Faith & Healing
Faith & Healing
Can religion improve health? While the debate rages in journals and medical schools, more patients ask for doctors' prayers
By Claudia Kalb
Newsweek, November 17, 2003
On a quiet saturday afternoon, Ming He, a fourth-year medical student in Dallas, came across a man dying in the VA Hospital. Suffering from a rare cancer and hooked up to an oxygen tank, the man, an Orthodox Jew, could barely breathe, let alone speak. There were no friends or relatives by his bed to comfort him. When the young student walked into his room, the man looked at her and said, “Now that I’m dying, I realize that I never really learned how to live.” Ming He, 26, had no idea how to respond.
I thought, ‘My God, the chaplain doesn’t work on weekends, what do I do?’ ” She held the man’s hand for a few minutes in silence; two days later, he died. And as soon as she could, she signed up for “Spirituality and Medicine” at the University of Texas Southwestern Medical School, a course that teaches students how to talk to patients about faith and illness.
Many med schools around the world now offer such courses, largely because patients are demanding more spiritual care. According to a newsweek Poll, 72 percent of Americans say they would welcome a conversation with their physician about faith; the same number say they believe that praying to God can cure someone—even if science says the person doesn’t stand a chance. On Beliefnet, a popular interfaith Web site, fully three quarters of more than 35,000 online prayer circles are health related: patients’ loved ones—as well as total strangers—can log on and send prayers into the electronic ether. Popular practices like these, as well as the growing belief in the medical community that what happens in a person’s mind can be as important to health as what happens on the cellular level, are leading many doctors to embrace the God they banished from the clinic long ago.
All over the medical establishment, legitimate scientists are seeking the most ethical, effective ways to combine patients’—and their own—spiritual beliefs with high-tech treatment. Former mutual-fund tycoon Sir John Templeton spends as much as $30 million a year funding scientific projects that explore the nature of God. “The Anatomy of Hope,” a meditation on the effects of optimism and faith on health, by The New Yorker magazine’s medical writer Jerome Groopman, M.D., is coming out early next year. The U.S. National Institutes of Health plans to spend $3.5 million over the next several years on “mind/body” medicine. “There’s been a tremendous shift in the medical profession’s openness to this topic,” says Dr. Andrew Newberg, a neurologist at the University of Pennsylvania who is studying the biological effects of meditation and prayer on the brain. “People like me are very intrigued by what we’re seeing.”
Modern medicine, of course, still demands scientific proof on top of anecdotal evidence. So over the past decade, researchers have been conducting hundreds of studies, trying to scientifically measure the effects of faith and spirituality on health. Can religion slow cancer? Reduce depression? Speed recovery from surgery? Can belief in God delay death? While the research results have been mixed (chart), the studies inevitably run up against the difficulty of using scientific methods to answer what are, essentially, existential questions. How do you measure the power of prayer? Can you separate the health benefits of going to church or synagogue from the fact that people who attend religious services tend to smoke less and be less depressed than those who don’t?
For critics of this trend, that’s precisely the problem. In 1999, crusading Columbia University Prof. Richard Sloan wrote a paper in the medical journal The Lancet attacking the faith and healing studies for weak methodologies and soft thinking. Along with a second paper published a year later in The New England Journal of Medicine, the broadside ignited furious letter-writing campaigns in the academic press and divided the medical profession into two camps. Some scientists, like Sloan, believe that religion has no place in medicine and that steering patients toward spiritual practice can do more harm than good. Others, like Duke University’s pioneering faith-and-medicine researcher Dr. Harold Koenig, believe that a growing body of evidence points to religion’s positive effects on health and that keeping spirituality out of the clinic is irresponsible.
To make sense of the morass of data, the NIH commissioned a series of papers, published earlier this year, in which scientists attempted to definitively assess the state of the faith-and-health research. Lynda H. Powell, an epidemiologist at Rush University Medical Center in Chicago, reviewed about 150 papers, throwing out dozens that had flaws. In one respect, her findings were not surprising: while faith provides comfort in times of illness, it does not significantly slow cancer growth or improve recovery from acute illness. One nugget, however, “blew my socks off,” Powell says. People who regularly attend church have a 25 percent reduction in mortality—that is, they live longer—than people who don’t. “This is really powerful,” she says.
In an effort to understand the health differences between believers and nonbelievers, scientists are beginning to parse the individual components that compose religious experience. Using brain scans, researchers have discovered that meditation can change brain activity and improve immune response; other studies have shown it can lower heart rate and blood pressure, both of which reduce the body’s stress response. Dr. Kailash Nath Kanwar, former head of research and development for the Indian arm of a U.S. pharmaceutical company, was deeply skeptical of the power of meditation before his wife persuaded him to visit a swami outside Bangalore. Racked with back pain, Kanwar spent nearly a month at an ashram with the guru Sai Baba, meditating and following a strict vegetarian diet. When he returned to New Delhi, his back pain disappeared. Now he’s a true believer, and has since visited Sai Baba twice more. “We know very little about spirituality,” says Kanwar, 79. “It’s beyond explanation but it’s very potent.”
Using prayer to affect health is perhaps the most controversial subject of research. In the newsweek Poll, 84 percent of Americans said praying for others can have a positive effect on their recovery, and 74 percent said that would be true even if they didn’t know the patient. But what does the science say? At a meeting of the American College of Cardiology last month, Duke researcher Dr. Mitchell Krucoff reported preliminary data on a national trial of 750 patients undergoing heart catheterization or angioplasty. A group of patients who were prayed for (by, among others, Roman Catholics and Sufi Muslims in the United States, Buddhist monks in Nepal and Jews at the Western Wall) did no better than a second group that received standard care or a third, which was given a special program of music, therapeutic touch and guided imagery. But a fourth “turbocharged” group, which received both prayers and the music program, had death rates 30 percent lower than any of the other patients. “Despite all the attention modern medicine has paid to new technology, it has neglected to ask what happens if you pay attention to the rest of the patient,” says Krucoff.
Overall, the prayer studies have not shown clear effects, and even religious proponents are skeptical that it can ever—or should ever—be tested. So many people already pray for the sick that scientists cannot establish a control group. And the studies prompt questions that no one will ever be able to answer: Can one extra prayer mean the difference between life and death? Can prayer be dosed, the way medicines are? Does harder praying mean better treatment by God? In the minds of many, especially theologians, those questions border on the sacrilegious.
Still, prayer can be an enormous source of comfort to patients and their families. After suffering repeated heart attacks, Elizabeth Nascimento Silva was fighting for her life in the intensive care unit of a Rio de Janeiro hospital. Doctors had informed her family there was little they could do. But Silva, a devout Protestant evangelical, found strength by contemplating the scruffy hill outside her window. “I always thought of Psalm 121,” she says: ” ‘I will lift up mine eyes unto the hills, from whence cometh my help.’ ” Two months later she was released from the hospital; before long she was singing in the church choir again. “When you have faith, hope follows,” she says. “If I hadn’t had faith, I’d probably be bedridden or dead by now.” Some patients are convinced that their faith has actually healed them. Patrick Theillier, head of the Lourdes Medical Office in France, is charged with documenting the accounts of pilgrims who claim they have been cured at the holy site. “As a doctor, I cannot claim, ‘This cure is miraculous,’ ” says Theillier. ”[But] as a practicing Catholic, I can recognize that it is miraculous.”
Some experts worry, however, that faith can sometimes interfere with a patient’s journey through illness. Dr. Suki Tepperberg, a family physician in Dorchester, Mass., has concerns about those who put too much faith in God’s will. One of her patients, a Jehovah’s Witness who has diabetes and hypertension, believes her illness is in God’s hands and she sometimes eats destructively, harming her health. In her review of the literature, Powell found several studies suggesting that praying with a sick person can sometimes impede recovery; one study concluded that the risk of a bad health outcome doubled, perhaps because patients believed God would protect them or that their illness was some kind of divine punishment.
Interpreting disease as retribution for sin has its roots in the Bible—Miriam and King Uzziah were struck with leprosy after offending their God—and it continues to haunt many patients today. Kenneth Pargament, a psychology professor at Bowling Green State University in Ohio, studied the religious coping methods of almost 600 patients with diseases ranging from gastrointestinal disorders to cancer. Those who thought God was punishing or abandoning them were up to 30 percent more likely to die over the next two years. “Spiritual struggles are red flags and need to be taken seriously,” says Pargament. “We don’t want to turn the medical profession into clergy and chaplains, but to treat these struggles as divorced from the patient’s medical problems is shortsighted.”
Koenig, director of Duke’s Center for the Study of Religion/Spirituality and Health, is leading the charge for a better understanding of patients’ religious and spiritual beliefs in the medical setting. “It just makes too much sense,” he says, when patient after patient tells him, “Doctor, religion is the most important thing; it keeps me going.” Koenig advocates that doctors take spiritual histories of any patient they are likely to have an ongoing relationship with, asking questions like: “Is religion a source of comfort or stress? Do you have any religious beliefs that would influence decision making?”
Not asking can have devastating consequences, says Dr. Susan Stangl, a family-medicine doctor at UCLA. Stangl recalls a Muslim patient who needed medication, but was observing Ramadan and couldn’t drink or eat during the day. After taking a spiritual history Stangl chose a once-a-day medication that could be taken after sundown. “If we hadn’t talked about it, I would have written him a prescription for four times a day and he would not have taken it,” she says.
Today, more and more medical schools are offering specific courses in spirituality or incorporating the theme into the curriculum. Twenty years ago, recalls Marie-Pierre Girard, French medical schools didn’t offer any classes in humanities. “They now take into account the whole of the human being and offer a more humble take on what we as doctors can do,” says Girard, who practices in a prison southwest of Paris.
Columbia’s Sloan agrees that patients want to be treated “as people and not lumps of tissue.” But he is concerned about religion creeping into the physician’s domain. Problems range from simple logistical issues, he says—physicians barely have enough time to ask how patients are feeling, let alone inquire about their faith—to ethical blunders. Doctors should feel free to refer patients to hospital chaplains, but that’s as far as the religious conversation should go. “Nobody disputes that in times of difficulty, religion provides comfort for an enormous number of people,” says Sloan. “The question is whether medicine can add to that. My answer is no.”
Few would disagree that doctors have to tread carefully. Dr. Jim Martin, head of the American Academy of Family Physicians, teaches residents to take spiritual histories, but “if a patient flinches, we don’t go there.” And if a patient says faith or spiritual beliefs are not important, “we check that box and move on.”
Even advocates of prayer in the clinic are concerned about practitioners like Dr. Darrell Hermann. A pediatric surgeon at Baylor, Hermann says he felt compelled to raise prayer with Tiffany Webb and Jeff Fendley, a young couple whose baby was born with dangerous abdominal-wall defect, even though he had no idea if they were religious. “I heard them make a comment that they wished she’d get better and I said, ‘You could take this a step further. You could pray’.” Fendley says he was pleased to make a religious connection with his baby’s doctor and that it helped him cope with the severity of her condition. But other patients might have seen it as an unacceptable intrusion. And so debate rages on, from the ivory tower to the bedside of a very sick child.
With Anne Underwood, Ellise Pierce, Joan Raymond, Jenny Hontz, Karen Springen, Ian MacKinnon, Marie Valla, Mac Margolis, Liat Radcliffe and Sarah Childress
Read entire article at the original source
Thursday, February 24, 2005
Using the Mind to Heal the Body
Using the Mind to Heal the Body
Using the Mind to Heal the Body
NEWSWEEK's Geoffrey Cowley joined us to discuss new views of the mind-body connection in a Live Talk on Wednesday, Sept. 22, 2004 at noon ET.
WEB EXCLUSIVE
Newsweek
That thoughts and feelings can affect our health is hardly news. But the relationship between emotion and physical well-being is turning out to be more significant than most of us could have imagined. Viewed through the lens of 21st-century science, anxiety, alienation and hopelessness are not just feelings. Neither are love, serenity and optimism. All are physiological states that may affect our health just as clearly as obesity or physical fitness. And the brain, as the source of such states, offers a potential gateway to countless other tissues and organs--from the heart and blood vessels to the digestive tract and the immune system. The challenge is to map the pathways linking mental conditions to medical ones, and learn how to travel them at will. Placebos are just the beginning. Mounting evidence suggests that any number of soothing emotional experiences can improve our physical health. Using our minds, can we teach ourselves to be healthier? NEWSWEEK's Geoffrey Cowley, the senior editor behind this week's Health for Life cover package, discussed new views of the mind-body connection in a Live Talk on Wednesday, Sept. 22, at noon ET. Read the transcript below.
Geoffrey Cowley has led NEWSWEEK's medical coverage since 1990, working both as a writer and an editor to produce groundbreaking articles on topics ranging from brain science to global health. In news stories, cover articles and special reports, Cowley has chronicled countless trends in medicine and public health, from the advent of Prozac and the sequencing of the genome to the failures of profit-driven health care and the boom in complementary and alternative medicine. He was among the first American journalists to recognize the promise of evolutionary psychology, the significance of chronic fatigue syndrome and the hazards of the sleep medication Halcion. By reporting in 1992 that the drug's approval was based on tainted data, he triggered an FDA inquiry that lasted several years and brought changes in the agency's drug-approval process. In recent years, Cowley's work has helped NEWSWEEK win several nominations for the National Magazine Award, the most prestigious prize in U.S. magazine journalism. His contributions include a 2002 special report on integrative medicine, a 1998 cover story on the science of memory and 1997 cover stories on heart disease and childhood asthma. Cowley joined NEWSWEEK as a general editor in March 1988. He was promoted to senior writer in August 1988 and to senior editor in August 1997. He came to NEWSWEEK from The Sciences, where he had been a senior editor since 1985.
Geoffrey Cowley: Hi, Thanks for logging on. This is Geoff Cowley, ready to talk about the new science of mind-body medicine.
_______________________
Silver Spring, MD: Can we regenerate our cells using our minds?
Geoffrey Cowley: I don't think we can will our cells to do anything supernatural. But to the extent that our cells are capable of repairing or regenerating themselves, I suspect we can improve their odds of success.
Researchers discovered back in the 1970s that the immune system could be taught to suppress itself in response to a stimulus. The researchers gave mice saccharine along with an anticancer drug that suppresses immune function. Once the animals' bodies associated the saccharine with the drug, the researchers tried administering saccharine without any medication. The saccharine still drove down their immune function.
If our expectations can suppress our immune cells, then states of mind should be able to boost them as well. Researchers at the University of Miami have shown that stress-management training can quell immune-suppressing stress hormones in HIV-positive men. And at UCLA, scientists have found that HIV-positive men with optimistic outlooks have more robust immune responses. None of this is to say that you can mental states can overcome HIV. It's still a progressive illness that, left untreated, is fatal. But these studies, and others like them, suggest that states of mind may affect the rate of progression.
_______________________
Houston, TX: Is it possible to lower one's blood pressure without medication?
Geoffrey Cowley: Definitely. Exercise and nutrition can have a big impact on blood pressure. Relaxation techniques can help too. But if you suffer from hypertension, don't leave it untreated in the hope that you can think yourself healthy. Talk to your doctor about how best to combine medication, lifestyle and stress reduction to keep yourself safe.
_______________________
San Francisco, CA: Why is this such a suprise to people, especially since the Chinese have known about this for 2000 years?
Geoffrey Cowley: I think that what we're seeing right now is not just a return to ancient ways but a synthesis and integration of ancient wisdom with modern science.
Most pre-scientific people share a sense that states of mind are connected to states of health. With the discovery of germs and the advancement of medical science in 19th and 20th centires, Western physicians lost sight of the connection.
It's now clear that neither perspective is complete without the other. It's exciting to me to see the two traditions being integrated into a larger, more humane vision of health that has room both for meditation and for life-saving high-tech procedures.
_______________________
Uniontown, PA: Is it possible that the mind body connection works the other way as well: that people who believe they are sick or will get sick can make themselves measurably phyically ill?
Geoffrey Cowley: I don't think there's any question about it. Many of the stories in this week's issue describe how mental states can harm the body as well as heal it.
The placebo effect can prompt amazing recoveries in people who expect to get better, but studies have shown that it can also cause real illness in people who expect to get sick. In one experiment, researchers rubbed a harmless substance on the arms of people allergic to lacquer leaves. When told that the harmless substance was a lacquer leaf, many developed severe rashes.
_______________________
Gilbert, AZ: Can stress make you infertile?
Geoffrey Cowley: Be sure to read the article by Dr. Alice Domar of Harvard in this week's issue ("A New Fertility Factor"). "No one has proved that feelings of distress actually cause infertility," Domar writes, "but there are good reasons to think so. Women with a history of depression are twice as likely to suffer from the problem, and research has shown that distressed women are less responsive to treatment."
_______________________
American Fork, UT: Do those who are less stressed have lower rates of cancer, heart disease and other serious illnesses?
Geoffrey Cowley: What the studies show is that people who are /more/ stressed -- because of depression or anger or social isolation -- are at higher risk of those conditions. But it stands to reason that better stress control should help protect against those diseases.
In Dr. Dean Ornish's program for reversing heart disease, patients use relaxation and group support as well diet and exercise, and they achieve remarkable results. No one knows how large a role the mental and emotional exercises play, but Ornish considers it indispensable.
_______________________
Springdale, UT: I have been told by a colleage that she believes the study of the brain is not the domain of psychology, it should be left up to medical doctors. What do you think?
Geoffrey Cowley: I think it's critical that we bridge that chasm. Psychology doesn't make sense without a basis in brain science -- and brain science is a sterile endeavor unless you view the brain as an organ with built-in psychological functions. I think it's exciting to see the perspectives of medicine and psychology merging.
Be sure to read Steven Pinker's essay ("How to Think About the Mind") in this week's issue. It sheds good light on this question.
_______________________
Denton, TX: If I think my empty pocket is full of money, will it happen?
