Looking for the cure within

Does the mind affect illness?

Does anybody not believe that the mind affects the body? Surely the notion has become part of our cultural landscape. We just assume we can perform mental tricks like stave off a cold during exams (I'll get sick when I'm darn well finished!).

Author Anne Harrington. (Photo courtesy Susan Kreiter/Boston Globe).

Anne Harrington, who teaches at Harvard, provides us with a graphic example in her recent book, The Cure Within: A History of Mind-Body Medicine. It concerns a certain Mr. Wright.

"Mr. Wright was a very sick man," Harrington writes. He had been admitted to hospital with a diagnosis of cancer of the lymph nodes. "Tumours, some the size of oranges, infested his neck, groin and armpits." His doctors had given up all hope for recovery.

But Mr. Wright hadn't. He learned that a new drug called Krebiozen was being tried in the hospital where he was staying. He became persuaded the drug would be his miracle cure.

Mr. Wright begged his doctor to let him try it. He didn't really fit the criteria for the drug trial, but he was persistent. So he was given the injection on Friday and on Monday, his doctor found him walking around the hospital corridors, chatting with the nurses. His tumours were half their previous size; they had melted, Harrington observes, like "snow balls on a hot stove."

But the story gets more tangled. Mr. Wright continued his remarkable recovery until he read a report that cast doubt on the effectiveness of the new drug. His confidence undermined, he relapsed.

Once more with feeling

So his doctor tried some well-intentioned duplicity. He told Mr. Wright the first drug he'd been given was substandard. A new extra-potent batch was being prepared.

Mr. Wright was feverish with excitement. His doctor injected him again. This time, his recovery was even more remarkable.

What his doctor didn't tell Mr. Wright was that he had injected him with distilled water.

Mr. Wright was released, flew home (piloting his own plane!). He was the very picture of health. Until he read in the newspaper another report that the American Medical Association had denounced the new drug as worthless.

Mr. Wright relapsed once again and was readmitted to hospital. The poor fellow was dead in two days.

The placebo effect

Anne Harrington said she found this story in a psychiatric journal from the 1950s and that it had haunted her ever since. (She was in our Ideas studio for an interview).

For years, Harrington had studied the placebo effect, where inert substances are used as treatment. Mr. Wright seemed to be its most dramatic example.

Dummy injections and pills can cure. But as with Mr. Wright, when you discover they are fake, the revelation can send you back to your sick bed. (It reminds me of a saying I've heard from doctors: "Take the pills while they're new and you think they still work.")

Harrington's book is full of great stories. In fact, the idea of the story is at the heart of her academic research. She says we all live with stories —"lived themes," you might call them. They are like the air we breathe.

In Mr. Wright's case, he did not consciously will himself to health. He believed in the magisterial power of modern medicine, a profession staffed by deft, magician-doctors who used the latest science to treat disease.

This belief in the magical, healing power of a priesthood has ancient religious roots, says Harrington. It is a story that is firmly planted in our subconscious.

Giving up the ghost

All cultures have healing rites that tap into the sacred. When Mr. Wright discovered his cure had been downgraded by the physician wizards of the AMA, his mind gave out and his body crumbled. He gave up the ghost, you might say, if you believed in such things.

At one time, people believed almost routinely in demonic possession. Jesus cast out demons (the Catholic Church still has a rite of exorcism, which it uses very selectively when all modern medicine fails). Who wasn't frightened by Linda Blair's devilish head twirling in the1973 film The Exorcist?

But modernity has given us alternative explanations. We no longer have to believe in demonic spirits. We can chalk up our problems all sorts of rationales, such as sexual abuse or a lesion in the brain.

In a way, we are all Freudians now, even if we don't like Sigmund Freud's outmoded theories about women and penis envy.

His lasting contribution to modern life is to put the unconscious front and centre as a cultural artifact, as a handy excuse on which to blame our personal failures.

Brooding on cancer

Even Freud, says Harrington, was part of a long tradition where religion is unseated and replaced by secular, though not necessarily scientific, beliefs.

In 1960, the American writer Norman Mailer stabbed his wife with a penknife at a drunken party. And what was his defence? That had he repressed his towering rage, he would have developed cancer.

Now, it is true that the egomaniacal Mailer had a habit of throwing metaphors around. In his writings, he brooded on a cancerous America and its soul-deadening technology.

But his core, Freudian belief — that repressed emotion causes illness — is widespread in today's thinking. Many people believe they acquire dread diseases like cancer from having the wrong personality traits, says Harrington.

We've all heard versions of this. Harrington has even heard a doctor say a certain patient would never get cancer because she was too mean. In other words, she wasn't repressed enough to let her rage fester inside.

As if those who suffer from a terrible disease didn't have enough to worry about! Top off your illness with a dollop of guilt.

The body does speak

Yale surgeon Bernie Siegel, who wrote the 1986 best seller, Love, Medicine and Miracles, believed a version of this cultural trope. "Cancer might be called the disease of nice people," he wrote.

He wanted to discover how resilient people fended off disease. He came to believe that love was the key. His book sold two million copies.

Harrington tells us that for many "Siegel's vision of cancer was a lifeline." It inspired hope. Unfortunately, Harrington reports, women with breast cancer who went through Siegel's treatment program died at the same rate as the control group.

That doesn't mean those women who revelled in great heaps of love didn't feel much, much better. But they didn't live longer.

It must be said that Harrington acknowledges this story can get complicated. Emotions do affect our health. Take depression.

Depressed people get sick. But she suggests that people with depression may be prone to sickness not because they think and feel depressed thoughts (or repress them), but because they sleep badly. Their immune system becomes weakened. They can't fight off disease.

They may not eat or exercise as well as they should. In these cases, lifestyle itself becomes a breeding ground for illness.

"The body does speak," says Harrington. Our bodies are always sending messages. They are always conversing, signaling, yammering. The problem is that we drown out the messages, or reinterpret them, according to our beliefs. We listen selectively.

In that respect, we are all varieties of poor Mr. Wright. We believe in all manner of things, true or not, as we get sick and well.