THE MIND, HEALTH & DISEASE
By Hal Mansfield
Psychosomatic Medicine is that area of medicine that believes that with some diseases there is a psychological factor in the development and the manifestation of the disease, as well as a physiological – that is, medical – component. Examples cited in the literature are some cases of asthma, heart disease, cancer and skin disorder, with the important caution that I say only some cases in each of these categories. In other words, the mind can be a factor in health and disease.
The title that I chose for this talk is only one of many titles that might have fit the subject. The idea that the mind (or the brain) is importantly involved in certain diseases is both complex and controversial. It is now recognized that several diseases that were thought to be psychopathological, schizophrenia comes to mind, have physical origins. Early theories linked the development of schizophrenia to childhood trauma. Now, it is generally recognized that brain chemistry is probably the dominant factor.
It was thought that ulcers were psychogenic, that ulcers developed as a result of psychological stress. Today, medical evidence strongly indicates that certain bacteria infections are a factor in some, if not many, cases of ulcers.
It may be that subsequent medical and neurological research will determine that brain chemistry is involved in still more disorders that are presently labeled as psychological. So, what I have to say today – as with all science – is tentative; that is, subject to change based on additional research evidence.
First, a word about what psychosomatic medicine is not. It is not malingering; goldbricking, pretending to be ill to get out of doing something, as we used to say in the Army. It is not hypochondriasis, thinking one is ill when one is not. Psychosomatic illnesses are real. There is both a psychological (mind) and a physical (body) component in some diseases, according to our present level of understanding.
Having said that, let’s look to the topic at hand. To do so, I will first introduce Little Lord Fauntleroy by Frances Hodgson Burnett. It is one of literature’s most misunderstood books. When I have mentioned it in conversation over the years, the common rejoinder is: “Isn’t that about the little kid who had to dress in fancy clothes?” or a remark similar to that. Saying that is a little like saying that Don Quixote is only a book about a crazy old man that tilts with windmills.
Actually, Little Lord Fauntleroy is a children’s book – for the young at heart of all ages. Like an onion, the story has layers and layers of meaning and is therefore subject to multiple interpretations. There is a fine movie with Ricky Schroder and Alex Guinness based on the book and an earlier movie with Mickey Rooney.
Among other things, the book is a scathing critique of: Aristocracy, Primogeniture, Prejudice, Xenophobia, and Self-centeredness. Here’s the storyline: An English Earl had three sons. The oldest and next oldest were nearly totally unsatisfactory human beings; the youngest was a wonderful man in personality, behavior and temperament but he married an American woman and moved to the United States against the old Earl’s wishes. The Earl and the son became irrevocably estranged. This is where the English laws of primogeniture enter in. The two oldest sons die; so does the youngest son who leaves behind his widow and their young son.
The old Earl ‘swallows his pride’ and sends for the grandson in America, since that grandson is now in line to become the Earl when the old man dies. With the death of the Earl’s three sons, the grandson automatically becomes Lord Fauntleroy.
The grandson has a charming personality and through this and his thoughtfulness toward others, he wins the old man’s heart. Not by design but by example and gentle exhortation, the grandson changes the old man into a – relatively speaking – humane, human being.
Just where does psychosomatic medicine enter in? The old man is ill tempered and ill; he has gout of the most painful sort. He is a grouch, a real curmudgeon. He hated his sons and his memories about them cause him great distress. He hates his wider family, including his grandson’s mother (even though he has never met her and refuses to do so) his servants, and those who farm his vast estates. In short, he hates the world and the life that he feels is his lot.
The boy shows great affection for the old man; the old man begins to return that affection. The boy shows selfless concern for others. The old man, at first, shows some compassion, mostly to increase the boy’s interest in and affection for the old Earl. Later, it becomes genuine.
As the old Earl’s attitudes and behaviors change, his health improves and his gout goes into remission. He and the boy ride their horses. And the Earl hosts a grand party. Finally, the Earl’s attitude toward the boy’s mother changes. The three become a happy family.
Why is this an example of psychosomatic medicine? It has all of the elements: change a person’s attitudes and behaviors and you change the mind; change the mind and the body changes. In this case, health was regained. It is both that simple and that complex!
For centuries, it was thought that the body was material and the mind insubstantial. It was believed that thought was instantaneous and separate from physiology. In fact, at one time it was thought that the brain was the body’s ‘radiator,’ that it cooled the body and that thought was situated in the heart. The mind/body problem has occupied the attention of some of the best thinkers in the history of philosophy and science.