Geoffrey Cowley: Try it and let me know.
_______________________
Los Angeles, CA: What are the three most useful discoveries about the brain for people to apply in their everyday life?
Geoffrey Cowley:
1. Emotions are physiological states with consequences for our health.
2. Emotional distress (anger, alienation, hopelessness, fear) can make you sick.
3. Most of us can improve or protect our health by nurturing relationships with other people and learning how to relax and manage stress.
_______________________
Ajo, AZ: Is our brain separate from our mind? Are they two different things or the same?
Geoffrey Cowley: A good closing question. Neuroscience has taught us that what feels like a separate "mind" is in fact the activity of the brain. Once you accept that fact, the "mind-body connection" becomes less mysterious. It's not a matter of one realm affecting another through supernatural means. Emotions are physical phenomena, and physical health is an emotional phenomenon. Both are part of the same system.
Thanks for tuning in today. Here's wishing you peace and good health.
Read the entire article at the original source
Using the Mind to Heal the Body
NEWSWEEK's Geoffrey Cowley joined us to discuss new views of the mind-body connection in a Live Talk on Wednesday, Sept. 22, 2004 at noon ET.
WEB EXCLUSIVE
Newsweek
That thoughts and feelings can affect our health is hardly news. But the relationship between emotion and physical well-being is turning out to be more significant than most of us could have imagined. Viewed through the lens of 21st-century science, anxiety, alienation and hopelessness are not just feelings. Neither are love, serenity and optimism. All are physiological states that may affect our health just as clearly as obesity or physical fitness. And the brain, as the source of such states, offers a potential gateway to countless other tissues and organs--from the heart and blood vessels to the digestive tract and the immune system. The challenge is to map the pathways linking mental conditions to medical ones, and learn how to travel them at will. Placebos are just the beginning. Mounting evidence suggests that any number of soothing emotional experiences can improve our physical health. Using our minds, can we teach ourselves to be healthier? NEWSWEEK's Geoffrey Cowley, the senior editor behind this week's Health for Life cover package, discussed new views of the mind-body connection in a Live Talk on Wednesday, Sept. 22, at noon ET. Read the transcript below.
Geoffrey Cowley has led NEWSWEEK's medical coverage since 1990, working both as a writer and an editor to produce groundbreaking articles on topics ranging from brain science to global health. In news stories, cover articles and special reports, Cowley has chronicled countless trends in medicine and public health, from the advent of Prozac and the sequencing of the genome to the failures of profit-driven health care and the boom in complementary and alternative medicine. He was among the first American journalists to recognize the promise of evolutionary psychology, the significance of chronic fatigue syndrome and the hazards of the sleep medication Halcion. By reporting in 1992 that the drug's approval was based on tainted data, he triggered an FDA inquiry that lasted several years and brought changes in the agency's drug-approval process. In recent years, Cowley's work has helped NEWSWEEK win several nominations for the National Magazine Award, the most prestigious prize in U.S. magazine journalism. His contributions include a 2002 special report on integrative medicine, a 1998 cover story on the science of memory and 1997 cover stories on heart disease and childhood asthma. Cowley joined NEWSWEEK as a general editor in March 1988. He was promoted to senior writer in August 1988 and to senior editor in August 1997. He came to NEWSWEEK from The Sciences, where he had been a senior editor since 1985.
Geoffrey Cowley: Hi, Thanks for logging on. This is Geoff Cowley, ready to talk about the new science of mind-body medicine.
_______________________
Silver Spring, MD: Can we regenerate our cells using our minds?
Geoffrey Cowley: I don't think we can will our cells to do anything supernatural. But to the extent that our cells are capable of repairing or regenerating themselves, I suspect we can improve their odds of success.
Researchers discovered back in the 1970s that the immune system could be taught to suppress itself in response to a stimulus. The researchers gave mice saccharine along with an anticancer drug that suppresses immune function. Once the animals' bodies associated the saccharine with the drug, the researchers tried administering saccharine without any medication. The saccharine still drove down their immune function.
If our expectations can suppress our immune cells, then states of mind should be able to boost them as well. Researchers at the University of Miami have shown that stress-management training can quell immune-suppressing stress hormones in HIV-positive men. And at UCLA, scientists have found that HIV-positive men with optimistic outlooks have more robust immune responses. None of this is to say that you can mental states can overcome HIV. It's still a progressive illness that, left untreated, is fatal. But these studies, and others like them, suggest that states of mind may affect the rate of progression.
_______________________
Houston, TX: Is it possible to lower one's blood pressure without medication?
Geoffrey Cowley: Definitely. Exercise and nutrition can have a big impact on blood pressure. Relaxation techniques can help too. But if you suffer from hypertension, don't leave it untreated in the hope that you can think yourself healthy. Talk to your doctor about how best to combine medication, lifestyle and stress reduction to keep yourself safe.
_______________________
San Francisco, CA: Why is this such a suprise to people, especially since the Chinese have known about this for 2000 years?
Geoffrey Cowley: I think that what we're seeing right now is not just a return to ancient ways but a synthesis and integration of ancient wisdom with modern science.
Most pre-scientific people share a sense that states of mind are connected to states of health. With the discovery of germs and the advancement of medical science in 19th and 20th centires, Western physicians lost sight of the connection.
It's now clear that neither perspective is complete without the other. It's exciting to me to see the two traditions being integrated into a larger, more humane vision of health that has room both for meditation and for life-saving high-tech procedures.
_______________________
Uniontown, PA: Is it possible that the mind body connection works the other way as well: that people who believe they are sick or will get sick can make themselves measurably phyically ill?
Geoffrey Cowley: I don't think there's any question about it. Many of the stories in this week's issue describe how mental states can harm the body as well as heal it.
The placebo effect can prompt amazing recoveries in people who expect to get better, but studies have shown that it can also cause real illness in people who expect to get sick. In one experiment, researchers rubbed a harmless substance on the arms of people allergic to lacquer leaves. When told that the harmless substance was a lacquer leaf, many developed severe rashes.
_______________________
Gilbert, AZ: Can stress make you infertile?
Geoffrey Cowley: Be sure to read the article by Dr. Alice Domar of Harvard in this week's issue ("A New Fertility Factor"). "No one has proved that feelings of distress actually cause infertility," Domar writes, "but there are good reasons to think so. Women with a history of depression are twice as likely to suffer from the problem, and research has shown that distressed women are less responsive to treatment."
_______________________
American Fork, UT: Do those who are less stressed have lower rates of cancer, heart disease and other serious illnesses?
Geoffrey Cowley: What the studies show is that people who are /more/ stressed -- because of depression or anger or social isolation -- are at higher risk of those conditions. But it stands to reason that better stress control should help protect against those diseases.
In Dr. Dean Ornish's program for reversing heart disease, patients use relaxation and group support as well diet and exercise, and they achieve remarkable results. No one knows how large a role the mental and emotional exercises play, but Ornish considers it indispensable.
_______________________
Springdale, UT: I have been told by a colleage that she believes the study of the brain is not the domain of psychology, it should be left up to medical doctors. What do you think?
Geoffrey Cowley: I think it's critical that we bridge that chasm. Psychology doesn't make sense without a basis in brain science -- and brain science is a sterile endeavor unless you view the brain as an organ with built-in psychological functions. I think it's exciting to see the perspectives of medicine and psychology merging.
Be sure to read Steven Pinker's essay ("How to Think About the Mind") in this week's issue. It sheds good light on this question.
_______________________
Denton, TX: If I think my empty pocket is full of money, will it happen?
Geoffrey Cowley: Try it and let me know.
_______________________
Los Angeles, CA: What are the three most useful discoveries about the brain for people to apply in their everyday life?
Geoffrey Cowley:
1. Emotions are physiological states with consequences for our health.
2. Emotional distress (anger, alienation, hopelessness, fear) can make you sick.
3. Most of us can improve or protect our health by nurturing relationships with other people and learning how to relax and manage stress.
_______________________
Ajo, AZ: Is our brain separate from our mind? Are they two different things or the same?
Geoffrey Cowley: A good closing question. Neuroscience has taught us that what feels like a separate "mind" is in fact the activity of the brain. Once you accept that fact, the "mind-body connection" becomes less mysterious. It's not a matter of one realm affecting another through supernatural means. Emotions are physical phenomena, and physical health is an emotional phenomenon. Both are part of the same system.
Thanks for tuning in today. Here's wishing you peace and good health.
Read the entire article at the original source
How to Think About the Mind
How to Think About the Mind
How to Think About the Mind
Neuroscience shows that the 'soul' is the activity of the brain
By Steven Pinker
Newsweek, September 27, 2004
Every evening our eyes tell us that the sun sets, while we know that, in fact, the Earth is turning us away from it. Astronomy taught us centuries ago that common sense is not a reliable guide to reality. Today it is neuroscience that is forcing us to readjust our intuitions. People naturally believe in the Ghost in the Machine: that we have bodies made of matter and spirits made of an ethereal something. Yes, people acknowledge that the brain is involved in mental life. But they still think of it as a pocket PC for the soul, managing information at the behest of a ghostly user.
Modern neuroscience has shown that there is no user. "The soul" is, in fact, the information-processing activity of the brain. New imaging techniques have tied every thought and emotion to neural activity. And any change to the brain—from strokes, drugs, electricity or surgery—will literally change your mind. But this understanding hasn't penetrated the conventional wisdom. We tell people to "use their brains," we speculate about brain transplants (which really should be called body transplants) and we express astonishment that meditation, education and psycho-therapy can actually change the brain. How else could they work?
This resistance is not surprising. In "Descartes' Baby," psychologist Paul Bloom argues that a mind-body distinction is built into the very way we think. Children easily accept stories in which a person changes from a frog to a prince, or leaves the body to go where the wild things are. And though kids know the brain is useful for thinking, they deny that it makes them feel sad or love their siblings.
The disconnect between our common sense and our best science is not an academic curiosity. Neuroscience is putting us in unfamiliar predicaments, and if we continue to think of ourselves as shadowy users of our brains we will be needlessly befuddled. The Prozac revolution provides an example. With antidepressant and anti-anxiety drugs so common, critics wonder whether we're losing the ability to overcome problems through force of will. Many an uncomprehending spouse has asked, "Why don't you just snap out of it?" But depressed people don't have lazy souls. The parts of their brains that could "snap out of it" are not working properly. To depressed people it is objectively obvious that their prospects are hopeless. Tweaking the brain with drugs may sometimes be the best way to jump-start the machinery that we call the will.
Prozac shouldn't be dispensed like mints, of course, but the reason is not that it undermines the will. The reason is that emotional pain, like physical pain, is not always pathological. Anxiety is an impetus to avoid invisible threats, and most of us would never meet a deadline without it. Low mood may help us recalibrate our prospects after a damaging loss. But just as surgeons don't force patients to endure agony to improve their characters, people shouldn't be forced to endure anxiety or depression beyond what's needed to prompt self-examination.
To many, the scariest prospect is medication that can make us better than well by enhancing mood, memory and attention. Such drugs, they say, will undermine striving and sacrifice; they are a kind of cheating, like giving the soul a corked bat. But anything that improves our functioning—from practice and education to a good night's sleep and a double espresso—changes the brain. As long as people are not coerced, it's unclear why we should tolerate every method of brain enrichment but one.
In Galileo's time, the counter-intuitive discovery that the Earth moved around the sun was laden with moral danger. Now it seems obvious that the motion of rock and gas in space has nothing to do with right and wrong. Yet to many people, the discovery that the soul is the activity of the brain is just as fraught, with pernicious implications for everything from criminal responsibility to our image of ourselves as a species. Turning back the clock on the ultimate form of self-knowledge is neither possible nor desirable. We can live with the new challenges from brain science. But it will require setting aside childlike intuitions and traditional dogmas, and thinking afresh about what makes people better off and worse off.
Pinker is the Johnstone Family Professor in the psychology department at Harvard. His books include "How the Mind Works" and "The Blank Slate."
Read the entire article at the original source
How to Think About the Mind
Neuroscience shows that the 'soul' is the activity of the brain
By Steven Pinker
Newsweek, September 27, 2004
Every evening our eyes tell us that the sun sets, while we know that, in fact, the Earth is turning us away from it. Astronomy taught us centuries ago that common sense is not a reliable guide to reality. Today it is neuroscience that is forcing us to readjust our intuitions. People naturally believe in the Ghost in the Machine: that we have bodies made of matter and spirits made of an ethereal something. Yes, people acknowledge that the brain is involved in mental life. But they still think of it as a pocket PC for the soul, managing information at the behest of a ghostly user.
Modern neuroscience has shown that there is no user. "The soul" is, in fact, the information-processing activity of the brain. New imaging techniques have tied every thought and emotion to neural activity. And any change to the brain—from strokes, drugs, electricity or surgery—will literally change your mind. But this understanding hasn't penetrated the conventional wisdom. We tell people to "use their brains," we speculate about brain transplants (which really should be called body transplants) and we express astonishment that meditation, education and psycho-therapy can actually change the brain. How else could they work?
This resistance is not surprising. In "Descartes' Baby," psychologist Paul Bloom argues that a mind-body distinction is built into the very way we think. Children easily accept stories in which a person changes from a frog to a prince, or leaves the body to go where the wild things are. And though kids know the brain is useful for thinking, they deny that it makes them feel sad or love their siblings.
The disconnect between our common sense and our best science is not an academic curiosity. Neuroscience is putting us in unfamiliar predicaments, and if we continue to think of ourselves as shadowy users of our brains we will be needlessly befuddled. The Prozac revolution provides an example. With antidepressant and anti-anxiety drugs so common, critics wonder whether we're losing the ability to overcome problems through force of will. Many an uncomprehending spouse has asked, "Why don't you just snap out of it?" But depressed people don't have lazy souls. The parts of their brains that could "snap out of it" are not working properly. To depressed people it is objectively obvious that their prospects are hopeless. Tweaking the brain with drugs may sometimes be the best way to jump-start the machinery that we call the will.
Prozac shouldn't be dispensed like mints, of course, but the reason is not that it undermines the will. The reason is that emotional pain, like physical pain, is not always pathological. Anxiety is an impetus to avoid invisible threats, and most of us would never meet a deadline without it. Low mood may help us recalibrate our prospects after a damaging loss. But just as surgeons don't force patients to endure agony to improve their characters, people shouldn't be forced to endure anxiety or depression beyond what's needed to prompt self-examination.
To many, the scariest prospect is medication that can make us better than well by enhancing mood, memory and attention. Such drugs, they say, will undermine striving and sacrifice; they are a kind of cheating, like giving the soul a corked bat. But anything that improves our functioning—from practice and education to a good night's sleep and a double espresso—changes the brain. As long as people are not coerced, it's unclear why we should tolerate every method of brain enrichment but one.
In Galileo's time, the counter-intuitive discovery that the Earth moved around the sun was laden with moral danger. Now it seems obvious that the motion of rock and gas in space has nothing to do with right and wrong. Yet to many people, the discovery that the soul is the activity of the brain is just as fraught, with pernicious implications for everything from criminal responsibility to our image of ourselves as a species. Turning back the clock on the ultimate form of self-knowledge is neither possible nor desirable. We can live with the new challenges from brain science. But it will require setting aside childlike intuitions and traditional dogmas, and thinking afresh about what makes people better off and worse off.
Pinker is the Johnstone Family Professor in the psychology department at Harvard. His books include "How the Mind Works" and "The Blank Slate."
Read the entire article at the original source
This Is Serious Fun
This Is Serious Fun
This Is Serious Fun
Can videogames equipped with neurofeedback help kids deal with their learning disabilities?
By N'Gai Croal
Newsweek, September 27, 2004
A stitch in time saves nine. An apple a day keeps the doctor away. And videogames will rot your brain. Conventional wisdom? Maybe, but psychologist Dominic Greco is determined to prove that at least one of those sayings is not true. Greco, the 52-year-old founder of CyberLearning Technology, uses neurofeedback-enhanced versions of off-the-shelf videogames like Ratchet & Clank to help treat children and adolescents with attention-deficit disorder or cognitive-processing difficulties. If that sounds like futuristic, space-age technology, you're not far off; CyberLearning Technology has built its system, dubbed S.M.A.R.T. Brain Games, around a neurofeedback patent it obtained exclusively from NASA.
Here's how S.M.A.R.T. Brain Games work. A normal human brain, when awake and focused on an activity, produces a lot of fast brain waves. But people with cognitive-processing or learning disabilities produce large amounts of slower brain waves—like the ones generated when we're sleeping or daydreaming. That makes staying focused extremely difficult.
S.M.A.R.T. Brain Games use a specially designed headgear, with built-in sensors, to monitor the player's brain waves. The child or adolescent operates a regular videogame console like the PlayStation 2, but with a controller that has been modified by CyberLearning Technology. If the player remains focused while speeding through the streets of Tokyo in a racing game like Gran Turismo 3: A-Spec, he or she will be able to drive unimpeded. But the moment the youngster's attention wanders, the system steadily reduces the top speed available to the player, causes the controller to rumble and produces atonal sounds, letting the child know that he or she must refocus. Once the kid does, the sounds disappear, the rumble goes away and the child can once again achieve top speed. "We're exercising the brain to a higher level of processing and attention," says Greco, who's been using neurofeedback to work with children since 1990. Though neurofeedback hasn't been studied as extensively as drug therapy, it has fewer side effects, and many families swear by it. Dr. Ali Hashemi of the California-based Attention and Achievement Center cautions that while the principles of neurofeedback are well established, as yet there are no peer-reviewed studies of Greco's methods (though one is expected by the year-end).
