By
Arthur Preston Smith
Claremont Graduate University: 1998
©Copyright by Arthur Preston Smith 1998
All Rights Reserved
We, the undersigned, certify that we have read this dissertation
and approve it as adequate in scope and quality for the degree of
Doctor of Philosophy.
Dissertation Committee:
David Ray Griffin, Chair
John Roth, Member
Fred Sontag, Member
Abstract of the Dissertation
The Power of Thought to Heal:
An Ontology of Personal Faith
By
Arthur Preston Smith
Claremont Graduate University: 1998
This dissertation discusses the philosophical issues involved with psychosomatic healing. It attempts to establish two theses. The first is that psychosomatic healing is a very real, if not common, phenomenon. The second is that it is also a natural process, i.e., it need not involve any supernatural Divine intervention. If it involves God's action at all, then God is acting through natural processes. Evidence from numerous sources, such as the placebo effect, the new science of psychoneuroimmunology, scientific studies and experiments, and historical events, is used to support the first thesis. Although this evidence strongly supports the proposition that thoughts, attitudes and beliefs can significantly affect health, it tells us nothing about the interaction involved, if any, between the mind and the brain.
The apparent mystery of psychosomatic healing can be traced to two underlying philosophical enigmas: the mind-body relationship and efficient causation as real influence, neither of which can be resolved empirically. An overview of the current mind-body debate in contemporary philosophy is presented, in which the dualists and materialists, the two major contenders in this debate, are shown to have succeeded in refuting each other. Accordingly, we must reject both positions. The idealist alternative, the prevailing paradigm among advocates of mental healing, is also examined, and it too is shown to be inadequate.
The apparent mystery of mental healing, as well as the presumption that it must somehow be supernatural, are both attributed to modern philosophy's attempt to understand efficient causation and the mind-body relationship in terms of substance-and-attribute thinking. To understand either efficient causation in general, or mind-body interaction in particular, we must change the context of the discussion from one of substance and attribute to one of process and creativity. Whitehead's philosophical model, in that it addresses this point directly, is therefore an excellent starting point in unraveling the mystery of psychosomatic healing.
Dedication
This dissertation is dedicated to three people who shared with me the risks and sacrifices required to complete it. The first of these was my mother, the late Dr. Margaret Smith (1914-1995), who provided both financial aid and inspiration during my graduate studies. The second is my wife, Robin Smith, who supported us financially during my years of full-time study, and who shared equally with me all the emotional and financial burdens involved. Moreover, her on-going struggle with systemic lupus erythematosus dramatically demonstrated how important and powerful the psychosomatic element in healing can be. The third is my daughter, Ariella Smith, who seems to be growing into a wonderful human being, in spite of the fact that her father was less available than he should have been during the first three years of her life.
Acknowledgments
I owe thanks to many people, whose assistance was indispensable in completing this project. First among these is David Ray Griffin, advisor and committee chair, for his thoroughness and promptness in reviewing my work in progress -- even when it involved considerable discomfort and inconvenience on his part. Without his on-going feedback, it would have been impossible to maintain the standard of scholarship that this project required. I thank Professors John Roth and Fred Sontag, for their participation in my dissertation committee, and for their valued feedback too. I thank the faculty of both the Religion and Philosophy departments of the Claremont Graduate University, for accepting and supporting a student whose interests in graduate study were somewhat unconventional. I thank my father, Dr. Carroll H. Smith, for supporting me through my undergraduate studies, and for sharing with me his medical career experiences, without which I would never understood what it is like to be medical doctor. I thank Drs. Anthony Smart and Colleen Fitzpatrick, my two physicist friends, for reviewing my work from a scientific perspective. I thank the people at Compulink Management Center, Inc., of Torrance, CA, where I worked during my years of candidacy, and whose LaserFiche® document imaging software rendered my empirical research so much easier. I thank Larry Gneiting, my personal coach, for giving me the inspiration and guidance I needed to keep going when the project appeared to be impossible. Finally, I would like to thank Rev. Linda McNamar, United Church of Religious Science, who, when acting as associate dean of the Ernest Holmes College seminary, suggested that I return to graduate school in the first place.
Part I
Introduction to the Project
Chapter 1 Introduction2
I. Overview of the Topic2
II. Importance of the Topic5
III. Overview of My Approach10
Chapter 2 Definitions of Terms and of Regulative Principles15
I. Definitions of Terms15
II. Regulative Principles22
Part II
Empirical Evidence
Chapter 3 An Overview of the Empirical Evidence29
I. Organizing the Evidence29
II. Selection of the Evidence Presented32
Chapter 4 Evidence from the Placebo Effect35
I. Introduction35
II. The Power of the Placebo Effect37
III. Conclusion41
Chapter 5 The Nascent Science of Psychoneuroimmunology43
I. What Psychoneuroimmunology Is43
II. The Development of a New Branch of Science45
III. Conclusion49
Chapter 6 Controlled Statistical Studies of Mental Healing52
I. General Effects of Thinking on Health52
II. The Effectiveness of Mental Healing Techniques56
III. Heart Disease59
IV. Cancer70
V. Acquired Immune Deficiency Syndrome (AIDS)90
VI. Summary and Conclusion92
Chapter 7 Documented Evidence for Psychosomatic Causation93
I. Hypnosis95
II. Spiritual Practice100
III. Hysterical Psychosomatic Phenomena113
IV. Biofeedback Studies118
V. Summary and Conclusion130
Part III
Philosophical ArgumentsI
Chapter 8 Conclusions from the Evidence131
I. Merits of Examining the Evidence131
II. The Place of Psychosomatic Therapies in
Scientifically Based Health Care 131
III. The Evidence and the Philosophical Issues131
Chapter 9 Of Ghosts and Machines:
Understanding the Mystery of Mind over Matter 131
I. Philosophical Implications of the Evidence for Mental Healing 131
II. The Discovery of the Problem in the Philosophy of Descartes 131
III. An Overview of the Current Mind-body Debate131
IV. The Idealist Alternative131
V. Mental Healing as a Problem for Modern Philosophy131
Chapter 10 Whitehead's Process Model131
I. Two Fallacies: Simple Location and Misplaced Concreteness 131
II. Whitehead's Reconstruction of Mind and Matter131
III. Theory of Causation and Mind-body Interaction131
IV. How Psychosomatic Healing Would Occur in Whitehead's System 131
Chapter 11 Objections, Replies, and Conclusion131
I. Objections and Replies131
II. Summary and Conclusion131
Introduction to the Project
This dissertation is an attempt to take a serious, scholarly, and philosophical look at the power of thoughts and beliefs in healing the human body, as well as at the attempts to apply this power in practice. My aim is to formulate an ontology that explains both the power of the mind and the stubbornness of facts. I intend to establish two theses:
1. That our thoughts and beliefs are a real and potent force in healing wounds and disease.
2. That there is nothing supernatural in this apparently "miraculous" process.
On the contrary, I believe the healing power of thought to be really quite mundane, once we let go of some philosophical assumptions that have dominated nineteenth- and twentieth-century intellectual life, assumptions that I believe are, in any case, long overdue for serious questioning and critical evaluation.
The theory that our thoughts can heal is perhaps as old as the practice of healing itself. In modern times, however, the philosophical inquiry into the phenomenon was initiated by two American spiritual movements that began in the late nineteenth century. One was an organized church that called itself "Christian Science," the central teachings of which were outlined in Science and Health by Mary Baker Eddy, the founder of Christian Science.(1) The other was a loosely organized confederation of religious and quasi-religious organizations that comprised the International New Thought Alliance (INTA). INTA organizations were first inspired by writers such as Horatio Dresser, Ralph Waldo Trine, and (later) Emma Curtis Hopkins.
The ideology of these two movements was first formulated by a nineteenth-century New England clock-maker named Phineas Parkhurst Quimby, who taught that the mind has the power to cure disease.(2) It was this very power of the mind, Quimby proclaimed, that Jesus used in his healing ministry. For Quimby and his philosophical followers, the so-called "miracles" of the world's great religions never involved the suspension of natural laws by a Supernatural Deity, but were manifestations of natural metaphysical principles, immutable "scientific" laws, much like those of thermodynamics. However, these "laws" include some very debatable propositions, such as the omnipotence, omnipresence, and omnibenevolence of God and an idealist metaphysical principle called the "law of cause and effect." This particular rendition of causality states simply that mind is cause and matter its effect. The entire material world is nothing but a projection of our own belief systems. We could all be eternally healthy, wealthy, and wise were it not for our conscious and subconscious beliefs to the contrary. This idea involved a literal interpretation of the Biblical proverb, "So as he thinketh in his heart, so is he" (Proverbs 23:6, KJV), and Jesus' words, "If ye have faith and doubt not... [and] if ye shall say unto this mountain, Be thou removed, and be thou cast into the sea; it shall be done" (Matthew 21:21, KJV). In this metaphysic, all physical medical cures, such as drugs, surgery, and even nutrition, are placebos. The real way to "cure" any disease is to become aware of one's own Divinity and thereby one's innate wholeness and perfection. Physical cures are really nothing more than ways to convince ourselves that we are already well -- even though we may have a fever of 103 and be in considerable pain at the time. The problem is that this entails believing what our senses tell us is contrary to fact. However, if we can somehow come to believe sincerely that our real nature is health, our mind (the true causal agent of the cure) will heal us, and all appearances to the contrary will vanish. The physical treatment is really nothing more than a convincing form of self-hypnosis.(3)
For over a century this movement, which William James labeled "mind-cure" or "the religion of healthy-mindedness,"(4) has had its ebbs and flows. Although it has never captured the hearts of the American mainstream, neither has it disappeared entirely. This is as true today as it was nearly a century ago, when James devoted an entire chapter of his Varieties of Religious Experience to it.(5) Cynics and materialists will argue that the only reason these philosophies persist is the unfortunate human tendency towards wishful thinking. However, like James, I find it hard to dismiss them so quickly. There is too much supporting evidence to write them all off as childish dreams. On the other hand, it is equally difficult to argue that mental power is absolute, as Christian Scientists and most New Thought thinkers claim. While faith has in some instances cured cancer and even AIDS, its record of success with broken bones and ruptured appendices, not to mention broken fan belts, is much less impressive. These problems still require a doctor or mechanic, not a minister or psychotherapist. Orthodox believers in Christian Science or New Thought will attribute the failures of mind-cure to a lack of faith. In short, it would seem that there is something obviously wrong as well as something very right with Christian Science and New Thought philosophies.
