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Posts Tagged ‘health’

23 JUNE, 2014

Rethinking the Placebo Effect: How Our Minds Actually Affect Our Bodies

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The startling physiological effects of loneliness, optimism, and meditation.

In 2013, Neil deGrasse Tyson hosted a mind-bending debate on the nature of “nothing” — an inquiry that has occupied thinkers since the dawn of recorded thought and permeates everything from Hamlet’s iconic question to the boldest frontiers of quantum physics. That’s precisely what New Scientist editor-in-chief Jeremy Webb explores with a kaleidoscopic lens in Nothing: Surprising Insights Everywhere from Zero to Oblivion (public library) — a terrific collection of essays and articles exploring everything from vacuum to the birth and death of the universe to how the concept of zero gained wide acceptance in the 17th century after being shunned as a dangerous innovation for 400 years. As Webb elegantly puts it, “nothing becomes a lens through which we can explore the universe around us and even what it is to be human. It reveals past attitudes and present thinking.”

Among the most intensely interesting pieces in the collection is one by science journalist Jo Marchant, who penned the fascinating story of the world’s oldest analog computer. Titled “Heal Thyself,” the piece explores how the way we think about medical treatments shapes their very real, very physical effects on our bodies — an almost Gandhi-like proposition, except rooted in science rather than philosophy. Specifically, Marchant brings to light a striking new dimension of the placebo effect that runs counter to how the phenomenon has been conventionally explained. She writes:

It has always been assumed that the placebo effect only works if people are conned into believing that they are getting an actual active drug. But now it seems this may not be true. Belief in the placebo effect itself — rather than a particular drug — might be enough to encourage our bodies to heal.

She cites a recent study at the Harvard Medical School, in which people with irritable bowel syndrome were given a placebo and informed that the pills were “made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.” As Marchant notes, this is absolutely true, in a meta kind of way. What the researchers found was startling in its implications for medicine, philosophy, and spirituality — despite being aware they were taking placebos, the participants rated their symptoms as “moderately improved” on average. In other words, they knew what they were taking wasn’t a drug — it was a medical “nothing” — but the very consciousness of taking something made them experience fewer symptoms.

Illustration by Marianne Dubuc from 'The Lion and the Bird.' Click image for more.

This dovetails into recent research confirming what Helen Keller fervently believed by putting some serious science behind the value of optimism. Marchant sums up the findings:

Realism can be bad for your health. Optimists recover better from medical procedures such as coronary bypass surgery, have healthier immune systems and live longer, both in general and when suffering from conditions such as cancer, heart disease and kidney failure.

It is well accepted that negative thoughts and anxiety can make us ill. Stress — the belief that we are at risk — triggers physiological pathways such as the “fight-or-flight” response, mediated by the sympathetic nervous system. These have evolved to protect us from danger, but if switched on long-term they increase the risk of conditions such as diabetes and dementia.

What researchers are now realizing is that positive beliefs don’t just work by quelling stress. They have a positive effect too — feeling safe and secure, or believing things will turn out fine, seems to help the body maintain and repair itself…

Optimism seems to reduce stress-induced inflammation and levels of stress hormones such as cortisol. It may also reduce susceptibility to disease by dampening sympathetic nervous system activity and stimulating the parasympathetic nervous system. The latter governs what’s called the “rest-and-digest” response — the opposite of fight-or-flight.

Just as helpful as taking a rosy view of the future is having a rosy view of yourself. High “self-enhancers” — people who see themselves in a more positive light than others see them — have lower cardiovascular responses to stress and recover faster, as well as lower baseline cortisol levels.