Adults can benefit from neurofeedback as well. The Wild Divine Project has released a CD-ROM for Mac and PC called Journey to the Wild Divine, which uses sensors attached to the fingers to monitor skin conductance and heart-rate variability via the computer's USB port. The story-based game teaches things ranging from yogic breathing to meditation through lush visuals that respond to your actions, like lighting a virtual fire by exhaling calmly and smoothly. "I was always frustrated by how boring biofeedback was," says Corwin Bell, Wild Divine's 40-year-old designer. "Raise a bar, make a face smile. It wasn't very entertaining. The challenge for me and my team was to bring in a visual metaphor." Mission accomplished.
Read the entire article at the original source
This Is Serious Fun
Can videogames equipped with neurofeedback help kids deal with their learning disabilities?
By N'Gai Croal
Newsweek, September 27, 2004
A stitch in time saves nine. An apple a day keeps the doctor away. And videogames will rot your brain. Conventional wisdom? Maybe, but psychologist Dominic Greco is determined to prove that at least one of those sayings is not true. Greco, the 52-year-old founder of CyberLearning Technology, uses neurofeedback-enhanced versions of off-the-shelf videogames like Ratchet & Clank to help treat children and adolescents with attention-deficit disorder or cognitive-processing difficulties. If that sounds like futuristic, space-age technology, you're not far off; CyberLearning Technology has built its system, dubbed S.M.A.R.T. Brain Games, around a neurofeedback patent it obtained exclusively from NASA.
Here's how S.M.A.R.T. Brain Games work. A normal human brain, when awake and focused on an activity, produces a lot of fast brain waves. But people with cognitive-processing or learning disabilities produce large amounts of slower brain waves—like the ones generated when we're sleeping or daydreaming. That makes staying focused extremely difficult.
S.M.A.R.T. Brain Games use a specially designed headgear, with built-in sensors, to monitor the player's brain waves. The child or adolescent operates a regular videogame console like the PlayStation 2, but with a controller that has been modified by CyberLearning Technology. If the player remains focused while speeding through the streets of Tokyo in a racing game like Gran Turismo 3: A-Spec, he or she will be able to drive unimpeded. But the moment the youngster's attention wanders, the system steadily reduces the top speed available to the player, causes the controller to rumble and produces atonal sounds, letting the child know that he or she must refocus. Once the kid does, the sounds disappear, the rumble goes away and the child can once again achieve top speed. "We're exercising the brain to a higher level of processing and attention," says Greco, who's been using neurofeedback to work with children since 1990. Though neurofeedback hasn't been studied as extensively as drug therapy, it has fewer side effects, and many families swear by it. Dr. Ali Hashemi of the California-based Attention and Achievement Center cautions that while the principles of neurofeedback are well established, as yet there are no peer-reviewed studies of Greco's methods (though one is expected by the year-end).
Adults can benefit from neurofeedback as well. The Wild Divine Project has released a CD-ROM for Mac and PC called Journey to the Wild Divine, which uses sensors attached to the fingers to monitor skin conductance and heart-rate variability via the computer's USB port. The story-based game teaches things ranging from yogic breathing to meditation through lush visuals that respond to your actions, like lighting a virtual fire by exhaling calmly and smoothly. "I was always frustrated by how boring biofeedback was," says Corwin Bell, Wild Divine's 40-year-old designer. "Raise a bar, make a face smile. It wasn't very entertaining. The challenge for me and my team was to bring in a visual metaphor." Mission accomplished.
Read the entire article at the original source
Altered States - Hypnosis
Altered States
Altered States
Hypnosis can help with problems from anxiety to pain. How it works, and what it does in the brain
By David Noonan
Newsweek, September 27, 2004
At 27, Beth, an Indiana housewife, came down with chronic diarrhea that plagued her for the next three years. "I knew where every bathroom in town was," she says with a laugh. But it was no joke. "I didn't really want to go out at night because it's just not fun." Doctor after doctor told her it was stress-related. She tried diet changes and medicines, but nothing helped. Then she went to see Dr. Marc Oster, a Chicago-area psychologist. After 12 sessions of hypnosis with Oster, during which Beth explored the traumatic events that preceded her illness (including her husband's agonizing two-week stay in a burn unit), the problem disappeared. Two years later Beth (who asked that her last name not be used) tried hypnosis during the birth of her second child. Three years after that she went back again, this time to deal with her fear of flying. Could there be more hypnosis in her future? "If the need ever arises, you bet," says Beth, now 38.
Despite widely held misconceptions about hypnosis (in part because of its long history as a type of entertainment), a growing body of research supports the ancient practice as an effective tool in the treatment of a variety of problems, from anxiety to chronic pain. Today, as practitioners work to assess and refine the clinical applications of hypnosis, they are also exploring its underlying mechanisms, using state-of-the-art imaging technology to document changes in the brain that occur when someone is in a hypnotic state. This increased understanding of how hypnosis works and what it does makes it a legitimate option for patients whose needs have not been met by more traditional methods.
To appreciate the therapeutic potential of hypnosis, you first have to forget about things like swinging watches and hapless audience members who prance around onstage, crowing like roosters. "One of the interesting ironies about hypnosis is that old fantasy that it takes away control," says Dr. David Spiegel, professor and associate chair of psychiatry at Stanford University School of Medicine and a leading expert on the practice. "It's actually a way of enhancing people's control, of teaching them how to control aspects of their body's function and sensation that they thought they couldn't."
Hypnosis is "a form of highly focused attention," says Spiegel—an induced state of mind that enables people to alter the way they perceive and process reality. During a typical session, the doctor guides the subject into a state of receptive concentration, asking him to imagine he is in a safe and comfortable place. Once the patient is in a state of hypnosis, the practitioner makes specific suggestions—a hockey player with back spasms was told that when his pads touched his back, the muscles relaxed—to address the problem. (This focus on a problem distinguishes hypnosis from more passive states, like meditation.) The doctor then terminates the trance and teaches the patient how to use self-hypnosis to reactivate and maintain the therapeutic effect. The benefits can last for years.
Besides pain management and stress reduction, habit control is another popular clinical application of hypnosis; it's routinely used by people who want to quit smoking. It has also been used successfully as an alternative to sedation during invasive medical procedures like angiography. And at the University of Pennsylvania School of Medicine, Dr. Peter Bloom, clinical professor of psychiatry and past president of the International Society of Hypnosis, sometimes uses it to enhance therapy sessions. "Hypnosis allows us to interact with the people who seek our care in more than one dimension," says Bloom. "It involves the totality of the person. Clinically, when I get stuck, I use hypnosis and see if that gives me a different way of linking up with them." As it is practiced by medical professionals like Bloom and Spiegel, hypnosis is generally safe, though there are occasional surprises, such as the unplanned recall of a forgotten trauma (something a lay hypnotist might not handle as well as a doctor or psychologist).
Practitioners often use vivid imagery when making hypnotic suggestions. Dr. Olafur Palsson, a psychologist at the University of North Carolina, developed a detailed, seven-session hypnosis protocol for the treatment of irritable bowel syndrome, a disorder often accompanied by abdominal pain. "One of the ingredients is visualizing your stomach and your intestines and visualizing a strong protective coating being applied inside your intestines," explains Palsson. "And this special protective coating only allows pleasant sensations through, and keeps all uncomfortable sensations out. And then it is suggested that this protective coating grows stronger and thicker and harder day by day."
It's well known that some people are more responsive to hypnosis than others. Hypnotizability, experts say, is a trait, like eye color. As a rule, the more "absorbed" a person is able to get in things—movies, sunsets, daydreams—the more hypnotizable he is. (Researchers use standardized measures to screen subjects.) People who describe themselves as more trusting of others tend to be more hypnotizable, says Spiegel, while those who are very logical and never take anything at face value tend to be less hypnotizable.
Several studies using positron emission tomography (PET) have looked at what goes on in the brain during hypnosis. In one, hypnotized subjects had their hands immersed in "painfully hot" water but were told it was comfortably warm. This not only altered their perception of the pain but also altered blood flow in pain-related parts of the brain. In another study, highly hypnotizable people were shown a black-and-white pattern and asked to see color. The results: the regions of the brain normally activated during color perception were activated in the hypnotized subjects. "It's not just a fantasy," says Spiegel. "It's not just telling people things because that's what you think they want to hear. If you think you are seeing color, you actually see it, and your brain acts as though it's seeing it." It's easy to see why, in the field of hypnosis these days, nobody is getting sleepy.
Read the entire article at the original source
Altered States
Hypnosis can help with problems from anxiety to pain. How it works, and what it does in the brain
By David Noonan
Newsweek, September 27, 2004
At 27, Beth, an Indiana housewife, came down with chronic diarrhea that plagued her for the next three years. "I knew where every bathroom in town was," she says with a laugh. But it was no joke. "I didn't really want to go out at night because it's just not fun." Doctor after doctor told her it was stress-related. She tried diet changes and medicines, but nothing helped. Then she went to see Dr. Marc Oster, a Chicago-area psychologist. After 12 sessions of hypnosis with Oster, during which Beth explored the traumatic events that preceded her illness (including her husband's agonizing two-week stay in a burn unit), the problem disappeared. Two years later Beth (who asked that her last name not be used) tried hypnosis during the birth of her second child. Three years after that she went back again, this time to deal with her fear of flying. Could there be more hypnosis in her future? "If the need ever arises, you bet," says Beth, now 38.
Despite widely held misconceptions about hypnosis (in part because of its long history as a type of entertainment), a growing body of research supports the ancient practice as an effective tool in the treatment of a variety of problems, from anxiety to chronic pain. Today, as practitioners work to assess and refine the clinical applications of hypnosis, they are also exploring its underlying mechanisms, using state-of-the-art imaging technology to document changes in the brain that occur when someone is in a hypnotic state. This increased understanding of how hypnosis works and what it does makes it a legitimate option for patients whose needs have not been met by more traditional methods.
To appreciate the therapeutic potential of hypnosis, you first have to forget about things like swinging watches and hapless audience members who prance around onstage, crowing like roosters. "One of the interesting ironies about hypnosis is that old fantasy that it takes away control," says Dr. David Spiegel, professor and associate chair of psychiatry at Stanford University School of Medicine and a leading expert on the practice. "It's actually a way of enhancing people's control, of teaching them how to control aspects of their body's function and sensation that they thought they couldn't."
Hypnosis is "a form of highly focused attention," says Spiegel—an induced state of mind that enables people to alter the way they perceive and process reality. During a typical session, the doctor guides the subject into a state of receptive concentration, asking him to imagine he is in a safe and comfortable place. Once the patient is in a state of hypnosis, the practitioner makes specific suggestions—a hockey player with back spasms was told that when his pads touched his back, the muscles relaxed—to address the problem. (This focus on a problem distinguishes hypnosis from more passive states, like meditation.) The doctor then terminates the trance and teaches the patient how to use self-hypnosis to reactivate and maintain the therapeutic effect. The benefits can last for years.
Besides pain management and stress reduction, habit control is another popular clinical application of hypnosis; it's routinely used by people who want to quit smoking. It has also been used successfully as an alternative to sedation during invasive medical procedures like angiography. And at the University of Pennsylvania School of Medicine, Dr. Peter Bloom, clinical professor of psychiatry and past president of the International Society of Hypnosis, sometimes uses it to enhance therapy sessions. "Hypnosis allows us to interact with the people who seek our care in more than one dimension," says Bloom. "It involves the totality of the person. Clinically, when I get stuck, I use hypnosis and see if that gives me a different way of linking up with them." As it is practiced by medical professionals like Bloom and Spiegel, hypnosis is generally safe, though there are occasional surprises, such as the unplanned recall of a forgotten trauma (something a lay hypnotist might not handle as well as a doctor or psychologist).
Practitioners often use vivid imagery when making hypnotic suggestions. Dr. Olafur Palsson, a psychologist at the University of North Carolina, developed a detailed, seven-session hypnosis protocol for the treatment of irritable bowel syndrome, a disorder often accompanied by abdominal pain. "One of the ingredients is visualizing your stomach and your intestines and visualizing a strong protective coating being applied inside your intestines," explains Palsson. "And this special protective coating only allows pleasant sensations through, and keeps all uncomfortable sensations out. And then it is suggested that this protective coating grows stronger and thicker and harder day by day."
It's well known that some people are more responsive to hypnosis than others. Hypnotizability, experts say, is a trait, like eye color. As a rule, the more "absorbed" a person is able to get in things—movies, sunsets, daydreams—the more hypnotizable he is. (Researchers use standardized measures to screen subjects.) People who describe themselves as more trusting of others tend to be more hypnotizable, says Spiegel, while those who are very logical and never take anything at face value tend to be less hypnotizable.
Several studies using positron emission tomography (PET) have looked at what goes on in the brain during hypnosis. In one, hypnotized subjects had their hands immersed in "painfully hot" water but were told it was comfortably warm. This not only altered their perception of the pain but also altered blood flow in pain-related parts of the brain. In another study, highly hypnotizable people were shown a black-and-white pattern and asked to see color. The results: the regions of the brain normally activated during color perception were activated in the hypnotized subjects. "It's not just a fantasy," says Spiegel. "It's not just telling people things because that's what you think they want to hear. If you think you are seeing color, you actually see it, and your brain acts as though it's seeing it." It's easy to see why, in the field of hypnosis these days, nobody is getting sleepy.
Read the entire article at the original source
Menopause: Easing the Transition
Menopause: Easing the Transition
By Nancy Ferrari; Leslee Kagan, N.P.; Bruce Kessel, M.D., and Herbert Benson, M.D.
Newsweek, September 27, 2004
Some women glide through menopause without breaking a sweat. For others, hot flashes, mood swings, insomnia and PMS become a constant burden. Short-term hormone therapy can temper severe symptoms, but it carries risks as well as benefits. And though other treatments abound, none of them is a cure-all. A few studies have found that soy and black cohosh (an herbal remedy sold as Remifemin) can help relieve symptoms, though not as reliably as hormones. For women who want relief without risk, mind-body techniques offer another valuable option. These techniques can ease all the core symptoms of menopause—and in our experience, most women get at least some relief from them.
At the heart of the mind-body approach is the relaxation response, a state of calm achieved through exercises such as yoga, meditation, biofeedback, progressive muscle relaxation or a breathing technique called paced respiration. In two clinical studies, researchers trained menopausal women in paced respiration and encouraged them to practice it for 15 to 20 minutes once or twice a day. The participants experienced a 50 percent reduction in hot flashes—as measured objectively by skin temperature—compared with women who didn't receive the training. In these studies, paced respiration improved hot flashes better than progressive muscle relaxation or biofeedback. Some women who learn this breathing technique find that it can even short-circuit an oncoming hot flash. Other studies suggest it may be equally helpful in controlling symptoms of PMS.
In addition to the relaxation response, most mind-body programs use exercise, good nutrition and cognitive behavioral therapy to counter the mood changes menopause can bring. Studies have yet to compare mind-body interventions with hormone therapy. And because every woman is different, we can't tell in advance who will benefit most from a given approach. Finding the right combination often requires some trial and error.
But in our experience, most women can learn the techniques, incorporate them into their daily lives and feel better as a result.
Adapted from "Mind Over Menopause: The Complete Mind/Body Approach to Coping With Menopause" (Free Press. 2004). For more information go to health.harvard.edu/NEWSWEEK.
Read article at the original source
By Nancy Ferrari; Leslee Kagan, N.P.; Bruce Kessel, M.D., and Herbert Benson, M.D.
Newsweek, September 27, 2004
Some women glide through menopause without breaking a sweat. For others, hot flashes, mood swings, insomnia and PMS become a constant burden. Short-term hormone therapy can temper severe symptoms, but it carries risks as well as benefits. And though other treatments abound, none of them is a cure-all. A few studies have found that soy and black cohosh (an herbal remedy sold as Remifemin) can help relieve symptoms, though not as reliably as hormones. For women who want relief without risk, mind-body techniques offer another valuable option. These techniques can ease all the core symptoms of menopause—and in our experience, most women get at least some relief from them.
At the heart of the mind-body approach is the relaxation response, a state of calm achieved through exercises such as yoga, meditation, biofeedback, progressive muscle relaxation or a breathing technique called paced respiration. In two clinical studies, researchers trained menopausal women in paced respiration and encouraged them to practice it for 15 to 20 minutes once or twice a day. The participants experienced a 50 percent reduction in hot flashes—as measured objectively by skin temperature—compared with women who didn't receive the training. In these studies, paced respiration improved hot flashes better than progressive muscle relaxation or biofeedback. Some women who learn this breathing technique find that it can even short-circuit an oncoming hot flash. Other studies suggest it may be equally helpful in controlling symptoms of PMS.
In addition to the relaxation response, most mind-body programs use exercise, good nutrition and cognitive behavioral therapy to counter the mood changes menopause can bring. Studies have yet to compare mind-body interventions with hormone therapy. And because every woman is different, we can't tell in advance who will benefit most from a given approach. Finding the right combination often requires some trial and error.
But in our experience, most women can learn the techniques, incorporate them into their daily lives and feel better as a result.
Adapted from "Mind Over Menopause: The Complete Mind/Body Approach to Coping With Menopause" (Free Press. 2004). For more information go to health.harvard.edu/NEWSWEEK.
Read article at the original source
A New Fertility Factor
A New Fertility Factor
Stress is just one of many obstacles to pregnancy, but it's one you can control
A productive calm: Studies have found that distress can hamper fertility - and that relieving it can improve the chances of conceiving
By Alice D. Domar, Ph.D.
Newsweek, September 27, 2004
Melissa was 33 when I met her, and she'd been trying to get pregnant for more than two years. Fertility tests had found nothing wrong with her or her husband. Yet all she had gained from two cycles of injected fertility medication was some extra weight. And though she was running 20 miles a week to reduce stress, the experience had left her feeling overwhelmed and isolated. Melissa was crying almost every day when she joined the 10-week mind-body program I oversee in Boston, but she soon realized that she was neither helpless nor alone. Supported by peers and counselors, she dialed back on her running regimen (excessive exercise can hamper fertility), gave up caffeine and alcohol, and started practicing relaxation techniques. After five weeks she resumed fertility-drug injections and conceived on her next cycle. Her daughter arrived nine happy months later.
