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통증과 고통 중재법을 중심으로 본 불교 수행의 생리적 치유 기제와 의학적 의미

Physiological mechanisms and medical implications of Buddhist practices focused on its mediating effects on pain and suffering

윤희조|신경희
한국동서철학회 (Korean Society For Philosophy East-West)|2021.03|동서철학연구 (Studies in Philosophy East-West)|제99호|pp. 217-244|DOI 10.15841/kspew..99.202103.217

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참고문헌

키워드

pain마음챙김mindfulness통증고통suffering사무량심the four immeasurable minds심신의학mind-body medicine고(苦)duḥkha
주제분류철학

초록

지난 수십 년의 연구를 통해 말초에서 발생한 통증 신호가 뇌로 전달되는 과정과 중추에서의 하향식 통증 조절 기제가 면밀히 규명되고 있으며, 이 통증 신호들이 다양한 심리ㆍ사회적 요인과 행동에 의해 조절될 수 있다는 것이 확인되고 있다. 통증은 통각이라는 생리적 감각에 의해 발생하는 신체적 경험이고 고통은 통증의 주관적 측면이다. 통증 자극을 단지 통각으로만 경험할 것인지, 통증으로 경험할 것인지, 고통으로 경험할지는 그 경험의 주체에게 달려 있다. 통증의 정도는 심리ㆍ사회적 상태에 따라 크게 좌우되므로 통증을 효과적으로 완화하기 위해서는 인지적, 정서적, 사회적 요소들이 통합적으로 고려되어야 한다. 다양한 심리ㆍ사회적 중재와 행동학적 중재가 통증과 고통을 완화시킬 수 있음이 연구를 통해 확인되고 있는데, 이들 중재법에는 불교의 수행 방식이나 붓다의 가르침과 상당한 유사성이 있음이 발견된다. 본 연구에서는 마음챙김이 통증과 고통을 완화하는 생리학 기제, 명상의 이완의학적 기제, 사무량심과 종교 공동체를 통한 사회적 결속의 치유 기제를 심신의학과 정신신경면역학의 원리에 기초하여 검토하고 있다. 후속 연구를 통하여 불교의 수행법과 붓다의 가르침이 현대인의 심신 건강과 삶의 질 향상에 기여할 수 있는 사회ㆍ문화적 자본으로 재발견되고 보건의료시스템 및 사회복지시스템과의 실질적 협력이 모색되기를 기대한다.

Abstract

Several decades of researchers have elucidated the process by which pain signals transmitted from the periphery are sent to the brain and that descending pain control mechanisms can be regulated by psychosocial or behavioral factors. Pain is a physical experience caused by the physiological sense of pain, and suffering is subjective experience. The subject of the experience dictactes whether the pain stimulus will be experienced only through nociception or pain, or pain with suffering. Since the degree of pain also depends greatly on the psychological and social context, the cognitive, emotional, and social factors should be considered in an integrated manner to control pain. It has been confirmed that various psychosocial and behavioral interventions can alleviate pain and suffering. Such interventions are consistent with Buddhist practices and Buddha's teachings. In this study, the physiological mechanism that relieves pain and suffering through mindfulness, meditation as relaxation medicine, healing from the four immeasurable minds and social connection through the religious community are reviewed based on the principles of mind-body medicine and psychoneuroimmunology. Further research is expected in which Buddhist practices and the teachings of Buddha will be newly appreciated as social and cultural capital that can contribute to improving the mental and physical health and quality of life of people, and to seek practical cooperation with the health care system and social welfare system.

참고문헌 (55)

