The Mind Benign or Malign? By Bernie S. Siegel, MD

Part of the mind's effect on health is direct and conscious. The extent to which we love ourselves determines whether we eat right, get enough sleep, smoke, wear seat belts, exercise, and so on. Each of these choices is a statement of how much we care about living. These decisions control about 90 percent of the factors that determine our state of health. The trouble is that most people's motivation to attend to these basics is deflected by attitudes hidden from everyday awareness. As a result, many of us have mixed intentions.

Consider, for example, Sara, a woman who came to me with breast cancer a few years ago; she was smoking when I walked into her hospital room. Her action clearly stated: "I want you to get rid of my cancer, but I'm ambivalent about living, so I think I'll risk a second cancer." She looked up sheepishly and said, "I suppose you're going to tell me to stop smoking."

"No," I said, "I'm going to tell you to love yourself. Then you'll stop."

She thought for a moment and replied, "Well, I do love myself. I just don't adore myself." (Sara ultimately did come to adore herself—and stopped smoking.)

It was a good quip, but it exemplified an important problem many people have with themselves. Self-love has come to mean only vanity and narcissism. The pride of being and the determination to care for our own needs have gone out of the meaning. Nevertheless, an unreserved, positive self-adoration remains the essence of health, the most important asset a patient must gain to become exceptional. Self-esteem and self-love are not sinful. They make living a joy instead of a chore.

The mind does not act only through our conscious choices, however. Many of its effects are achieved directly on the body's tissues, without any awareness on our part. Consider some of our common expressions: He's a pain in the neck/ass. Get off my back. This problem is eating me up alive. You're breaking my heart. The body responds to the mind's messages, whether conscious or unconscious. In general, these may be either "live" or "die" messages. I am convinced we not only have survival mechanisms, such as the fight-or-flight response, but also a "die" mechanism that actively stops our defenses, slowing the body's functions and bringing us toward death when we feel our life is not worth living.

The Physiology of Immunity

Every tissue and organ in the body is controlled by a complex interaction among chemicals circulating in the bloodstream, the hormones secreted by our endocrine glands. This mixture is controlled by the "master gland', the pituitary gland, located in the middle of the head just below the brain. The output of pituitary hormones in turn is controlled by both chemical secretions and nerve impulses from the neighboring part of the brain, called the hypothalamus. This tiny region regulates most of the body's unconscious maintenance processes, such as heartbeat, breathing, blood pressure, temperature, and so forth.

Nerve fibers enter the hypothalamus from nearly all other regions of the brain, so that intellectual and emotional processes occurring elsewhere in the brain affect the body. For example, about five years ago, child-development researchers discovered "psychosocial-dwarfism", a disturbingly common syndrome in which an unhealthy emotional atmosphere at home stunts a child's physical growth. When a child is caught in a crossfire of hostility and feels rejected by his or her parents, thereby growing up with little self-esteem, the brain's emotional center, or limbic system, acts upon the nearby hypothalamus to shut off the pituitary gland's production of growth hormone.

The immune system consists of more than a dozen different types of white blood cells concentrated in the spleen, thymus gland, and lymph nodes, and patrolling the entire body through the blood and lymphatic systems. They are divided into two main types. One group, called B cells, produces chemicals that neutralize poisons made by disease organisms while helping the body mobilize its own defenses. The other group, called T cells, consists of killer cells and their helpers, which destroy invading bacteria and viruses.

Recent research has shown heretofore-unknown nerves connecting the thymus and spleen directly to the hypothalamus. Other work has proven that white blood cells respond directly to some of the same chemicals that carry messages from one nerve cell to another.

This anatomical evidence for direct control of the immune system by the brain has been confirmed in studies of animals. Two groups of scientists have independently used Pavlovian conditioning techniques to change the immune response. At the University of Rochester Medical Center, psychiatrist Robert Ader and immunologist Nicholas Cohen repeatedly gave rats saccharin-sweetened water along with an immune-suppressant drug. Later they were able to "trick" the animals into suppressing their own immune responses by giving them the sweetened water alone. Working for the National Institutes of Health, Dr. Novera Herbert Spector similarly conditioned mice to increase their immune responses when exposed to the smell of camphor.