In addition to what we now view as weird views of what the function of various parts of the body were, medical practice through the years had some strange notions. One of these was bloodletting. The theory was that by letting blood out, a person would be more apt to get well. Well? As we know, the blood contains some of the body’s most important disease fighting entities. So, if a patient got well, they did so in spite of the treatment. And, people did get well, amazingly enough, especially when they believe in their physician and in the treatment. Here is some ‘historical’ evidence for the powerful force that the mind can exercise over the body.
Bloodletting was not the weirdest treatment. At one time, manure was commonly thought to have healing capability. And, what about ‘eye of newt and wart of toad?’
As medical technology advanced, it became obvious that the brain was not a radiator and that thought was not centered in the heart. Helmholtz, the great German physicist of the 19th century, measured the speed of neural impulses and found them to be relatively slow, just a few hundred feet per second, rather than instantaneous, which was the prevailing view for centuries. Even before that, it was known that different people’s reaction times vary.
It is now accepted that the brain is the seat of thinking and memory. However, it is still not known exactly how the brain and mind are related and, in fact, there are some scientists with high credentials that believe that aspects of the mind may be in all or most all body cells, as well as in the brain. The ability of stem cells to ‘choose’ which body structures they will morph into may some day add substance to those believes. Cell ‘intelligence,’ if it exists, may play a role in psychosomatic disease and health.
What is clearly substantiated by countless scientific, medical and anecdotal sources is that the mind – or the brain – can exercise great control over bodily functions. Studies done from such diverse perspectives as meditation, biofeedback, faith healing, and information from modern medical practice and research, neurological research and electrical recording studies using EGGs, MRIs and CT and PET Scans have confirmed and reconfirmed this over and over.
Our nervous system is divided into autonomic and somatic systems. The autonomic is divided into sympathetic and parasympathetic systems. The autonomic is ‘supposed’ to be just that: Automatic, and thus beyond the control of the individual. The problem with that is that a vast range of information shows that autonomic activities can be changed by an ‘exercise of the mind.’ It is the action of the autonomic on the somatic that provides one way psychosomatic healing occurs.
Let’s examine some of these diverse data:
If you seal a yogi master who is in a trance state in an airtight compartment and reduce the oxygen level in the compartment by pumping out most of the air and keep the yogi in the compartment for an extended period of time, the master will emerge, when the compartment is opened, with no evidence of physical damage, even though the oxygen level has been so low that the average person would die from the lack of oxygen or, at the very least, suffer brain damage and other physical complications.
How is this done? First, let me stress that this comes from carefully controlled, carefully monitored studies. The yogi, in the trance state, somehow goes into what might be described as a kind of hibernation. His heart rate slows to near zero; his breathing become shallow and intermittent. His body, thus, requires only a fraction of the oxygen that it would normally require. Thus, no damage results. This is dramatic evidence that the mind can control the body.
The brain produces four fairly distinct brain wave patterns. The most common is that associated with waking activities and is called beta waves. These are rapid, low voltage waves. Another pattern is called Alpha, because they were the first wave patterns measured in the early days of measuring brain wave activity by placing electrodes on the skull.
Accomplished yogi practitioners can produce large amounts of alpha wave activity, both in terms of amplitude – the electric power of the waves – and in terms of a percentage of total brain wave activity. This happens during waking states when beta waves should predominate. Alpha wave production is associated with reports of a host of positive feelings, greater vitality, more creativity and many other desired results. Brain wave control thus enters into the realm of psychosomatic medicine.
It was my privilege to work with two of the pioneers during the early days of biofeedback research. Biofeedback is where you take a physiological measurement and feed it back – that is, you let the person know what is happening with that activity. Examples are with the Alpha waves I just mentioned. In the research we did, normal subjects, those who had never had yogic training, were hooked up to an advanced EEG machine. Their EEG record was where they could see it. They were asked to produce Alpha waves, but were not specifically told how to do that.
Most subjects were able to increase their Alpha wave activity substantially, just by watching the EEG record and ‘letting the mind’ do whatever increased the presence of Alpha waves. Different subjects reported thinking different thoughts; some produced the most Alpha by ‘clearing’ their mind of thoughts, so to speak.
In 1975, I was invited to so some biofeedback consulting for a clinic in California. The director had purchased some rather sophisticated, state-of-the-art biofeedback equipment but did not know how to use it effectively or how to set up biofeedback studies. While I was out there, I took advantage of the availability of the equipment to perform biofeedback on myself on a daily basis. I was able to increase my Alpha wave activity and finger temperatures rather substantially during the two weeks I was out there.
