From multiple sclerosis to chronic pain to HIV, science is increasingly showing us how a patient's mind affects the way the body heals.
I met Tunde Balogh at the Catholic pilgrimage site in Lourdes, France. The 37-year-old woman, originally from Hungary, had been diagnosed with breast cancer a year earlier, but refused conventional treatment.
"They had cut my chest, I didn't want to do that," he told me. Instead, she felt the answer was inside her. He tried reiki, reflexology, and finally the new German medicine, which teaches that cancer is caused by emotional conflict. But none of that worked; The cancer soon spread to his bones. When he arrived in Lourdes, his only hope was a miracle cure.
Let's be clear: claims that the mind can heal are not harmless. When done in the absence of evidence, they create false hope, and if people reject the conventional treatment they need, they can die. That includes cancer patients, but less dramatic cases also risk lives. Homeopaths regularly warn parents not to vaccinate their children against potentially fatal childhood infections, for example, and advise travelers against conventional medications to protect themselves against malaria.
Perhaps not surprisingly, then, skeptics react to any suggestion of thought healing as an evil threat that must be eliminated, marking 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 is also not supported by science. Although the mind is not a miracle cure, we will always need drugs and physical 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 relieves pain in burn patients by up to 50 percent (PDF) more than drugs alone, while research on placebos (sham treatments) tells us that psychological factors such as expectation and interaction social alleviate symptoms through biological changes. similar to those caused by drugs. Placebo pain relievers trigger the release of natural pain relieving chemicals called endorphins. Parkinson's patients respond to placebos with a necessary rush of dopamine. Breathing fake oxygen can lower levels of neurotransmitters called prostaglandins, which cause many of the symptoms of altitude sickness.
It may sound crazy that thoughts and expectations have drug-like effects, but underlying many placebo responses is the simple principle that the symptoms we feel are not a direct and inevitable consequence of physical damage to the body. Such damage is important, of course, but ultimately our experience is created and controlled by the brain. If we feel stressed and alone, warning signs like pain, fatigue and nausea are amplified. If we feel safe and cared for (whether that means being around friends or receiving what we believe to be effective medical treatment), our symptoms ease.
This means that for many medical conditions, investing more and more resources in medications and physical interventions, while reducing appointment times and reducing medical staff, can 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 empathetic rather than cold but courteous, regardless of the treatment they received. Similarly, patients with acid reflux disease improved dramatically after a long consultation (42 minutes) with a doctor, compared to a standard visit (18 minutes). In situations ranging from back pain (PDF) to delivery, patient outcomes depend not only on what medications are prescribed but on how that care is delivered.
But this is not all
Because the brain controls physiological functions from digestion to the immune system, the mind not only determines our subjective experience; It can also be relevant to the physical progression of the disease. These processes are generally not under voluntary control; We cannot "wish" ourselves better. But we can influence them, particularly by modulating our response to stress.
When you're anxious, your heart beats faster, for example, putting more pressure on your cardiovascular system. This is not usually a problem, but in some circumstances it can be dangerous or even fatal. Natural disasters like earthquakes sometimes kill as many people from heart attacks as they do from falling debris. Trials show that during invasive medical procedures, such as breast biopsies or tumor destruction, people who feel negative or anxious beforehand experience more complications (things like prolonged oxygen deprivation, high or low blood pressure, postoperative bleeding or an abnormally slow heart rate)) Relaxation techniques, such as visualizing a safe place, greatly reduce pain and anxiety during these procedures, as well as the rate of adverse events.
Feeling stressed can also have physical consequences on the gut. If we are unhappy with the bathroom arrangements, we may not go for days, while facing a challenge like an exam or competition can make us empty our bowels. These processes exacerbate conditions such as IBS, and trials show that gut-focused hypnotherapy, which teaches patients to combat stress and calm their digestive system, is a highly effective treatment. A course of this type of hypnotherapy reduces the sensitivity of the intestine to pain, and while hypnotized, patients can alter their rate of intestinal contractions, something that we normally cannot 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 helpful in an emergency, but if triggered long-term by chronic stress, it disrupts healthy immune responses and corrodes body tissues, making us more susceptible to infections, allergies, and autoimmune diseases. And that doesn't just mean eczema flare-ups 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 on whether stress-reducing interventions can reverse these changes is just beginning, but there is some preliminary evidence that stress management therapy can halt the progression of MS and that mindfulness meditation can slow HIV.
The mind and cancer
There is even evidence that the mind plays a role in cancer. Inflammation cleanses 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 cause a variety of cancers to spread faster, while patient trials suggest that stress management interventions reduce inflammation, although the jury does not yet know if this contributes to improvement survival times.