WITH JOAN BORYSENKO, PhD, FOUNDER OF THE MIND-BODY CLINIC, HARVARD MEDICAL SCHOOL
It was the late 1950s and a new, experimental drug called Krebiozen was being heralded as a potential cancer cure. For one patient, however, it seemed that the drug had appeared too late to be of any benefit. The lymphoma had spread an extensive trail of tumors throughout his body, and he was not expected to live more than a few days. The patient, however, had heard of this potential “wonder drug” and begged his physician. Dr. Bruno Klopfer, to include him in the clinical trial. Dr. Klopfer was reluctant; the drug was in short supply, and the patient would certainly not last the expected length of the trial. However, the patient was insistent, and so the physician agreed, administering the first dose on a Friday before leaving for the weekend. When he returned to the hospital the following Monday, he was stunned to discover the patient walking the halls, chatting with the staff and other patients. Over the weekend his tumors had shrunk to half their size. Within two weeks he appeared completely cancer-free and was soon released from the hospital.
A couple of months later researchers reported serious doubts about the efficacy of this touted cure. When the patient read this in the newspaper, his tumors quickly reappeared and he was once again hospitalized. Dr. Klopfer now suspected that it was not the drug, but the patient’s strong belief in the drug that was responsible for the remission. With the patient’s condition deteriorating, he decided to tell the patient he was going to receive a double dose of a much stronger form of Krebiozen. In fact, the special preparation was only distilled water. Incredibly, the six tumors again disappeared, and the patient was released from the hospital for the second time. However, a few months later researchers reported conclusively that the drug was absolutely worthless. Upon hearing this news, the patient suffered a relapse. In three days he was dead.
How should one interpret such a remarkable demonstration of the power of belief to influence illness? Was it a merely a medical fluke, lacking in scientific importance, an anomaly best left in the sideshow of spontaneous remissions, unexplainable recoveries and other clinical curiosities that fill medicine’s long history? Or does this tale from the archives of medical folklore provide a glimpse into the medicine of tomorrow, to a time when the mysteries of the body’s own inner healing mechanisms will be harnessed by science and the practice of medicine transformed in the most profound manner?
In recent years a new branch of research called psychoneuroimmunology has emerged that is exploring the mysteries of the mind-body connection from a scientific perspective. This new field is expanding the traditional investigative framework, integrating the latest findings in neurology, psychology and immunology to reveal the actual physiology of thoughts and emotions and their effects on the body and its various systems.
Mind-body research is posing some fascinating as well as fundamental questions: Are certain personality types prone to specific diseases? How does the placebo effect actually work? What are the effects of psychological stress on the body’s physiology? Is there, as best-selling author Norman Cousins once asked, a biology of hope, an inner healing system rooted in belief that represents medicine’s most formidable ally?
A clue to the magnitude of impact that knowledge of this inner healing system may have is evident in the phenomenon of the placebo effect. Medical researchers are aware that a certain percentage of partici pants in medical studies who are treated with placebo drugs or proce dures (i.e., treatments of no known medical value) will improve because they believe they have received a potent treatment.
In the past, researchers tended to dismiss the placebo effect as a distraction, a confounding psychological variable that interfered with the real aims of the research. Yet the fact that belief can over ride the physiological actions of potent medicines demonstrates the remarkable capability of this inner healing force.
The Physiology of Emotion
The study of the placebo effect provides impressive clues to the mind’s seemingly miraculous powers. But is there evidence in the everyday world that the mind’s emotions and thoughts influence physiology in clinically significant ways? In fact, a growing number of research studies are showing that the answer is Yes.
One research study, for example, found that women with early-stage breast cancer who had a generally pessimistic outlook had very low levels of a type of white blood cell called a natural killer cell. These cells locate and destroy virus-infected cells as well as cancer cells. This was not true of women who were considered more fundamentally optimistic. In another study, blood samples taken from a group of medical students showed that natural killer cells were also low in students who scored high on a loneliness assessment test .
In evaluating the relationship between psychological stress and heart disease, cardiologists have become aware that not all stress is necessarily damaging to the heart. Research has shown that the high-pressure lifestyle often associated with the so-called Type A personality does not in itself pose a danger to the heart. But it is another matter when the stress is associated with chronic feelings of hostility and cynicism, which can increase the potential risk of heart disease.
But exactly how do hostility and cynicism damage the heart? What is happening at a molecular level that causes these emotions to damage the inside walls of the arteries and change the metabolism of cholesterol so that plaque deposits accumulate? In general, how do the thoughts and emotions forming the rhythms of our personalities orchestrate the symphony of biochemical activity that produces such physiological changes? These are the questions that intrigue researchers in the field of psychoneuroimmunology.
According to Joan Borysenko. PhD. author of Minding the Body, Mending the Mind and co-founder and former director of the Mind/Body Clinic at New England Deaconess Hospital in Boston, the answer to these questions has led scientists to focus on the study of neuropeptides, a group of hormonal messengers (neurotransmitters) secreted by the brain, immune system and digestive system. Endorphins, for example, which are commonly associated with the “runners’ high” experienced by joggers, are one among several dozen neuropeptides researchers have identified. These substances represent a rich pharmacy of natural drugs that the body produces in response to various internal and external stresses.
