The History of Self-Regulation: Early Western Medical Interest

By Sat Bir Singh Khalsa, Ph.D.

The ability to self-regulate internal states, either physical, mental, or emotional, is a fundamental construct underlying not only the field of mind-body medicine (which includes yoga), but also much of what is in the broader field of behavioral medicine. The practices in this realm include cognitive and meditation skills, relaxation techniques, and the contemplative mind-body practices of yoga, tai chi, and qi gong. Through these practices, one acquires the skills of regulating functions including physical movement, respiratory activity, cardiovascular functions, and cognitive and emotional activity and reactivity. Research studies have confirmed that yoga practice can lead to significant improvements in muscular tension, neuro-muscular activity and coordination, basal respiratory rate, blood pressure, heart rate, cognitive performance, meta-cognition, and management of mental stress and reactivity of emotion.

The control of some of these functions is mediated through the direct command of the central nervous system including the ability to consciously relax muscles and change respiration rate – this is somewhat self-evident. What has been of more interest scientifically, with respect to self-regulation, is the ability to exert control over processes believed to be automatically regulated, such as the autonomic nervous system, which can affect changes in the activity of internal organs and functions including heart activity, blood pressure, and metabolic rate. This is because historically, and even currently, in the field of medicine these activities have been believed to be out of the control of conscious will. One of the most well-known measures of this self-regulation of autonomic function is heart rate. Historically, what is of particular interest, are the early descriptions of instances/cases in the West that have suggested the feasibility of this kind of self-regulation.

William James was a very notable philosopher, psychologist, medical doctor, and Harvard faculty in the late 19th century. In fact, the Department of Psychology on the Harvard University campus now bears his name, William James Hall. He was a pioneer in the field of psychology who gained widespread recognition from his seminal 1890 textbook The Principles of Psychology, a tome of 1,200 pages taking 12 years to complete. He also had the opportunity to interact personally with yoga master and proponent Swami Vivekananda during his visits to Boston in the late 1800’s. This influenced his work in research on contemplative states and practices, and meditation specifically, culminating in his landmark 1902 book The Varieties of Religious Experience. He was one of the early academics to recognize and describe the mind-body interaction and the capacity for self-regulation. In his 1890 text he wrote a clear statement of the mind-body connection: “Mental states occasion also changes in the calibre of blood-vessels, or alteration in the heart-beats, or processes more subtle still, in glands and viscera. …it will be safe to lay down the general law that no mental modification ever occurs which is not accompanied or followed by a bodily change.” He then cites cases of “exceptional individuals” reporting direct effects on the heart rate at will –a famous medical anecdote of a Colonel Townsend who could stop his heart at will and a 1889 report on voluntary control of the heart by a Dr. S.A. Pease.

The case of Colonel Townsend can be traced back to its first description by George Cheyne M.D. in his 1733 book A Treatise of Diseases of all Kinds. He recounts being called to examine Townsend with two medical colleagues near the end of his life, as he was on his death bed suffering from a terminal disease. It was Townsend’s wish to convey to them an experience/phenomenon in which “…composing himself, he could die or expire when he pleased, and yet by an effort or somehow, he could come to life again.” Despite cautions by the doctors not to do a demonstration given his condition, the Colonel insisted, and Cheyne describes the event of that morning.

They then began to conclude that he had gone too far and had actually died. Surprisingly, after a half-hour he showed signs of life.

Townsend died the next evening, leaving an intriguing anecdote about his possibility of controlling his heart.

The 1889 5-page report by Pease in the Boston Medical and Surgical Journal, the first U.S. medical journal and precursor to the New England Journal of Medicine, was entitled “Voluntary Control of the Heart”. In this paper he contended that “… we have now evidence that there are gifted individuals who have a certain amount of direct control over it” and noting that previously “physiologists have long been aware of the close relationship between the heart’s action and that of the brain; yet, for lack of sufficient evidence, have not granted that any direct control over the heart could be induced by a simple effort of the will”. He then recounts several anecdotes/cases of simple willful direct control of heart rate (including the Townsend report) distinguishing these from anecdotes describing an indirect effect on the heart rate due to physical/mechanical manipulation of the vagus nerve (such as physical pressure on the neck) or forced evocation of mental imagery or emotion (such as sadness). One of the cases he mentions describes the research by a Russian physician on an individual who was able to increase his heart rate, through direct willful control, by up to 35 beats per minute. Dr. Pease then presented a detailed analysis of heart, breath, and blood pressure recordings of an individual at Harvard Medical School who was also capable of increasing his heart rate, in this case by about 25 beats per minute. From his analysis, he concluded that this change was indeed through simple willful control or pure self-regulation of heart rate.

These articles and reports on control of heart rate occurring so early in the field of Western medicine indicate the early openness to the possibility and concept of the self-regulation of internal state. Once reports appeared in the West from India on advanced yogis who claimed the ability to self-regulate internal states, it was not so surprising that scientists began studies on these yogis. Ultimately, those studies provided a foundation for further research, the evolution of the field of biofeedback, and ultimately to our work in modern yoga research, which has expanded to studying the self-regulatory capabilities of yoga practices to change many internal psychophysiological functions. Most of these were believed to be out of the range of self-regulation, and most of modern medicine is still under that impression.

Sat Bir Singh Khalsa, Ph.D. is the KRI Director of Research, Research Director for the Kripalu Center for Yoga & Health, and Assistant Professor of Medicine at Harvard Medical School. He has practiced a Kundalini Yoga lifestyle since 1973 and is a KRI certified Kundalini Yoga instructor. He has conducted research on yoga for insomnia, stress, anxiety disorders, and yoga in public schools. He is editor in chief of the International Journal of Yoga Therapy and The Principles and Practice of Yoga in Health Care and author of the Harvard Medical School ebook Your Brain on Yoga.