Marchant notes that it’s as beneficial to amplify the world’s perceived positivity as it is to amplify our own — something known as our “self-enhancement bias,” a type of self-delusion that helps keep us sane. But the same applies to our attitudes toward others as well — they too can impact our physical health. She cites University of Chicago psychologist John Cacioppo, who has dedicated his career to studying how social isolation affects individuals. Though solitude might be essential for great writing, being alone a special form of art, and single living the defining modality of our time, loneliness is a different thing altogether — a thing Cacioppo found to be toxic:

Being lonely increases the risk of everything from heart attacks to dementia, depression and death, whereas people who are satisfied with their social lives sleep better, age more slowly and respond better to vaccines. The effect is so strong that curing loneliness is as good for your health as giving up smoking.

Illustration by Marianne Dubuc from 'The Lion and the Bird.' Click image for more.

Marchant quotes another researcher, Charles Raison at Atlanta’s Emory University, who studies mind–body interactions:

It’s probably the single most powerful behavioral finding in the world… People who have rich social lives and warm, open relationships don’t get sick and they live longer.

Marchant points to specific research by Cacioppo, who found that “in lonely people, genes involved in cortisol signaling and the inflammatory response were up-regulated, and that immune cells important in fighting bacteria were more active, too.” Marchant explains the findings and the essential caveat to them:

[Cacioppo] suggests that our bodies may have evolved so that in situations of perceived social isolation, they trigger branches of the immune system involved in wound healing and bacterial infection. An isolated person would be at greater risk of physical trauma, whereas being in a group might favor the immune responses necessary for fighting viruses, which spread easily between people in close contact.

Crucially, these differences relate most strongly to how lonely people think they are, rather than to the actual size of their social network. That also makes sense from an evolutionary point of view, says Cacioppo, because being among hostile strangers can be just as dangerous as being alone. So ending loneliness is not about spending more time with people. Cacioppo thinks it is all about our attitude to others: lonely people become overly sensitive to social threats and come to see others as potentially dangerous. In a review of previous studies … he found that tackling this attitude reduced loneliness more effectively than giving people more opportunities for interaction, or teaching social skills.

Illustration by André François for 'Little Boy Brown,' a lovely vintage ode to childhood and loneliness. Click image for more.

Paradoxically, science suggests that one of the most important interventions to offer benefits that counter the ill effects of loneliness has to do with solitude — or, more precisely, regimented solitude in the form of meditation. Marchant notes that trials on the effects of meditation have been small — something I find troublesomely emblematic of the short-sightedness with which we approach mental health as we continue to prioritize the physical in both our clinical subsidies and our everyday lives (how many people have a workout routine compared to those with a meditation practice?); even within the study of mental health, the vast majority of medical research focuses on the effects of a physical substance — a drug of some sort — on the mind, with very little effort directed at understanding the effects of the mind on the physical body.

Still, the modest body of research on meditation is heartening. Marchant writes:

There is some evidence that meditation boosts the immune response in vaccine recipients and people with cancer, protects against a relapse in major depression, soothes skin conditions and even slows the progression of HIV. Meditation might even slow the aging process. Telomeres, the protective caps on the ends of chromosomes, get shorter every time a cell divides and so play a role in aging. Clifford Saron of the Center for Mind and Brain at the University of California, Davis, and colleagues showed in 2011 that levels of an enzyme that builds up telomeres were higher in people who attended a three-month meditation retreat than in a control group.

As with social interaction, meditation probably works largely by influencing stress response pathways. People who meditate have lower cortisol levels, and one study showed they have changes in their amygdala, a brain area involved in fear and the response to threat.

If you’re intimidated by the time investment, take heart — fMRI studies show that as little as 11 hours of total training, or an hour every other day for three weeks, can produce structural changes in the brain. If you’re considering dipping your toes in the practice, I wholeheartedly recommend meditation teacher Tara Brach, who has changed my life.