Borysenko explains: “When you react to your boss as if he is a saber- toothed tiger, your body secretes chemicals that prepare you to die rather than helping you to live. These drugs are then pumped out into the blood stream and eventually bind to the surface of all the cells in the body the way that a key fits into a lock. They then affect the function of the cells. So, if you are fearful, for example, it is not just an emotion. It is that every cell in your body has now received a biochemical signal about fear broadcast by the neuropeptide system, and has changed its metabolism in some way.”
As exciting as these insights are, Borysenko adds an important caveat when she cautions not to exaggerate the connection between personality and disease. “It is not as if everyone who is hostile and cynical will have heart disease or that everyone who acts like a doormat will develop cancer,” she explains. “Personality is only one of many variables that can affect health.”
Awakening the Inner Healer
A matter of practical importance to behavioral researchers is whether it is possible to teach people how to tap the mind’s inner healing system as they contend with illness. For example, the fact that the body produces its own anti-viral, anti-cancer cell poses a question: Could the pessimistic women with early-stage breast cancer in the study cited earlier learn to produce more of these natural killer cells by becoming more optimistic? Such a question is especially intriguing considering that medicine has yet to produce very effective anti-cancer drugs in the laboratory.
Borysenko answers in the affirmative. ”We have found in our research,” she explains, “that basic forms of meditation involving progressive muscle relaxation, practiced three times a week in a population of elderly people, doubled natural killer cell activity after only three weeks. We would expect that to have a clinical effect on control of cancer or virally related illnesses.”
In addition, research conducted by Borysenko’s Harvard University colleague, Dr. Herbert Benson, author of The Relaxation Response, has shown that meditation not only improves immune function, but is associated with a host of other beneficial physiological effects, such as altered brain wave states, decreased heart rate, and lower blood pressure.
Of course, psychoneuroimmunology has only begun to piece together the extraordinarily complex mechanisms that regulate the mind-body connection. The growing stock of applied behavioral techniques and interventions (meditation, biofeedback, autogenic training, guided imagery, social support systems, etc.) are but the first in what are sure to be increasingly sophisticated approaches toward activating the body’s inner healing system.
The Medicine of Tomorrow
In a sense, psychoneuroimmunology can be viewed as a bridge between the old field of psychosomatic medicine and the emerging field of behavioral medicine. In the past, the study of psychosomatic phenomenon—the relationship between personality or emotions and physical illness—was generally viewed by the medical community as a rather unimportant area of study. Even though physicians were aware at times of the important role a patient’s attitude seemed to play in his or her illness, the link remained murky, more of a hunch than a clinically verifiable reality. In fact, the term psychosomatic was often popularly used as a pejorative expression, a way to imply that a person’s illness was somehow not real, but “all in their head.”
In reality, every illness or state of health is a blend of mental and physical factors. Too much psychological stress can lead to excessive secretion of hydrochloric acid and the onset of ulcers. The physiological stress associated with a viral infection can induce temporary psychological depression. A genetic proclivity toward high cholesterol levels can set the stage for a heart attack triggered by sudden psychological trauma.
In subtle and everyday ways mind and body interact to affect our state of mind and sense of well-being. The amount of exercise in our lives, the foods we eat, a hug from a loved one can all have a decided influence on our moods. In turn, anxious or worried thoughts can cause such physiological effects as tense muscles or elevated blood pressure. Emotional depression can translate into fatigue. And having fun with people we enjoy can create energy.
In truth, health represents a complex and dynamic interplay of attitudes, emotions, and physiology. Psychoneuroimmunology and the related field of behavioral medicine are rooted in this perspective of the integrated nature of mind and body. In this perspective we also discover another truth: to activate the body’s own ability to engage in physical healing can often open a door to a reawakened sense of our whole self. In a sense, to tap the inner self-healer requires an act of imagination, of learning to believe in ourselves and our ability to heal. It is thus, above all, an act of hope. And hope is the source of the great healing power of the human spirit.
To cultivate hope when serious illness confronts us may require casting aside fears and opinions that shroud our innate reverence for life. To nurture hope when the body is battered by disease may require letting go of emotions and beliefs that separate us from the core of what makes us strong and authentic in life. Thus, to discover hope can be the beginning of an animating journey toward not only renewed physical health, but emotional and spiritual growth as well.
Modern medicine has a right to take pride in its accomplishments. Infectious diseases that once led to devastating epidemics are now controlled with simple injections. Surgeons perform intricate neurological and cardiac procedures that only a few decades ago would have seemed beyond imagination. Yet the truth remains that the great majority of illnesses that afflict human beings resolve on their own. In other words, the body cures itself. To the extent that science can learn how to summon the wisdom of this inner healer, it will revolutionize the practice of medicine.
Originally published in Nightingale-Conant’s Insight magazine [No. 139].