Bad science writing plus reductionism equals: arrggh!

Mechanism Behind Mind-Body Connection Discovered, says the headline.

Quite a headline, yes? Unfortunately, it is parked at the top of an article that comes nowhere near supporting the claim. To begin with, the writing is nearly incomprehensible. The article appears to be about a new study but never once tells us directly what the study is about or where it was done. The reader has to infer a lot, and the headline itself is never addressed.

After re-reading a few times, I think the basic gist is that there are these tiny structures on cells (called telomeres) that shorten as we age, and also shorten when we are under a lot of stress. Shortened telomeres have already been associated with a number of diseases, including, says the article, "HIV, osteoporosis, heart disease, and aging." (Hello? Aging is a "disease"?) It has also been known, previous to the new study, that an enzyme (telomerase) released in cells helps preserve telomere length.

The article then states, in the second paragraph:

"UCLA scientists found that the stress hormone cortisol suppresses immune cells' ability to activate their telomerase. This may explain why the cells of persons under chronic stress have shorter telomeres."

So it seems that the study being (barely) reported on proved this one thing: that cortisol, a stress hormone, suppresses the activation of telomerase in immune cells. From this new piece of information, researchers are suggesting that this may be why people under a lot of stress over a long period of time have shorter telomeres. Which in turn theoretically exposes them to the potential for any number of diseases.

Exactly how does this relate to the headline? Maybe here, in the third paragraph, sort of:

"The study reveals how stress makes people more susceptible to illness. The findings also suggest a potential drug target for preventing damage to the immune systems of persons who are under long-term stress [snip]."

Mind-body mechanism discovered? Geez. All that's happened is that research has yet again shown that our mental and/or emotional state physically affects our bodies. Which anyone who has ever blushed or who has ever felt butterflies in the stomach knows already.

The idea that shortened telomeres are somehow at the epicenter of the mind-body connection is laughable--western science reductionism at its finest (that is to say, worst). Okay, let's say that this is exactly right: that when we get stressed out over time, we lose the capacity to keep our telomeres long and this threatens our immune system.

Then what? Well, western scientists know exactly what to do with that--that's where the "potential drug target" comes in.

Rita Effros, apparently one of the UCLA researchers involved in this project (she's never identified directly as such), is quoted in the story.

"When the body is under stress, it boosts production of cortisol to support a 'fight or flight' response," explains Effros. "If the hormone remains elevated in the bloodstream for long periods of time, though, it wears down the immune system. We are testing therapeutic ways of enhancing telomerase levels to help the immune system ward off cortisol's effect. If we're successful, one day a pill may exist to strengthen the immune system's ability to weather chronic emotional stress."

So you see where this goes. We've discovered that stress can suppress the production of an enzyme that is required for good health, so we're going to develop a drug that will get the production going again.

How many things are just plain wrong with this world view?

How about working to educate and support people so that they can better deal with life circumstances that currently cause a lot of stress?

And how about recognizing that the material incarnation of an emotional state is not necessarily the baseline reality--may in fact never be the baseline reality? Scientists are themselves the ones who have come to realize and inform us that everything ultimately is energy. And yet in our bodies, energy does not exist to science.

Time and time again, western science presumes, and therefore seeks, a material cause for an energetic circumstance. That is, they identify a concrete, physical reality associated with an energetic state (stress, for instance), and then insist that this material reality (say, the suppression of the production of an enzyme) can be manipulated so that we "feel better" or get "healthier," without any awareness that the energetic state that created the physical symptom is itself the more powerful reality.

If we are under a great deal of stress over a long time, our bodies get damaged. If we continue to think that finding the key material circumstance associated with how damage to the body may occur is going to solve the great mystery of existence, and let us all live forever, we will continue to miss an opportunity to understand what human life is and has the potential to be. Western researchers who arrogantly ignore the body's energy system and seek some sort of Fountain of Youth in its chemistry are fooling themselves, and us, year after year.

Thomas Moore gets it

"I’m tempted to say that every illness is primarily a soul malady and only secondarily a physical problem. In sickness, the soul comes into the foreground. It asks for attention. If its wounds are addressed, then perhaps the physical manifestations will no longer be necessary. But care of the soul is not a surface activity; nor is it easy. It demands that you finally confront yourself and decide to live fully rather than halfheartedly. It asks that you learn to love with your whole heart and get over any self-pity or cynicism that may still remain in your heart. It asks that you transcend yourself in genuine concern for others and in a feeling of community that knows no boundaries. This is not an easy task, but it is the only way, finally, to health."
- Thomas Moore, Dark Nights of the Soul

Dr. Robert Bazell on MSNBC

In "Mind-body medicine needs a check-up," posted today on MSNBC, Dr. Robert Bazell writes skeptically of the burgeoning field of alternative and complementary medicine. There is always plenty to be skeptical about, to be sure. Charlatans and quacks proliferate in the area of alternative medicine precisely because there is so little regulation and accepted certification. You can't simply say you're a medical doctor and begin practicing (well, you can, but you can be arrested for such things). In alternative medicine, you can do lots of things without any meaningful certification.