Theta waves are primarily produced as we move from wakefulness to sleep and vice versa, the so-called hypnogogic and hypnopompic states. Delta waves are primarily produced during deep sleep. For now, these two types of brain waves do not concern us, even though there is some evidence to suggest that the production of Theta waves are related to certain kinds of creativity and, thus, may play a role in certain aspects of psychosomatic medicine.
Other biofeedback studies have been done measuring site-specific body temperature, such as on the arm, blood pressure (the least satisfactory results, overall, are with blood pressure), blood oxygen levels, blood sugar levels and certain other measures. Most of the studies done have shown positive results from most subjects; that is, the subjects were able to control their ‘so-called autonomic’ processes. Autonomic control represents a key aspect of psychosomatic medicine.
Since I retired, studies using Positive Emission Tomography and Computer Tomography Scans have added volumes to an understanding of the brain’s activities under different experimental and medical situations. That is a literature that I am not familiar with..
Progressive relaxation, autogenic relaxation training and similar techniques have also been applied to teach subjects (in experiments) and patients in medical research and practice to control autonomic activities, adding to the multitude of positive results regarding the mind’s ability to effect the body.
I am sure you have all heard about placebos – the infamous ‘sugar pills.’ Actually, most placebos are not sugar pills. They are pills made of substances that have no medical, physical or pharmacological value or effect.
Modern science now recognizes that placebos can have and have had powerful effects – when the individual taking the pills believe that they will produce certain effects. In many scientifically controlled, double blind studies, placebos produce results that are almost as good as the results from actual medicines or other physical or pharmacological substances. According to one study, those subjects who self-talked themselves in to believing in the power of what they were taking, produced the best results. Amazing? Yes, but sometimes truth is stranger than fiction. This is evidence of the mind’s control over the body? Psychosomatic medicine? Yes.
Spontaneous remissions are another kind of phenomena that demonstrate the power of the mind – or brain – over the body and thus must be considered in any discussion of psychosomatic medicine. There has long been anecdotal evidence for remarkable remissions from normally fatal diseases. Now there is a growing and substantial list of medically supervised remissions.
One of my friends in Green Valley is a dramatic example of this. Over 18 months ago, he was diagnosed with cancer, including cancer of the brain. The doctors gave him three months to live, at most. I saw him at the local library the other day. His cancer is – at least for the time being – in remission. He feels good. His mind is active. He is physically active, to be honest not like he was before the cancer diagnosis. In addition, his blood sugar level, which was clinically high, is now down substantially. He says that he may not be a miracle but he is probably close to one.
How did this happen? He has no ready explanation. We may never know. One factor that must be considered is his attitude. The diagnosis of cancer, the three-month death sentence and the medical therapies were all taken in stride. He maintained a positive attitude through it all. He tried to maintain as normal a life as he could. I think his mind – brain if you will – rallied the natural healing forces of his body and, together with the medical treatments, met and conquered the disease, making his case a dramatic instance of the power of psychosomatic healing processes, in his case with a death sentence from a critical medical diagnosis.
Years ago, one of my best friends had a heart attack. He was lying in his hospital bed when I went to see him and he was totally despondent. He indicated that he was dying; in fact, he asked me what he had to live for. He was in his mid-60s at the time. He was a successful writer and public speaker. He was one of the most intellectually curious men I have known.
I told him that he should live to see what tomorrow brings, that his curiosity could sustain and re-vitalize him. That he could get out of the hospital and back into his successful life. He thanked me and I left. A few days later he was discharged from the hospital. He wrote another book and showed evidence of fully enjoying his life. A few years later, he lost both of his daughters to cancer. That was too much for him He died from a stroke shortly after the death of his second daughter. In this case, his mind carried him through the heart attack aftermath and, then, may have killed him with the stroke because of the extreme sorrow he experienced when he lost both of his beautiful, young daughters to cancer.
My friend’s stroke brings me to the other side of psychosomatic medicine. On the one hand it can cure; on the other, it can kill. In the 1960s, one of our neighbors was an especially strong-willed woman. She and her husband unofficially became ‘gramma’ and ‘grandpa’ to our daughter. The couple had four married children. The oldest daughter left her husband and three children and ran away with a man. A few days later, she called her mother. The mother told her to come home at once and if she did not, she, the mother, would be dead within a week.
This was on a Monday evening. Tuesday evening while bathing the youngest grand daughter, the grandmother fell against the side of the tub, injuring three ribs. On Thursday morning she was admitted to the hospital with double pneumonia. On Saturday she died in spite of all that modern medical intervention could provide. She willed herself to death. I believe this was an example of psychosomatic health in reverse; that is, psychosomatic death.
Soon after her death, her husband was diagnosed with cancer. He died not too long after the diagnosis, even though he seemed perfectly healthy and held down a responsible job before the daughter ran off and before his wife died so suddenly.