But perhaps the most striking finding in exploring how our beliefs affect our bodies has to do with finding your purpose and, more than that, finding meaning in life. The most prominent studies in the field have defined purpose rather narrowly, as religious belief, but even so, the findings offer an undeniably intriguing signpost to further exploration. Marchant synthesizes the research, its criticism, and its broader implications:

In a study of 50 people with advanced lung cancer, those judged by their doctors to have high “spiritual faith” responded better to chemotherapy and survived longer. More than 40 percent were still alive after three years, compared with less than 10 percent of those judged to have little faith. Are your hackles rising? You’re not alone. Of all the research into the healing potential of thoughts and beliefs, studies into the effects of religion are the most controversial.

Critics of these studies … point out that many of them don’t adequately tease out other factors. For instance, religious people often have lower-risk lifestyles and churchgoers tend to enjoy strong social support, and seriously ill people are less likely to attend church.

[…]

Others think that what really matters is having a sense of purpose in life, whatever it might be. Having an idea of why you are here and what is important increases our sense of control over events, rendering them less stressful. In Saron’s three-month meditation study, the increase in levels of the enzyme that repairs telomeres correlated with an increased sense of control and an increased sense of purpose in life. In fact, Saron argues, this psychological shift may have been more important than the meditation itself. He points out that the participants were already keen meditators, so the study gave them the chance to spend three months doing something important to them. Spending more time doing what you love, whether it’s gardening or voluntary work, might have a similar effect on health. The big news from the study, Saron says, is “the profound impact of having the opportunity to live your life in a way that you find meaningful.”

Philosopher Daniel Dennett was right all along in asserting that the secret of happiness is to “find something more important than you are and dedicate your life to it.”

Each of the essays in Nothing: Surprising Insights Everywhere from Zero to Oblivion is nothing short of fascinating. Complement them with theoretical physicist Lawrence Krauss on the science of “something” and “nothing.”

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05 JUNE, 2014

Van Gogh and Mental Illness

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“One feels as if one were lying bound hand and foot at the bottom of a deep dark well, utterly helpless.”

Around the time that Tolstoy was tussling with depression and his spiritual crisis, on the other side of Europe another creative icon was struggling with the darkness of his own psychoemotional landscape. As he was painting some of the most celebrated and influential art of all time, Vincent Van Gogh was combating his anguishing mental illness — frequent episodes of depression, paralyzing anxiety and, according to some accounts, the symptoms of bipolar disorder — which would eventually claim his life in 1890, shortly after his 37th birthday.

Van Gogh’s most direct and honest account of his psychoemotional turmoil comes from the letters to his brother Theo, originally published in 1937 as the hefty tome Dear Theo: The Autobiography of Vincent van Gogh and later excerpted in My Life & Love Are One (public library) — the same wonderful 1976 gem that gave us his thoughts on love, tracing “the magic and melancholy of Vincent van Gogh.” The title comes from a specific letter written during one of the painter’s periods of respite from mental illness, in which he professes to his brother: “Life has become very dear to me, and I am very glad that I love. My life and my love are one.”

Dutch newspaper report from December 30, 1888: 'Last Sunday night at half past eleven a painter named Vincent Van Gogh, appeared at the maison de tolérance No 1, asked for a girl called Rachel, and handed her ... his ear with these words: 'Keep this object like a treasure.' Then he disappeared. The police, informed of these events, which could only be the work of an unfortunate madman, looked the next morning for this individual, whom they found in bed with scarcely a sign of life. The poor man was taken to hospital without delay.'

In one of the early letters, Van Gogh expressed an aspiration that remained significant for him throughout his life:

Let us keep courage and try to be patient and gentle. And not mind being eccentric, and make distinction between good and evil.

It’s also a thought bittersweet in hindsight, given the self-compassion it implies for being eccentric. Years later, that very eccentricity would be interpreted as madness by his neighbors, who would evict him from his house and lead to his checking into an insane asylum.

Meanwhile, his bouts of depression, when they descended upon him, were unforgiving. In another letter to Theo, he writes:

I am so angry with myself because I cannot do what I should like to do, and at such a moment one feels as if one were lying bound hand and foot at the bottom of a deep dark well, utterly helpless.

