TIME: Almanac 1993/TIME Almanac 1993.iso/time/031290/0312130.000

Text File | 1992-08-28 | 7.6 KB | 161 lines

                                                                                HEALTH, Page 76

Can the Mind Help Cure Disease?


Scientists study the links between mental and physical
well-being

By MELISSA LUDTKE


    When Donald arrived for his first group-therapy session at
UCLA's Neuropsychiatric Institute and Hospital, he was in a
wheelchair, suffering from malignant melanoma and severely
depressed. But after he spent six months sharing stories and
good times with other cancer patients and learning relaxation
techniques, his mood had improved considerably -- and so had his
condition. As his attitude brightened, an important change took
place inside his body: an increase in the activity of his
"natural killer cells," a crucial link in the immune system. By
year's end, though he still had cancer, Donald was able to dance
a jig for his group.

    What role, if any, do emotions play in preventing or curing
illness? The question is older than Western medicine, but it has
been given new importance by modern science's discovery of
innovative ways to measure the mind's impact on the body's
health. Scientists are studying whether, and to what extent,
disease can be affected by the use of such mind-body techniques
as meditation, yoga, group therapy, guided imagery (visualizing
the desired effect) and relaxation. "There is little question
that we can alter the course of disease by manipulating
psychological factors," contends Dr. Robert Ader, a professor at
the University of Rochester medical school and a pioneer in
mind-body research. "But to make this knowledge useful to
physicians, we need to understand the mechanisms." Dr. N.
Herbert Spector, a neurophysiologist at the National Institutes
of Health, is convinced that when researchers can pin down the
appropriate clinical uses for mind-body therapies, the result
will be "a revolution in medical practice."

    For many patients, the revolution has already begun.
Increasingly, people are using mind-body therapies on their own,
even while seeking conventional medical treatment. A spate of
books on the subject has been published in recent years. The
latest is Norman Cousins' new best seller, Head First: The
Biology of Hope (Dutton; $19.95), which documents recent strides
made in mind-body research.

    Stories of seemingly miraculous recoveries may grab the
public's attention, but the real work is being done quietly and
out of sight. In laboratories around the world, medical
researchers are exploring the mind-body connection, separating
myth from reality, intuition from fact, belief from science.
Much of this work centers on the actions of neuropeptides,
molecular messengers that travel through the body linking the
nervous, immune and endocrine systems. In the 1970s
neuropharmacologist Candace Pert at the National Institute of
Mental Health found that these peptides bind to receptors on a
cell, beginning a cascade of biomedical effects, including
protein synthesis and cell division. "It's like ringing a
doorbell. All kinds of reactions happen inside," says Pert. "The
whole metabolism of a cell can be altered." Because their
activity fluctuates with emotional states of mind, Pert refers
to these peptides as "the biochemical units of emotion."
Exhilaration triggers certain neuropeptides; depression sets off
others.

    Following Pert's landmark work, research on mind-body
connections accelerated. Recent examples:

    -- In a ten-year follow-up study of women found to have
breast cancer, those who received psychotherapy in groups
survived on average nearly twice as long as similar women who
did not. "Frankly, I didn't expect any major effect on the
course of the disease," says Dr. David Spiegel, who conducted
the survey at Stanford University.

    -- A study by Dr. Dean Ornish of the Preventive Medicine
Research Institute in Sausalito, Calif., has provided evidence
that a mind-body program of group meetings, exercise, a low-fat
diet and stress-management techniques like meditation can be
effective in reversing even severe coronary-artery blockage
after only a year. "To the degree heart disease can be reversed,
it can be prevented," says Dr. Ornish.

    -- In a joint British-American study, more than 1,000
people have subjected themselves to a common cold virus in the
most comprehensive such investigation ever undertaken. The
objective: to see how accurately researchers can predict who
will get sick based on a psychological profile and measurements
of immune function before infection. "Assuming that stress puts
people at higher risk," asks Sheldon Cohen, a professor of
psychology at Carnegie Mellon University, "will people who have
social support in confronting stresses be protected [from
contracting disease]?" The results are being analyzed.

    Even some conservative bastions of the medical
establishment have become interested in mind-body therapies as
an adjunct to conventional care. The American Medical
Association's Council on Scientific Affairs gingerly explored
this heretofore off-limits topic at a meeting last week. Leading
medical schools, such as those at Harvard and UCLA, are
including mind-body research in their course offerings.

    Some doctors urge patients to supplement routine medical
care with mind-enhancing therapies. Last year for the first time
more of the patients at the New England Deaconess Hospital's
Mind-Body Clinic had been referred there by doctors than by
friends and family. At the clinic, patients learn in groups how
to achieve Dr. Herbert Benson's relaxation response, a physical
state of deep rest. Nearly 80% of hypertension patients lower
their blood pressure and require less medication; cancer
patients report less nausea during chemotherapy. "Does it
prolong life?" asks Dr. Benson. "We don't know. Some people
promise that, but I think they are jumping the gun."

    Many physicians still deride mind-body therapies as
something akin to quackery. Some fear that patients may abandon
standard treatment to try unproved therapies. Doctors are also
concerned that patients may blame themselves for not being able
to control illness. "It is enough to have a diagnosis of
cancer," says Dr. Jimmie Holland, chief of psychiatry at
Memorial Sloan-Kettering Cancer Center in New York City. "It is
too much to be told you caused the damn thing."

    But proponents of mind-body therapies believe they should be
a component of standard medical care. Though they may not cure
the illness, they can improve a person's quality of life -- and
that just might alter the disease. "Physicians walk a very fine
line between promising more than we know and destroying a
person's hope," says Sandra Levy, a psychologist at the
Pittsburgh Cancer Institute. "We know mental health helps.
Currently, we cannot go beyond that."

    Much of what Western medicine is trying to prove
scientifically Eastern cultures have long taken for granted.
Ayurvedic medicine, which began in India some 6,000 years ago,
uses transcendental meditation, massage and herbal therapies to
trigger the body's natural healing response. Dr. Deepak Chopra,
an endocrinologist who has practiced Ayurvedic medicine, poses
an intriguing question: "Inside of us there must be a `thinking
body' that responds to the mind's commands. But where could it
be, and what is it made of?"

    Even with modern tools, medicine may still be far from
finding all the body's hidden healers. In the meantime, though,
the search seems to be uncovering new ways in which doctors can
help their patients. That ought to make everybody feel better.