  1. "A8:1 ｢자애경(Mettā-sutta)｣", ~
  2. 고익진, "불교의 체계적 이해" (2015), 광륵사
  3. 신경희, "정신신경면역학 개론 : 통합의학·전인치유의 과학적 기초 몸과 마음의 통합생리학" (2018), 학지사
  4. 대림 스님, "앙굿따라니까야 5" (2007), 초기불전연구원
  5. Benedetti, F., "Placebo effects" (2020), Oxford university press
  6. Feuerstein, G., "요가사전 : 요가와 탄트라에 대한 백과사전" (2018), 여래
  7. Goldstein, Joseph, "Mindfulness : A Practical Guide to Awakening" (2013), Sounds True
  8. Humphrey, N., "The Inner Eye : social intelligence in Evolution" (1986), Oxford University Press
  9. Nietzsche, F., "The Gay science" (1974), vintage
  10. Sargeant, Winthrop, "The Bhagavad Gita" (2009), SUNY Press
  11. Sir M. Monier Williams, "SED = A Sanskrit-English Dictionary" (1988), Oxford University Presss
  12. Spinoza, Baruch, "Ethics" (1992), Hackett Publishing
  13. Anwar-McHenry, J., "Lifestyle medicine: Lifestyle, the environment and preventive medicine in health and disease", pp.263~281 (2017), Academic Press
  14. Beecher, H. K., "Relationship of significance of wound to pain experienced", Journal of the American Medical Association, 161(17), pp.1609~1613 (1956)
  15. Beecher. H. K., "The measurement of pain", Pharmacological reviews, 9(1), pp.59~209 (1957)
  16. Berkman, L. F., "Social networks, host resistance, and mortality : a nine-year follow-up study of Alameda County residents", American journal of Epidemiology, 109(2), pp.186~204 (1979)
  17. Bruehl, S., "The association between anger expression and chronic pain intensity : evidence for partial mediation by endogenous opioid dysfunction", Pain, 106(3), pp.317~324 (2003)
  18. Bultz, B. D., "Emotional distress; the sixth vital sign-future directions in cancer care", Psycho-Oncology, 15, pp.93~95 (2006)
  19. Centers for Disease Control and Prevention, "Vital signs: overdoses of prescription opioid pain relievers and other drugs among women – United States", MMWR Morb Mortal Wkly Rep, 62(26), pp.537~542 (2010)
  20. Damasio, A. R., "Subcortical and cortical brain activity during the feeling of self-generated emotions", Nature neuroscience, 3(10), pp.1049~1056 (2000)
  21. de la Fuente-Fernández R., "Expectation and Dopamine Release : Mechanism of the Placebo Effect in Parkinson’s", Science, 293, pp.1164~1166 (2001)
  22. DeWall, C. N., "Acetaminophen reduces social pain : Behavioral and neural evidence", Psychological Science, 21(7), pp.931~937 (2010)
  23. Deyo, R. A., "Diagnostic evaluation of LBP : reaching a specific diagnosis is often impossible", Archives of internal medicine, 162(13), pp.1444~1447 (2002)
  24. Dezutter, J., "Meaning in life in chronic pain patients over time : associations with pain experience and psychological well-being", Journal of behavioral medicine, 38(2), pp.384~396 (2015)
  25. Eisenberger, N. I., "Why rejection hurts : a common neural alarm system for physical and social pain", Trends in cognitive sciences, 8(7), pp.294~300 (2004)
  26. Fawzy, F. I., "Malignant melanoma : effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later", Archives of General Psychiatry, 50(9), pp.681~689 (1993)
  27. Holt-Lunstad, J., "Social relationships and mortality risk : a meta-analytic review", PLoS medicine, 7(7), pp.e1000316~ (2010)
  28. Hutchison, W. D., "Pain-related neurons in the human cingulate cortex", Nature neuroscience, 2(5), pp.403~405 (1999)
  29. Janssen, S. A., "Negative affect and sensitization to pain", Scandinavian journal of psychology, 43(2), pp.131~137 (2002)
  30. Kennell, J., "Continuous emotional support during labor in US hospital : A randomized control trial", Journal of the American Medical Association, 265, pp.2197~2201 (1991)
  31. Koyama, T., "The subjective experience of pain : where expectations become reality", Proceedings of the National Academy of Sciences, 102(36), pp.12950~12955 (2005)
  32. Krueger, C., "Ask the Expert : Do NSAIDs Cause More Deaths Than Opioids?", Practical Pain Management, 13(10) (2013)
  33. Kulik, J. A., "Social support and recovery from surgery", Health Psychology, 8, pp.221~238 (1989)
  34. Levine, J. D., "Influence of the method of drug administration on analgesic response", Nature, 312(5996), pp.755~756 (1984)
  35. Levine, J. D., "Analgesic responses to morphine and placebo in individuals with postoperative pain", Pain, 10(3), pp.379~389 (1981)
  36. Lieberman, M. D., "Putting feelings into words", Psychological science, 18(5), pp.421~428 (2007)
  37. Loeser, J. D., "Pain and suffering", The Clinical journal of pain, 16(2), pp.S2~S6 (2000)
  38. Longe, S. E., "Counter-stimulatory effects on pain perception and processing are significantly altered by attention : an fMRI study", Neuroreport, 12(9), pp.2021~2025 (2001)
  39. Melzack, R., "Pain Mechanisms : A New Theory", Science, 150(3699), pp.971~979 (1965)
  40. Merboth, M. K., "Managing pain : the fifth vital sign", The Nursing Clinics of North America, 35(2), pp.375~383 (2000)
  41. Merskey, H., "Classification of chronic pain : Descriptions of chronic pain syndromes and definitions of pain terms", Pain, Suppl, 3, pp.226~ (1986)
  42. Øvrum, A., "Inequality in health versus inequality in lifestyle choices", Nordic Journal of Health Economics, 3(1), pp.18~33 (2015)
  43. Pennebaker, J. W., "Disclosure of traumas and immune function : Health implications for psychotherapy", Journal of Consulting and Clinical Psychology, 56, pp.239~245 (1988)
  44. Petrovic, P., "Imaging cognitive modulation of pain processing", Pain, 95, pp.1~5 (2002)
  45. Price, D. D., "A comprehensive review of the placebo effect : recent advances and current thought", Annu Rev Psychol, 59, pp.565~590 (2008)
  46. Raij, T. T., "Brain correlates of subjective reality of physically and psychologically induced pain", Proceedings of the National Academy of Sciences USA, 102(6), pp.2147~2151 (2005)
  47. Rainville, P., "Psychological methods of pain control: basic science and clinical perspectives", pp.117~141 (2004), IASP Press
  48. Rilling, J. K., "A neural basis for social cooperation", Neuron, 35(200), pp.395~405 (2002)
  49. Sprecher, S., "Enhancement of mood and self-esteem as a result of giving and receiving compassionate love", Current Research in Social Psychology, 11(16), pp.227~242 (2006)
  50. Strong, C. A., "The psychology of pain", Psychological Review, 2(4), pp.329~347 (1895)
  51. Tracey, I., "The cerebral signature for pain perception and its modulation", Neuron, 55(3), pp.377~391 (2007)
  52. Wade, J. B., "A canonical correlation analysis of the influence of neuroticism and extraversion on chronic pain, suffering, and pain behavior", Pain, 51(1), pp.67~73 (1992)
  53. Wiech, K., "The influence of negative emotions on pain : behavioral effects and neural mechanisms", Neuroimage, 47(3), pp.987~994 (2009)
  54. Willer, J. C., "Electrophysiological evidence for a release of endogenous opiates in stress-induced ‘analgesia’ in man", Brain research, 198(2), pp.419~426 (1980)
  55. Zaza, C., "Cancer pain and psychosocial factors : A critical review of the literature", Journal of Pain and Symptom Management, 24, pp.526~542 (2002)

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