That said, Bazell is too high and mighty for his--or our--own good. While his language allows for the existence of creditable and helpful alternative medical practitioners, his arguments proceed as if they don't exist:

"As I have written before, many practitioners of alternative medicine either see no need for their claims to be tested with scientific studies, or simply ignore results if they don't like they way come out."

Ah, yes: "many"--not a very scientific assertion there, Dr. Bazell. This leaves the distinct possibility that "many" others do exactly the opposite and are actually helpful healers. But he can overlook that to imply, in a number of different ways, that the entire field is suspect precisely because traditional Western medical practice does not accept it.

As for ignoring results if they don't like the way they come out, alternative medical providers have not cornered the market on that particular attitude by any means. Western medical doctors likewise do this all the time--a fact that, I should note, routinely keeps alternative types of knowledge and understanding from getting anywhere in the traditional medical world. Take, for example, all the studies that have been done that show that back pain is by and large not dependent upon physical conditions. And then look at all the back pain clinics that are set up around the country, by good old accredited medical doctors, and tell me (or tell Dr. Bazell) that these doctors are not simply ignoring results that they don't like.

More on The Cure Within

A little late with this one, but: the Chicago Tribune offered a quick overview of The Cure Within in late February, and a nice Anne Harrington interview. The headline alone displayed an unusual sensitivity to nuance for mainstream media coverage of the mind-body connection, however prosaically expressed: "The mind can heal or cripple the body." Ah! At last, a little less of either extreme that tends to dominate when mainstream publications write about this. Usually you get either breathlessness (see Parade: "Thoughts Can Heal Your Body") or sniping skepticism (see Slate: "The Psychosomatic Secret: The Unscientific Allure of Mind-Body Medicine").

The more thorough fact of the matter is that the mind and the body have an ongoing, complex sort of interaction. Your thoughts and emotions can either help you or hurt you, both psychologically and physiologically, and often unconsciously.

I am now by the way in the middle of reading The Cure Within myself. Although I'm having a hard time feeling warm and fuzzy about Harrington's distinctly postmodern organizational framework, the book is relentlessly interesting, informative, and, even, entertaining.

Conscious Entities

A site "devoted to short discussions of some of the major thinkers and theories about consciousness."

Friendly, informative, and fascinating, the site is enhanced by its uncluttered and amiable design. Anyone interested in mind-body interaction has ultimately to tackle the concept of consciousness, and this modest site is a great starting point.

The Mind Body Awareness Project

Sickened by a horrific, random act of violence here in Philadelphia this week, I found myself wondering about the effect on the body of being relentlessly exposed to violent images, as so many people are simply by watching TV and movies in the 21st century. I was thinking that surely this exposure via the mind has ancillary effects not only on behavior but on the body itself somehow.

I did some quick Googling and discovered something called The Mind Body Awareness Project. While this organization does not relate directly to my question, it turns out to relate very directly to my tragic inspiration. The Mind Body Awareness Project "is a non-profit organization dedicated to teaching essential life skills to at-risk youth through the practices of meditation and yoga," according to the site.

What happened here the other day was this. Four teenagers attacked a man at a subway station for this reason: they had nothing to do, and just thought they'd go beat this guy up. Turns out he died of a stress-induced asthma seizure. The man was in his late 30s; he was a mild-mannered, hard-working Starbucks employee. Life ended by four young men who would've been called "droogs" in A Clockwork Orange; Anthony Burgess may have had no idea how realistic his dystopian masterpiece might turn out to be. We have raised a sub-species of human being within our midst and I can't believe that the violence we strew so casually throughout our entertainment is unrelated to the existence of people who seem to have had their humanity removed when it comes to the casual use of exceptional violence.

At the same time, I know for a fact there are groups of very good and very helpful people in the world--for instance, the folks behind the Mind Body Awareness Project. Had they been working with the kids who committed this stupid, senseless crime, one man would have been spared a frightening and pointless death.

The incident like the one I've described saddens me to my core, but it does not leave me defeated. We can and must do better than this. Think about the violence you expose yourself to and ask yourself if you can do better than that.