'Self-Portrait with Straw Hat' by Vincent van Gogh, winter 1887/1888

But underlying his deep despair is a subtle sense of optimism that carries him and enables him to continue painting despite the mental anguish:

This is my ambition, which is founded less on anger than on love, founded more on serenity than on passion. It is true that I am often in the greatest misery, but still there is within me a calm, pure harmony and music. In the poorest huts, in the dirtiest corner, I see drawings and pictures. And with irresistible force my mind is drawn towards these things. Believe me that sometimes I laugh heartily because people suspect me of all kinds of malignity and absurdity, of which not a hair of my head is guilty — I, who am really no one but a friend of nature, of study, of work, and especially of people.

Like artist Maira Kalman, who asserted nearly a century and a half later that work and love are the two keys to a full life, Van Gogh begins to see his work as his unflinching sense of purpose, his salvation:

How much sadness there is in life! Nevertheless one must not become melancholy. One must seek distraction in other things, and the right thing is to work.

Having at one point subsisted primarily on bread, coffee and absinthe, he embraces work as life’s highest reward, worth any sacrifice:

I believe more and more that to work for the sake of the work is the principle of all great artists: not to be discouraged even though almost starving, and though one feels one has to say farewell to all material comfort.

'Self-Portrait with Bandaged Ear,' 1889, painted shortly after he sliced off his own ear

But in reflecting — as Kurt Vonnegut memorably did — on what makes life fulfilling, it seems that rather than conveying a conviction to his brother, Van Gogh is trying to convince himself:

I have nature and art and poetry, and if that is not enough, what is enough?

And yet, Van Gogh ultimately sees his psychological struggles not as something to negate but as his artistic truth, as a vital part of his honest experience, which is the necessary foundation of great art:

Do you know that it is very, very necessary for honest people to remain in art? Hardly anyone knows that the secret of beautiful work lies to a great extent in truth and sincere sentiment.

Complement My Life & Love Are One with Kierkegaard on creativity and anxiety, then revisit Van Gogh’s never-before-revealed sketchbooks.

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21 MAY, 2014

Children’s Endearing Letters to Judy Blume About Masturbation, and the Beloved Author’s Response

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“Dear Judy, I want to ask you a very important question…”

In 1879, Mark Twain delivered a brilliant satirical lecture about masturbation, mocking the cultural hypocrisies around a practice so prevalent, so natural, yet so condemned. Nearly 130 years later, science writer extraordinaire Mary Roach traced the perilous religious roots of these hypocrisies. But the most poignant reflections on the subject come from those that suffer from such stigmas most acutely and with the least social support available: children. It’s no surprise, then, that kids whose parents and teachers either don’t address the subject or shroud it in censorship and condemnation would look for solace elsewhere.

Generations have found such solace — as well as a comforting sense of being less alone and less abnormal in their unwitting normalcy — in the books of beloved author Judy Blume, who has tackled many timelessly tricky subjects in her young-adult novels, including masturbation in the 1973 classic Deenie. But Blume addresses the subject directly in a chapter of the wholly excellent Letters to Judy (public library) — the same wonderful vintage compendium that gave us children’s moving letters to Blume about being queer.

Judy Blume signing a copy of Deenie (photograph by Mariah Jasmine Bonifacio)

In one letter, 13-year-old Nikki sends an itemized list of questions that might appear amusing at first glance, but is, upon closer inspection, emblematic of a profound cultural failure — a failure to inform, and an implicit failure to comfort by normalizing the very thing that is so natural and common yet so capable of instilling a soul-shattering sense of isolation in children made intentionally unaware of this prevalence:

Dear Judy,

I read your book Deenie. You wouldn’t believe how happy I was to know that I’m not the only person to do what Deenie does. You are the only person who has ever mentioned anything about this. So could you please answer my questions.