I chose this topic for two reasons -- one primarily intellectual, the other deeply personal. Intellectually, I believe it is an important philosophical topic that philosophers are neglecting.
In popular literature, it has recently been a hotly-debated topic for several years. According to one religious historian, the influence of New Thought on American religion is far greater than its relatively small numbers would suggest.(6) In health care it is already in the spotlight. In alternative medicine its gospel has been preached for decades. Moreover, as the appointment of writer Norman Cousins to the UCLA medical school faculty in the 1980s indicates, it has recently begun to attract the attention of the medical mainstream. Mental health care professionals are also very much interested in its ideas. In my experience attending Religious Science and other New Thought churches, I have observed a relatively large number of psychotherapists of various sorts among its members. Positive-thinking philosophy is perhaps surprisingly well established in the business community. Pragmatic and sometimes materialistic as they are, business people are often quicker than academicians to accept positive-thinking philosophy. The power of positive thinking is now almost orthodox in sales training. Sales trainers from Dale Carnegie to "Zieg" Ziegler have been advocating it since the 1930s -- and sales people also attend New Thought churches in disproportionately high numbers. From my own observation, there seem to be more people from sales, in fact, than from any other single occupation in New Thought. Management consultants are also embracing its ideas. I have personally heard speakers at both the Society for the Advancement of Management and the American Society for Training and Development say, "To think is to create."
Conspicuously absent from the discussion are academic philosophers. At first, this surprised me, because the discussion is philosophical from the outset. Few of the people teaching these concepts have any formal philosophical training and background, and even fewer have undertaken formal graduate study in philosophy. In the entire United States I know of only one active professional academic philosopher, Alan Anderson, of Curry College in Massachusetts, who attends INTA meetings. This lack of training becomes evident in some of the popular literature, in which some respected and well-known "authorities" on the subject propagate all kinds of hair-brained and fantastic notions. Meanwhile, serious philosophers remain conspicuously silent. In short, a very large segment of the population has a very real philosophical need that serious philosophers are simply ignoring.
One possible reason why philosophers have neglected the topic is suggested by David Ray Griffin, who argues that philosophers, whether they acknowledge it or not, are still trapped in the seventeenth-century Cartesian paradigm of mind and matter as different types of things. Mind is conceived as a thinking, perceiving and feeling substance, and matter is an extended substance that has mass and velocity. Those who explicitly affirm dualism have the problem of explaining how the mind and body interact. The other popular alternative, materialism, is really a form of crypto-dualism, insofar as the body is regarded as devoid of all experience while the reality of what we call the mind's experience cannot help but be acknowledged. Those who adopt any version of materialism still have the problem of explaining how experience could arise from matter. Moreover, insofar as they deny to the mind any autonomy from the brain, they cannot attribute any freedom or efficacy to our conscious experience. While they might be comfortable in intellectually embracing radical determinism and epiphenomenalism, they do not (and probably cannot) avoid presupposing in practice some form of free will and causation from the mind to the body.(7) However, from a materialist perspective, any argument saying that the mind can heal would appear as simply impossible and not worthy of serious discussion.
This dissertation is therefore aimed at two audiences: The first is those who want to take a critical look at theories about the mind's power before or while attempting to apply them. My aim is to provide a resource that people can use to evaluate positive-thinking philosophies -- before they have invested too much time and money in them. The second intended audience is composed of fellow philosophers and theologians, who are missing a tremendous opportunity. These are not good economic times for education in general and liberal arts education in particular. I would like to suggest the hypothesis that maybe our budgets would not shrink so fast if we directed more attention and effort towards serving the actual needs of the community that supports us. I am not saying that we should cease writing papers in professional journals for review by our peers. But I am suggesting that this is not the main reason why the tax-payers and philanthropists fund philosophy and religion departments. We have a chance here to breathe new life into public interest in philosophy, and especially the philosophy of religion. Carpe diem!
The other reason is personal. The well-known "Serenity Prayer" of Alcoholics Anonymous, originally written Reinhold Niebuhr, reads:
God, give us the serenity to accept what cannot be changed;
Give us the courage to change what should be changed;
Give us the wisdom to distinguish one from the other.(8)
I believe the Stoics were right in saying we have direct control over only two aspects of life: our own thoughts and actions. The motto of the Church of Religious Science is: "Change your thinking, change your life." If this proposition is true, we may have a tremendous untapped capacity locked up in our belief systems and habits of thinking. Since I first became involved in New Thought over ten years ago, my life has become a testing ground for this very hypothesis. Sometimes its teachings appear true; other times not. However, the nature and extent of their truth is for me a matter of intense personal interest. I have witnessed my wife's successful use of mental healing techniques to bring herself out of a life-threatening flare-up of systemic lupus, a congenital disease for which there is no conventional medical cure. During this period, moreover, she also came to see how the flare-up itself had originated from her own attitudes and beliefs. I too have used the various techniques of positive-thinking philosophy, such as affirmations, visualizations, and prayer, in all aspects of my life -- with varying degrees of success.
This essay contains eleven chapters, divided into three parts. Part I, "Introduction to the Project," introduces the essay and defines both terminology and the criteria for a satisfactory theory. It consists of the following chapters:
1. Introduction (this chapter)
2. Definitions of Terms and of Regulative Principles
Part II, "Empirical Evidence," presents some of the evidence supporting the thesis that psychosomatic healing occurs. It consists of five chapters:
1. An Overview of the Empirical Evidence
2. Evidence from the Placebo Effect
3. The Nascent Science of Psychoneuroimmunology
4. Controlled Statistical Studies of Mental Healing
5. Documented Evidence for Psychosomatic Causation
Part III, "Philosophical Arguments," investigates the philosophical problems surrounding the subject of mental healing and presents suggestions about how we might begin to resolve them. It consists of the following four chapters.
1. Conclusions from the Evidence
2. Of Ghosts and Machines: Understanding the Mystery of Mind over Matter
3. Whitehead's Process Model
4. Objections, Replies and Conclusions
In the Chapter 2, I formulate working definitions of basic concepts such as mind, matter, thought, belief, and faith. I pay special attention to the last three, because, although they are not the same, they are easily confused. I also outline the regulative principles that define a satisfactory theory of the power of thought. Finally, I distinguish two forms of mental healing. Psychosomatic healing is the ability to heal one's self via one's own thinking, and psychokinetic healing is the ability of one person to heal another. The scope of this essay is limited to the former.
The next five chapters deal with the empirical evidence supporting the proposition that thoughts can heal. References include works by Michael Murphy, Norman Cousins, Larry Dossey, and Bernie Siegel, as well as other authors to whom they refer. Some examples of this evidence are studies of the placebo effect, hypnosis, biofeedback, mental and spiritual healing, and the infant science of psychoneuroimmunology. These chapters focus on the power of thought to heal or affect bodily functions in unusual ways. The Chapter 3, "An Overview of the Evidence," discusses the kinds of evidence included and presents an overview of the material covered in the next four chapters. Chapter 4, "Evidence from the Placebo Effect," covers evidence for the power of mental healing via placebos. Chapter 5, "The Nascent Science of Psychoneuroimmunology," covers recent discoveries linking the immune system with the nervous and endocrine systems. Chapter 6, "Controlled Statistical Studies of Mental Healing," reviews some of the controlled empirical studies supporting the proposition that thinking can both cause and cure disease. Chapter 7, "Documented Evidence for Psychosomatic Causation," moves beyond evidence for mental healing as such to documented evidence for various extraordinary ways in which thinking can affect the body. In all cases discussed, logic and common sense indicate that the probability of any fraud or coincidence is extremely low.
Chapter 8, "Conclusions from the Evidence," the first chapter in the philosophical part, serves as a transition to the philosophical discussions that follow. It summarizes the immediate implications of the evidence. Because so many have seriously argued that the evidence is not worth examining, the first section of this chapter is devoted to the merits of examining the evidence. The second section explains how the evidence indicates that psychosomatic factors do indeed play a role in causing, preventing, and curing disease. The third section is an overview of the immediate philosophical implications of the evidence.
In Chapter 9, "Of Ghosts and Machines: Understanding the Mystery of Mind over Matter," I address the philosophical problems involved with psychosomatic healing in greater detail. First, I summarize the philosophical implications of the empirical evidence presented in the previous chapter. Then I trace the origins of the mystery of mind over matter to certain assumptions in Descartes's philosophy. The third section is an overview of current state of affairs in mind-body philosophy. Drawing heavily from David Ray Griffin's Unsnarling the World-Knot, I argue that, in recent times, only two theories of mind and matter have been given legitimacy: Cartesian dualism and monistic materialism. Epiphenomenalism, a possible third alternative, is a compromise between the other two, but it leans heavily in the direction of materialism. In epiphenomenalism the mind is a mere effect generated by the brain; in materialism it does not really exist as a distinct entity or activity at all. It is extremely difficult to explain any power of thought -- even the ability to make simple decisions -- in terms of any of these three views. According to materialism and epiphenomenalism, mental power is simply impossible, so that any appearances of such must be illusory.
Dualism, the view that mind and matter are both real but totally different types of actualities, can account for the mind's freedom and ability to make decisions, but it cannot explain how mind and matter interact. In dualism, the power of thought to affect the body is mysterious if not supernatural. Mental or spiritual healing is often viewed as a "miracle" effected by the personal intervention of God. I suggest that, if we stop limiting our alternatives to dualism, materialism, and epiphenomenalism, the so-called paranormal effects of mind on matter seem much less bizarre.
The idealist alternative, although out of vogue among academic philosophers, has been the preferred metaphysical view among advocates of mental healing, who generally work outside the academy. Although the idealist model explains mental healing better than dualism or materialism, it fails to explain the limitations of the mind's power and why psychosomatic healing techniques often fail.
I end Chapter 9 with a general observation about the mind-body problem, which traces its origins back beyond Descartes to the thinking of Aristotle. I argue that, as long as we attempt to address the philosophical issues underlying the problem of mental healing, i.e., mind-body interaction and efficient causation as real influence, in terms of substances and attributes, then any attempt to understand either mental healing or the underlying philosophical issues is doomed to failure. A radically new way of understanding the world is needed to render these concepts intelligible.
In Chapter 10, "Whitehead's Process Model," I present a philosophical framework that was specifically designed to address the two philosophical issues, efficient causation and the mind-body relationship, which underlie the problem of mental healing. I briefly overview Whitehead's argument that the basic elements of our experience are not the minds and bodies that comprise the subject matter of ordinary conversation, but "actual occasions," moments of experience that are both mental and physical. Next, I outline how he develops his theories of causation and the mind-matter relationship based on this view. Then I show how they apply to the process of psychosomatic healing.