The immune system, then, is controlled by the brain either indirectly through hormones in the bloodstream, or directly through the nerves and neurochemicals. One of the most widely accepted explanations of cancer, the "surveillance" theory, states that cancer cells are developing in our bodies all the time but are normally destroyed by white blood cells before they can develop into dangerous tumors. Cancer appears when the immune system becomes suppressed and can no longer deal with this routine threat. It follows that whatever upsets the brain's control of the immune system will foster malignancy.

This disruption occurs primarily by means of the chronic stress syndrome first described by Hans Selye in 1936. The mixture of hormones released by the adrenal glands as part of the fight-or-flight response suppresses the immune system. This was all right in dealing with the occasional threats our ancestors faced from wild beasts. However, when the tension and anxiety of modern life keep the stress response "on" continually, the hormones lower our resistance to disease, even withering away the lymph nodes. Moreover, there is now experimental evidence that "passive emotions", such as grief, feelings of failure, and suppression of anger produce over-secretion of these same hormones, which suppress the immune system.

State of Mind / State of Body

We don't yet understand all the ways in which brain chemicals are related to emotions and thoughts, but the salient point is that our state of mind has an immediate and direct effect on our state of body. We can change the body by dealing with how we feel. If we ignore our despair, the body receives a "die" message. If we deal with our pain and seek help, then the message is "Living is difficult but desirable", and the immune system works to keep us alive.

I therefore use two major tools to change the body—emotions and imagery. These are the two ways we can get our minds and bodies to communicate with each other. Our emotions and words let the body know what we expect of it, and by visualizing certain changes we can help the body bring them about. Both emotions and imagery are obviously transmitted through the central nervous system and may relate to work that Robert Becker, an orthopedic surgeon and researcher, has done.

Becker has studied the body's electrical systems. His work led directly to the use of electricity to heal broken bones that have failed to knit. Becker found that hypnotized patients could produce voltage changes in specific areas of the body on command. If these voltages control the chemical and cellular processes of healing, as Becker believes, then we soon may have a scientific explanation for hypnosis cures and the placebo effect. It is well known, for example, that hypnotized patients can cure their own warts (which are caused by viruses). As Lewis Thomas wrote in The Medusa and the Snail:

"You can't sit there under hypnosis, taking suggestions in and having them acted on with such accuracy and precision, without assuming the existence of something very like a controller. It wouldn't do to fob off the whole intricate business on lower centers without sending along a quite detailed set of specifications, way over my head.

"Some intelligence or other knows how to get rid of warts, and this is a disquieting thought.

"It is also a wonderful problem, in need of solving. Just think what we would know, if we had anything like a clear understanding of what goes on when a wart is hypnotized away . . . we would be finding out about a kind of super-intelligence that exists in each of us, infinitely smarter and possessed of technical know-how far beyond our present understanding. It would be worth a War on Warts, a Conquest of Warts, a National Institute of Warts and all."

Bioelectricity may someday enable us to reach this "controller" directly, to understand exactly how and why tumors sometimes regress when patients are convinced that an unorthodox treatment — hypnosis, diet, prayer, meditation — is going to work. As Becker once wrote to me, "the placebo effect is not only real but of great importance, and your methods may be far more effective than you think they are".

Whether or not we can ever control all healing with electrical stimuli, exceptional patients — that is, potentially all patients — need not wait helplessly for artificial aids. They can learn to heal themselves and stay well. If I can teach you how to feel good about your life, love yourself and others, and achieve peace of mind, the necessary changes can occur. My loving and hugging may look silly on the ward, but they're scientific. The problem is that we don't yet know the psychological techniques necessary to turn on the healing process quickly and efficiently in everyone. So many of the changes happen at an unconscious level that they are hard to measure clinically without careful psychological testing. One day I hope we can prescribe something like "one hug every three hours" instead of a drug or electrical impulse, but for the moment we must return to our consideration of the mind's potential for harm, as a prelude to finding its antidote.

From Love, Medicine, and Miracles by Bernie S. Siegel; © 1986 by Bernie S. Siegel; used with permission by Harper and Row Publishers, San Francisco.

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