Newsweek on the placebo effect

Here's another mainstream media take on placebos. Sharon Begley acknowledges from the outset how resistant both doctors and patients can be about the very concept of the placebo effect. Then she writes:

"But the fact remains that placebos are at least somewhat effective and sometimes very effective for some patients. Rather than railing against that finding or pretending it doesn't exist, what we should be doing is learning how brain activity that corresponds to the expectation of cure translates into clinical improvement."

I remain rather flabbergasted that so many people would rather ignore evidence that placebos often work than figure out what exactly is going on. How odd that the doctors who require clinical evidence before drawing conclusions on treatment will nevertheless overlook or disavow knowledge of clinical evidence that has proven, over and over, that placebos can and do work under many circumstances. So it's not clinical proof they really want; what they really want, like so many of us, is to have their own preconceived ideas to be continually affirmed.

Friday quotation (on a Sunday)

"What an abyss of uncertainty, whenever the mind feels overtaken by itself; when it, the seeker, is at the same time the dark region through which it must go seeking and where all its equipment will avail it nothing."
- Marcel Proust, Swann's Way

Dr. Howard Schubiner

Dr. Howard Schubiner, one of a handful of doctors who has joined Dr. John Sarno in discussing and treating TMS, has a notable new web site up and running. The site presents a clear overview of TMS, including four video presentations.

The site also has an online course available, for a fee. Whether or not you feel inclined to sign up (the cost is $250), the web site is definitely worth a visit for anyone seeking more information about the mind-body connection in general, and its relation to this condition that has been labeled TMS by Sarno and his followers.

Friday quotation

"If we are open only to discoveries which will accord with what we know already, we may as well stay shut."
- Alan Watts, The Wisdom of Insecurity

New study: back pain largely mind-induced

In the Daily Mail, a British paper, an article about new research that claims that most back pain is not from actual physical injury. (Note that this is no news to TMS sufferers, or followers of Dr. John Sarno.)

The study was specifically looking at trends in health following the reunification of Germany in the early '90s.

Shortly after East and West Germany were reunited, statistics show that 84 percent of West Germans were affected by back pain, compared to 69 percent of East Germans. By 2003, the percentages has just about equalized.

What accounted for the rise in back pain among residents of the former East Germany? "Researchers blame increased exposure to media reports on how back pain could be a severely disabling condition," says the Daily Mail, and quoted the published study directly:

"After reunification, all those 'myths' and misconceptions about back pain being pervasive in Western societies immediately spread to East Germany."

The study claims that only about 15 percent of back pain is actually due to a structural problem of some kind.

The Daily Mail found not too much receptivity to this idea at home, however. "British experts said if back pain is all in the mind, this is only true in a very few cases."

And right here is exactly why so many people seem to reject out of hand the idea of mind-induced pain, because it's often said to be "all in the mind." Neither traditional doctors nor many patients want to be told this because the implication is that the pain is somehow imaginary.

So let's be clear here: when people talk about the mind creating pain, this does not mean the pain is "all in the mind." The pain is still very much in the body.

Personally, I don't see what's so hard to understand about this, but it seems to trip lots and lots of people up. They hear about how the mind may create pain and think that means someone's basically making it all up.

In the case of back pain this is completely not true. The pain is real, and really happening in your body. Mind-induced pain is real, physical pain. Just like mind-induced embarrassment can turn your actual cheeks actually red.

Presuming cause and effect--an ongoing theme

"Older men with lower free testosterone levels in their blood appear to have higher prevalence of depression," according to new research in Australia, as reported in Science Daily.

This kind of linking of body chemistry to mental health goes on all the time in our biochemical-crazy age. And there's nothing wrong with linking, but our cultural predisposition is to go immediately from "link" to "cause," and that's where the mishigas starts. Here:

"A total of 203 of the participants (5.1 percent) met criteria for depression; these men had significantly lower total and free testosterone levels then men who were not depressed. After controlling for other factors--such as education level, body mass index and cognitive scores--men in the lowest quintile (20 percent) of free testosterone concentration had three times the odds of having depression compared to men in the highest quintile."

See how the biochemical fact of having low testosterone and the psychological fact of having depression (this would be a straightforward link) is converted--without any evidence--to a cause when it's phrased this way: that men with the lowest testosterone have "three times the odds of having depression." This makes it sound like low testosterone may lead to depression when it's more likely, to anyone who understands the mind-body connection, that it's the depression that leads to the low testosterone levels.

The fact that the researchers talk immediately about the treatment implications of the finding--they want to do a trial to see if treating depressed men with extra testosterone helps them--shows that as far as they're concerned, cause and effect is a done deal: low testosterone causes depression, adding testosterone to depressed men will undepress them.