In Chapter 11, "Objections, Replies, and Conclusions," I attempt to anticipate and answer objections that might be raised. I divide the objections and replies by philosophical paradigm, beginning with the likely objections of materialists, moving on to those of dualists and idealists, and then to some general objections against the Process model that anyone could raise. I conclude that, although Whitehead surely does not have the last word on the philosophical issues involved in mental healing, his philosophy certainly is an excellent starting point, in that provides a viable, natural theology of mental healing.
Chapter 2
Definitions of Terms and of Regulative Principles
In this chapter, I formulate the parameters that guide the following discussion, specifically the definitions of several ambiguous terms and the regulative principles that define a satisfactory theory of the power of thought.
This discussion deals with general philosophical terms only. In the chapter on Whiteheadian Process Philosophy, I deal extensively with problems in terminology, but that discussion covers problems unique to the process model. The terms are defined as they would apply in Parts I and II of this essay. Some of these definitions are significantly narrowed by implication in Part III, where I take a more definite philosophical stand on the issues. However, for purposes of Parts I and II, the following definitions apply:
Thought
Thought is any mental activity, as ordinary language uses the term "mental." It includes things such as fantasies, beliefs, ideas, concepts, intentions, volitions, decisions, hallucinations, and ratiocinations. For Parts I and II of this essay, I leave aside the issue of whether thought is accompanied by, caused by, or identical to any corresponding brain activity. On the other hand, I do exclude things that necessarily involve other bodily activities, such as bodily positions, movements, and even sensations. Initially, I leave the ultimate nature of what constitutes thought open. It could be "mental" activity in the Cartesian sense, i.e., an activity of a completely immaterial substance, or it could be no more than the way in which our brain and other bodily states are experienced, as materialists and epiphenomenalists would claim. Under this definition, even materialists can say that we have thoughts, although they would also say that only the corresponding brain states have causal efficacy.
I have chosen to begin with this broad definition for three reasons. The first is that I would like to avoid committing myself, simply by definition, to any particular position on the mind-body problem, such as dualism, materialism, or some version of idealism. I especially want to avoid committing myself to some form of Cartesian dualist interactionism. (I intend to argue, in fact, that the unstated presupposition of Cartesian dualism is what has made mental healing seem so strange in the first place.) The second reason is that if I defined "thought" in a way that presupposes a particular position, then later chose to argue for that position, I would run the risk of circularity. However, I do indeed address the mind-body problem, it being the central philosophical issue in this essay.
The third reason for adopting a broad definition of thought is to mitigate some of the opposition to mental healing in health care, especially the opposition to examining the data on the grounds that mental healing is "unscientific." Materialists may argue that the evidence for mental healing is irrelevant, because we are trying to prove the existence of something known to be impossible, namely mental causation. However, this would only be true if mental healing entailed causation by an immaterial substance. Although I am no materialist, I share the materialists' objections to Cartesian dualist interactionism. By defining "thought" broadly, I am deliberately entertaining the possibility that mental healing may really be just a manifestation of brain and other central nervous system activity, a phenomenon that should be palatable even for materialists. It is probably a vain hope, but I would like to encourage even materialists to examine the evidence for mental healing and mental healing techniques, especially those who are involved in health care and can significantly help or hinder the incorporation of psychosomatic therapy into modern medicine. My motives in making this move may be political, as well as philosophical, but I believe the move to be well worth making and consistent with my arguments.
Belief
For purposes of this essay, the term "to believe" means to hold a proposition, which can be expressed by a sentence, as true or false. Such propositions can be universal or particular, positive or negative. For example, a positive universal proposition would be "All crows are black." "A crow is white" and "Some crows are white" are positive particular propositions. A negative universal proposition would be "No crows are white." Negative particular propositions are illustrated by: "Some crows are not black" and "This crow is not black." For purposes of this discussion, beliefs can include value judgments -- even though this kind of proposition may actually say more about the person uttering the statement than about the logical subject. For example, the proposition "California wines are tasty" appears to speak about the qualities inherent in the wine, but my belief in this proposition may in fact say more about my preferences in wine than it does about the characteristics of the wine itself. I make this distinction because some of the kinds of beliefs that deal with the quality of our lives express propositions of this sort. In this essay, we will be looking at the capacity of beliefs in propositions such as "The universe is friendly" to become self-fulfilling prophesies.
Faith
For our purposes, faith constitutes more than belief, in that it also entails an element of decision and commitment. To believe in a proposition is to accept it as true intellectually. To have faith in a proposition is to be willing to act on the presumption of its truth. The strength of faith may or may not correlate with the certainty of a belief. I may, for example, be quite convinced that flying on the airlines is safe. However, I may also, based on a peculiar phobia with respect to flying, refuse to fly. Or, suppose that I am playing a hand of stud poker and holding three aces, while the person across the table from me is showing a hand of four clubs. The odds say that his hold card is of a suit other than clubs, and therefore that he does not have the flush that beats my three-of-a-kind. However, if he throws a $1,000 bet on the table, his bet suggests otherwise. In this case, I may be very uncertain if he has the flush, but if I call his bet, I am certainly acting on faith that he does not. Of course, faith and belief usually go together. For example, I have talked with people who have done the fire walk, in which they walked barefoot on red-hot coals for a distance of 20 feet or more. All of them have told me that, by the time they actually did the walk, they thoroughly believed that the hot coals would not burn them and felt safe from harm. But there are other times when we have to act on faith with very little sense of certainty, such as in the poker game described above. Of course, one could argue, along with the pragmatists, that any professed beliefs upon which we are not willing to act are insincerely held. My refusal to fly would therefore belie my claim to believe flying is safe. What I really believe may be limited to what I presuppose in practice. For now, I will leave this issue unresolved, allowing for at least the possibility of intellectually believing in some propositions without also having the faith needed to act on them.
Matter
Defining matter is not easy. The definition I learned from high school physics class was "anything that has mass and occupies space." Even back then I found the definition less than satisfying. For one thing, there were entities like photons that did not fit neatly into this definition, but which could hardly be called immaterial. Also, it was known that matter can be converted into energy and vice versa. Finally, it turned out that matter itself consists of energy. However, energy does not always have mass, nor does it always occupy space. I was left with the rather unsettling conclusion that matter was by definition ultimately not really material!
I must confess that, in the intervening years, I am still unclear on this issue, and I certainly do not intend to provide a definitive solution to the problem here. For purposes of this essay, especially in Parts I and II, I will stick with the commonsense, high-school-physics definition presented above, with the acknowledgment that the definition ultimately breaks down when one gets really technical.
Two philosophical technicalities, however, need to be addressed: We are not necessarily defining matter in the Berkeleyan sense, as something that exists independently of all perception of it (in which sense Berkeley denied its existence). For purposes of the first two parts this essay, it may or may not exist independently of our perceptions. Secondly, I am not defining matter as something that is necessarily devoid of all experience, as something that can only be "in itself" and never "for itself." I am, therefore, leaving the door open to the view that, if matter does exist independently of perception of it, this may be because it has a kind of perceptual experience in its own right. In Berkeley's terms, if the essence of what we call matter is not simply percipi (to be perceived), this may be because its essential nature is percepere (to perceive). Such a position might still be called a form of "physicalism" or "materialism" insofar as the inherited sense of the "material" or the "physical" can be modified in this fashion. I discuss this possibility in Part III.
Mind
For our purposes, I will define a "mind" as any enduring entity that has the capacity to have experience. By this definition, all animals -- including insects, snails, and possibly even protozoa -- have minds, albeit in some cases primitive ones. Plants too may possess minds. However, by our definition minds endure through time. What is called the "mental pole" of a single "occasion" of experience in Whiteheadian philosophy is, accordingly, not a mind by our definition. For the purposes of Parts I and II, I am also setting aside the issue of whether the mind is ultimately identical to the brain. As in the definition of "thought" above, I intend to postpone discussion of this issue until we address the mind-body problem in Part III.
Idealism and Realism
The idealism-realism debate arises from the Cartesian paradigm of mind and matter as two substances that are self-existent but can causally affect one another. Idealists argue that Descartes was right with respect only to minds or Mind. Matter may or may not exist, but its existence depends totally on the existence of a mind to experience it. For purposes of this essay, "idealism" is the claim that fully conscious mind is the only kind of self-existent thing, with everything else being creations of some mind. "Realism" is simply the denial of this claim. Realism holds that there are some entities that can exist independently of a mind's perception of them. Such entities, be they lifeless matter, or mental-physical entities like Leibnizian monads or Whiteheadian occasions, can exist without some other mind to perceive them. By this definition, idealism is the affirmative position and is more extreme. Its true counterparts among realist ontologies are epiphenomenalism and materialism, which take the more extreme position that matter-energy is the only fully actual thing, reducing the mind's status to that of a mere effect or property of matter, or else an outright illusion.
Objectivism and Subjectivism
Our definition of objectivism and subjectivism at this stage is preliminary, because it can actually carry several different meanings in a discussion of the mind-body problem. However, for purposes of this essay, the terms "objectivism" and "subjectivism" will have the following meaning, unless otherwise specified. In an objectivist world, insofar as two experiencing subjects experience the same thing, they do so at least partly on account of the nature of the thing experienced, not just on account of the similarity between the experiencing subjects. In a subjectivist world, the similarities of their experiences are wholly due to the fact that their natures are similar. By this definition, subjectivists would usually lean towards idealism; objectivists, toward realism.
Psychosomatic Healing
Psychosomatic healing is defined as the healing of one's own body by means of one's own thoughts, beliefs, or other mental states or activities.
Psychokinetic Healing
Psychokinetic healing is defined as the healing of a person by means of the thoughts, beliefs, or other mental states or activities of another person.
By "regulative principles" I mean the guidelines by which one evaluates a theory, i.e., the criteria by which one defines a theory as satisfactory or unsatisfactory. Griffin defines these principles as follows:
All discussions of the mind-body relation presuppose various regulative principles. Some of these are formal, such as, that a theory should be self-consistent. Others are substantive, such as the principle that a theory should be compatible with the evolutionary origin of human beings. Regulative principles, by specifying the conditions to which any theory must conform to be potentially acceptable by the author or community in question, indicate the range of theories that can be eliminated a priori.(9)
The danger in using regulative principles, especially those of the substantive type, is implicitly presupposing the thesis one is trying to prove in the very act of applying the regulative principle itself, which renders one's argument circular. However, without using at least some regulative principles, there is no way to distinguish acceptable theories from unacceptable ones. Accordingly, I have attempted to keep them to a minimum here. The regulative principles I use to define an acceptable philosophical theory of psychosomatic healing are as follows:
Adequacy of Explanation
This essay is intended to provide a philosophical explanation of psychosomatic healing -- both its successes and its failures. Both Christian Science and New Thought have formulated theories of how mental healing can occur, but neither offers what I consider an adequate explanation of its apparent limitations. Materialists, on the other hand, can tell us why it fails (it is said to be impossible), but not why it sometimes works. A satisfactory theory should explain both the successes and the failures.