On a lighter note, Norman Cousins, the famous author and magazine editor, came back from what was then the Soviet Union with a life threatening immune and systemic disorder. It was a disease that could have been fatal. Cousins was not satisfied with the medical treatment he was getting, or with the results. He took matters into his own hands. He believed that ‘laughter is the best medicine.’ He had his doctor move him into a private room, had a movie projector set up and began to watch comic movies, such as the Marx brothers’ movies. In addition, he began to both read and tell jokes and other material that was, for him, belly-laughing funny. He got well and he wrote a book about his experiences: Anatomy of an Illness: As Perceived by the Patient.
Later, after a heart attack, he again took control of his recovery. And, along with a positive attitude, laughter, changes in diet and the introduction of an exercise routine, he managed to live for several years. In fact, he wrote a book called The Healing Heart wherein he detailed his experiences.
Bernard Lown, a famous Boston heart doctor, wrote the introduction to the Cousins book. Lown’ introduction is one of the most beautiful expositions of the power of mind/body interaction I have ever read. Lown tells of a heart patient who was near death. Lown was making rounds and asked some of the interns that were with him to listen to the man’s ‘wholesome gallop.’ Now, a wholesome gallop is a term that describes the last stages of heart failure in certain heart disorders. One by one, the interns dutifully listened and nodded assent. The group moved on.
Over the next few days, the man showed dramatic improvement. Soon, he was dismissed from the hospital. At the six-month check-up, Lown mentioned how surprised he was by the man’s progress. The man said that he could tell Dr. Lown exactly when his heart problem turned around. It was when Lown told the interns that the man had a wholesome gallop and they agreed. The man said that he knew that Dr. Lown might not be fully truthful with him about his condition but that he would not lie to the interns. So, he thought that the fact that his heart had a wholesome gallop was a good news and that he should stop feeling sorry for himself and get out the hospital, which he did. Lown kept the truth to himself.
Another dramatic case that Lown described concerned a middle-aged woman who was in the hospital for a non-life-threatening heart ailment. Her doctor was a man with a powerful presence and a masterful bedside manner. However, as he was making rounds with several interns, he mentioned that the woman was ‘ts.’ The interns nodded soberly and the group passed on. Soon, the woman began to experience heart failure. Attempts were made to summon the doctor who had left the hospital. This was before cell phones. The woman indicated that her doctor has said she was ‘ts.’ “We all know what that means, I am in a terminal situation,” she was reported to have said. No efforts could save her. She died before the doctor got back to the hospital.
Norman Cousins and Dr. Bernard Lown were believers in and practitioners of psychosomatic medicine in the best sense of that term, as was Lown’s ‘wholesome gallop’ patient, though the patient was not aware that he, too, was practicing psychosomatic medicine of the best and most powerful sort. With fatal results, the woman who convinced herself that she was dying – and did – was also demonstrating the power of psychosomatic medicine.
At Colorado State University in Fort Collins a number of years ago, a group of beagles were operated on to simulate heart attacks. Then, the dogs were divided into experimental and control groups. The experimental groups were put on special diets and on systematic exercise programs, routines that were not given to the controls. The experimental group dogs lived much longer than the controls. Moreover, autopsies revealed that the dogs’ bodies in the experimental group had offset the heart damage by building new structures to perform the functions damaged by the surgery. Even without the mind’s intervention, the body can display remarkable healing.
Of course, the same techniques could be applied with human heart attack victims replacing the need for a great deal of heart surgery. However, the healing took time and the dogs’ routines were systematic and sustained over a relatively long time, something most people would prefer to avoid; so, humans all-too-often opt for surgery (or the doctor makes that decision for the patient).
One of my many cousins developed heart trouble in his early eighties. He went into the hospital in serious condition. He and his preacher had a talk and my cousin indicated that he was ready to die. He and the preacher agreed that everyone has to go sooner or later. A few days later, he died peacefully. He accepted the fact that he was going to die and he did just that.
Famed author, Louis L’Amour lived in the Durango area during part of the year for a number of years. Finally, he bought his ‘dream ranch’ a few miles west of Durango. A major power transmission company decided to route a large power line across the line, using eminent domain. Louis fought the power company in courts of law. Some of us joined Louis in his efforts. He lost. Not too long after that, he contracted lung cancer and died.