There are many myths about becoming pregnant. In truth, deciding to adopt a child doesn't boost the odds of conception. Nor does taking a vacation, having a glass of wine before sex or trying an unusual new position. But frustrated couples shouldn't assume that mind-body medicine is irrelevant to their quest for pregnancy. Studies are now confirming what Melissa's experience implies. Distress can hamper fertility—and relieving distress can help improve your chances of conceiving. Though practices like meditation and yoga certainly can't guarantee pregnancy, they have now established their place along with high-tech medicines and procedures.
What do we really know about fertility and the mind? For starters, we know that infertility is stressful. Women who have difficulty conceiving suffer as much anxiety and depression as women with heart disease or cancer. A recent study found that 40 percent of them were anxious or depressed. This shouldn't be surprising. Procreation is one of the strongest instincts in the animal kingdom. Males will die fighting for a chance to mate, and females will die to protect their young. Moreover, most people assume they are fertile. When you've spent your adult life taking precautions to avoid pregnancy, it's a shock to discover that you can't make it happen at will. Treatment can add to the anguish. You get poked, prodded, injected, inspected and operated on, and you have mechanical sex on schedule.
No one has proved that feelings of distress actually cause infertility, but there are good reasons to think so. Women with a history of depression are twice as likely to suffer from the problem—and research has shown that distressed women are less responsive to treatment. In one recent trial, high-tech fertility procedures were 93 percent less effective in highly distressed women than in those reporting less emotional upset.
Can mind-body medicine counter these effects? The first mind-body fertility program started in 1987 at Boston's Deaconess Hospital. Thousands of patients have since participated, and the results have been encouraging. Approximately 45 to 50 percent become pregnant within six months (success rates are closer to 20 percent when patients lack psychological support), and most participants experience a significant reduction in both physical and psychological symptoms. My own research supports these observations. With funding from the National Institute of Mental Health, I conducted a controlled clinical trial comparing women in mind-body programs with those receiving only routine medical care. Pregnancy and delivery rates were nearly three times higher among the women who got the additional support. In yet another study, Turkish researchers found that couples attempting in vitro fertilization achieved a 43 percent pregnancy rate when their treatment included psychological help, but only a 17 percent success rate when it didn't.
Mind-body fertility programs vary, but the ones I have led share several key features. Besides practicing relaxation techniques, participants learn to cut back on caffeine and alcohol, and they use cognitive behavioral therapy to transform negative thoughts ("I will never have a baby") into positive ones ("I am doing everything I can to try to get pregnant"). Indeed, our programs focus less on getting pregnant than on getting your life back—and thinking about all the possible paths to parenthood, including adoption and egg or sperm donation. Similar programs are taking shape in many parts of the world, and their patients are enjoying similar benefits: less distress, higher pregnancy rates and a better quality of life.
Adapted from "6 Steps to Increased Fertility" by Robert L. Barbieri, M.D.; Alice D. Domar, Ph.D., and Kevin R. Loughlin, M.D. (Fireside. 2001). For more information about mind-body techniques and fertility go to health.harvard.edu/NEWSWEEK.
Read article at the original source
Stress is just one of many obstacles to pregnancy, but it's one you can control
A productive calm: Studies have found that distress can hamper fertility - and that relieving it can improve the chances of conceiving
By Alice D. Domar, Ph.D.
Newsweek, September 27, 2004
Melissa was 33 when I met her, and she'd been trying to get pregnant for more than two years. Fertility tests had found nothing wrong with her or her husband. Yet all she had gained from two cycles of injected fertility medication was some extra weight. And though she was running 20 miles a week to reduce stress, the experience had left her feeling overwhelmed and isolated. Melissa was crying almost every day when she joined the 10-week mind-body program I oversee in Boston, but she soon realized that she was neither helpless nor alone. Supported by peers and counselors, she dialed back on her running regimen (excessive exercise can hamper fertility), gave up caffeine and alcohol, and started practicing relaxation techniques. After five weeks she resumed fertility-drug injections and conceived on her next cycle. Her daughter arrived nine happy months later.
There are many myths about becoming pregnant. In truth, deciding to adopt a child doesn't boost the odds of conception. Nor does taking a vacation, having a glass of wine before sex or trying an unusual new position. But frustrated couples shouldn't assume that mind-body medicine is irrelevant to their quest for pregnancy. Studies are now confirming what Melissa's experience implies. Distress can hamper fertility—and relieving distress can help improve your chances of conceiving. Though practices like meditation and yoga certainly can't guarantee pregnancy, they have now established their place along with high-tech medicines and procedures.
What do we really know about fertility and the mind? For starters, we know that infertility is stressful. Women who have difficulty conceiving suffer as much anxiety and depression as women with heart disease or cancer. A recent study found that 40 percent of them were anxious or depressed. This shouldn't be surprising. Procreation is one of the strongest instincts in the animal kingdom. Males will die fighting for a chance to mate, and females will die to protect their young. Moreover, most people assume they are fertile. When you've spent your adult life taking precautions to avoid pregnancy, it's a shock to discover that you can't make it happen at will. Treatment can add to the anguish. You get poked, prodded, injected, inspected and operated on, and you have mechanical sex on schedule.
No one has proved that feelings of distress actually cause infertility, but there are good reasons to think so. Women with a history of depression are twice as likely to suffer from the problem—and research has shown that distressed women are less responsive to treatment. In one recent trial, high-tech fertility procedures were 93 percent less effective in highly distressed women than in those reporting less emotional upset.
Can mind-body medicine counter these effects? The first mind-body fertility program started in 1987 at Boston's Deaconess Hospital. Thousands of patients have since participated, and the results have been encouraging. Approximately 45 to 50 percent become pregnant within six months (success rates are closer to 20 percent when patients lack psychological support), and most participants experience a significant reduction in both physical and psychological symptoms. My own research supports these observations. With funding from the National Institute of Mental Health, I conducted a controlled clinical trial comparing women in mind-body programs with those receiving only routine medical care. Pregnancy and delivery rates were nearly three times higher among the women who got the additional support. In yet another study, Turkish researchers found that couples attempting in vitro fertilization achieved a 43 percent pregnancy rate when their treatment included psychological help, but only a 17 percent success rate when it didn't.
Mind-body fertility programs vary, but the ones I have led share several key features. Besides practicing relaxation techniques, participants learn to cut back on caffeine and alcohol, and they use cognitive behavioral therapy to transform negative thoughts ("I will never have a baby") into positive ones ("I am doing everything I can to try to get pregnant"). Indeed, our programs focus less on getting pregnant than on getting your life back—and thinking about all the possible paths to parenthood, including adoption and egg or sperm donation. Similar programs are taking shape in many parts of the world, and their patients are enjoying similar benefits: less distress, higher pregnancy rates and a better quality of life.
Adapted from "6 Steps to Increased Fertility" by Robert L. Barbieri, M.D.; Alice D. Domar, Ph.D., and Kevin R. Loughlin, M.D. (Fireside. 2001). For more information about mind-body techniques and fertility go to health.harvard.edu/NEWSWEEK.
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Digestion: Soothing a Sensitive Gut
Digestion: Soothing a Sensitive Gut
By Kathleen Cahill Allison and Lawrence S. Friedman, M.D.
Newsweek, September 27, 2004
It's probably happened to you. You're driving to work and suddenly remember that a neglected assignment is due today. Your gut clenches, your intestines twist and before you know it you're feeling downright ill. One person in four ends up seeking medical attention for a gastrointestinal problem such as heartburn or irritable bowel syndrome (IBS). When doctors examine these patients, their blood tests and abdominal X-rays are usually normal. But the absence of ulcers or tumors doesn't mean that nothing is wrong. The brain and gut communicate through an impressive network of hormones, peptides and neurotransmitters. When emotional distress disrupts this dialogue, the effects can be seen on a brain scan. An area known as the midcingulate cortex goes into overdrive—and the gut suffers potentially devastating consequences.
Stress-related digestive problems often defy conventional treatments, such as antacids and anti-diarrhea medications. But mind-body techniques such as relaxation, hypnosis or cognitive behavioral therapy can provide a safe, effective alternative. Last year, for example, researchers at the University of North Carolina showed that cognitive behavioral therapy was effective in treating IBS. When the brain perceives pain, it tends to fret over the sensation and amplify it. In cognitive behavioral therapy, a trained therapist helps patients quell that amplification by reorienting negative ways of thinking. Instead of tensing up at the first sign of abdominal pain, a patient might learn to tell herself, "I can manage this pain and still live my life." In the North Carolina study, 70 percent of IBS patients reported less pain, bloating and diarrhea after 12 weeks of cognitive behavioral therapy, compared with just 37 percent who received only educational information about the condition. And when cognitive behavioral therapy was compared with the antidepressant desipramine, the two treatments were equally effective.
Studies are still lacking on other mind-body treatments for digestive problems, but several techniques are likely to help. Here are some remedies worth trying:
Relaxation therapy: Stress stimulates the autonomic nervous system, a part of the nervous system that controls such involuntary functions as heartbeat and intestinal contractions. Meditation and other relaxation techniques can calm the autonomic nervous system by tuning out stress-inducing thoughts, feelings and sensations. One common technique, known as progressive muscle relaxation, can be done alone or with a therapist. Simply lie or sit quietly, and then flex and relax each set of muscles, starting with your feet and progressing slowly upward to your neck and shoulders.
Hypnotherapy: This technique can help create a long-lasting state of relaxation and may help calm painful muscular motion in the intestine. A trained therapist can teach you the steps to enter a hypnotic state. You focus on your breathing and imagine what it feels like to be completely relaxed. Once you know the steps, you can use this technique to lower your tension and pain perception whenever symptoms strike.
Biofeedback: Using an electronic monitor at the office of a trained specialist, you learn to sense, and control, muscular activity in the bowel. No one knows exactly how biofeedback works, but the technique is widely accepted and many insurance plans will cover at least part of the cost of treatment.
Adapted from "The Sensitive Gut," a Special Health Report from Harvard Medical School. For more information go to health.harvard.edu/NEWSWEEK.
Read article at original source
By Kathleen Cahill Allison and Lawrence S. Friedman, M.D.
Newsweek, September 27, 2004
It's probably happened to you. You're driving to work and suddenly remember that a neglected assignment is due today. Your gut clenches, your intestines twist and before you know it you're feeling downright ill. One person in four ends up seeking medical attention for a gastrointestinal problem such as heartburn or irritable bowel syndrome (IBS). When doctors examine these patients, their blood tests and abdominal X-rays are usually normal. But the absence of ulcers or tumors doesn't mean that nothing is wrong. The brain and gut communicate through an impressive network of hormones, peptides and neurotransmitters. When emotional distress disrupts this dialogue, the effects can be seen on a brain scan. An area known as the midcingulate cortex goes into overdrive—and the gut suffers potentially devastating consequences.
Stress-related digestive problems often defy conventional treatments, such as antacids and anti-diarrhea medications. But mind-body techniques such as relaxation, hypnosis or cognitive behavioral therapy can provide a safe, effective alternative. Last year, for example, researchers at the University of North Carolina showed that cognitive behavioral therapy was effective in treating IBS. When the brain perceives pain, it tends to fret over the sensation and amplify it. In cognitive behavioral therapy, a trained therapist helps patients quell that amplification by reorienting negative ways of thinking. Instead of tensing up at the first sign of abdominal pain, a patient might learn to tell herself, "I can manage this pain and still live my life." In the North Carolina study, 70 percent of IBS patients reported less pain, bloating and diarrhea after 12 weeks of cognitive behavioral therapy, compared with just 37 percent who received only educational information about the condition. And when cognitive behavioral therapy was compared with the antidepressant desipramine, the two treatments were equally effective.
Studies are still lacking on other mind-body treatments for digestive problems, but several techniques are likely to help. Here are some remedies worth trying:
Relaxation therapy: Stress stimulates the autonomic nervous system, a part of the nervous system that controls such involuntary functions as heartbeat and intestinal contractions. Meditation and other relaxation techniques can calm the autonomic nervous system by tuning out stress-inducing thoughts, feelings and sensations. One common technique, known as progressive muscle relaxation, can be done alone or with a therapist. Simply lie or sit quietly, and then flex and relax each set of muscles, starting with your feet and progressing slowly upward to your neck and shoulders.
Hypnotherapy: This technique can help create a long-lasting state of relaxation and may help calm painful muscular motion in the intestine. A trained therapist can teach you the steps to enter a hypnotic state. You focus on your breathing and imagine what it feels like to be completely relaxed. Once you know the steps, you can use this technique to lower your tension and pain perception whenever symptoms strike.
Biofeedback: Using an electronic monitor at the office of a trained specialist, you learn to sense, and control, muscular activity in the bowel. No one knows exactly how biofeedback works, but the technique is widely accepted and many insurance plans will cover at least part of the cost of treatment.
Adapted from "The Sensitive Gut," a Special Health Report from Harvard Medical School. For more information go to health.harvard.edu/NEWSWEEK.
Read article at original source
Combination Therapy
Combination Therapy
Mind-body techniques may not cure cancer, but they make living with it a whole lot easier
By Peg Tyre
Newsweek, September 27, 2004
Mary Peterson stands in a conference room at the Dana-Farber Cancer Institute in Boston with her arms stretched above her head. As her instructor intones directions, she visualizes energy pouring into her liver, leans against a wall, then lets out a resounding exhalation. Peterson, who has metastatic breast cancer, receives regular chemotherapy. She and three other women are also taking part in another form of cancer treatment called qigong, an ancient Chinese movement and meditation technique. So far, she says, qigong has reduced her muscle pain and anxiety. Her cancer, which has spread to her liver, is under control for now.
Qigong, says Peterson, has given her "a wonderful sense that I'm participating in my own recovery." And she's not alone. These days tens of thousands of cancer patients are using mind-body practices like conscious relaxation, talk therapy, music therapy, visualization, tai chi, qigong and prayer to help them deal with their disease. Eighty percent of cancer patients report using some kind of complementary medicine, a category that includes mind-body techniques as well as nutritional supplements and other holistic approaches. And no wonder. Scientists have found that mind-body practices help patients sleep better and cope with the pain, anxiety and depression often associated with traditional cancer treatments. Recent research has shown that mind-body practices can subtly enhance a cancer patient's immune system, too. While there's no evidence to suggest that yoga practice can defeat melanoma, cancer patients say they're eager to do everything they can to stay as healthy as possible.
Among doctors, skepticism is gradually giving way to support. For decades data-driven oncologists ignored the largely untested mind-body practices. But in the last few years, "patients have made it clear that they were eager to try it. And oncologists began looking for ways to combine it with the best medicine possible," says Dr. Barrie Cassileth, chief of integrative medicine at Memorial Sloan-Kettering Cancer Center in New York. Of the nation's 26 major cancer centers, 14 now offer complementary-medicine programs, mostly in the form of nutritional counseling, support groups and instruction in guided imagery. Cassileth recently helped found the Society for Integrative Oncology in order to bring together top oncologists and alternative practitioners working with cancer patients. The group will hold its first international conference this fall. Lorenzo Cohen, head of integrative medicine at the M.D. Anderson Cancer Center in Houston, predicts that mind-body techniques will soon become as much a part of standard cancer care as chemotherapy or radiation. "In the not-so-distant future," says Cohen, "oncologists will send patients to learn tai chi or yoga the way cardiac specialists now send patients to stress-management courses after they've had a heart attack."
Although many of these techniques have been around for thousands of years, scientists have only recently been exploring how they can be used in the fight against cancer. In 1989 research efforts got a boost when Stanford University psychiatrist David Spiegel published a much-ballyhooed study showing that terminal cancer patients who attended support groups were not only happier but actually lived 18 months longer than those who didn't. Almost overnight, cancer-support groups sprang up around the nation. That initial burst of enthusiasm waned quickly, though, as follow-up studies found that mind-body techniques had little or no effect on survival rates. What did improve markedly, however, was the patients' attitudes. In a five-year study published in The New England Journal of Medicine in 2001, doctors at the University of Toronto found that breast-cancer patients who attended weekly support groups and talk therapy in addition to undergoing conventional chemotherapy reported much less anxiety and pain than patients who went through standard treatment without such help.
Quality of life became nearly as important as quantity of life for Mary McGovern, a former international-health-care consultant who was diagnosed with chronic bladder cancer in 1999. Within five years McGovern had had two relapses and multiple rounds of chemo. She left her job and lost touch with many of her friends. Her blood pressure rose, and she began suffering from headaches, back pain and depression. In desperation, she enrolled in a course for cancer patients at the Mind/Body Medical Institute in Boston. There she learned conscious relaxation, visualization and the benefits of keeping a journal. At first McGovern, a no-nonsense woman, didn't see how writing down her feelings would make her feel better. "My first reaction was, 'You can't be serious'," she says. But after 14 weeks, her blood pressure dropped and her headaches and backaches improved. "These therapies," says McGovern, "helped me live with the uncertainty of having chronic cancer."
Researchers say McGovern's gains aren't just in her mind. Repeated studies have shown that conscious relaxation and meditation can counteract stress by lowering heart rate and blood pressure, and reducing levels of the stress hormones cortisol, epinephrine and norepinephrine in the bloodstream. They also enhance immune function. In a study published this month, researchers at the Ohio State University Comprehensive Cancer Center observed 227 breast-cancer patients for 10 years. Scientists found that the patients who received regular relaxation training and attended therapy and a support group had higher T-cell function than those who didn't participate in mind-body training.
