Psychology - THINK YOUR WAY TO HEALTH

by Vanit Nalwa

He made her melancholy, sad, and heavy; and so she died; had she being light like you of such a merry, nimble, stirring spirit, she might ha' been a grandma ere she died; and so may you, for a light heart lives long.

Love's labour's lost
William Shakespeare.

Ancient wisdom never lies. Four thousand years ago in India, it had been stated in the Mahabharata (the longest epic in the world):

"There are two classes of diseases—bodily and mental. Each arises from the other, and neither can exist without the other. Thus mental disorders arise from physical ones, and likewise physical disorders arise from mental ones."

In more recent times, Sir William Osler, often considered the father of modern medicine, was said to have observed that in order to predict the out come of pulmonary tuberculosis, it was as important to know what was going on inside a man's head as what was going on in his chest.

The placebo effect has been long known to medical science—this is a cure effected by sugar pills, which the patient believes to be medicine. Faith healing is yet another demonstration of how mere belief can influence the body to heal. Now there is scientific proof available to back all this and the new discipline of psychoneuroimmunology shows how this happens. Psychoneuroimmunology turns the searchlight on to the common belief that our personalities and emotions influence our health. How does what you think and feel (psyche) influence the brain and nervous system (neuro), which in turn tempers the body's disease fighting system (immuno)? In other words, to what extent can depression, anxiety, psychological distress, social support, or an optimistic outlook change our ability to resist disease? Can we alter immunity and hence susceptibility to disease through psychological intervention?

THE INNER WORLD

The way we think and feel, our way of dealing with events, our defense mechanisms, our ability to remain happy and healthy must impinge on the question: "Who am I?" It must seek to address the nature of our uniquely individual personality our distinctive pattern of thought, emotions and behavior which characterize our style.

Consider an ordinary event to see how your interpretation of an event has a bearing on 'your child has failed the final exam'. Depending on how you explain this event to yourself, will determine whether it will be a major source of trauma for you and for your child. Whether you judge it as your inability to devote enough time to your child, or his reluctance to work, or put it down to the fact that you moved house around the time of the exams, will decide the stress factor posed by this event. It is not the event itself that is stressful; rather it is your perception of it that makes it so.

Suppose you react strongly to the failure, giving full vent to your anger at the sight of the report card; notice your physical reactions. Your explosive outburst will immediately bring about bodily changes (in the heart rate, blood pressure, breath count, tense muscles) in both you and your child. Even long after the event you may notice such psychological reactions as anxiety, anger and aggression, apathy and depression, and an inability to think clearly. In fact, in time you might not even connect the residual bad feeling, which may persist with the event that originally caused it. Months later you may wonder at the cause for your child's persistent apathy or aggression. Our bodies obviously react deeply to the way we think and feel about different happenings that touch our lives.

Topping the list of the countless events, which may jolt our mental balance, are natural and man-made disasters, life events like the death of a spouse, divorce, marital separation, marital reconciliation and even marriage itself. Other events that strongly affect our psyche include the death of a close family member, personal injury or illness, losing a job, and retiring can trigger off bad feelings—be it getting stuck in traffic, a forthcoming examination, an argument with your boss, a telephone disconnection for nonpayment of an incorrect bill.

Strong emotional reactions to 'negative' life-changing events or even cutting off all responses by blocking or suppressing emotions can sap motivation, corrode interest in life, weigh one down with negative thoughts and cause disturbance and disharmony at the body levels, often resulting in sleep disruption, loss of appetite, and fatigue. At a deeper level it can begin to play havoc with your immune system and make you prey to serious illness. The more life-changes you experience, the harder you need to work to stay well.

Psychologists have found that people could be trained to improve their resistance to disease by recognizing the mind-body link in disease and learning to deal more effectively with emotionally challenging events.

FROM THE MEDICAL WORLD

Immunologists, neurobiologists, endocrinologists, and psychologists at the National Institutes of Health (NIH), Maryland, Bethesda, a premier medical research facility in the USA, are actively involved in unraveling the mysterious connection between the mind and disease. According to Dr G.Chrousos, an endocrinologist at NIH: "It has not been shown scientifically but mental states can influence the body's resistance to disease."

Though researchers have known for over a decade that the brain can shape the immune response, it is only recently that they have come close to explaining the 'how' more fully.

It was once considered that the body's network of immune defenses was a system unto itself. Research over the past few years has shown that this is not so. The immune system is connected, both physically and chemically, with the nervous and endocrine systems. Neurons, or nerve cells of the spleen and the lymph nodes.

The communication between the brain and the immune system is two-way. The brain apparently registers the stress and then activates the release of certain chemicals that carry the information to the immune system, which in turn signals back to the brain to cause the body to react.

At the Third International Congress of the International Society for Neuroimmunomodulation, held in November 1996, Dr Esther Sternberg, a rheumatologist, observed: "We are making important advances in understanding the infrastructure of how these systems communicate and how breaking the communications can result in disease."

THE IMMUNE SYSTEM

Your body's immune system consists of specialized cells that protect it from disease. The function of the immune system is the identification and destruction of foreign cells such as microorganisms. Your immune system is able to ward off an attack by bacteria, viruses, fungi and parasites. Disease occurs when this defense breaks down.

Research shows that the immune system is affected by stress and other psychological conditions. Whether you are happy or sad determines your susceptibility to infectious diseases, allergies, cancers, and autoimmune disorders such as lupus and rheumatoid arthritis, in which the immune cells themselves attack the normal tissue of the body.