  1. How did you find out about this?
  2. Is it a kind of disease?
  3. How did I know to start doing this?
  4. Am I weird?
  5. How many other letters have you received saying that other people do this (if any)?
  6. Approximately how many people do this?
  7. Is what I do going to harm my insides (like by not letting me have children)?
  8. Am I a fag?

I hope to hear from you very soon. Please!

Blume targets the source and addresses the parents who make such anguishing and unnecessary spirals of anxiety possible, relaying a story at once heartening in showing that kids will always find a way to pursue their curiosity, and heartbreaking in revealing the outrageous acts of censorships of which adults are capable in their efforts to curtail that boundless curiosity:

When you are choosing books about sexuality for your kids make sure that there is an honest discussion of masturbation included. Chances are, they’re not going to want to talk about it with you, but just finding out that it’s okay will be a relief for them.

A young man wrote that he didn’t get a good night’s sleep during his adolescent years. He tried to train his mind before he went to sleep to think about mathematical problems. He tried to concentrate on them so he wouldn’t have erections, or worse, wet dreams.

When Then Again, Maybe I Won’t was published I met a woman who told me that her son had been given a copy for his twelfth birthday. She read the book first but before giving it back to him she cut out two pages. “How did you do that?” I asked. “With a scissors,” she said. When I asked why she had cut out those two pages she told me that she didn’t think her son was old enough to read about wet dreams or masturbation.

Last year I met her son. He is twenty-four now. I asked him if he remembered the book. “Sure,” he said. “And I always knew that my mother had cut out those pages even though she told it was a printing error. So I went down to the public library and I read the rest of the book there.”

Another 13-year-old, Jolene, speaks to the precious gift of Blume’s books in pulverizing that sense of isolation and aberration:

Dear Judy,

I have read all of your books. They helped me not to be afraid and they answer my questions. I thought I was different but I’m not. In your books are things I would never bring out in the open with my mother. Like in your book Deenie — she touches her special place. Well, I do that too, but I always thought I was the only one.

14-year-old Barbara is on the same page:

Dear Judy,

My mom and I have a very open relationship. But the one thing I cannot bring myself to mention to anyone is masturbation. I know (and your books helped me to understand) that it’s not bad. Just something about it is really embarrassing.

In this heartbreaking letter, 12-year-old Heather offers another account of the traumatic and toxic cultural narrative purveyed to children about one of the body’s most natural physical experiences:

Dear Judy,

I want to ask you a very important question. Okay, I’ll start from the beginning. When I was little, about four or five, I started touching my special place. And I got a nice feeling. I had a baby-sitter during this time. Her name was Donna. And she knew that I touched my special place. She said that if I kept touching it, it would get big, then it would bleed, then it would fill with pus and pop! Then I would have to have an operation. So I stopped touching it.

When I was going into sixth grade I started again. And one day this stuff came out of me. My mom said it was discharge and that it’s normal. But I’m scared to even touch my special place now. I think it will pop. This is serious. I told my mom and she told me that Donna was just lying but I’m still scared. Can you explain what happened? Please answer this letter as I am very scared.

Blume addresses the all too pervasive issue:

Yes, there are still myths about masturbation! The stories that Donna told Heather were frightening and destructive. A grown man wrote that his adolescent years were “a quiet hell of silent suffering.” He said that he thought it was the fact that nobody ever talked about masturbation that led him to believe that he was the only disgusting, degenerate pervert in the world.

I never heard the word masturbation when I was growing up. Yet at twelve I knew I had a special place and that I could get that good feeling by touching it. I talked about it with some of my friends, who had also discovered that they had special places. I never found anything relating to my early sexuality in books, so there was some comfort in finding out from my friends that I was not alone.

For an added delight, complement Letters to Judy with Amanda Palmer’s tribute to Judy Blume, from the altogether fantastic collaborative record An Evening with Neil Gaiman & Amanda Palmer:

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