I also address the religious implications of the theory. Is it God, or the mere belief in God, that actually heals? Knowing what I do about the placebo effect, I am careful not to underestimate its power. However, although I intend to put forth a naturalist theory of psychosomatic healing, I do not intend to reduce God's role to that of a placebo. I am merely ruling out Divine intervention in the form of suspending the laws of nature or otherwise interrupting the normal causal processes in the world. Psychosomatic healing, as I conceive it, still involves Divine activity, but God is working in and through nature, not contrary to it. This position seems more adequate to both the facts and the implications for religious faith in healing. Indeed, given the fact that prayer for healing does not always result in healing, I hold that my position provides a better basis for sustaining faith than the view that God interrupts or overrides nature.
Rationality
Another criterion is that the theory should be rational, i.e., it should be both self-consistent and compatible with the evidence. Internally inconsistent theories and those that do not square with the evidence must be rejected. This does not mean, however, that the theory will always dictate that one should always be rational. For example, an acute coronary patient may have a better chance of recovery by denying the gravity of the situation or even the heart attack itself. In this case, intellectual integrity can be unhealthy. A theory that says it may be healthier, at times, to be irrational is not necessarily an irrational theory.
"Hard-core" Common Sense
A concept borrowed from David Ray Griffin is the regulative principle of "hard-core" common sense, which says that certain commonsense beliefs, such as the existence of a real world beyond ourselves and consciousness, should hold the epistemological status of indubitable facts in determining issues of adequacy and rationality. Drawing on arguments made by Thomas Reid, and more recently by Whitehead, Griffin says that we must presuppose these beliefs in practice even if we deny them in theory. Therefore, whenever a theory denies these beliefs, either directly or by implication, then we must reject it as irrational. Insofar as it fails to explain relevant hard-core commonsense beliefs, it is inadequate.
Common sense has been a much-abused term in philosophy. There was a time, for example, when common sense dictated that the earth was flat, as well as a time when going to the moon was the paradigm of impossibility. Griffin refers to these notions as "soft-core" common sense. Soft-core commonsense beliefs can be widely held, or even widely presupposed in practice. However, we need not necessarily presuppose them in order to function as human beings. This is the critical difference, according to Griffin, between hard-core and soft-core commonsense beliefs. For example, we presuppose the existence of consciousness whenever we attempt to engage in an intelligent conversation. We presuppose the existence of real objects whenever we pick one up. Hard-core commonsense beliefs can therefore be denied only in hypocrisy or in self-contradiction.(10)
We must be careful in applying the hard-core commonsense regulative principle, because it is easy to confuse a hard-core commonsense belief with a particular interpretation or understanding of it. For example, we treat living things differently from non-living ones, self-moving creatures differently from those that cannot move, and most of us treat humans differently from other forms of life. The existence of mentality at various levels would be a hard-core commonsense belief. However, making these distinctions does not necessarily commit us to believing in a world with ghosts in machines. Cartesian dualism is but one particular interpretation or understanding of relating mentality to the body. It is also possible to formulate other theories explaining the differences between the living and non-living, the self-moving and the non-self-moving, and the human from the animal. What hard-core common sense tells us is that we can expect living things to behave differently from non-living ones and humans to behave differently from animals.
Ockham's Razor (Parsimony)
Whenever two theories are equally acceptable according to other criteria, I follow the principle of Ockham's razor and argue for the simpler of the two. Unfortunately, what is "simpler" can depend a great deal on one's perspective. For example, idealism offers a very "simple" explanation of the power of thought: What we call reality is simply what we dream up and believe. It sounds simple enough, but when one takes into account the problem of how two dreamers in the same room have shared experiences of the room, idealism quickly becomes quite complex. For purposes of this essay, I adopt a general bias against ideas that are unnecessarily complex. However, complexity is sometimes necessary to satisfy other criteria, such rationality or adequacy. Each application of Ockham's razor will, accordingly, need to be discussed individually.
Scientific Bias
Like Ockham's razor, this criterion is applied when choosing the better of two or more alternatives. By "scientific bias," I mean that I prefer theories that fit with other known, empirically-verified explanations of similar phenomena over those that do not. In other words, if I can explain something in terms of chemistry, biology, and physics, I will prefer that explanation over one that involves evil spirits or even benevolent ones.
Ease of Applicability
Finally, I would prefer to develop a theory that ordinary people, who have not been to graduate school in philosophy or theology, can understand well enough to apply in their daily lives. Faith healers themselves are more often than not intellectually unsophisticated. Moreover, I have a personal bias towards pragmatism and prefer theories that work. Note that this does not mean that I expect everybody to follow the logic of how I derive or defend my views. Nevertheless, I would prefer to put forth a theory that is relatively easy to apply, even if its underlying rationale is complex. After all, technically unsophisticated people learn to drive cars and operate personal computers -- without understanding any of the inner workings of either.
Part II
Empirical Evidence
Chapter 3
An Overview of the Empirical Evidence
Readers familiar with the subject of faith healing may find references to some of the best-known faith healers, e.g., the seventeenth-century healer Valentine Greatrakes, conspicuously absent here. The reason for this is that most of these healers derived their fame from their ability to heal others, which renders their major achievements psychokinetic and beyond the scope of this project. Nevertheless, there is no shortage of empirical evidence on the psychosomatic side, as this and the following five chapters should demonstrate.
The body of empirical evidence in support of psychosomatic healing is voluminous. I have chosen to divide the discussion of the evidence presented in Part II into six chapters:
3. An Overview of the Empirical Evidence
4. Evidence from the Placebo Effect
5. The Nascent Science of Psychoneuroimmunology
6. Controlled Statistical Studies of Mental Healing
7. Documented Evidence for Psychosomatic Causation
In Chapter 3 (the present chapter), I identify what I consider to be bona fide evidence and the criteria by which it is included. Four chapters that present the evidence itself follow.
Evidence from the Placebo Effect (Chapter 4). This is the phenomenon of healing via a drug or other remedy that the patient believes is efficacious, when in fact the remedy itself is not. The classic example of a placebo is a sugar pill given to someone who has been told he or she is receiving a miracle drug. The placebo effect occurs when the mere belief in the remedy renders the remedy effective. It is one of the most extensively documented and widely accepted forms of mental healing. In fact, it may be the only one that mainstream medical research has fully acknowledged. For example, in attempting to prove a new drug effective, researchers conduct "double-blind" studies, in which neither the recipients nor the administrators of the experiment know who is getting the placebo and who is getting the real thing -- in order to prevent the placebo effect from invalidating the test.
The Nascent Science of Psychoneuroimmunology (Chapter 5). In recent years, medical researchers have discovered that the nervous, endocrine, and immune systems all interact with one another, suggesting that the brain may be involved in healing. As we shall see later in this essay, psychoneuroimmunology is a double-edged sword for advocates of mental healing. Although it tells us the role of the central nervous system in healing, it does not tell us if or how thoughts can move gray matter.
Controlled Statistical Studies of Mental Healing (Chapter 6). There are also many controlled studies verifying the effects of one's thinking -- both constructively and destructively -- on one's health. In this chapter, I review a sample of these studies. Some deal with the overall effect of thought processes on health. Others deal specifically with heart disease and cancer, the first of which takes more American lives than all other diseases combined.(11) I also cite a documented case study indicating that AIDS may be subject to mental cure or at least regression.
Documented Evidence for Psychosomatic Causation (Chapter 7). This chapter presents individual cases and experimental evidence demonstrating the extraordinary ways in which thinking can affect the body. Although little of it deals with mental healing per se, it does render the phenomenon of mental healing more plausible. Included in this section are biofeedback experiments and documented case studies of hypnosis. (The section on hypnosis includes cases in which hypnosis alone has successfully anesthetized individuals undergoing major surgery. The biofeedback studies are significant primarily because they proved that processes previously believed to be autonomous could be brought under conscious control. This suggests that we might some day learn to direct our own immune and endocrine systems consciously.) Also included are well-documented individual cases involving saints, mystics, and even a few neurotics. Some involve Indian yogis who survived live burial for days on end. Others describe of the charisms, or the extraordinary events, surrounding the Catholic saints and mystics. Still others document phenomena as bizarre as false pregnancy in men. When compared to these kinds of phenomena, psychosomatic healing seems almost mundane.
II.Selection of the Evidence Presented
What we review here is evidence supporting a causal connection from thought to healing. The kind of causality we are discussing is "efficient" causality, i.e., the influence of an antecedent on a subsequent one.
One of the most common methods of finding a causal connection is by means of controlled statistical studies. These studies use probability theory to show that the correlation of an independent variable (or presumed cause) and the dependent variable (the effect) is stronger than it would be if the two variables were to occur at random. By itself, a statistical correlation does not identify a causal relationship. It only identifies a risk factor. To determine a causal relationship, a mechanism or formula explaining how the independent variable affects the dependent one is necessary. For example, two factors, male homosexuality and intravenous drug use, were both identified as risk factors for AIDS long before its cause, the human immunodeficiency virus or HIV, was found. The identification of the virus, as well as blood contact as the primary means of transmission, also explained the risk factors.
Risk factors do not always indicate causes. They may be merely other effects. As a hypothetical example, if cigarette smoking were found to be higher at lower socio-economic classes, and these same people also suffer from poorer nutrition, a statistical link between smoking and cancer would not demonstrate that smoking causes cancer at all. The real cause of the high cancer rate among smokers might be the poor nutrition suffered by the lower socio-economic classes, who also tend to be chain smokers. (There is the anecdote of the New Yorker who wore a lions-tooth necklace to protect himself from attack by lions. When his friend reminded him that one does not see many lions in the streets of Manhattan, he replied, "It works, doesn't it!") Serious researchers must exercise great care in eliminating extraneous variables from their studies, and how well they have done so is a major topic of debate in medical journals and academic journals in the social and biological sciences.
