You Can Heal
Yourself With Your Mind (For Real)
From
multiple sclerosis to chronic pain to HIV, science is increasingly showing us
that what’s in a patient’s head affects how the body heals.
I met Tunde Balogh at the Catholic
pilgrimage site of Lourdes, France. The 37-year-old, originally from Hungary,
had been diagnosed with breast cancer a year earlier but refused conventional
treatment.
“They’d cut off my breast, I
didn’t want to do that,” she told me. Instead, she felt the answer was inside
her. She tried reiki, reflexology, and eventually German
New Medicine, which teaches that cancer is caused by emotional
conflict. But none of it worked; the cancer soon spread to her bones. By the
time she made it to Lourdes, her only hope was a miracle cure.
Let’s be clear: Claims that the
mind can heal aren’t harmless. When made in the absence of evidence they raise
false hope, and if people reject conventional treatment they need, they can
die. That includes cancer patients, but less
dramatic cases risk lives, too. Homeopaths regularly caution parents not to vaccinate their children against
potentially fatal childhood infections, for example, and advise travelers
against conventional drugs toprotect against malaria.
Perhaps it’s not surprising, then,
that skeptics react to any suggestion of healing thoughts as an evil threat to
be stamped out, branding everything from placebo research to integrative medicine as
“quackery.” But when researching my book, Cure: A Journey Into the Science of
Mind Over Body, I came to the conclusion that this position
isn’t supported by the science either. Although the mind isn’t a miracle
cure—we will always need physical drugs and treatments—there is now
overwhelming evidence that it drives biological changes that are crucial for
physical health, influencing everything from pain to the immune system.
Our mental state has particularly
dramatic effects when it comes to the symptoms we experience: things like pain,
nausea, fatigue and depression. Playing a virtual-reality game eases pain in
burn patients by as much as 50 percent (PDF) more than drugs alone,
while research on placebos—fake treatments—tells us that psychological factors
such as expectation and social interaction ease symptoms via biological changes
very similar to those caused by drugs. Placebo painkillers trigger the release of
natural pain-relieving chemicals called endorphins. Parkinson’s patients respond to placebos
with a flood of needed dopamine. Breathing fake oxygen can reduce the levels of
neurotransmitters called prostaglandins, which cause many of the symptoms of altitude sickness.
It might sound crazy that thoughts
and expectations should have similar effects to drugs, but underlying many
placebo responses is the simple principle that the symptoms we feel aren’t a
direct, inevitable consequence of physical damage to the body. Such damage is
important, of course, but ultimately our experience of it is created and
controlled by the brain. If we feel stressed and alone, warning signals such as
pain, fatigue, and nausea are amplified. If we feel safe and cared for (whether
that means being surrounded by friends or receiving what we believe to be an
effective medical treatment), our symptoms are eased.
This means that for many medical
conditions, pouring ever more resources into physical drugs and interventions,
while squeezing appointment times and cutting medical staff, may be counterproductive.
One trial found that patients with irritable bowel syndrome (IBS) had much greater relief from
their symptoms if the practitioner was warm and empathic rather then cold but
polite—regardless of the treatment they received. Similarly, patients with acid
reflux disease did dramatically better after
an extended (42-minute) consultation with a physician, compared with a standard
(18-minute) visit. In situations from back pain (PDF) to childbirth, patient
outcomes depend not just on what drugs are prescribed but on how that care is
delivered.
But this isn’t all. Because the
brain controls physiological functions from digestion to the immune system, the
mind doesn’t simply determine our subjective experience; it can be relevant for
the physical progression of disease, too. These processes aren’t generally
under voluntary control; we can’t “wish” ourselves better. But we can influence
them, particularly by modulating our response to stress.
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When you’re anxious your heart
beats faster, for example, putting a greater strain on your cardiovascular
system. This isn’t usually a problem, but in some circumstances it can be
dangerous or even fatal. Natural disasters such as earthquakes sometimes kill as many people from
heart attacks as from falling rubble. Trials show that during
invasive medical procedures such as breast biopsies or destruction of tumors,
people who feel negative or anxious beforehand suffer more complications (things
like prolonged lack of oxygen, low or high blood pressure, post-operative
bleeding or an abnormally slow heart rate). Relaxation techniques such as
visualizing a safe place vastly reduce pain and anxietyduring
these procedures—as well as the rate of adverse events.
Feeling stressed can also have
physical consequences on the gut. If we’re unhappy with toilet arrangements we
might not go for days, whereas facing a challenge such as an exam or
competition can cause us to empty our bowels. These processes exacerbate
conditions such as IBS, and trials show that gut-focused hypnotherapy,
which teaches patients to tackle stress and calm their digestive system—is a
highly effective treatment. A course of such hypnotherapy reduces the sensitivity of the gut to
pain, and while hypnotized, patients can alter their rate of gut contractions,
something that we can’t normally do at will.
Third, stress triggers a branch of
the immune system called inflammation: the body’s first line of defense against
infection or injury. This is useful in an emergency but if triggered long-term
by chronic stress, it disrupts healthy immune responses and eats away at the
body’s tissues, making us more susceptible to infections, allergies, and
auto-immune disease. And that doesn’t just mean eczema flareups or a few extra
colds. Through its effects on the immune system, stress has also been shown to
accelerate the progression of life-threatening conditions such as multiple sclerosis and HIV. Research
into whether interventions that reduce stress can reverse these changes is only
just beginning, but there’s some preliminary evidence that stress-management
therapy can stall progression in MS,
and that mindfulness meditation may slow HIV.
There’s even evidence that the
mind plays a role in cancer. Inflammation clears damaged cells and promotes the
growth of new blood vessels, which is useful for wound healing but also gives
tumors the space and food supply they need to grow. In animal studies, stress
hormones make a range of cancers spread faster, while
patient trials suggest that stress-management interventions reduce
inflammation, although the jury is still out on whether this feeds
through into improved survival times.
Even if reducing stress doesn’t
directly affect survival in cancer, however, there are other ways in which
psychological approaches can improve physical prognosis. If easing the fatigue
and nausea caused by chemotherapy helps someone stick to their treatment
regime, it can improve survival. Meanwhile, social support helps patients to
make better decisions. In one study, terminal cancer patients offered early
palliative care chose to receive less aggressive treatment. They
were less depressed, had a better quality of life—and they lived longer.
The mind can’t heal everything,
and to reject physical treatments for life-threatening conditions is dangerous
and misguided. But it’s clear that our mental state does have wide-ranging
physiological effects that can affect health in many different ways, and which
are relevant even to the most serious conditions such as cancer, multiple
sclerosis, and HIV.
Skeptics are right to warn of
exaggerated claims in mind-body medicine. But denying the role of the mind has
its own risks. It pushes people—particularly those with direct experience of
how it can help—away from science and toward the crackpot explanations of
alternative therapists. And it blinds us to insights that could be hugely
important for medicine. In Cure, I argue that we need to combine
both approaches: to care for patients’ bodies and their minds.
Jo Marchant
author of Cure: A Journey into the Science of Mind over Body