It's truly hard for me to remember that people think this way, and that those people have been in charge of our view of health, and our health care system, for a long time. They see the chemical sign of a mental or emotional state and relentlessly (and, I contend, harmfully) presume--without an apparent second thought--that the chemistry causes the mental or emotional state.

Even though it is clear to an elementary school student that our mental or emotional state can obviously and clearly cause changes to our bodies. Our bodies are made up of chemicals. There is no reason not to conclude that our mental or emotional states can cause chemical changes in our bodies.

As for the potential for harm: if it's depression causing the low testosterone, there's resume to believe that additional testosterone will root out the depression, while we cannot know the side effects of fiddling with our body's chemistry unnecessarily.

Another mainstream go at the mind-body connection

This time in Parade.

I'm thinking this sort of article is largely a good thing, part of the slow, steady effort that will be required to get the general public, over time, clued in to the reality of the mind-body connection.

So of course there's the typical arms-length introduction--this "may seem like New Age thinking"; note the implication that "New Age thinking" is assumed to be foolish and wrong. And then we're walked through the subject with a focus on extreme examples (the hypnosis subjects told they were touching something very hot who develop a burn blister, for instance).

This gets people's attention, I suppose. To me, it would be much better to talk about, say, how psychogenic back pain is far too often incorrectly approached as a physical ailment (see previous post).

But we'll get there someday. We'll really have to.

Pitcher may be looking for the wrong "something "

The Philadelphia Phillies have a pitcher named Adam Eaton who had a terrible year last year. His record was an average enough 10-10 but his ERA was a league-worst 6.29. Part of his troubles were linked to back problems he has suffered.

This spring was going to be the time for the pitcher to redeem himself, but so far, so not good: he is 0-2 in two starts, with an eye-opening 15.75 ERA.

Note that the Phillies signed Eaton before the 2007 season to a three-year, $24.5 million contract.

Eaton now says he has a back injury again, or maybe it never really went away. He has been X-rayed and examined two times recently; those examinations, reports the Philadelphia Inquirer, "have shown nothing specifically wrong with his back."

And yet he is in significant pain. His conclusion: "There's got to be something there for it to feel like this."

Most definitely there is something there. I might suggest he stop looking for it in an x-ray or an MRI, however. I of course can't possibly know the situation from just reading a newspaper article, but it sure sounds like a good old case of TMS to me.

Look: he didn't do anything specifically to his back this spring, he's just feeling a lot of pain. Examinations are revealing no structural issues.

But stress? Eaton must have it coming out the wazoo. The man is earning millions of dollars a year, but gets the stuffing knocked out of him just about every time he pitches. That's got to mess with his emotional state; all the more so because, as a professional athlete, he is not encouraged to examine his emotional state in any way, shape, or form.

I feel badly for him, and wish him access to the wisdom, ultimately, that will lead to a cure. But in the meantime, I wish him off the mound! (So, okay, I'm a Phillies fan.)

Is depression caused by chemical imbalance? Um, maybe not.

"Biochemical roots of depression challenged," says the headline in an article on the Psych Central web site.

Ideally this should be a headline blazed across every mainstream web site and TV news show. This is a big big deal and it will probably get very little attention because marketplace economics are dead set against it.

Scientifically what's going on here is no new news at all. There has yet to be any conclusive, clinical proof that chemical imbalances "cause" depression. None. It was a theory that gained footing in the '60s but 40 years later, the Diagnostic and Statistical Manual of Mental Disorders, continues to tell us, in no uncertain terms, that the cause of depression and anxiety is "unknown."

Authors of a study quoted in the Psych Central article suggest that the media has played a large role in passing the chemical imbalance theory along as fact, fueled in large part by how apparently successful certain drugs were in alleviating depression.

Only--uh oh--it turns out the drugs don't work so well after all. Some recent studies have questioned how effective these drugs actually are. One study published last month suggests that most of the perceived effectiveness of several of the most common SSRIs (Selective Serotonin Reuptake Inhibitors, often prescribed for depression) is due to the placebo effect.

All of this, to me, relates to an incredible, largely unexamined bias in our day and age towards treating our bodies reductively, particularly when it comes to biochemistry and genetics. It's like every Valentine's Day when there are articles in the newspaper about the chemistry of love, quoting scientists talking about whichever chemicals that get secreted in the brain when we are in love. And the underlying presumption much of the time is that the chemical is somehow causing the feeling of love.

Western scientists truly have an irrational faith in the fact that the chemicals cause the emotions. That's how the "chemical imbalance causes depression" arose so naturally.