There are other ways to rule out random chance besides statistics. One of them is deductive logic. For example, if emotional depression adversely affects known immune system functions, and these functions protect us from disease, logic dictates that emotional depression also leads to disease. This relationship can be expressed in a syllogism:
Major premise: All immune system functions serve to protect us in some ways from disease.
Minor premise: Emotional depression adversely affects at least some of our immune system functions:
Conclusion: Therefore, emotional depression adversely affects some of the functions protecting us from disease.
Strictly speaking, more steps may be needed to construct a valid formal proof here in terms of quantifier logic, but the above syllogism should convince anyone who accepts the premises.
Another way to rule out random chance is common sense. For example, it is highly unlikely that the stigmata of Christ's wounds appearing every Good Friday on the hands of a devout Catholic would develop purely at random. That would be like a monkey pounding out the same Shakespeare sonnet on the typewriter week after week by randomly poking at the keys. Something else is at work here that certainly seems related to the individual's religious convictions. In any case, common sense would rule out a purely random connection.
In short the evidence from the placebo effect, psychoneuroimmunology, controlled studies, and certain kinds of historical and scientific evidence were chosen because they all indicate a genuine causal relationship going from thinking to healing. With that, we now turn to the evidence itself.
Chapter 4
Evidence from the Placebo Effect
The placebo effect itself is probably the best-documented way in which thoughts are known to affect health. A placebo is a chemically ineffective treatment, such as a sugar pill, given to patients who believe it works. The patient's belief itself becomes the healing agent. Historically, the placebo effect has often been regarded more as a hindrance than a help in medical research, misleading researchers into thinking an ineffective drug or remedy works. Outside the field of research, it has also given quacks and charlatans the anecdotal evidence they have needed to peddle their ineffective and often dangerous merchandise.
Researches have combated the problem with "blind" and even "double-blind" studies. In single-blind studies, the experimenters take care to ensure that the subjects do not know whether they are in the control group, i.e., the one receiving the placebo. The problem with single-blind studies is that sometimes the beliefs of the experimenters have contaminated the study. A doctor's enthusiastic endorsement of a cure is contagious. The patient takes advantage of the placebo effect indirectly -- by believing in the doctor or, in the case of medical research, the experimenter.
To counteract this effect of the placebo-by-proxy, researchers have resorted to the double-blind study, in which neither the subjects nor the experimenters know which subjects are receiving the placebo. However, according to Dr. Larry Dossey in Healing Words: The Power of Prayer and the Practice of Medicine, the placebo effect has contaminated even double-blind studies. For example, researcher Jerry Solfvin conducted three double-blind studies on the effectiveness of vitamin E on heart patients' angina pectoris, the chest pain associated with heart disease.
[A]n enthusiastic doctor who believed in vitamin E found it significantly more effective than a placebo, while two studies conducted by skeptics showed no effect.(12)
Dossey cites other studies dealing with meprobamate, an early tranquilizer of questionable effectiveness, which showed similar results:
Enthusiasts consistently found that it worked, while skeptics could find no effects beyond those of a placebo. To clarify this situation, researchers designed a double-blind study in which one of the physicians had a "skeptical, experimental" attitude toward the drug, while the other had an "enthusiastic, therapeutic" attitude toward it. They were totally unaware which pills were which, meprobamate or placebo. The patients also were in the dark; they did not even know they were involved in an experiment. The results: meprobamate proved significantly more powerful than the placebo -- but only for the physician who believed in it. There was no drug effect for the skeptical physician's patients.
This study was repeated, conducted simultaneously at three metropolitan psychiatric outpatient clinics. The results were replicated in two of the three clinics.... Thus Solfvin concludes,
"....As a general rule, the double-blind cannot any longer be assumed to guarantee the exclusion of the nonspecific effects of the treatment, especially when the actual treatment has a weak or variable effect." [Emphasis in the original study cited by Dossey.](13)
This suggests the existence of something truly extraordinary: Experimenters' and physicians' beliefs about a remedy can be communicated to their subjects or patients subliminally, if not telepathically.
In any case, the placebo effect points directly towards my first major thesis: that thoughts do in fact heal. The very existence of this effect, especially to the extent that researchers must take great pains to work around it, proves that some kinds of thoughts, namely the belief in the efficacy of a cure, can and do heal. Faith in the cure was one of the essential elements in healing in statements attributed to Jesus (Matt: 17:20, 13:58, and Mark 6:6).
II.The Power of the Placebo Effect
Michael Murphy, in The Future of the Body, a comprehensive treatise on extraordinary human abilities, devotes an entire chapter to the placebo effect. Some of the studies he cites are summarized below:
Angina Pectoris. This is a chest pain normally associated with heart disease. In the early 1950s, it was a common practice in the United States to perform a ligation of the internal mammary artery to relieve pain and improve coronary blood flow. In the late 1950s, two researchers performed a double-blind experiment. Each patient received a skin incision, but only in randomly selected cases was the ligation actually performed. The researchers found no significant difference in the improvement rates of those patients who received the ligation and those who received a simple skin incision. The ligation procedure was subsequently abandoned.(14)
Warts. The placebo effect, using some of the most outrageous remedies, has worked exceptionally well with warts. In 1934, a physician conducted a double-blind study showing that placebos worked almost as well as sulpharsphenamine, the drug commonly used to treat warts at the time. Another physician was able to cure 44% of his patients of one kind of wart, and 88% of those with another kind, using suggestion alone. Studies like these led psychiatrist Montague Ullman to conclude in the 1950s that suggestion, when compared against X-ray, drugs, and surgery, was the most important factor in curing warts.(15)
Asthma. One study showed that 19 out of 40 subjects developed asthmatic symptoms after inhaling a saline solution they believed to be allergenic. Twelve developed full-blown wheezing and bronchial spasms, which disappeared completely three minutes after receiving another saline solution placebo. The same researchers induced bronchospasms in 15 out of 29 subjects who were told that the saline solution they inhaled contained allergenic agents. The researchers concluded that suggestion played a significant role in precipitating asthmatic attacks.(16)
Pain Relief. In 11 double-blind studies conducted over a 15-year period, a researcher found that 36% of 908 subjects who received placebos achieved at least 50% reduction in various kinds of pain. The results match a 35% rate in another similar study.(17)
Arthritis. Arthritic patients who received placebos experienced the same levels of relief as those who took conventional antiarthritic drugs. Subjects noted improvement in eating, sleeping, elimination, and swelling.(18)
Medication Side Effects. In another study, published in 1955, researcher Henry Beecher showed that placebos could produce symptoms such as nausea, dry mouth, heaviness, headache, concentration difficulties, drowsiness, fatigue, and unwanted sleep.(19) In a study of the drug mephenesin, researchers found that placebos produced "combinations of weakness, palpitation, nausea, rash, epigastric pain, diarrhea, urticaria, and swelling of the lips that mimicked known side effects of the drug."(20) Mexican researchers found that placebos could induce some of the known side effects of contraceptives.
Cancer. Statistical studies of placebo treatments for cancer are also rare, which is understandable, considering the risks of belonging in the control group. However, in his book Meaning and Medicine, Dr. Larry Dossey gives an anecdotal account that strongly suggests that placebos can cure cancer in some cases:
A man with an advanced cancer was no longer responding to radiation treatment. He was given a single injection of an experimental drug, Krebiozen, considered by some at the time to be a "miracle cure." (It has since been discredited.) The results were shocking to the patient's physician, who stated that his tumors "melted like snowballs on a hot stove."
Later the man read studies suggesting the drug was ineffective, and his cancer began to spread once more. At this point his doctor, acting on a hunch, administered a placebo intravenously. The man was told the plain water was a "new, improved" form of Krebiozen. Again, his cancer shrank away dramatically. Then he read in the newspapers the American Medical Association's official pronouncement: Krebiozen was a worthless medication. The man's faith vanished, and he was dead within days.(21)
One of the most spectacular demonstrations of the placebo effect occurred during a high school football game. It is described by Norman Cousins in The Healing Heart as follows:
The item, which appeared on the front page [of the Los Angeles Times], concerned an episode that occurred at a Monterey Park, California, football game. What had happened was that four persons had to leave their seats during the game because of severe nausea and dizziness. Questioning on the spot by school officials established the fact that the ill persons had consumed soft drinks from a dispensing machine under the stands. Syrup had been mixed with water out of the local piping system. Was the culprit the syrup or the water? In the latter case, had copper sulfate from the pipes infiltrated the water? If the former, had bacteriological organisms contaminated the syrup?
The football stadium lacked loudspeaker facilities. The cheerleaders were therefore directed to make a public announcement requesting that no one consume any soft drinks from the beverage-dispensing machines until the precise cause of the sudden illness affecting several persons could be ascertained. The immediate effect of the announcement was that the stadium became an arena of fainting and retching people. One hundred and ninety-one persons had to be hospitalized. Local ambulances and private cars plied back and forth between the stadium and five hospitals in the area. Emergency-room physicians reported that the symptoms of food poisoning were genuine. No one knows how many persons at the game went to their own physicians.
Laboratory analysis showed there was nothing wrong with the water or the syrup. This fact no doubt figured in the subsequent and sudden improvement of all those who had become ill during the game.(22)
The incident was admittedly not a systematic experiment conducted by trained researchers, but it qualifies as one of those cases where common sense is sufficient to rule out chance or coincidence.
Placebos have their drawbacks. In addition to their capacity to work destructively, placebos almost necessarily involve an element of self-deceit, or at least some degree of ignorance. They all work via false beliefs.
Placebos also work best under proper social conditions, which Michael Murphy summarizes as follows:
Enlarging patient groups in which treatments are administered can improve responses to placebos, probably because the power of suggestion is increased by the greater number of participants.
A placebo's effectiveness depends to a large extent upon the physician's interest in the patient involved, interest in the treatment, and concern about the treatment's results.
A placebo's power is increased by experimental studies that impart a sense of interest and care to their subjects.
Placebo effects in most treatments are increased when the treatment has a good reputation.(23)
Relationships with others are an important element in reinforcing the beliefs.
The placebo effect offers some of the most convincing evidence there is for the existence of psychosomatic healing, and for two reasons:
1. It is overtly acknowledged, and almost universally presupposed in practice, by mainstream medical research.
2. Its effects can be quite dramatic.
Accordingly, it not only demonstrates the reality of psychosomatic healing, but it also demonstrates the extent of the mind's power in effecting it. Hence, it poses a very serious problem for anyone who would deny either the reality or the significance of the power of thought to heal.