Could the disappointment of having the magnificent natural views on the ranch sullied by the power line and the disappointment of losing the lawsuits, have triggered the cancer? I think so. He told me that he never smoked. He also told me that he had 50 more books in his mind that he wanted to write. He had already written over 100 books, with millions of copies sold worldwide. I think the disappointment changed a robust and dynamic man into a cancer victim. Of course, that kind of thing cannot be “proven,” but it is suggestive of what is known about the power of the mind/body relationship in the field of psychosomatic health and disease.
Faith healing works if the one seeking the healing believes unequivocally in the healer and if the psychosomatic disorder is one that is amenable to psychosomatic curing. Hypochondriacs, of course, are ideal subjects for faith healing results.
Finally, a personal note: About 22 years ago, I began having severe pain in my feet, especially the right foot. I went to my neighbor, the podiatrist, to find out what was wrong. He examined my foot and took x-rays. His diagnosis was that calcification around one of the tiny holes in a bone in the foot was growing – and thus jamming – against a key nerve. He suggested shoe inserts but said I would have to be on pain medication for the rest of my life and that things would likely get worse.
I decided I didn’t want that. I imagined my body reabsorbing the calcification. Over time, the pain disappeared. When I get some tinges of pain in the foot, I re-imagine the reabsorbtion process and the twinges go away. Mind over matter? I think so, though I have never had the foot re-x-rayed to see if the calcification has dissipated. Why spend the money? The pain is gone.
I also practice what I term ‘Pac-Man Immunology.’ What I do is imagine that my body’s natural defenders seek out, surround, ingest, digest and excrete any and all factors that might cause disease, especially when I feel that I might be getting sick. I also use similar ideation to help ‘stay’ the onset of inflammations and general aches and pains, such as those from arthritis.
Nothing is perfect. I still get sick once in a while. In fact, I developed a rather severe case of valley fever in November of 2007. So, the things that I practice don’t always work. Likewise, psychosomatic medicine works some – but by far – not all of the time, even when the patient knows how to apply the principles and believes deeply in the efficacy of the techniques.
A few words can change the course of history. Think of Hitler’s fiery speeches in the evil sense and Churchill’s rallying talks in the sense of a stalwart refusal to accept defeat. And a few words can change the course of an individual’s medical situation as we have seen from examples given above. A few mis-stated words can alter the entire course of a political campaign for which there are several dramatic examples in 2008. In extreme cases, there are words of healing and words of death, depending on how those words affect the ‘minds of those people involved.’
What I have presented are just a few examples from the vast array of medical, neurological, biofeedback, meditation, anecdotal and personal data that relate the mind/body interactions (or brain/body, if you will) within the theory and practice of psychosomatic medicine; that is, psychosomatic health and disease.
The practice of and the results from psychosomatic medicine are not for everyone. Most people are different; some are really different. What works for one person might have no effect on another person. In some cases, attitude and fortitude are the keys. Some people seem to be natural psychosomatic medicine virtuosos just as there are especially talented people in every other area of human existence and experience; some people can’t do it or won’t even try. In the final analysis, life is a ‘fatal disease’ since all humans are mortal.
For years, I have thought that humans have what I call an ‘acceptance gene’ (or gene conglomeration) that allows us to accept life’s dramatic changes: aging, illness, bad government, natural catastrophes and many of the “slings and arrows of outrageous fortune” to quote the Bard of Avon. In a sense many of the positive outcomes of the application of psychosomatic medicine mean that the person must not accept ‘fate’ or ‘fortune,’ but rather rise up and vanquish that which is ‘written in the sand.’
It was Hippocrates that said something to the effect that patients are most likely to get well when they have the greatest regard for the physician. I would add to that they are most likely to get well when they believe that they can enhance getting and staying well by focusing the mind’s and the body’s natural processes; that is, through the practice of psychosomatic medicine, broadly conceived.
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Author Note: Hal Mansfield was born in Fort Collins, Colorado. After serving in the U. S. Army, he graduated from Colorado State University, in 1958. He received his Ph.D. from The University of Denver, in 1974. In 1993, he retired from Fort Lewis College in Durango, Colorado, where he taught psychology, statistics and writing for 18 years. In addition to fiction writing, part of his retirement regimen includes researching, thinking through, and writing about critical contemporary social issues. After a ‘life-time’ in Colorado, including the last 31 years in Durango, he moved to Green Valley, Arizona in 2005. Some of his writing efforts, including letters to the editor, have appeared in The Durango Herald (since the mid-1970s) and other newspapers, as well as in Solar Age Magazine, crimemagazine.com and Crossroads: A Journal of the Southwest. Since moving to Green Valley, he has given presentations to the Green Valley Forum, to the Tattersallers Group, to the Osher Lifetime Learning Institute, to the Jewish Men’s Group and to the Unitarian/Universality Congregation’s Forum.