular system, and many aspects of your mood; it can be a great tool for focusing the ‘monkey mind’ and becoming more sensitive to the inner landscape of our body.

And of course changes in all these processes feedback on how we move and socially respond and interact with others.

All these processes are ecologically intertwined with each other.

But I also still think it’s useful to unpack the interconnected components—for example to teach breathing exercises on their own and to study the physiological impacts of breathing exercises, in isolation of the larger package of Tai Chi.

As a teacher, focusing on individual components helps brings awareness to finer scale processes, and it helps make a clearer teaching intention.

Also talking about the physiology of breathing in classes helps some students appreciate the work, and for the students, there can be a lot of power in knowing.

Most of us like to be told why we are doing a given practice in a given way.

It really helps if students are informed.

It creates buy in.

I really love building bridges between traditional practices and modern science for this reason.

8 Active Ingredients of Tai Chi

How does a mind-body therapy like Tai Chi work?

In modern medicine, drugs are prescribed because of their active ingredients. Well-defined, laboratory-synthesized chemical compounds, such as ibuprofen, the active ingredient in Advil or Motrin, are specifically designed to impact physiological pathways to elicit a predictable, desired effect—in the case of ibuprofen, blocking the sensation of pain and reducing inflammation and fever.

Tai Chi is obviously different than drug therapy. It has no well-defined, single chemical ingredient, and is more a mixture of exercise, meditative, and psychosocial components.

A writer-colleague, Dan Ferber, addresses this issue in a new article in Kung Fu magazine in his fascinating interview with Tai Chi Master Yang Yang, Director of the Center for Taiji Studies in Champaign, Illinois, who spoke last October at the First International Symposium on Exercise Therapy, which took place at the Mayo Clinic in Rochester, Minnesota.

Yang Yang notes that mind-body treatments are considerably more complex than treatment with pharmaceuticals: “The effectiveness of a new drug is typically tested in a trial that is double-blinded, which means that the subjects themselves do not know which treatment they received. In a trial of taiji and other mind-body modalities, the subjects will know which treatment they have received. Gold-standard pharmaceutical trials are also placebo-controlled, meaning that patients receive either drug or a sugar-pill that they can’t distinguish from the drug. Placebo controls are difficult to achieve for trials of mind-body interventions. Unlike a drug, which acts via a single cellular mechanism, mind-body interventions like taiji exert their effects in multiple ways simultaneously.”

He notes recent research by Drs. Peter Wayne and Ted Kaptchuk of Harvard Medical School into the effects of Tai Chi on musculoskeletal strength and flexibility training, deep breathing, mindfulness, visualization and intention, and massage or gentle touch, psychosocial interaction, ritual and spirituality.

“Which are the effective ingredients? Do they work together? Is it possible to create a placebo, or ‘sham’ taiji intervention to assess the efficacy of taiji versus a placebo? Is it necessary? All these questions remain to be answered,” says Yang Yang.

In a recent conversation, Wayne told me “for a variety of reasons, I have found it useful to think of and teach Tai Chi within a framework of active ingredients. My colleagues and I have come to call the ‘8 Active Ingredients’ of Tai Chi. They are: Awareness, Mindfulness, and Focused Attention; Intention, Belief and Expectation; Dynamic and Structural Integration, Form and Function; Moderate Effort and Relax Actively; Natural, Freer Breathing; Psychosocial Support; Alternative Health Paradigm; and Ritual and Repetition of Practice. We use this conceptual framework to evaluate the clinical benefits of Tai Chi, to explore its underlying mechanisms of action, and to shape the way we teach Tai Chi in our trials.”

In practice, each of these active ingredients is interdependent and interwoven with the others. For example, you can not substantially change your breathing without altering your posture, neuromuscular dynamics, inner awareness, intention, and mood. As Wayne says “just as white light shining through a prism leads to a rainbow of colors, the 8 Active Ingredients allow you to appreciate the multiple components that make up the whole of Tai Chi.”