Chapter 5
The Nascent Science of Psychoneuroimmunology
I.What Psychoneuroimmunology Is
Psychoneuroimmunology is the emerging science of the interaction between the nervous, endocrine, and immune systems. The way in which the nervous, endocrine and immune systems are linked should be easy enough to understand -- at least to anyone who has studied recent military history. The lopsided victory in the Persian Gulf War was largely due to the fact that the allies had effectively knocked out the Iraqi system of command and control with air strikes, preventing Saddam Hussein from ever mounting a well-coordinated resistance. The immune system is, in effect, the body's military, and, like any other military, it needs a system of intelligence, command and control. (In fact, the HIV or AIDS virus uses similar tactics: It disrupts the production of Helper T cells, which function primarily as messengers.(24))
Because the nervous system is the body's normal means of command and control for other systems, such as the skeletal-muscular, digestive and circulatory systems, it would be economical for the immune system to utilize the same communications infrastructure. This is in fact what it does. However, according to earlier twentieth-century medical dogma, it did not. The immune system, about which very little was known, was presumed to be autonomous, having its own communications network -- even though that network had never been discovered.(25)
In Head First, Norman Cousins describes psychoneuroimmunology as follows:
A biology of the emotions is coming into view. For example, discoveries have been made that both the neuroendocrine and immune systems can produce identical substances (peptide hormones, or neuropeptides) that influence both neuroendocrine and immune activity. The two systems also share the same array of receptors with which these substances can interact and transmit their messages.(26)
Cousins depicts how the immune system responds to an attack by a cold or flu virus. Viruses infect us by injecting their DNA into a cell, which in turn replaces the original DNA of the cell. Instead of performing its normal function, the cell metabolism begins replicating the virus within itself, until it finally bursts and releases the new viruses to infect other cells. This process would always be lethal were it not for the immune system, which can destroy viruses. Here is Cousins's play-by-play description of the immune system's defense against these invaders:
1. The race is on. Viruses [Cousins's emphasis] try to replicate before the immune system can gear up. Two [in Cousins's graphic] have already taken over cells in the body.
2. Macrophages [cells that engulf invaders in much the same way that the ameba eats] quickly recognize the viruses as a foreign threat. They begin destroying viruses by engulfing them.
3. Stimulated by the release of interleukins from macrophages, Helper T cells, and interferons. Natural Killer cells join the attack on virally infected cells. They also fight cancer cells.
4. Helper T cells, the battle managers of the immune system, emit signals to B cells and cytotoxic T cells to join the attack.
5. B cells (produced in bones) mature into plasma cells, which in turn produce antibodies.
6. Antibodies are proteins designed specifically to recognize a particular viral or bacterial invader. Antibodies bind to the virus and neutralize it.
7. Cytotoxic T cells wage chemical warfare on virally infected cells by firing lethal proteins at them.
8. As the body begins to conquer the viruses, Suppressor T cells help the immune system gear down. Otherwise it might attack the body.
9. As the viruses are being defeated, the body creates Memory T and B cells that circulate permanently in the bloodstream, ensuring that next time, the particular virus will be swiftly conquered.(27)
According to Cousins, we have only very recently had sufficient knowledge of the immune and nervous systems to begin learning how they interact. What has been discovered is that the immune system is not confined to any particular bodily location or process. Therefore, when asked what sorts of things can influence the immune system, Cousins replies:
Practically everything. The immune system can be affected by biochemical changes in the body, by an invasion of microorganisms, by toxicity, by hormonal forces, by emotions, by behavior, by diet, or by a combination of all these factors in varying degrees. The immune system is a mirror to life, responding to its joy and anguish, its exuberance and boredom, its laughter and tears, its excitement and depression, its problems and prospects. Scarcely anything that enters the mind does not find its way into the workings of the body. Indeed, the connection between what we think and how we feel is perhaps the most dramatic documentation of the fact that mind and body are not separate entities but part of a fully integrated system.(28)
II.The Development of a New Branch of Science
Medical history is filled with breakthroughs that began as accidents. Alexander Flemming was not the first to notice that mold spoils bacteria cultures. In fact, pathologists and researches had been cursing this phenomenon for years. However, he raised some unusual questions with respect to this that led to the discovery of antibiotics. Jenner noticed that milk maids did not get smallpox. His speculation, that their exposure to cowpox, a much milder relative of the disease, seemed to coincide with their apparent immunity to smallpox, led to the development of immunization -- as well as scathing criticism of Jenner by his medical contemporaries.
Psychoneuroimmunology had similar beginnings. In an interview with television commentator Bill Moyers, Dr. David Felten, one of the pioneers in the field, explained how he made his first major discovery:
FELTEN: [It happened] almost by accident. I came to it [psychoneuroimmunology] with an M.D. and a Ph.D. directed toward neurosciences.... One day I was looking through a microscope at tissue sections of liver in order to identify nerves that travel alongside blood vessels. I was having trouble seeing what the cells really looked like, so I said, "Let's go to the spleen. Everybody knows what the spleen looks like." So I started looking at blood vessels and some of the surrounding areas in the spleen. And there, sitting in the middle of these vast fields of cells of the immune system, was a bunch of nerve fibres. I looked at them and thought, what is this? Nerve fibers aren't supposed to talk to cells of the immune system. What are they doing here?
So we cut some more sections, and looked -- and there they were again. We tried other blocks of tissue, and there they were again. They kept showing up again and again. We and others eventually discovered nerve fibers going into virtually every organ of the immune system and forming direct contacts with the immune system cells.
MOYERS: What was the significance of this?
FELTEN: Well it suggested that the nerves might influence the immune system.
MOYERS: So when you were looking into that microscope, were you seeing something about the healing process for the first time?
FELTEN: I didn't realize it at the time, except that I was struck by the possibility that the nerves might be controlling some aspect of the immune response. A student of mine, John Williams, carried out some of the first studies demonstrating this. But in those days it was almost dogma that the immune system is autonomous and doesn't have any outside controls. We were almost afraid to tell anyone for fear people would say: "Oh, jeez, don't you know the work of Blutz and colleagues?" -- or they'd come up with some reference that we had never found and make us look like a bunch of dufuses because we didn't know what we should have known. So we scoured the literature and searched high and low and tried to find every citation on the subject. And the more we looked, the more we realized that if you looked carefully at some of the photographs in other people's publications, you could see nerve fibers sitting out among the lymphocytes -- but nobody ever commented on it.
When we went to the immunology literature, we found that the immunologists had discovered receptors for neurotransmitters sitting on the surface of cells of the immune system, but they couldn't quite make sense of it. Why would a lymphocyte have a receptor for a neurotransmitter? The question just fell by the wayside. Nobody really put two and two together and tried to make a story about the brain having a direct influence on the immune system.
So we joined some of our colleagues, who are immunologists, and started studying immunologic changes that occur when you use drugs to affect the neurotransmitters or when you take the nerves away. Much to our surprise, we found that if you took the nerves away from the spleen or the lymph nodes, you virtually stopped immune responses in their tracks.(29)
The discovery of receptors for neurotransmitters on immune cells was just the beginning. Other research revealed receptors for methione enkaphalin, a natural opiate produced by the body, on T-cell lymphocytes.(30) Enkaphalins and endorphins were previously believed to function primarily as natural anesthetics, i.e., nervous system activity suppressers. It is highly unlikely that these receptors exist on immune cells for decoration. It made more sense that they be there to decode messages distributed by the nervous system.
Still other studies have revealed more connections between the immune and nervous systems. Dr. Branislav Jankovic of the University of Belgrade conducted studies showing the effect of brain lesions on immune responses.(31) Dr. Rudy Ballieux of the University of Utrecht (the Netherlands) showed that immune responses can be proportionately reduced with the power of an electro-shock.(32) Two Swiss doctors, Walter Pierpaoli and Georges J. M. Maestroni, conducted experiments showing ongoing control of the immune system by the neuroendocrine system. For example:
[I]nterference with the cyclical release of the hormone melatonin (released by the pineal gland) profoundly handicaps immunity. Pierpaoli's research has also shown that the immune system has important regulatory effects on the neuroendocrine system.(33)
Another Swiss researcher described a feedback loop between the immune system and the brain:
[A]ctivated monocytes and macrophages produce interleukin-I, which in turn increases corticotropin-releasing factor activity in the hypothalamus, which results in an increase in adrenocorticotropic hormone and corticosterone blood levels, and decreased immune activity.(34)
Disorders in the brain, such as schizophrenia, have also been linked to decreased immune system activity.(35) Sometimes playing with the immune system affects the nervous system. For example, the thymus gland, an immune system organ, secretes a substance that affects the nervous system.(36)
In one sense, the discovery of the connection between the nervous and immune systems has explained how thoughts can heal. Although a direct link between the system that thinks and the one that heals has been firmly established, the discovery raises more questions than it answers. The set of feedback loops between the immune, endocrine, and nervous systems is enormously complex. In fact, each system individually is extremely complex. The more we study the interactions among them, the more we discover how little we know. Few, if any, questions can be answered by a simple formula, at least at the biochemical level.
On the macrobiotic level, we have known how it works for centuries: It simply follows the GIGO (garbage-in-garbage-out) principle: Thoughts of sadness, guilt, depression, fear, and despair tend to make us sick. Thoughts of joy, hope, forgiveness, humor, and enthusiasm tend to make us healthy. Some emotions, such as anger, can affect health in either direction. Up until recently, medical doctors viewed these principles as common knowledge.
However, here it must be emphasized that psychoneuroimmunology begs the question with respect to the mind-body issue of philosophy. What it shows is a brain-body connection. Recent scientific investigations into brain functions have revealed that the brain actually functions as a gland, secreting, combining, and regulating the levels of chemicals, such as endorphins and enkephalins, that serve not only to control pain but also to regulate the immune system and tumor growth. Thus, the brain appears to have regulatory functions along with cognition. Norman Cousins makes this point:
Ever since scientific investigators have begun to probe the structure and function of the human brain, the main research has been connected to consciousness and cognition. Just in the past half-century, as stated elsewhere, new findings have emphasized the glandular role of the brain.(37)
All that psychoneuroimmunology has shown us is that the nervous system, of which the brain is an important part, can be an agent in the maintenance and recovery of health. It never attempts to address the philosophical issue of the relationship between brain activities, on the one hand, and thoughts and emotions, on the other.