When a person has been stressed for some time, there will be changes in his behavior, his central nervous system, and in the balance of hormones in the body. All three are interrelated and influence body cells that provide protection from disease-the immune system. It is as if the fortifications have been damaged. The result is that the person runs the risk of disease.

THE MIND-BODY LINK AND DISEASE

Evidence from disparate sources suggests that stress affects the ability of the immune system to defend the body. Invasion of the body by a disease-causing agent is not sufficient cause for. Disease occurs when the person's defenses are compromised or unable to recognize the foreign material. For example, one study published in 1991 in The New England Journal of Medicine validated the common belief that we are more likely to catch a cold when under stress.

Simply being in the presence of someone who has a bad cold is not enough reason to get one, the probability that you will catch it when exams are round the corner is much higher!

Disruptive daily events and chronic family stressors have now been clearly associated with greater susceptibility to upper respiratory infections.

Susceptibility to influenza, for instance, is higher in families that are rigid and chaotic than in balanced families.The reverse is true as well. Psychologists have found that people could be trained to improve their resistance to disease by recognizing the mind-body link in disease and learning how to deal more effectively with emotionally challenging events. In such cases, what is important is the extent to which you can bring change in yourself by recognizing and altering the patterns of behavior that characterize you. For example, a person with a Type A personality will typically have a short-fuse reaction to situations he perceives as stressful. Such a person is impatient, always pressed for time, extremely competitive, achievement-oriented, extremely competitive and loses his cool easily. Such people are more likely to fall victims to heart ailments.

A Type B personality to more likely to stay disease free for he is relaxed and is not easily aroused to anger. However, one could easily confuse a Type B with a Type C personality who presents a calm front simply by suppressing emotional reactions, especially anger. This creates blocks within. Withheld emotions, which find no outlet fester within the person. Typically Type C people, who have a strong need to conform, display a tendency to give up easily rather than fight. They often don't say what needs to be said; they act and feel helpless and hopeless and work with the mechanisms of repression and denial. This can adversely affect immunity. Many cancer patients belong to this personality type. Indeed some of the most interesting insights into the mind-body-disease nexus come from the study of people suffering from heart disease and cancer.

WHAT BEHIND HEART DISEASE?

More people die of heart attacks than from all other causes of death combined, including cancer, AIDS, infectious diseases, accidents and homicides.

In 1990, Dr. Dean Ornish at the University of California, San Francisco, and colleagues, published an article in the prestigious medical journal Lancet, titled: 'Can lifestyle changes reverse coronary heart disease?' The response to which was a clear-cut: 'Yes'. Over a period of one year, most heart patients put on Ornish's special program; reported that their chest pain had virtually disappeared; in 82 per cent of the cases clogged arteries had cleared without any surgery.

Consider a story reported by a patient in Dr Dean Ornish's book Program for Reversing Heart Disease. Bob Finnel, 53, had been diagnosed as having two totally blocked coronary arteries and a third that was 79 per cent blocked. In addition, he had suffered a silent heart attack.

Several cardiologists suggested a bypass surgery. Advised a concentrate on fresh fruits and vegetables, Bob was able to bring down his cholesterol level from 232 to 128 in a few months. He lost weight, felt fit and energetic, and underwent important mental and emotional transformation.

"After a year, my angiogram showed the blockages in my coronary arteries were beginning to reverse. And the PET scan showed that the blood flow to my heart was much better. And not only to my heart—my sex life has improved a lot."

This was the first time that scientifically accepted proof has been offered to show that heart disease can be halted or even reversed simply by changing one's eating habits, taking exercise and changing the way one thinks.

THE MIND-BODY LINK AND CANCER

In the film Manhattan, the character played by Woody Allen, a perfect Type C personality, confesses that he never shows his anger, just "grows a tumor", reflecting the popular idea that cancer patients are emotionally inhibited. The development and progression of cancer has been associated with a Type C personality.

If a particular set of psychological factors can promote the onset of cancer, it is reasonable to assume that changing these will have a beneficial effect, both in retarding the progression of the disease and its cure. The use of psychotherapy, hypnosis, meditation, imagery as aids in altering the personality, which in turn bolsters the immune function, is how well-documented.

It is a little known fact that cancer cells develop in most, if not all, individuals some time during their life. In a healthy individual, the immune system normally destroys these cells before they can do harm. Psychological techniques can be used to destroy cancer cells after the disease has developed. As far back as 1989, Dr Spiegal and colleagues reported in Lancet how women with advanced breast cancer who had experienced group psychotherapy for a year, in addition to the regular treatment, showed much better chances of survival than those who did not. This is clear evidence that the immune system can be influenced by changing the way an individual thinks.

BOOST YOUR IMMUNE SYSTEM

So the question to consider is: What can I do to remain healthy or heal myself?

Whose life is it anyway? Begin by taking responsibility for your state of health or disease. Actively involve yourself in maintaining your health. If you are ill, involve yourself in the process of getting well. Do not leave it all to doctors. The importance of this is now reflected in the fact that all the major heart and cancer institutes worldwide teach patients how to effect changes in their life style.

In India, the Escorts Heart Institute And Research Centre in New Delhi runs a stress management clinic. Dr Peeyush Jain, consultant cardiologist, Department of Preventive and Rehabilitative Cardiology, at the institute, says that though the emphasis right now is on rehabilitation, in the future they hope to be able to teach high-risk people how to preempt the need for surgery.