Motivational speaker Maureen Murray of Pittsburgh says she doesn't need a bar graph to convince her of the power of prayer. When she was diagnosed with breast cancer four years ago, she was terrified. Shortly before her surgery, a friend gave her a prayer chain—a schedule of people who prayed around the clock for her recovery. Although there's no science to show that prayer can extend survival, Murray felt comforted and began her own deep, regular conversations with God—and it helped. Last year the Oncology Nursing Society published her book of prayers for breast-cancer patients, "You Are Never Alone." "I want my book to give cancer patients a little serenity," says Murray. And along with lifesaving drugs, a little serenity may be exactly what the doctor ordered.
Read article at the original source
Mind-body techniques may not cure cancer, but they make living with it a whole lot easier
By Peg Tyre
Newsweek, September 27, 2004
Mary Peterson stands in a conference room at the Dana-Farber Cancer Institute in Boston with her arms stretched above her head. As her instructor intones directions, she visualizes energy pouring into her liver, leans against a wall, then lets out a resounding exhalation. Peterson, who has metastatic breast cancer, receives regular chemotherapy. She and three other women are also taking part in another form of cancer treatment called qigong, an ancient Chinese movement and meditation technique. So far, she says, qigong has reduced her muscle pain and anxiety. Her cancer, which has spread to her liver, is under control for now.
Qigong, says Peterson, has given her "a wonderful sense that I'm participating in my own recovery." And she's not alone. These days tens of thousands of cancer patients are using mind-body practices like conscious relaxation, talk therapy, music therapy, visualization, tai chi, qigong and prayer to help them deal with their disease. Eighty percent of cancer patients report using some kind of complementary medicine, a category that includes mind-body techniques as well as nutritional supplements and other holistic approaches. And no wonder. Scientists have found that mind-body practices help patients sleep better and cope with the pain, anxiety and depression often associated with traditional cancer treatments. Recent research has shown that mind-body practices can subtly enhance a cancer patient's immune system, too. While there's no evidence to suggest that yoga practice can defeat melanoma, cancer patients say they're eager to do everything they can to stay as healthy as possible.
Among doctors, skepticism is gradually giving way to support. For decades data-driven oncologists ignored the largely untested mind-body practices. But in the last few years, "patients have made it clear that they were eager to try it. And oncologists began looking for ways to combine it with the best medicine possible," says Dr. Barrie Cassileth, chief of integrative medicine at Memorial Sloan-Kettering Cancer Center in New York. Of the nation's 26 major cancer centers, 14 now offer complementary-medicine programs, mostly in the form of nutritional counseling, support groups and instruction in guided imagery. Cassileth recently helped found the Society for Integrative Oncology in order to bring together top oncologists and alternative practitioners working with cancer patients. The group will hold its first international conference this fall. Lorenzo Cohen, head of integrative medicine at the M.D. Anderson Cancer Center in Houston, predicts that mind-body techniques will soon become as much a part of standard cancer care as chemotherapy or radiation. "In the not-so-distant future," says Cohen, "oncologists will send patients to learn tai chi or yoga the way cardiac specialists now send patients to stress-management courses after they've had a heart attack."
Although many of these techniques have been around for thousands of years, scientists have only recently been exploring how they can be used in the fight against cancer. In 1989 research efforts got a boost when Stanford University psychiatrist David Spiegel published a much-ballyhooed study showing that terminal cancer patients who attended support groups were not only happier but actually lived 18 months longer than those who didn't. Almost overnight, cancer-support groups sprang up around the nation. That initial burst of enthusiasm waned quickly, though, as follow-up studies found that mind-body techniques had little or no effect on survival rates. What did improve markedly, however, was the patients' attitudes. In a five-year study published in The New England Journal of Medicine in 2001, doctors at the University of Toronto found that breast-cancer patients who attended weekly support groups and talk therapy in addition to undergoing conventional chemotherapy reported much less anxiety and pain than patients who went through standard treatment without such help.
Quality of life became nearly as important as quantity of life for Mary McGovern, a former international-health-care consultant who was diagnosed with chronic bladder cancer in 1999. Within five years McGovern had had two relapses and multiple rounds of chemo. She left her job and lost touch with many of her friends. Her blood pressure rose, and she began suffering from headaches, back pain and depression. In desperation, she enrolled in a course for cancer patients at the Mind/Body Medical Institute in Boston. There she learned conscious relaxation, visualization and the benefits of keeping a journal. At first McGovern, a no-nonsense woman, didn't see how writing down her feelings would make her feel better. "My first reaction was, 'You can't be serious'," she says. But after 14 weeks, her blood pressure dropped and her headaches and backaches improved. "These therapies," says McGovern, "helped me live with the uncertainty of having chronic cancer."
Researchers say McGovern's gains aren't just in her mind. Repeated studies have shown that conscious relaxation and meditation can counteract stress by lowering heart rate and blood pressure, and reducing levels of the stress hormones cortisol, epinephrine and norepinephrine in the bloodstream. They also enhance immune function. In a study published this month, researchers at the Ohio State University Comprehensive Cancer Center observed 227 breast-cancer patients for 10 years. Scientists found that the patients who received regular relaxation training and attended therapy and a support group had higher T-cell function than those who didn't participate in mind-body training.
Motivational speaker Maureen Murray of Pittsburgh says she doesn't need a bar graph to convince her of the power of prayer. When she was diagnosed with breast cancer four years ago, she was terrified. Shortly before her surgery, a friend gave her a prayer chain—a schedule of people who prayed around the clock for her recovery. Although there's no science to show that prayer can extend survival, Murray felt comforted and began her own deep, regular conversations with God—and it helped. Last year the Oncology Nursing Society published her book of prayers for breast-cancer patients, "You Are Never Alone." "I want my book to give cancer patients a little serenity," says Murray. And along with lifesaving drugs, a little serenity may be exactly what the doctor ordered.
Read article at the original source
The Serenity Workout
The Serenity Workout
Regular exercise can strengthen the mind as well as the muscles, and studies show it improves mood, too
By Karen Springen
Newsweek, September 27, 2004
It's now clear that emotions can affect our physical health, but what about the reverse? Can physical activity affect the health of our minds? Hippocrates thought so. He advised melancholy Greeks to get out and walk, and modern science suggests he was on to something. In fact, getting off the couch may help some people as much as Prozac or psychotherapy. 'Exercise can improve anyone's mood and mental performance,' says Carl Cotman, director of the Institute for Brain Aging and Dementia at the University of California, Irvine. 'It's free, it's fun and it doesn't take a whole lot of time.'
Whether they survey children or adults, researchers find that active people are happier than sofa jockeys, and less prone to depression and suicide."
Read the entire article at original source
Regular exercise can strengthen the mind as well as the muscles, and studies show it improves mood, too
By Karen Springen
Newsweek, September 27, 2004
It's now clear that emotions can affect our physical health, but what about the reverse? Can physical activity affect the health of our minds? Hippocrates thought so. He advised melancholy Greeks to get out and walk, and modern science suggests he was on to something. In fact, getting off the couch may help some people as much as Prozac or psychotherapy. 'Exercise can improve anyone's mood and mental performance,' says Carl Cotman, director of the Institute for Brain Aging and Dementia at the University of California, Irvine. 'It's free, it's fun and it doesn't take a whole lot of time.'
Whether they survey children or adults, researchers find that active people are happier than sofa jockeys, and less prone to depression and suicide."
Read the entire article at original source
We All Need a Dose of the Doctor
We All Need a Dose of the Doctor
The healing relationship between patient and physician plays a vital role in medical care
By Michael C. Miller, M.D.
Newsweek, September 27, 2004
You're the doctor. Your patient feels ill, but you don't have anything curative in your medicine bag. What do you do? That question has long stymied physicians. But as the Hungarian psychoanalyst Michael Balint recognized a half century ago, persistent or mystifying symptoms are not necessarily untreatable. Listen to patients' stories, Balint urged his colleagues. Treat them as friends. They may need a dose of the strongest drug of all: the doctor.
Balint's prescription is as timely today as it was in the 1950s. A founding insight of mind-body medicine is that everyone needs a dose of the doctor, even when state-of-the-art tests and treatments are available. Patients who have a good and trusting relationship with a clinician are more satisfied, studies show—and satisfied patients get better clinical results. They're more motivated to take care of themselves, more comfortable seeking help when problems arise, and more willing to follow advice and take medication as prescribed. A healthy doctor-patient relationship can also give consolation when bad news comes. Whether the diagnosis is HIV or heart disease, a patient whose doctor is a comrade doesn't have to worry about being scolded or abandoned. The relationship itself provides an emotional safety net.
Yet as science confirms the power of the healing relationship, other forces are conspiring to undermine it. Our health system can leave both patients and doctors feeling stressed out and alienated from one another. Relationships take time—and time is short in the world of managed care. Fifteen minutes may be long enough for a skilled practitioner to diagnose an infection and dash off a prescription or a referral to a specialist. It's rarely long enough to make sense of another person's experience, convey that understanding or act as an advocate. At its worst, our system of managed care can turn the doctor-patient encounter into an anonymous retail transaction.
The medical profession, to its credit, is struggling to revive the healing relationship. The medical schools at Harvard, Columbia, Duke and the University of Arizona have all created programs intended to pull medicine away from an exclusive focus on disease and toward the promotion of wellness, stressing the doctor's role as partner, teacher and coach. And at least two thirds of all U.S. medical schools now devote some part of their curriculum to integrating conventional care with complementary and alternative therapies that patients find more friendly. With the right reorganizing of priorities, the system can still cultivate a deeper role for physicians.
Consumers, for their part, are not waiting passively for the medical system to change. They're venturing outside of it in search of healing practices that involve less technology and more of the human touch. Few of these patients would give up effective drugs or surgery in favor of more sympathy, but most recognize that pills and procedures are an incomplete model of care. They want a dose of the healer who remembers their name.
Even the best doctor-patient relationship has boundaries, of course. No one should expect a parent's love from an internist (or a shaman, for that matter). But anyone with access to health care can take steps to improve the therapeutic exchange. Step one is to communicate freely. Educate yourself about whatever condition ails you, and share the information you find. Don't hold back for fear of being a nuisance. A good clinician is eager to teach and learn, and willing to acknowledge medicine's limits. In fact the healing relationship sometimes grows stronger when a doctor runs out of more treatments to offer. In that moment, he or she sheds authority and becomes a peer who is struggling forthrightly with the emotional consequences of illness. Doctor and patient become allies in an effort to sustain hope and find meaning in suffering.
For a healing relationship to thrive, then, patients must be experts about their needs, values and objectives. Doctors must be experts on wellness and illness and have finely attuned eyes, ears and hands. Few physicians emerge from training without some qualms about caring for other people. We become good at what we do by learning that even when we can't cure illness, we can make it less baffling and less onerous. The value of the doctor-patient relationship is not always easy to measure, but it is always immeasurable.
Miller is editor in chief of the Harvard Mental Health Letter (http://www.health.harvard.edu/newsweek).
Read article at the original source
The healing relationship between patient and physician plays a vital role in medical care
By Michael C. Miller, M.D.
Newsweek, September 27, 2004
You're the doctor. Your patient feels ill, but you don't have anything curative in your medicine bag. What do you do? That question has long stymied physicians. But as the Hungarian psychoanalyst Michael Balint recognized a half century ago, persistent or mystifying symptoms are not necessarily untreatable. Listen to patients' stories, Balint urged his colleagues. Treat them as friends. They may need a dose of the strongest drug of all: the doctor.
Balint's prescription is as timely today as it was in the 1950s. A founding insight of mind-body medicine is that everyone needs a dose of the doctor, even when state-of-the-art tests and treatments are available. Patients who have a good and trusting relationship with a clinician are more satisfied, studies show—and satisfied patients get better clinical results. They're more motivated to take care of themselves, more comfortable seeking help when problems arise, and more willing to follow advice and take medication as prescribed. A healthy doctor-patient relationship can also give consolation when bad news comes. Whether the diagnosis is HIV or heart disease, a patient whose doctor is a comrade doesn't have to worry about being scolded or abandoned. The relationship itself provides an emotional safety net.
Yet as science confirms the power of the healing relationship, other forces are conspiring to undermine it. Our health system can leave both patients and doctors feeling stressed out and alienated from one another. Relationships take time—and time is short in the world of managed care. Fifteen minutes may be long enough for a skilled practitioner to diagnose an infection and dash off a prescription or a referral to a specialist. It's rarely long enough to make sense of another person's experience, convey that understanding or act as an advocate. At its worst, our system of managed care can turn the doctor-patient encounter into an anonymous retail transaction.
The medical profession, to its credit, is struggling to revive the healing relationship. The medical schools at Harvard, Columbia, Duke and the University of Arizona have all created programs intended to pull medicine away from an exclusive focus on disease and toward the promotion of wellness, stressing the doctor's role as partner, teacher and coach. And at least two thirds of all U.S. medical schools now devote some part of their curriculum to integrating conventional care with complementary and alternative therapies that patients find more friendly. With the right reorganizing of priorities, the system can still cultivate a deeper role for physicians.
Consumers, for their part, are not waiting passively for the medical system to change. They're venturing outside of it in search of healing practices that involve less technology and more of the human touch. Few of these patients would give up effective drugs or surgery in favor of more sympathy, but most recognize that pills and procedures are an incomplete model of care. They want a dose of the healer who remembers their name.
Even the best doctor-patient relationship has boundaries, of course. No one should expect a parent's love from an internist (or a shaman, for that matter). But anyone with access to health care can take steps to improve the therapeutic exchange. Step one is to communicate freely. Educate yourself about whatever condition ails you, and share the information you find. Don't hold back for fear of being a nuisance. A good clinician is eager to teach and learn, and willing to acknowledge medicine's limits. In fact the healing relationship sometimes grows stronger when a doctor runs out of more treatments to offer. In that moment, he or she sheds authority and becomes a peer who is struggling forthrightly with the emotional consequences of illness. Doctor and patient become allies in an effort to sustain hope and find meaning in suffering.
For a healing relationship to thrive, then, patients must be experts about their needs, values and objectives. Doctors must be experts on wellness and illness and have finely attuned eyes, ears and hands. Few physicians emerge from training without some qualms about caring for other people. We become good at what we do by learning that even when we can't cure illness, we can make it less baffling and less onerous. The value of the doctor-patient relationship is not always easy to measure, but it is always immeasurable.
Miller is editor in chief of the Harvard Mental Health Letter (http://www.health.harvard.edu/newsweek).
Read article at the original source
Health for Life MD: Mind Over Matter
Health for Life MD: Mind Over Matter
Readers sent us their mind-body questions. We asked a Harvard psychologist for some answers
WEB EXCLUSIVE
Newsweek, September 19, 2004
Earlier this month, you wrote to us with queries about the connection between mind and body. We handed them over to Alice D. Domar, Ph.D., director of the Mind/Body Center for Women’s Health at Boston IVF. Here are her responses to some of those questions, including those excerpted in the Sept. 27 issue of NEWSWEEK.
Chicago: Since mid-June, I've had persistent low-grade pain on the left side of my neck and upper back. I've started seeing a chiropractor periodically and am doing the at-home exercises he recommends. I also do yoga 2-3 times a week, and have practiced yoga for three years. I have a stressful, demanding job that I'm becoming increasingly unhappy with. Is it possible that my stress and unhappiness at my job can override the benefits from my chiropractor and my yoga practice? Can a job actually be unhealthy for you?
Alice Domar: Yes, and yes. As much as we would like to think that no matter how tough life gets, wonderful activities like yoga can conquer all, that is often not the case. Yoga can do a lot in terms of strengthening, toning and relaxing but it may not be enough if your job is really getting to you. You didn't say what kind of work-up you have had to make sure that chiropractic care is indeed the best treatment for you, but you might want to check in with your primary-care physician since the pain isn't getting better. He or she may recommend further tests and the solution may range from getting a new pillow and/or sleeping in a different position to physical therapy to continuing with your chiropractor. Recent research does show that job stress leads to a whole host of physical and psychological symptoms, so you might want to rethink your job situation, as well. Can you look for another one? Is there a way to make your current job more palatable? Sometimes we are in situations that are making us sick but we don't take the time to think about how to change things.
Kangwon Province, South Korea: Does a positive attitude boost the immune system to fight cancer and other diseases? I have known a lot of cancer survivors who have attributed their recovery to a positive outlook and trust in divine powers.
This is a really good question and is probably one of the most-asked question about cancer. The research to date has not provided a clear answer. A study by David Spiegel, M.D., in the late-'80s indicated that women with breast cancer who participated in a support group not only were less anxious and depressed but lived twice as long as women who did not participate. Some subsequent research replicated the emotional benefits of groups, but not the survival advantage, while other studies also showed that patients who participated in psychological interventions lived longer. A very recent study (about a week ago!) indicated that indeed psychological therapy was associated with improved immune function. However, there is no definitive evidence that a positive attitude per se can fight off cancer. Pessimists can survive and some optimists do not. My advice to cancer patients is to seek out the support you need and want and not worry that your attitude will truly impact your life span.
Caloocan City, Philippines: My weight is 160 pounds. According to the charts, I am around 15 to 20 pounds overweight. But I am muscular, I lift heavy weights. My waistline is 31 inches. Can I be heavier because I am muscular? I see athletes who are overweight. Is it all right to be overweight if you are muscular?
Muscle indeed weighs more than fat so anyone who lifts weights may well be fit but heavier than the charts suggest you should be. And a study that came out recently showed that being sedentary and thin is worse for you than being fit and overweight. I would suggest examining your eating habits: are you eating lots of fruits, veggies, whole grains and lean meats? If you have solid eating habits and your primary-care physician is satisfied with your weight in terms of your muscle mass, you are most likely in good shape.
Upland, Calif.: I used to get that endorphin kick after my workouts, but no more. Is that proof or refutation of the mind-body connection?
Good question! Actually, a recent study indicated that the early research showing that people get an endorphin high during and after exercise may have been flawed. It raised the question of whether there is an endorphin high after all. That is totally contrary to the experience of many athletes—and to my own personal experience (of course, a study about 10 years ago put into question the existence of PMS, and we all know that must exist!). I would venture a guess that if you no longer get the same satisfaction from your exercise regimen it may be because your body has gotten used to the level of exercise and you might want to push yourself a bit more and see what happens.