The evidence from psychoneuroimmunology is a double-edged sword for advocates of mental healing. Although I believe it provides some convincing evidence for the value of mental healing therapies, it may turn out to be just the excuse materialist skeptics need to continue to ignore the data. Although these skeptics may now have more reason to recognize the value of affirmations and imagery, the effectiveness of these therapies may no longer serve as a counterexample to materialism. All that data, which they have chosen to ignore over the years, may have no philosophical significance anyway. We now have a "natural" explanation of faith healing: The brain is doing it. "Yes," the materialist skeptic can now say, "You should affirm and visualize positive and healing thoughts whenever you are sick, and probably when you are healthy as well. Just do not kid yourself into believing that some purely spiritual entity, such as a soul or God, is involved in the process. As it turns out, what you have called 'mental and spiritual healing' is no more mental or spiritual than the simple act of raising one's right arm. It is the brain within that does the work."
My answer to this argument is that this healing is also no less mental and spiritual than raising an arm. From a philosophical perspective, what psychoneuroimmunology has accomplished is to toss the whole subject of mental healing into the arena of the mind-body debate -- and, as I shall argue later in this essay, rightfully so. The philosophical issue now is not whether psychosomatic healing occurs, but whether what we have called mental healing is really mental at all, and if so, how so.
Chapter 6
Controlled Statistical Studies of Mental Healing
For most of the twentieth century, mainstream medical research never addressed a phenomenon that many practicing clinicians routinely observed: Attitudes, beliefs, and ideation all play a significant role in health. Since the 1970s, however, this has changed, and the research over this relatively short period has produced a gush, not a trickle, of evidence in support of psychosomatic healing. To reduce the job of reviewing these studies to a manageable size, I have chosen to focus on cancer and heart disease. Although cancer may be the more frightening of the two diseases, heart disease alone kills more Americans than all other diseases combined.(38) I will also cite an account of remission from acquired immune deficiency syndrome, or AIDS, primarily for the sake of public interest in the disease. However, we will first review some of the some of the studies relating to the overall effect of thinking on health, as well as evidence of the effectiveness of imagery practice, the best-known mental healing technique.
I.General Effects of Thinking on Health
The great Hasidic sage Rebbe Nachman of Breslov (1722 - 1810) once made this generalization about disease and health: "All the illness that afflicts people comes only because of a lack of joy.... And joy is the great healer."(39) Dr. Bernie Siegel offers a more contemporary perspective in referring to the "contentment factor." Siegel cites a long-term study dealing with the death rate among Harvard graduates, in which:
Those who were extremely satisfied with their lives had one-tenth the rate of serious illness and death suffered by their thoroughly dissatisfied peers even after the effects of alcohol, tobacco, obesity, and ancestral longevity were statistically eliminated.(40)
The two best-known mental and emotional factors that adversely affect health are stress and grief, especially if the latter is accompanied by loneliness. In the first half of this century, Walter Cannon discovered that heightened emotional states could stimulate the spleen, an organ that was later found to play a major role in the immune system.(41)
One study showed that medical students have diminished immune system functioning at exam time. Activities of natural killer T-cells and levels of interferon were both found do be lower during that period. Students also reported higher incidents of coughs and colds.(42)
According to Larry Dossey, grief, especially when accompanied by loneliness, can also adversely affect the immune system. In a 1977 study of the immune systems of widowed people in Sydney, Australia, researchers found that the bereaved showed significantly less immune activity than the control group. Another study, conducted at Ohio State University, found that medical students who had the highest scores on tests for loneliness and stress also had the lowest levels of natural killer T-cells.(43)
Of course, illness itself can lead to the same loneliness that aggravates the disease. In one study, conducted over nine years in Alameda County, California, death rates in a group of 7,000 people were correlated with indicators of social interaction, such as church membership, marital status, and other indicators of social activity. Death rates were found to be highest among those who had the fewest relationships -- even when factors such as socioeconomic status, cigarette smoking, and other health-related factors were taken into consideration. Isolation was linked to higher death rates from heart disease, cancer, and all other illnesses, as well as suicide and accidental death. Of course, the study naturally raises the question of whether the diseases caused the isolation, or vice versa. According to Dossey, the cause was the loneliness. Another study, conducted in Tecumseh, Michigan, "confirmed that increased loneliness and absence of social networks were the cause and not the result of disease and illness."(44) Dossey is quick to point out that nonetheless the culprit is not the experience of being alone per se, but the meaning ascribed to the isolation. Other researchers performed a follow-up of the Alameda County study, in which:
Women who had many social contacts but felt isolated had 2.4 times the normal risk of dying from hormone-related cancers (breast, uterine, and ovarian). And those women who had few social contacts and felt isolated were five times as likely to die from such cancers.
Interestingly, social ties did not seem to affect whether men got cancer in general, but among those who developed cancer, death was sooner in those who were socially isolated.(45)
If, as recent breakthroughs in psychoneuroimmunology suggest, the immune, nervous, and endocrine systems are all highly interrelated, then it would follow that tampering with the immune system might have emotional side effects. One study has corroborated this theory:
If the approach to treating cancer involves the immune system, the brain should manifest alterations as well. In support of this hypothesis, it was pointed out that scientists are now finding that the administration of interferon (an immune regulator that also inhibits viral cell growth) promotes severe depression in AIDS patients.(46)
Given some of the studies cited earlier, one has to wonder if the side effects of the cure could actually exacerbate the disease.
Finally, we cannot ignore the effect of doctor-patient relationships, a subject that has been the focus of three of the most commonly cited authors in this essay, Cousins, Dossey, and Siegel. Cousins, arguing that "a very simple effort to improve patient-physician interactions can result in significant improvement in a patient's condition," cites a series of four studies of ulcer, hypertension, diabetes, and breast cancer patients, conducted by Drs. Sheldon Greenfield and Sherrie Kaplan of the UCLA School of Public Health. In these studies, the control group was given only general information on self-observation and care, while the experimental group was given a full, twenty-minute training session on how to be more active in their treatment. The researchers found that the increased level of patient control, as well as the greater interest shown by physicians towards their patients, both positively correlated with improved health. Cousins infers that:
Research such as Drs. Kaplan and Greenfleld's project suggests that a more active patient role helps to foster a greater sense of control over illness, better health outcome, more rapid recovery, and greater compliance with treatment. Dr. Rose Maly of the UCLA School of Public Health utilized a simple technique to improve patient interactions with their physicians. The study observed corresponding attitudinal, behavioral, and health status changes in patients, as well as attitudinal changes in physicians....
Preliminary results indicate a significant improvement in the functional status of those who experienced the enhanced interaction with their physician -- the benefits having their greatest impact on individuals over age sixty.(47)
These studies all suggest that physicians should encourage their patients to take a more active role in their treatment, which has two important implications. The first is that patients have an opportunity to take a more active role in their own healing by monitoring and directing their thinking. The second is that the very sense of being more in control is in itself conducive to better health. Studies dealing with heart disease and cancer, to which we now turn, corroborate this theory.
II.The Effectiveness of Mental Healing Techniques
As interest in the subject of mental healing grows, a variety of different techniques may evolve. As of today, however, the technique of imagery, or visualization, stands out as the most prominent. It actually consists of nothing more than rehearsing the experience you want to have in the imagination -- with the express purpose of directing the subconscious mind to bring the experience into reality. Siegel, who used visualization extensively with cancer patients, explains how it works with respect to healing in analyzing its effectiveness in training the highly-successful athletic teams of the former Soviet bloc:
Visualization takes advantage of what might almost be called a "weakness" of the body: it cannot distinguish between a vivid mental experience and an actual physical experience....
Eastern European trainers often have their students and athletes lie down and listen to calming music Then the athlete visualizes, in full color and complete detail, a winning performance. This is repeated until the physical act becomes merely a duplication of a mental act that has already been successfully visualized. Soviet research indicates that athletes who spend as much as three-fourths of their time on mental training do better than those who place more emphasis on physical preparation.(48)
If mental rehearsal can train the body in athletics, it can at least theoretically train it to fight disease. (If this seems farfetched now, our upcoming discussion of biofeedback may render it less so.) Dossey cites the following documented success story:
Dr. G. Richard Smith and his colleagues at the University of Arkansas College of Medicine reported what is perhaps the first fully documented case of a human being intentionally changing the immune system. It involved a thirty-nine-year-old woman who was able to change her positive skin test for varicella zoster (the chicken pox virus) at will -- from positive toward negative, and then toward positive, a feat she repeated six months later. She used a rather specific form of imagery, imagining the redness and swelling surrounding the skin test getting smaller and smaller, while sending "healing energy" to the area.(49)
Dossey elaborates, citing the Achterberg and Lawlis studies and others as evidence of the effectiveness of visualization in altering the immune system. Achterberg collaborated with Mark S. Rider in an experiment that measured the effects of visualization in white blood cell count. The subjects were divided into two groups. Each group was asked to visualize images of the shape, location, and movement of one of two types of white blood cells, neutrophils or lymphocytes. Blood counts were taken both before and after each twenty-minute visualization sessions:
Results showed that the neutrophils (but not the lymphocytes) decreased significantly in the neutrophil group, while the lymphocytes (but not the neutrophils) decreased significantly in the lymphocyte group. The authors concluded that the highly directed imagery was cell-specific; that is, it affected the cells toward which it was intended or directed, and not others.(50)
Siegel cites a study in which imagery increased the count of platelets, a third kind of white blood cell.
In 1980 psychologist Alberto Villoldo of San Francisco State College showed that regular meditation and self-healing visualization improved white-blood-cell response and improved the efficiency of hormone response to a standard test of physical stress -- immersing one arm in ice water. The subjects trained in meditation withstood the pain of the test far better than those who did not meditate, and two-thirds of them were able to stop bleeding immediately after a blood test merely by focusing their minds on the vein after the needle was removed.(51)
Finally, Siegel cites a 1976 study, conducted by Gurucharan Singh Khalsa, founder of Boston's Kundalini Research Institute, showing that: "[R]egular yoga and meditation increased blood levels of three important immune-system hormones by 100 percent."(52)
The proven effectiveness of imagery in healing the body has two important implications. The first is that it corroborates other evidence that thinking can heal. The second is that mental healing is not a process entirely out of reach for most of us. Although people may vary in their ability to visualize, most can apply this technique to some degree. Effective mental therapy already exists and is available to just about anyone who wants to use it.