Brasilia, Brazil: How much can fitness be responsible for satisfaction and well-being? Can aerobic exercises cure diseases like some cancers?
In my opinion, exercise comes pretty close to the ideal health promoter. If we could develop a pill that does everything exercise does (decrease the risk of heart disease, decrease the risk of certain cancers such as breast, colon and bladder, improve the immune system, decrease the risk of osteoporosis and decrease symptoms of anxiety and depression, to name a few), the whole world would be popping such a pill on a daily basis. Especially if the pill, like exercise, was free and had no side effects. So yes, fitness can definitely contribute to satisfaction and well-being. But no, I don't think we can go so far as to say that it can cure diseases like some cancers. However, patients with diseases such as AIDS and cancer who exercise do have stronger immune systems than patients who don't exercise.
Lakewood, Colo.: I'm pretty substantially overweight, by 60 pounds or so. Every time I lose a few pounds—enough for people to notice and comment on—I seem to lose my focus. Before I know it, I'm back to my old habits, even if my diet had been going really well. I can't help but think there's a connection. What do you say?
I say you are right in that the fact that people comment and compliment you may be a powerful force. In fact, just a few months ago, a new study came out that followed a group of people who were dieting as they lost weight and, unfortunately for most of them, as they gained it back. What the study showed was that as people lost weight, they attracted a lot of good attention (as in comments like: “You look fabulous!”). However, as time went on, the comments decreased in frequency and with the lack of attention, most of the dieting behavior stopped and the weight came back on. It seems that the work of dieting is worth it if people notice and make a fuss over you, but as they get used to the new you and the compliments stop, the effort may just not feel justified. The key to successful dieting may well be to try to make it more dependent on what you think and feel, rather than depending on the comments of others.
Abingdon, Va.: How does the mind-body connection work to reduce the recurrence of breast cancer? (Especially breast cancer that is receptor negative.) And how can you get the mind and body connected?
The mind-body connection can work in a lot of different ways. The goal for any cancer patient is to have an optimal immune system. There are numerous mind-body skills that are associated with improved immune function, including relaxation techniques, exercise, good nutrition, and social support. Relaxation techniques include everything from meditation to progressive muscle relaxation to imagery. The key to integrating relaxation techniques into your life is to try out several techniques and see which one or ones feel comfortable and effective for you.
The easiest way to start is with guidance; either purchase a tape/CD or go to a class. Next is exercise; adopting an exercise routine does not have to mean sweating it out in an aerobics class. Simply putting on a pair of sneakers and walking is an ideal way to start. You might only make it around half the block at first but if you slowly add distance, it will make a difference in your health. Good nutrition is a must for cancer survivors, especially as so many lose weight after surgery and during chemotherapy. Don't feel overwhelmed by suddenly making your diet ideal. There are three easy pieces of advice I had been told by nutritionists. First, balance your plate so instead of it being half meat, one-fourth starch and one-fourth vegetable, try making it half vegetable and one-fourth meat and one-fourth starch. Second, add as many colors as you can. The most healthful fruits and vegetables tend to be colorful. And finally, make three simple changes. Substitute whole grain bread for white, use brown rice instead of white, and when you make a salad, throw in lots of interesting things such as dried cranberries, grapes, different kinds of nuts, etc. Finally, seek out others who can provide support to you and to whom you can give support. Friends are crucial. In one study on breast cancer patients, the women who had numerous close friends were less likely to die than those who had few or no close friends. If you try any or all of these approaches, you will be happier and healthier.
Atlanta: I have been suffering some constipation and have also been feeling particularly moody even though I’ve gotten plenty of rest. Could the two be connected?
The two could be connected but in more ways than one. My advice is to get checked out by your primary-care physician to make sure there is no physical cause. Thyroid conditions can cause both constipation and mood changes so before we assume that this is a mind-body thing, let's make sure it is not a purely physical thing. If your doctor finds no physical cause, there are several things which could be going on. Stress can contribute to constipation so the two could be connected. Also, when people are feeling sad or depressed, they tend to move around less and eat poorly, which can cause constipation. Assuming that your doctor finds nothing physically wrong with you, I would recommend several approaches including exercise, making sure you drink plenty of water and eats lots of fruits and vegetables, and addressing what is going on in your life that may be contributing to your moodiness. Has anything changed lately? Are you in your 40s and experiencing perimenopause, which can actually cause hot flashes at night that can make you moody by day? Have you ever experienced this kind of moodiness before and if so, what helped you then? Finding a good therapist can help address these issues and cognitive-behavioral approaches can help treat the moodiness.
Austin, Texas: I am 57 years old and divorced. I left my husband two years ago to pursue a spiritual path. I was fairly healthy, enthusiastic and very excited to be free to follow my dreams of becoming a Native American Sundancer and Kundalini Yoga teacher. My brother, 48 years old, became ill within three months and was dying with cancer and wanted me there. I lived in hospitals and nursing homes for the following six months, being at his side 24/7, which was a blessing beyond explanation. I had done the same for my mother in 1990, except that she was at home. Anyway, something changed within me. Since that time, I have developed rheumatoid arthritis, lupus and chronic obstructive pulmonary disease. I could care not less if I get up in the mornings, and nothing I seem to do can restore my enthusiasm for life and my dreams. I know that there has to be a mind-body connection here, but I just cannot seem to break the code. Do you have any suggestions for me?
I would tend to agree with you that there is a mind-body connection here. Losing a close relative can cause all sorts of physical and psychological problems. My first guess is that you may be depressed. There are numerous symptoms of depression and the focus for diagnosis used to be what were called "vegetative signs" such as not being able to get out of bed, changes in appetite, etc. However, recently there has been more attention paid to changes in mood. Some of the more common symptoms are feeling hopeless about the future and not enjoying things you used to enjoy. That does sound similar to what you are describing. It is very common to experience symptoms of depression as part of a grief reaction. And depression is associated with decreases in immune function as well as a host of other physical ailments. In addition, rheumatoid arthritis and lupus are both autoimmune diseases which tend to worsen under conditions of stress. The good news is that you have a history of being a healthy, upbeat person and you clearly have an expertise in techniques such as yoga which can decrease stress levels. I would suggest that you also pursue treatment for your depressive symptoms. What I recommend to my patients is to start with antidepressant medication to get you over the hump, and then quickly start cognitive-behavior therapy (CBT). Research shows that the combination of these two treatments can get you healthy quickly and the CBT skills can keep you that way.
New York: I have minor headaches, dizziness and neck discomfort on and off all the time, especially when I'm anxious. I've had blood tests and even an MRI, which are normal. I try to relax and breathe and yet I often feel very debilitated by this. Any suggestions? I'm tired of going to doctors and suffering each day with this.
I don't blame you. Pain is exhausting and it is discouraging not to know why you feel so lousy all the time. Normally, if I have a patient with your symptoms, I make them see a physician for a complete work-up to make sure there is no physical cause. But since you have already done this, it makes sense to assume that mind-body techniques are a logical next step. The good thing about a mind-body approach is that the techniques involve minimal investment of time or money and they have no side-effects. And the worst thing that can happen is that don't help. But they usually do offer relief, both physically and psychologically. Since you report that the symptoms are worst when you are anxious, treating your anxiety is a logical first step. You might want to keep a diary for a week or so of your symptoms to see if there are any triggers. For example, if you find the symptoms are worst when driving, then learning to decrease anxiety while driving would help. Other common triggers of symptoms like yours can be work situations (such as confrontations with your boss or presenting before your colleagues), family members who "push your buttons," and even physical situations such as lifting groceries or sitting on the floor, or poor posture. Once you identify when you feel your worst and what might make you feel that way, you can concentrate on relieving your symptoms. Relaxation techniques would be a good place to start. Relaxing and breathing, as you are already doing, are a good start, but I would advise a more formal regular practice. Research shows that when you practice a regular relaxation technique, within a few weeks you experience a "carry-over" effect so you feel better throughout the day, not just while relaxing. Try hatha yoga, meditation, autogenic training, or imagery, and I wouldn't be surprised if you felt better within weeks.
Read article at the original source
Readers sent us their mind-body questions. We asked a Harvard psychologist for some answers
WEB EXCLUSIVE
Newsweek, September 19, 2004
Earlier this month, you wrote to us with queries about the connection between mind and body. We handed them over to Alice D. Domar, Ph.D., director of the Mind/Body Center for Women’s Health at Boston IVF. Here are her responses to some of those questions, including those excerpted in the Sept. 27 issue of NEWSWEEK.
Chicago: Since mid-June, I've had persistent low-grade pain on the left side of my neck and upper back. I've started seeing a chiropractor periodically and am doing the at-home exercises he recommends. I also do yoga 2-3 times a week, and have practiced yoga for three years. I have a stressful, demanding job that I'm becoming increasingly unhappy with. Is it possible that my stress and unhappiness at my job can override the benefits from my chiropractor and my yoga practice? Can a job actually be unhealthy for you?
Alice Domar: Yes, and yes. As much as we would like to think that no matter how tough life gets, wonderful activities like yoga can conquer all, that is often not the case. Yoga can do a lot in terms of strengthening, toning and relaxing but it may not be enough if your job is really getting to you. You didn't say what kind of work-up you have had to make sure that chiropractic care is indeed the best treatment for you, but you might want to check in with your primary-care physician since the pain isn't getting better. He or she may recommend further tests and the solution may range from getting a new pillow and/or sleeping in a different position to physical therapy to continuing with your chiropractor. Recent research does show that job stress leads to a whole host of physical and psychological symptoms, so you might want to rethink your job situation, as well. Can you look for another one? Is there a way to make your current job more palatable? Sometimes we are in situations that are making us sick but we don't take the time to think about how to change things.
Kangwon Province, South Korea: Does a positive attitude boost the immune system to fight cancer and other diseases? I have known a lot of cancer survivors who have attributed their recovery to a positive outlook and trust in divine powers.
This is a really good question and is probably one of the most-asked question about cancer. The research to date has not provided a clear answer. A study by David Spiegel, M.D., in the late-'80s indicated that women with breast cancer who participated in a support group not only were less anxious and depressed but lived twice as long as women who did not participate. Some subsequent research replicated the emotional benefits of groups, but not the survival advantage, while other studies also showed that patients who participated in psychological interventions lived longer. A very recent study (about a week ago!) indicated that indeed psychological therapy was associated with improved immune function. However, there is no definitive evidence that a positive attitude per se can fight off cancer. Pessimists can survive and some optimists do not. My advice to cancer patients is to seek out the support you need and want and not worry that your attitude will truly impact your life span.
Caloocan City, Philippines: My weight is 160 pounds. According to the charts, I am around 15 to 20 pounds overweight. But I am muscular, I lift heavy weights. My waistline is 31 inches. Can I be heavier because I am muscular? I see athletes who are overweight. Is it all right to be overweight if you are muscular?
Muscle indeed weighs more than fat so anyone who lifts weights may well be fit but heavier than the charts suggest you should be. And a study that came out recently showed that being sedentary and thin is worse for you than being fit and overweight. I would suggest examining your eating habits: are you eating lots of fruits, veggies, whole grains and lean meats? If you have solid eating habits and your primary-care physician is satisfied with your weight in terms of your muscle mass, you are most likely in good shape.
Upland, Calif.: I used to get that endorphin kick after my workouts, but no more. Is that proof or refutation of the mind-body connection?
Good question! Actually, a recent study indicated that the early research showing that people get an endorphin high during and after exercise may have been flawed. It raised the question of whether there is an endorphin high after all. That is totally contrary to the experience of many athletes—and to my own personal experience (of course, a study about 10 years ago put into question the existence of PMS, and we all know that must exist!). I would venture a guess that if you no longer get the same satisfaction from your exercise regimen it may be because your body has gotten used to the level of exercise and you might want to push yourself a bit more and see what happens.
Brasilia, Brazil: How much can fitness be responsible for satisfaction and well-being? Can aerobic exercises cure diseases like some cancers?
In my opinion, exercise comes pretty close to the ideal health promoter. If we could develop a pill that does everything exercise does (decrease the risk of heart disease, decrease the risk of certain cancers such as breast, colon and bladder, improve the immune system, decrease the risk of osteoporosis and decrease symptoms of anxiety and depression, to name a few), the whole world would be popping such a pill on a daily basis. Especially if the pill, like exercise, was free and had no side effects. So yes, fitness can definitely contribute to satisfaction and well-being. But no, I don't think we can go so far as to say that it can cure diseases like some cancers. However, patients with diseases such as AIDS and cancer who exercise do have stronger immune systems than patients who don't exercise.
Lakewood, Colo.: I'm pretty substantially overweight, by 60 pounds or so. Every time I lose a few pounds—enough for people to notice and comment on—I seem to lose my focus. Before I know it, I'm back to my old habits, even if my diet had been going really well. I can't help but think there's a connection. What do you say?
I say you are right in that the fact that people comment and compliment you may be a powerful force. In fact, just a few months ago, a new study came out that followed a group of people who were dieting as they lost weight and, unfortunately for most of them, as they gained it back. What the study showed was that as people lost weight, they attracted a lot of good attention (as in comments like: “You look fabulous!”). However, as time went on, the comments decreased in frequency and with the lack of attention, most of the dieting behavior stopped and the weight came back on. It seems that the work of dieting is worth it if people notice and make a fuss over you, but as they get used to the new you and the compliments stop, the effort may just not feel justified. The key to successful dieting may well be to try to make it more dependent on what you think and feel, rather than depending on the comments of others.
Abingdon, Va.: How does the mind-body connection work to reduce the recurrence of breast cancer? (Especially breast cancer that is receptor negative.) And how can you get the mind and body connected?
The mind-body connection can work in a lot of different ways. The goal for any cancer patient is to have an optimal immune system. There are numerous mind-body skills that are associated with improved immune function, including relaxation techniques, exercise, good nutrition, and social support. Relaxation techniques include everything from meditation to progressive muscle relaxation to imagery. The key to integrating relaxation techniques into your life is to try out several techniques and see which one or ones feel comfortable and effective for you.
The easiest way to start is with guidance; either purchase a tape/CD or go to a class. Next is exercise; adopting an exercise routine does not have to mean sweating it out in an aerobics class. Simply putting on a pair of sneakers and walking is an ideal way to start. You might only make it around half the block at first but if you slowly add distance, it will make a difference in your health. Good nutrition is a must for cancer survivors, especially as so many lose weight after surgery and during chemotherapy. Don't feel overwhelmed by suddenly making your diet ideal. There are three easy pieces of advice I had been told by nutritionists. First, balance your plate so instead of it being half meat, one-fourth starch and one-fourth vegetable, try making it half vegetable and one-fourth meat and one-fourth starch. Second, add as many colors as you can. The most healthful fruits and vegetables tend to be colorful. And finally, make three simple changes. Substitute whole grain bread for white, use brown rice instead of white, and when you make a salad, throw in lots of interesting things such as dried cranberries, grapes, different kinds of nuts, etc. Finally, seek out others who can provide support to you and to whom you can give support. Friends are crucial. In one study on breast cancer patients, the women who had numerous close friends were less likely to die than those who had few or no close friends. If you try any or all of these approaches, you will be happier and healthier.
Atlanta: I have been suffering some constipation and have also been feeling particularly moody even though I’ve gotten plenty of rest. Could the two be connected?
The two could be connected but in more ways than one. My advice is to get checked out by your primary-care physician to make sure there is no physical cause. Thyroid conditions can cause both constipation and mood changes so before we assume that this is a mind-body thing, let's make sure it is not a purely physical thing. If your doctor finds no physical cause, there are several things which could be going on. Stress can contribute to constipation so the two could be connected. Also, when people are feeling sad or depressed, they tend to move around less and eat poorly, which can cause constipation. Assuming that your doctor finds nothing physically wrong with you, I would recommend several approaches including exercise, making sure you drink plenty of water and eats lots of fruits and vegetables, and addressing what is going on in your life that may be contributing to your moodiness. Has anything changed lately? Are you in your 40s and experiencing perimenopause, which can actually cause hot flashes at night that can make you moody by day? Have you ever experienced this kind of moodiness before and if so, what helped you then? Finding a good therapist can help address these issues and cognitive-behavioral approaches can help treat the moodiness.
Austin, Texas: I am 57 years old and divorced. I left my husband two years ago to pursue a spiritual path. I was fairly healthy, enthusiastic and very excited to be free to follow my dreams of becoming a Native American Sundancer and Kundalini Yoga teacher. My brother, 48 years old, became ill within three months and was dying with cancer and wanted me there. I lived in hospitals and nursing homes for the following six months, being at his side 24/7, which was a blessing beyond explanation. I had done the same for my mother in 1990, except that she was at home. Anyway, something changed within me. Since that time, I have developed rheumatoid arthritis, lupus and chronic obstructive pulmonary disease. I could care not less if I get up in the mornings, and nothing I seem to do can restore my enthusiasm for life and my dreams. I know that there has to be a mind-body connection here, but I just cannot seem to break the code. Do you have any suggestions for me?
I would tend to agree with you that there is a mind-body connection here. Losing a close relative can cause all sorts of physical and psychological problems. My first guess is that you may be depressed. There are numerous symptoms of depression and the focus for diagnosis used to be what were called "vegetative signs" such as not being able to get out of bed, changes in appetite, etc. However, recently there has been more attention paid to changes in mood. Some of the more common symptoms are feeling hopeless about the future and not enjoying things you used to enjoy. That does sound similar to what you are describing. It is very common to experience symptoms of depression as part of a grief reaction. And depression is associated with decreases in immune function as well as a host of other physical ailments. In addition, rheumatoid arthritis and lupus are both autoimmune diseases which tend to worsen under conditions of stress. The good news is that you have a history of being a healthy, upbeat person and you clearly have an expertise in techniques such as yoga which can decrease stress levels. I would suggest that you also pursue treatment for your depressive symptoms. What I recommend to my patients is to start with antidepressant medication to get you over the hump, and then quickly start cognitive-behavior therapy (CBT). Research shows that the combination of these two treatments can get you healthy quickly and the CBT skills can keep you that way.
New York: I have minor headaches, dizziness and neck discomfort on and off all the time, especially when I'm anxious. I've had blood tests and even an MRI, which are normal. I try to relax and breathe and yet I often feel very debilitated by this. Any suggestions? I'm tired of going to doctors and suffering each day with this.
I don't blame you. Pain is exhausting and it is discouraging not to know why you feel so lousy all the time. Normally, if I have a patient with your symptoms, I make them see a physician for a complete work-up to make sure there is no physical cause. But since you have already done this, it makes sense to assume that mind-body techniques are a logical next step. The good thing about a mind-body approach is that the techniques involve minimal investment of time or money and they have no side-effects. And the worst thing that can happen is that don't help. But they usually do offer relief, both physically and psychologically. Since you report that the symptoms are worst when you are anxious, treating your anxiety is a logical first step. You might want to keep a diary for a week or so of your symptoms to see if there are any triggers. For example, if you find the symptoms are worst when driving, then learning to decrease anxiety while driving would help. Other common triggers of symptoms like yours can be work situations (such as confrontations with your boss or presenting before your colleagues), family members who "push your buttons," and even physical situations such as lifting groceries or sitting on the floor, or poor posture. Once you identify when you feel your worst and what might make you feel that way, you can concentrate on relieving your symptoms. Relaxation techniques would be a good place to start. Relaxing and breathing, as you are already doing, are a good start, but I would advise a more formal regular practice. Research shows that when you practice a regular relaxation technique, within a few weeks you experience a "carry-over" effect so you feel better throughout the day, not just while relaxing. Try hatha yoga, meditation, autogenic training, or imagery, and I wouldn't be surprised if you felt better within weeks.
Read article at the original source
Cut Stress - Cut Sugar
Cut Stress - Cut Sugar
Relaxation exercises may keep diabetes in check
By Mary Carmichael
Newsweek, September 27, 2004
Compared with other methods of managing diabetes—strict diets, insulin injections, vigilant blood-sugar monitoring—Richard Surwit's technique seems too easy to be true. It doesn't involve pills or shots. It doesn't technically require a doctor's supervision. And if you're a diabetic reading this, you can start treatment right now, just by taking a deep, relaxing breath. Feel better?
If Surwit is right, you should. By lowering stress, he argues, patients with diabetes, particularly type 2, can keep their illness in check. Stress raises the body's levels of cortisol and epinephrine and, via those hormones, the amount of glucose in the blood. Because diabetics cannot make enough insulin to metabolize the raised sugar levels, the sugar stays high long after the stress has ended.
Surwit, a psychologist, first stumbled on the principle 25 years ago. Mind-body medicine was in its infancy, and he was frankly more interested in its potential for preventing heart disease. But a colleague, a Duke University endocrinologist, came to him with a challenge: a woman with diabetes who couldn't keep her blood sugar low even with a rigorous diet and standard treatment. When her work or home life turned stressful, her glucose levels shot out of control, leaving her hospitalized. The endocrinologist was at a loss to help his patient; after one week of bio-feedback and muscle relaxation with Surwit, she was stable enough to leave the hospital.
Today relaxation is used to combat everything from asthma to labor pains, but there's a stumbling block for diabetic patients: most insurance companies won't pay for Surwit's therapy, classifying it as experimental. Nonetheless, other doctors are starting to pick up the idea, using it in conjunction with more conventional remedies. And this year Surwit has made the treatment widely available in a different manner; he published a book this spring. "The Mind-Body Diabetes Revolution" focuses on easy relaxation techniques, particularly cognitive behavioral therapy and progressive muscle relaxation. "Almost everybody can learn it," Surwit says of the latter, "and it only takes a week or so." Progressive muscle relaxation is just what it sounds like, a sequence of tightening, then slackening, exercises that allows people to monitor their stress levels based on muscle tension. Cognitive behavior therapy, says Surwit, consists of "getting the person to evaluate how they emotionally respond to situations, and to reality-test their response"—in other words, teaching people to think rationally in the face of adversity.
If these sound like techniques nondiabetics could stand to learn, too, that's no coincidence. Surwit says he wanted to design a program similar to others found in a wide variety of self-help manuals. "What's in my book is not magic," he says, although he does have one piece of advice for do-it-yourself types: keep it simple. "Some people try techniques that require almost a religious commitment," he says. "This isn't something you have to go to an ashram in India for."
Surwit's techniques may have a broader medical application, helping physicians diagnose patients at genetic risk for diabetes, allowing them to prepare for it and perhaps ward it off. Patients who don't have diabetes, but do carry some genes for it, respond to stress similarly to diabetics. Native Americans in the Pima tribe, for instance, are extremely susceptible to the disease. Even healthy Pimas have high blood-sugar levels when they're under stress. In the future, patients worried about their genetic risk could undergo a glucose test under lab-induced stress to find out whether they have something to worry about—and then can calm down.
Read article at original source
Relaxation exercises may keep diabetes in check
By Mary Carmichael
Newsweek, September 27, 2004
Compared with other methods of managing diabetes—strict diets, insulin injections, vigilant blood-sugar monitoring—Richard Surwit's technique seems too easy to be true. It doesn't involve pills or shots. It doesn't technically require a doctor's supervision. And if you're a diabetic reading this, you can start treatment right now, just by taking a deep, relaxing breath. Feel better?
If Surwit is right, you should. By lowering stress, he argues, patients with diabetes, particularly type 2, can keep their illness in check. Stress raises the body's levels of cortisol and epinephrine and, via those hormones, the amount of glucose in the blood. Because diabetics cannot make enough insulin to metabolize the raised sugar levels, the sugar stays high long after the stress has ended.
Surwit, a psychologist, first stumbled on the principle 25 years ago. Mind-body medicine was in its infancy, and he was frankly more interested in its potential for preventing heart disease. But a colleague, a Duke University endocrinologist, came to him with a challenge: a woman with diabetes who couldn't keep her blood sugar low even with a rigorous diet and standard treatment. When her work or home life turned stressful, her glucose levels shot out of control, leaving her hospitalized. The endocrinologist was at a loss to help his patient; after one week of bio-feedback and muscle relaxation with Surwit, she was stable enough to leave the hospital.
Today relaxation is used to combat everything from asthma to labor pains, but there's a stumbling block for diabetic patients: most insurance companies won't pay for Surwit's therapy, classifying it as experimental. Nonetheless, other doctors are starting to pick up the idea, using it in conjunction with more conventional remedies. And this year Surwit has made the treatment widely available in a different manner; he published a book this spring. "The Mind-Body Diabetes Revolution" focuses on easy relaxation techniques, particularly cognitive behavioral therapy and progressive muscle relaxation. "Almost everybody can learn it," Surwit says of the latter, "and it only takes a week or so." Progressive muscle relaxation is just what it sounds like, a sequence of tightening, then slackening, exercises that allows people to monitor their stress levels based on muscle tension. Cognitive behavior therapy, says Surwit, consists of "getting the person to evaluate how they emotionally respond to situations, and to reality-test their response"—in other words, teaching people to think rationally in the face of adversity.
If these sound like techniques nondiabetics could stand to learn, too, that's no coincidence. Surwit says he wanted to design a program similar to others found in a wide variety of self-help manuals. "What's in my book is not magic," he says, although he does have one piece of advice for do-it-yourself types: keep it simple. "Some people try techniques that require almost a religious commitment," he says. "This isn't something you have to go to an ashram in India for."
Surwit's techniques may have a broader medical application, helping physicians diagnose patients at genetic risk for diabetes, allowing them to prepare for it and perhaps ward it off. Patients who don't have diabetes, but do carry some genes for it, respond to stress similarly to diabetics. Native Americans in the Pima tribe, for instance, are extremely susceptible to the disease. Even healthy Pimas have high blood-sugar levels when they're under stress. In the future, patients worried about their genetic risk could undergo a glucose test under lab-induced stress to find out whether they have something to worry about—and then can calm down.
Read article at original source
For a Happy Heart
For a Happy Heart
Depression, loneliness and anger all take a toll on your cardiac health. New research shows what can help
By Anne Underwood
Newsweek, September 27, 2004
The Japanese have a word for it—karoshi, or "death by overwork." But can stress on the job really do you in? Finnish researchers decided to find out. The years 1991 to 1993 in Finland were as bad as it generally gets economically, with unemployment nearly tripling to 17 percent. Those who survived the downsizing had to assume greater work loads. During this period and for seven years afterward, Dr. Jussi Vahtera and psychologist Mika Kivimaki at the Finnish Institute of Occupational Health in Helsinki followed municipal workers who survived the cutbacks in four towns—from the mayor on down to teachers, nurses and janitors. Their sobering conclusion appeared this February in the British Medical Journal. Kivimaki puts it bluntly: "The only difference in mortality was in cardiovascular deaths. Those in work units with the most downsizing suffered twice the death rate from heart attack and stroke."
It should come as no surprise that emotions affect the heart—and not only in metaphorical terms. Suffer a fright, and your heart begins to pound. Get angry, and your blood pressure rises. Thirty years ago scientists told us that men with type A personalities—hard-charging, competitive and hostile—were more likely to suffer heart attacks. That turned out to be only partly true. Upon further investigation, anger and hostility were a problem, but not simple ambition or competitive drive. Today, scientists are using high-tech instruments to elucidate the mind-body connections that damage the heart. They are searching out the genes that increase our vulnerability to cardiac trouble. And they are applying an understanding of all these mechanisms to help point the way to nonsurgical treatments that may help trim our soaring medical bills.
If belligerence puts people at risk, science increasingly shows that a life of quiet desperation does, too. Study after study has now confirmed that factors like social isolation, depression and poor marital relations can contribute to heart disease. Patients who are depressed at the time of bypass surgery are more than twice as likely to die in the next five years as patients without clinical depression, although their disease is of comparable severity. Heart-attack survivors who live by themselves die at twice the rate of those who live with others. "They're heartbroken in more ways than one," says Dr. Herbert Benson, president of the Mind/Body Medical Institute in Boston and coauthor of "Mind Your Heart: A Mind/Body Approach to Stress Management, Exercise, and
Nutrition for Heart Health." In a major study in the Lancet this month, researchers surveyed more than 11,000 heart-attack sufferers from 52 countries and found that in the year before their heart attacks, the patients had been under significantly more stress—from work, family, financial troubles, depression and other causes—than some 13,000 healthy control subjects. "Severe stress didn't pose as great a risk as smoking," admits Dr. Salim Yusuf of McMaster University, senior investigator on the study. "But it was comparable to risk factors like hypertension and abdominal obesity. That's much greater than we thought before."
At every stage of heart disease, state of mind appears to play a role. It's most obvious in the later phases, where one can easily tally up heart attacks and deaths. "During the 1991 gulf war, fewer fatalities in Israel were due to Scud missiles than to [heart attacks] among frightened elderly people," says Stanford University stress expert Robert Sapolsky. During the 1994 L.A. earthquake, he points out, there was a similar spike. But thanks to high-tech scanning devices, scientists are now able to show that psychosocial factors play a role in the initial phases of the disease process as well. Psychologist Timothy Smith of the University of Utah is using CT scans to detect tiny calcium deposits in coronary arteries, an early sign of arterial damage. At the Society of Behavioral Medicine this year, he reported that couples with no history of heart trouble who were hostile or domineering in their interactions over money, kids, in-laws and household chores were more likely to have this type of damage. "The more strained their relationships, the more severe this silent atherosclerosis tended to be," he adds.
If there's a common explanation for these various effects, it may lie in the stress response. The classic stress condition is the fight-or-flight syndrome, which primes the body to flee from an attacker. The heart shifts into high gear and blood pressure rises, as the body speeds delivery of oxygen and glucose to muscles. Glucose and fatty acids flood the bloodstream for emergency fuel supplies. Platelets in the blood become more "sticky" to aid clotting in the case of a wound. That's perfect for a zebra sprinting from a lion, as stress expert Sapolsky puts it in the new edition of his book "Why Zebras Don't Get Ulcers."
But when the body responds the same way to everyday stressors like honking horns and looming deadlines, the cardiovascular system suffers. Chronic high blood pressure damages blood vessels, leading to inflammation and plaque formation. Excess glucose and fatty acids in the bloodstream can further damage arteries and veins. As if that's not bad enough, turbulent blood flow can rupture a plaque, with the resulting blood clot leading directly to a heart attack or stroke. And that's not all. When blood comes pounding back to the heart with extra force, it causes muscle tissue in the heart's receiving chamber to thicken—leading to an asymmetry in the heart that can produce potentially fatal irregular heartbeats.
The implications are dramatic—not only for our risks of developing heart disease, but also for treating it. Although a number of doctors are using lifestyle programs to help heal heart disease, Dr. Dean Ornish, president of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., has the most published work in this area. Not surprisingly (coming from the nation's leading proponent of an ultra-low-fat diet), a stringent diet and regular exercise are two pillars of his approach. But stress management is equally important, he insists. Stress reducers like yoga, meditation and group sharing have direct effects on cardiac risk, lowering levels of stress hormones and helping to relax arteries. They also have indirect effects. Participants gain a sense of well-being that helps them stick to a diet and exercise plan. And when their resolve falters, they have each other for support. "You can always call another member when you need help resisting a pastrami sandwich," says John Coleman, a retired MIT physicist who's participating in a spinoff program in Massachusetts. In fact, all the elements of the program bolster one another. If stress reduction makes you more likely to exercise, a half hour on the treadmill, in turn, lowers stress and depression. "Diet and exercise alone are like a two-legged stool," says Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University. "It's more stable with the third leg, stress management."
But does it really work? In one trial, patients who adopted Ornish's radical lifestyle changes reduced their atherosclerosis in one year and showed even greater improvements at five years, while those on standard care grew steadily worse. "Patients in our studies showed a 91 percent reduction in angina in a few weeks to a few months without the trauma or expense of angioplasty or bypass," says Ornish. This should logically translate into cost savings, and studies suggest that it does. In one set of published results, Mutual of Omaha applied the Ornish program to 194 heart patients—and saved $30,000 per patient over the next three years, compared with 139 patients on standard care. Medicare is now studying the program and a similar one under Benson's direction at the Mind/Body Medical Institute; the government will start providing coverage if officials conclude that they can reduce medical bills.
Of course, the ultimate cost saver would be prevention. Genetic profiling may help one day by pinpointing the people who could benefit the most from these measures. Williams at Duke is studying a gene that affects metabolism of the neurotransmitter serotonin. Those with a particular variation in this gene have greater changes in heart rate and blood pressure in response to stress, putting them at increased risk of heart trouble. "Three papers have now shown they have a higher incidence of heart attacks," says Williams.
No one is entirely risk-free, however. Given that heart disease is still the nation's leading killer, we could all benefit from an ounce of the prophylactic stuff. Major lifestyle changes may elude those without a gun to their hearts. But even 10 minutes of meditation a day can help with prevention; doctors say consistency of practice is more important than duration. And we can all gain by nurturing close relationships. "Simply looking at the picture of someone you love can help dampen stress responses," says Smith at the University of Utah. In a study this month, he reported that thinking about supportive friends for a few minutes before a stressful test helped participants minimize increases in heart rate and blood pressure. Cardiologist Harvey Zarren, medical director of the Healing Your Heart program at Union Hospital in Lynn, Mass., used to apply a simple version of this technique when he rode in the ambulance with heart patients. He would ask the patient to discuss the thing in life he or she loved most. As if by magic, high blood pressure fell and abnormal heart rhythms diminished. Unlike colleagues, says Zarren, "I never had a cardiac arrest in the ambulance."
It only goes to show, as the Bible stated long ago in Proverbs 17:22, "A cheerful heart is a good medicine." And that's reason for all of us to take heart.
Read article at original source
Depression, loneliness and anger all take a toll on your cardiac health. New research shows what can help
By Anne Underwood
Newsweek, September 27, 2004
The Japanese have a word for it—karoshi, or "death by overwork." But can stress on the job really do you in? Finnish researchers decided to find out. The years 1991 to 1993 in Finland were as bad as it generally gets economically, with unemployment nearly tripling to 17 percent. Those who survived the downsizing had to assume greater work loads. During this period and for seven years afterward, Dr. Jussi Vahtera and psychologist Mika Kivimaki at the Finnish Institute of Occupational Health in Helsinki followed municipal workers who survived the cutbacks in four towns—from the mayor on down to teachers, nurses and janitors. Their sobering conclusion appeared this February in the British Medical Journal. Kivimaki puts it bluntly: "The only difference in mortality was in cardiovascular deaths. Those in work units with the most downsizing suffered twice the death rate from heart attack and stroke."
It should come as no surprise that emotions affect the heart—and not only in metaphorical terms. Suffer a fright, and your heart begins to pound. Get angry, and your blood pressure rises. Thirty years ago scientists told us that men with type A personalities—hard-charging, competitive and hostile—were more likely to suffer heart attacks. That turned out to be only partly true. Upon further investigation, anger and hostility were a problem, but not simple ambition or competitive drive. Today, scientists are using high-tech instruments to elucidate the mind-body connections that damage the heart. They are searching out the genes that increase our vulnerability to cardiac trouble. And they are applying an understanding of all these mechanisms to help point the way to nonsurgical treatments that may help trim our soaring medical bills.