We turn now to the leading cause of death by disease in twentieth-century America, heart disease. Before we look at the mental factors that might be involved with it, we must look at the physical factors. With heart disease, there are both long- and short-term causes. The long-term causes deal with the general deterioration of the circulatory system in and around the heart, which usually consists of some sort of constriction (commonly called "hardening") of the coronary and associated arteries. This restriction of the blood flow weakens the heart and sometimes causes infarction, necrosis, or death of heart tissue. Short-term causes, such as anger, excitement, or excessive physical activity, place demands on the weakened heart that it cannot accommodate. In the case of infarction, the heart can rupture, causing instant death. Or, it can fibrillate, i.e., simply vibrate instead of pumping blood. Fibrillation can also be fatal, but it can sometimes be arrested with cardiopulmonary resuscitation (CPR). Milder heart attacks result in simple spasms, with symptoms such as dizziness, nausea, and chest pains (angina pectoris). Vigorous physical exercise can therefore be fatal to a person with an already weakened heart -- even though in the long run it can also prevent heart disease by improving circulation. Exercise is therefore both a short-term cause of, as well as a long-term check against, heart disease.
There are, correspondingly, both long- and short-term mental causes of heart attacks. The short-term cause is the fight-or-flight syndrome, i.e., panic, extreme excitement, rage, or other forms of autonomic arousal. The long-term causes are persistent mental attitudes. The short-term causes are easier to understand from a commonsense point of view. Both folklore and fiction are filled with tales of death by "heart failure," but can an individual in otherwise good cardiac health succumb? Norman Cousins argues that it is indeed possible, citing numerous studies in the medical literature to support his position. The heart, he argues, is a muscle, and all muscles can spasm. A sudden heart spasm can result in fibrillation and near-instantaneous death, if not arrested by CPR.(53)
An interesting and relevant statistic is that people are more prone to die of heart attacks on certain days of the year and during certain times of the day. For example, if you are Christian, you are most likely to die of a heart attack the day after Christmas, but if you are Chinese, the day after the Chinese New Year.(54) Even better documented is the "Black Monday syndrome," the fact that both heart attacks and strokes occur most frequently on Monday morning at about 9:00 a.m. According to Dossey, researchers had originally attributed these finding to biochemical factors, such as circadian rhythms, bodily cycles that occur over a twenty-four-hour period. However, circadian rhythms did not account for the greater occurrences of these maladies on Monday. Dossey attributes the Black Monday syndrome more to emotional factors:
Emotions can trigger biochemical changes of their own, which might act in concert with circadian flows. Studies of subordinate primates -- for example, male baboons forced by dominant males into inferior roles -- show that chronically stressed animals indeed have higher elevations of certain stress hormones that can have negative effects on heart function. Platelet aggregation or stickiness also is known to increase in persons under psychological stress, which might be more pronounced on Monday in someone returning to a job they dread.(55)
From personal experience, I have generally found that the stress of returning to work is greater than the stress of remaining at work. Any problems, such as mechanical breakdowns, the failure of co-workers, employees or vendors to come through, or a boss having a temper tantrum or making impossible demands, all seem to be more painful when they hit early Monday morning. Like a loud noise on a quiet night, the sudden surge of irritation and anxiety are exacerbated by a sense of shock.
Machines, too, are subject to a kind of Black Monday syndrome. Light bulbs are far more likely to go out when you first hit the switch. In delving into this topic, I asked a co-worker, a former mechanical engineer who designed gears, if machines also tended to break down more frequently on Monday morning. Although he himself could cite no statistics in this area, he did speak of the "80-20 rule" of engineering, which says that 80% of mechanical failures will occur during a 20% time segment of a machine's life, i.e., during peak loads or whatever time period when the machine is subject to maximum stress. Two known laws of physics can explain why there might be greater stress on machines during start-up. The first is the law of inertia. It requires more energy to move something at rest than something already in motion. The second is that the friction of rest is greater the friction of motion. Both of these principles suggest that there is more stress involved in getting things moving than in keeping them moving.
The same holds true for the human body. Athletes in training will always take time to do "warm-up" exercises before beginning their more rigorous training. Failure to do so can result in serious injuries. The same may also hold true for the body-mind in general. That sudden jolt of reality that hits when one returns to a stressful job after a relaxing weekend can put the body into a fight-or-flight state of emergency when it is not ready for it. Heart rates go up before blood vessels dilate. Muscles tighten before circulation rates increase, forcing them to work anaerobically. People may tend to get heart attacks and strokes Monday morning for the same reason that athletes tend to injure themselves when they train without warming up.
Dossey attributes Black Monday syndrome to the meaning, or lack of it, involved in the contemporary work place:
What does one's job mean to the patient -- satisfaction, loathing, dread, a challenge, or something else; and how do these perceived meanings affect the body to contribute to heart attacks on Monday morning? Another valid question is, What does the heart attack that occurs on Black Monday mean? What does it symbolize or represent -- job dissatisfaction, unhappiness, "something physical," or perhaps nothing at all? However meaning is approached, the answers are almost always laden with emotion.(56)
The meaninglessness and long-term dissatisfaction experienced at the workplace, however, pertains to the short-term causes of heart attacks as well as the long-term ones. Although the meaninglessness of one's work is often a chronic condition, the very context of that condition can exacerbate the experience of shock described above. If one's job is a private hell, the return to it from a period of respite becomes that much more traumatic.
The correlation between mental attitude and the long-term causes of heart disease is even stronger. One of the best-known predictors of heart disease is the "Type-A" personality.(57) Type-A personalities are driven to succeed and are prone to perfectionism. They also tend to be irritable and aggressive when frustrated. Although their ambition often drives them to positions of power and wealth, it also renders them more susceptible to heart disease.
Occupation can also be a predictor of heart disease. However, contrary to the stereotype, the high-powered executive or professional worker is not the most susceptible. According to Dossey, some of the more susceptible workers are "waiters, gasoline station attendants, and certain data processors." Dossey elaborates:
In these jobs, the worker is powerless to control the work load. No matter how high the volume, one can only struggle harder to cope with it. If the work load is excessive and protracted, the situation begins to resemble the "learned helplessness" situation described by researchers in animal behavior.
It is not difficult to understand how any employee could develop an indwelling sense of entrapment and helplessness in a similar situation, especially if controlled by supervisors who are insensitive to these issues.(58)
Dossey goes on to suggest that it is the sense of helplessness in the face of responsibility, as opposed to the position of responsibility itself, that causes the heart disease. It is not the situation itself, but our reaction to it, that kills us. Dossey cites a study of executives during the AT & T breakup, in which those who developed heart problems were compared with those who did not:
Those who stayed healthy judged their stresses differently and responded to them differently than the illness-prone group. The healthy individuals possessed what the psychologists called a capacity for "optimistic cognitive appraisal," meaning that they had a way of "seeing the cup half-full rather than half-empty." When stressful events occurred, they did not regard them as the end of the world but as a natural and inevitable part of their lives. This allowed their bodies to respond to stress differently, averting injurious biochemical responses. In effect these people could control their body's reaction to stress. They also interpreted stress differently by regarding it as a challenge, an opportunity to learn, grow, and become a wiser, better manager. Not only were the healthy executives deeply involved in their work, they had a strong commitment to their families and to life in general off the job.(59)
In other words, the healthy ones were those who confronted their problems with the belief that they could be solved, that what they were facing was an adventure, not imminent doom. Their bodies responded accordingly, reacting more as though they were competing in an athletic event than engaging in mortal combat. The results were lower blood pressure and less likelihood of heart spasm.
Stress is not the only important factor in job-related heart disease. Citing a 1972 study by the U.S. Dept. of Health, Education, and Welfare, Dossey argues that:
[T]he best predictor for heart disease was not any of the major physical risk factors (smoking, high blood pressure, elevated cholesterol, and diabetes mellitus) but job dissatisfaction. And the second best predictor was what the researchers called "overall happiness." This finding fits with the fact that most persons below the age of fifty in this country who have their first heart attack have none of the major physical risk factors for coronary artery disease.(60)
Dossey's argument here is reminiscent of Rebbe Nachman's cited above. It seems, for example, that although job dissatisfaction and overall unhappiness may themselves cause heart attacks, these factors, in turn, stem from a deeper cause, the sense of helplessness and powerlessness over one's destiny. However, we must be careful not to oversimplify the matter. Neither unhappiness nor job dissatisfaction is a simple phenomenon; each can stem from many different and often concurrent causes. What is important here is that both can be profoundly connected to the way one thinks about one's job or overall position in life.
There may also be a mental-emotional component to some of the physical causes of heart disease, e.g., atherosclerosis and blood cholesterol levels. A 1979 study showed that "tender loving care" could reduce atherosclerosis and the corresponding risk of heart attacks by 50% among rabbits fed large amounts of cholesterol.(61) Dossey cites other studies suggesting that cholesterol levels themselves can be affected by the way we think about stress and by applying mental disciplines:
Dr. Herbert Benson of Harvard Medical School has shown that the ability to maintain a healthy cholesterol level is directly related to the ability to handle stress through relaxation.... Studies of people who meditate regularly have shown that their physiological age is much lower than their chronological age. (62)
Dossey suggests here that, with a properly-designed program of meditation and exercise, we can teach hard-driving, success-oriented (Type A) persons to avoid heart attacks -- without losing their achievement-oriented behavior. In fact, he cites another study, this one taken over five years, in which "Type A" heart patients were divided into three groups. The first group received advice on diet and exercise, as well as a comprehensive program of psychological counseling, biofeedback training, and individual and group education, on how to alter their Type A behavior. What the experimenters found was that:
During this time some of the subjects had recurrent heart attacks, some of which were fatal. Others died suddenly, 'dropping dead" from cardiac arrest presumably due to their heart disease. It was found that the circumstances most often preceding these events were emotional crises, excessive physical activity, consumption of a large fatty meal, or some combination of these circumstances.
When the statistics were examined at the end of one year, the rates of nonfatal heart attacks were lowest in the group given in-depth instruction on modifying their Type A behavior. In contrast, the group receiving the typical advice about diet, weight, and exercise had three times, and the control group four times, as many nonfatal heart attacks. In addition, the in-depth group had less than half the number of fatal heart attacks as the control group.(63)
In interpreting the study, Dossey concludes that the patients had undergone a kind of "meaning therapy," a means of re-evaluating the unpleasant or traumatic events in their life in ways that reduced their physical and emotional impact:
With the creation of new meanings, the body responds in healthier ways. The "adrenaline rush" that is felt in a crisis is blunted, along with the rise in heart rate and blood pressure. The diffuse anxiety and hostility Type As feel throughout the day abates, and the body's "emergency" apparatus, the sympathetic nervous system, is quieted. One of the primary benefactors of these changes is the heart. This important study shows that
meanings can be changed,