If belligerence puts people at risk, science increasingly shows that a life of quiet desperation does, too. Study after study has now confirmed that factors like social isolation, depression and poor marital relations can contribute to heart disease. Patients who are depressed at the time of bypass surgery are more than twice as likely to die in the next five years as patients without clinical depression, although their disease is of comparable severity. Heart-attack survivors who live by themselves die at twice the rate of those who live with others. "They're heartbroken in more ways than one," says Dr. Herbert Benson, president of the Mind/Body Medical Institute in Boston and coauthor of "Mind Your Heart: A Mind/Body Approach to Stress Management, Exercise, and
Nutrition for Heart Health." In a major study in the Lancet this month, researchers surveyed more than 11,000 heart-attack sufferers from 52 countries and found that in the year before their heart attacks, the patients had been under significantly more stress—from work, family, financial troubles, depression and other causes—than some 13,000 healthy control subjects. "Severe stress didn't pose as great a risk as smoking," admits Dr. Salim Yusuf of McMaster University, senior investigator on the study. "But it was comparable to risk factors like hypertension and abdominal obesity. That's much greater than we thought before."
At every stage of heart disease, state of mind appears to play a role. It's most obvious in the later phases, where one can easily tally up heart attacks and deaths. "During the 1991 gulf war, fewer fatalities in Israel were due to Scud missiles than to [heart attacks] among frightened elderly people," says Stanford University stress expert Robert Sapolsky. During the 1994 L.A. earthquake, he points out, there was a similar spike. But thanks to high-tech scanning devices, scientists are now able to show that psychosocial factors play a role in the initial phases of the disease process as well. Psychologist Timothy Smith of the University of Utah is using CT scans to detect tiny calcium deposits in coronary arteries, an early sign of arterial damage. At the Society of Behavioral Medicine this year, he reported that couples with no history of heart trouble who were hostile or domineering in their interactions over money, kids, in-laws and household chores were more likely to have this type of damage. "The more strained their relationships, the more severe this silent atherosclerosis tended to be," he adds.
If there's a common explanation for these various effects, it may lie in the stress response. The classic stress condition is the fight-or-flight syndrome, which primes the body to flee from an attacker. The heart shifts into high gear and blood pressure rises, as the body speeds delivery of oxygen and glucose to muscles. Glucose and fatty acids flood the bloodstream for emergency fuel supplies. Platelets in the blood become more "sticky" to aid clotting in the case of a wound. That's perfect for a zebra sprinting from a lion, as stress expert Sapolsky puts it in the new edition of his book "Why Zebras Don't Get Ulcers."
But when the body responds the same way to everyday stressors like honking horns and looming deadlines, the cardiovascular system suffers. Chronic high blood pressure damages blood vessels, leading to inflammation and plaque formation. Excess glucose and fatty acids in the bloodstream can further damage arteries and veins. As if that's not bad enough, turbulent blood flow can rupture a plaque, with the resulting blood clot leading directly to a heart attack or stroke. And that's not all. When blood comes pounding back to the heart with extra force, it causes muscle tissue in the heart's receiving chamber to thicken—leading to an asymmetry in the heart that can produce potentially fatal irregular heartbeats.
The implications are dramatic—not only for our risks of developing heart disease, but also for treating it. Although a number of doctors are using lifestyle programs to help heal heart disease, Dr. Dean Ornish, president of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., has the most published work in this area. Not surprisingly (coming from the nation's leading proponent of an ultra-low-fat diet), a stringent diet and regular exercise are two pillars of his approach. But stress management is equally important, he insists. Stress reducers like yoga, meditation and group sharing have direct effects on cardiac risk, lowering levels of stress hormones and helping to relax arteries. They also have indirect effects. Participants gain a sense of well-being that helps them stick to a diet and exercise plan. And when their resolve falters, they have each other for support. "You can always call another member when you need help resisting a pastrami sandwich," says John Coleman, a retired MIT physicist who's participating in a spinoff program in Massachusetts. In fact, all the elements of the program bolster one another. If stress reduction makes you more likely to exercise, a half hour on the treadmill, in turn, lowers stress and depression. "Diet and exercise alone are like a two-legged stool," says Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University. "It's more stable with the third leg, stress management."
But does it really work? In one trial, patients who adopted Ornish's radical lifestyle changes reduced their atherosclerosis in one year and showed even greater improvements at five years, while those on standard care grew steadily worse. "Patients in our studies showed a 91 percent reduction in angina in a few weeks to a few months without the trauma or expense of angioplasty or bypass," says Ornish. This should logically translate into cost savings, and studies suggest that it does. In one set of published results, Mutual of Omaha applied the Ornish program to 194 heart patients—and saved $30,000 per patient over the next three years, compared with 139 patients on standard care. Medicare is now studying the program and a similar one under Benson's direction at the Mind/Body Medical Institute; the government will start providing coverage if officials conclude that they can reduce medical bills.
Of course, the ultimate cost saver would be prevention. Genetic profiling may help one day by pinpointing the people who could benefit the most from these measures. Williams at Duke is studying a gene that affects metabolism of the neurotransmitter serotonin. Those with a particular variation in this gene have greater changes in heart rate and blood pressure in response to stress, putting them at increased risk of heart trouble. "Three papers have now shown they have a higher incidence of heart attacks," says Williams.
No one is entirely risk-free, however. Given that heart disease is still the nation's leading killer, we could all benefit from an ounce of the prophylactic stuff. Major lifestyle changes may elude those without a gun to their hearts. But even 10 minutes of meditation a day can help with prevention; doctors say consistency of practice is more important than duration. And we can all gain by nurturing close relationships. "Simply looking at the picture of someone you love can help dampen stress responses," says Smith at the University of Utah. In a study this month, he reported that thinking about supportive friends for a few minutes before a stressful test helped participants minimize increases in heart rate and blood pressure. Cardiologist Harvey Zarren, medical director of the Healing Your Heart program at Union Hospital in Lynn, Mass., used to apply a simple version of this technique when he rode in the ambulance with heart patients. He would ask the patient to discuss the thing in life he or she loved most. As if by magic, high blood pressure fell and abnormal heart rhythms diminished. Unlike colleagues, says Zarren, "I never had a cardiac arrest in the ambulance."
It only goes to show, as the Bible stated long ago in Proverbs 17:22, "A cheerful heart is a good medicine." And that's reason for all of us to take heart.
Read article at original source
Pain and Mood: Depression Hurts
Pain and Mood: Depression Hurts
By James Bakalar
Newsweek, September 27, 2004
Every child knows that a scraped knee can bring tears as well as blood. Physical pain always has emotional overtones, and we now know that emotional distress can be physically painful. Depressed people suffer three times their share of chronic pain, according to recent studies, and people in pain are at high risk of depression. Some studies suggest that if physicians tested all pain patients for mood problems, they might discover 60 percent of all undiagnosed depression. If you're struggling with either problem, there's a good chance you're suffering from both of them.
The link between sensory pain and emotional pain is rooted in the nervous system. Both are governed by the same neurotransmitters (chemicals such as serotonin, norepinephrine and substance P), and both are processed in the same parts of the brain. When the circuitry is working properly, pain and anguish are self-limiting: we recoil from unpleasant experiences, the feelings fade and life goes on. But if a problem persists, or the circuitry malfunctions, the brain's distress signals stay switched on, with devastating consequences. One study found that over a two-year period, a person with a history of migraine was five times more likely than average to have a first episode of depression. In a related condition known as fibromyalgia, the brain's overactive pain centers cause pain and tenderness in muscles all over the body. Not surprisingly, at least 30 percent of fibromyalgia sufferers go on experience depression as well.
The bright side of this story is that treating chronic pain can often help alleviate depression, and vice versa. The older antidepressants, known as tricyclics, have well-known analgesic effects—even at lower doses than depressed patients receive. Newer antidepressants such as Prozac, Zoloft and Paxil (the selective serotonin reuptake inhibitors) may not be quite as effective, but they're safer and may be easier to tolerate. Almost any drug that relieves an underlying psychological condition can help control pain. In pain rehabilitation centers, specialists often combine these medicines with common analgesics such as aspirin, ibuprofen and acetaminophen.
Drugs aside, mind-body techniques such as meditation, hypnosis and progressive muscle relaxation can help modulate emotional responses to pain. And psychotherapy can teach us to recognize thoughts and behaviors that amplify our feelings of distress. No one escapes having those feelings from time to time. Fortunately, they don't have to dominate our lives.
Adapted from the Harvard Mental Health Letter. For more information go to health.harvard.edu/NEWSWEEK.
Read article at original source
By James Bakalar
Newsweek, September 27, 2004
Every child knows that a scraped knee can bring tears as well as blood. Physical pain always has emotional overtones, and we now know that emotional distress can be physically painful. Depressed people suffer three times their share of chronic pain, according to recent studies, and people in pain are at high risk of depression. Some studies suggest that if physicians tested all pain patients for mood problems, they might discover 60 percent of all undiagnosed depression. If you're struggling with either problem, there's a good chance you're suffering from both of them.
The link between sensory pain and emotional pain is rooted in the nervous system. Both are governed by the same neurotransmitters (chemicals such as serotonin, norepinephrine and substance P), and both are processed in the same parts of the brain. When the circuitry is working properly, pain and anguish are self-limiting: we recoil from unpleasant experiences, the feelings fade and life goes on. But if a problem persists, or the circuitry malfunctions, the brain's distress signals stay switched on, with devastating consequences. One study found that over a two-year period, a person with a history of migraine was five times more likely than average to have a first episode of depression. In a related condition known as fibromyalgia, the brain's overactive pain centers cause pain and tenderness in muscles all over the body. Not surprisingly, at least 30 percent of fibromyalgia sufferers go on experience depression as well.
The bright side of this story is that treating chronic pain can often help alleviate depression, and vice versa. The older antidepressants, known as tricyclics, have well-known analgesic effects—even at lower doses than depressed patients receive. Newer antidepressants such as Prozac, Zoloft and Paxil (the selective serotonin reuptake inhibitors) may not be quite as effective, but they're safer and may be easier to tolerate. Almost any drug that relieves an underlying psychological condition can help control pain. In pain rehabilitation centers, specialists often combine these medicines with common analgesics such as aspirin, ibuprofen and acetaminophen.
Drugs aside, mind-body techniques such as meditation, hypnosis and progressive muscle relaxation can help modulate emotional responses to pain. And psychotherapy can teach us to recognize thoughts and behaviors that amplify our feelings of distress. No one escapes having those feelings from time to time. Fortunately, they don't have to dominate our lives.
Adapted from the Harvard Mental Health Letter. For more information go to health.harvard.edu/NEWSWEEK.
Read article at original source
Forgive and Let Live
Forgive and Let Live
Revenge is sweet, but letting go of anger at those who wronged you is a smart route to good health
By Jordana Lewis and Jerry Adler
Newsweek, September 27, 2004
Of all the extraordinary events in the life of John Paul II, few can compare with the 21 minutes he spent in a white-walled cell in Rome's Rebibia prison. Just after Christmas, 1983, the pope visited Mehmet Ali Agca, the man who 30 months earlier had shot him in St. Peter's Square. He presented Agca with a silver rosary, and something else as well: his forgiveness.
It requires a Christ-like forbearance to pardon a would-be assassin, of course. But how many of us are ready to forgive an unfaithful lover, a scheming colleague or even the jerk who cut into the line at Krispy Kreme? Persistent unforgiveness is part of human nature, but it appears to work to the detriment not just of our spiritual well-being but our physical health as well. The subject is one of the hottest fields of research in clinical psychology today, with more than 1,200 published studies, up from just 58 as recently as 1997. It even has its own foundation—A Campaign for Forgiveness Research—which sponsored a conference last year with papers on topics like "Exploring Gender Differences in Forgiveness." (The largest number of papers dealt with forgiveness in marital and romantic relationships, which seem to generate an inordinate amount of interpersonal resentment.) Dr. Dean Ornish, America's all-purpose lifestyle guru, regards forgiveness as the tofu of the soul, a healthful alternative to the red meat of anger and vengeance. "In a way," Ornish says, "the most selfish thing you can do for yourself is to forgive other people."
Research suggests that forgiveness works in at least two ways. One is by reducing the stress of the state of unforgiveness, a potent mixture of bitterness, anger, hostility, hatred, resentment and fear (of being hurt or humiliated again). These have specific physiologic consequences—such as increased blood pressure and hormonal changes—linked to cardiovascular disease, immune suppression and, possibly, impaired neurological function and memory. One study examined 20 individuals in happy relationships, matched with 20 in troubled relationships. The latter had higher baseline levels of cortisol, a hormone associated with impaired immune function—which shot up even further when they were asked to think about their relationships. "It happens down the line, but every time you feel unforgiveness, you are more likely to develop a health problem," says Everett Worthington, executive director of A Campaign for Forgiveness Research.
The other benefit of forgiveness is more subtle; it relates to research showing that people with strong social networks—of friends, neighbors and family—tend to be healthier than loners. Someone who nurses grudges and keeps track of every slight is obviously going to shed some relationships over the course of a lifetime. Forgiveness, says Charlotte vanOyen Witvliet, a researcher at Hope College in Holland, Mich., should be incorporated into one's personality, a way of life, not merely a response to specific insults.
In fact, forgiveness turns out to be a surprisingly complex process, according to many researchers. Worthington distinguishes what he calls "decisional forgiveness"—a commitment to reconcile with the perpetrator—from the more significant "emotional forgiveness," an internal state of acceptance. Forgiveness does not require us to forgo justice, or to make up to people we have every right to despise. Anger has its place in the panoply of human emotions, but it shouldn't become a way of life. "When I talk about forgiveness, I mean letting go, not excusing the other person or reconciling with them or condoning the behavior," says Ornish. "Just letting go of your own suffering."
"It's a process, not a moment," says Dr. Edward M. Hallowell, a Harvard psychiatrist and the author of "Dare to Forgive." Forgiveness, he emphasizes, has to be cultivated; it goes against a natural human tendency to seek revenge and the redress of injustice. For that reason, he recommends doing it with help—of friends, a therapist or through prayer. It was from his faith that John Paul drew the strength to forgive Mehmet Agca, setting (as he no doubt intended) an example for the rest of us. The message is the same whether it's couched in the language of Christian charity, clinical psychology or the wisdom of Confucius, as quoted by Hallowell: "If you devote your life to seeking revenge, first dig two graves."
Read article at original source
Revenge is sweet, but letting go of anger at those who wronged you is a smart route to good health
By Jordana Lewis and Jerry Adler
Newsweek, September 27, 2004
Of all the extraordinary events in the life of John Paul II, few can compare with the 21 minutes he spent in a white-walled cell in Rome's Rebibia prison. Just after Christmas, 1983, the pope visited Mehmet Ali Agca, the man who 30 months earlier had shot him in St. Peter's Square. He presented Agca with a silver rosary, and something else as well: his forgiveness.
It requires a Christ-like forbearance to pardon a would-be assassin, of course. But how many of us are ready to forgive an unfaithful lover, a scheming colleague or even the jerk who cut into the line at Krispy Kreme? Persistent unforgiveness is part of human nature, but it appears to work to the detriment not just of our spiritual well-being but our physical health as well. The subject is one of the hottest fields of research in clinical psychology today, with more than 1,200 published studies, up from just 58 as recently as 1997. It even has its own foundation—A Campaign for Forgiveness Research—which sponsored a conference last year with papers on topics like "Exploring Gender Differences in Forgiveness." (The largest number of papers dealt with forgiveness in marital and romantic relationships, which seem to generate an inordinate amount of interpersonal resentment.) Dr. Dean Ornish, America's all-purpose lifestyle guru, regards forgiveness as the tofu of the soul, a healthful alternative to the red meat of anger and vengeance. "In a way," Ornish says, "the most selfish thing you can do for yourself is to forgive other people."
Research suggests that forgiveness works in at least two ways. One is by reducing the stress of the state of unforgiveness, a potent mixture of bitterness, anger, hostility, hatred, resentment and fear (of being hurt or humiliated again). These have specific physiologic consequences—such as increased blood pressure and hormonal changes—linked to cardiovascular disease, immune suppression and, possibly, impaired neurological function and memory. One study examined 20 individuals in happy relationships, matched with 20 in troubled relationships. The latter had higher baseline levels of cortisol, a hormone associated with impaired immune function—which shot up even further when they were asked to think about their relationships. "It happens down the line, but every time you feel unforgiveness, you are more likely to develop a health problem," says Everett Worthington, executive director of A Campaign for Forgiveness Research.
The other benefit of forgiveness is more subtle; it relates to research showing that people with strong social networks—of friends, neighbors and family—tend to be healthier than loners. Someone who nurses grudges and keeps track of every slight is obviously going to shed some relationships over the course of a lifetime. Forgiveness, says Charlotte vanOyen Witvliet, a researcher at Hope College in Holland, Mich., should be incorporated into one's personality, a way of life, not merely a response to specific insults.
In fact, forgiveness turns out to be a surprisingly complex process, according to many researchers. Worthington distinguishes what he calls "decisional forgiveness"—a commitment to reconcile with the perpetrator—from the more significant "emotional forgiveness," an internal state of acceptance. Forgiveness does not require us to forgo justice, or to make up to people we have every right to despise. Anger has its place in the panoply of human emotions, but it shouldn't become a way of life. "When I talk about forgiveness, I mean letting go, not excusing the other person or reconciling with them or condoning the behavior," says Ornish. "Just letting go of your own suffering."
"It's a process, not a moment," says Dr. Edward M. Hallowell, a Harvard psychiatrist and the author of "Dare to Forgive." Forgiveness, he emphasizes, has to be cultivated; it goes against a natural human tendency to seek revenge and the redress of injustice. For that reason, he recommends doing it with help—of friends, a therapist or through prayer. It was from his faith that John Paul drew the strength to forgive Mehmet Agca, setting (as he no doubt intended) an example for the rest of us. The message is the same whether it's couched in the language of Christian charity, clinical psychology or the wisdom of Confucius, as quoted by Hallowell: "If you devote your life to seeking revenge, first dig two graves."
Read article at original source
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