It rarely seems to occur to clinicians that the emotions may be causing the chemicals. That's because western scientists have such a hard time accepting the idea that the mind can impact the body so flagrantly. (Once again, I would ask: hasn't any of them ever blushed? Or seen someone blushing? Of course the mind can affect the body!)

And so with depression. No doubt a depressed individual does in fact have some chemical imbalances associated with that physical state. But all these years later there is no evidence to show that the imbalance comes first.

And here's the crazy dead-end of reductivist thinking anyway: even if the imbalance *did* come first, what then? We still wouldn't know what caused the imbalance. So the chemical imbalance theory is pointless before it even starts.

Yet it lives, and this small notice on a psychology web site is probably not enough to alert the world about how naked this particular emperor truly is.

Pain eased by more expensive pills--study

"New research shows that people who thought they were given a pricier painkiller reported less pain than those who believe they took the same drug at a discounted price."

Story on WebMD.

I also heard about this on NPR this morning, and the report there focused on the implications of the cost factor, as does this WebMD story. As one of the researchers asks, "How do we give people cheaper medication, or a generic, without them thinking it won't work?"

Two groups in the study were given sugar pills. One group was told the pills cost $2.50 each; the other was told they cost 10 cents each. Of those who took the "more expensive" pill, 85 percent experienced reduced pain when subsequently subject to an electric shock, while only 61 percent of those who took the "cheaper" pill felt their pain had been eased.

It seems to me there are many more important unanswered questions here than how do we give people cheaper drugs without undermining their effectiveness. Such as: why do we prescribe chemical substances at all when sugar pills often work just as well, as long as people think they're real drugs? Or, even: how is it that our bodies can heal themselves under the power of suggestion?

Newsweek interviews Domar

And now, Newsweek has an interview with Alice Domar, author of Be Happy Without Being Perfect: How to Break Free from the Perfection Deception. Domar is identified as "a pioneer in the study of stress and its effect on the body"; the interview here is substantive.

Note that just because I am discouraged at the strict gender presumptions (see previous post) doesn't mean that this isn't largely and legitimately a woman's issue, and an important one. And just because I, although a man, identify with some of the issues at hand, doesn't mean I don't understand that gender can, still, play a factor in the discussion. The body image problem, for instance, which Domar identifies as the "number one" perfectionist issue, most definitely--and sadly--affects many, many more women than men.

Body image problems are a particularly insidious form of mind-body disease. A woman with a body that may literally be healthy, although perhaps larger than she believes is "attractive," feels ongoing and maybe increasing stress about this perception. This in turn can cause actual physical health problems.

I read about a study once that showed that fatter women who lived in a culture in which fat was not socially stigmatized were far healthier than the same-sized women in the U.S.--far less prone to heart disease and other conditions we associated with overweight bodies. That's rather eye-opening; the implication is that some of the health problems we here automatically ascribe to the simple fact of being "overweight" may be much less straightforward than the traditional medical establishment--not to mention the diet industry--would have us believe.

This sounds like the subject of another post. And, in any case, if I can turn up the details of that study, I'll come back with more concrete information.

Friday quotation (on a Sunday)

"The universe was not made in jest but in solemn incomprehensible earnest. By a power that is unfathomably secret, and holy, and fleet. There is nothing to be done about it, but ignore it, or see it."
- Annie Dillard, Pilgrim at Tinker Creek

London Times article on mind affecting health

I find it odd when articles appear out of the blue, lacking any particular context for why it is appearing in a given publication at a given time, but that seems to be what happens in newspapers in particular. So here's an out-of-the-blue article about the mind-body connection in the (London) Times. The article's lead source is Harvard's Herbert Benson, although we are not told why the Times in London is abruptly quoting him.

The title--"Mind Control: Meditate Your Way to a Healthier Body"--is kind of random too. The article is basically about some actual, documented ways the mind can affect the body, not always having to do with meditation. Comments from actual, traditional medical folks who are open to the concept are included. This is not any sort of self-help article, as the title may imply.

The article is straightforward and informative, but I can't help feeling that its utter randomness is connected to how we culturally tend to look at mind-body medicine topics, when we bother to look at all, in this sort of cordoned off manner. We put some aspect of it on display in a sort of curio case; we can read it, go, "Hmmm. Interesting," and then proceed on with our usual world view.

Oddly enough, the article even pays lip service to the idea of using this information effectively, asking at one point, "So can we implement this mind over matter approach in our daily lives?" It proceeds, however, to fail to answer the question in any but the most general of terms.

"By repeating mantras to yourself, or practicing conscious repetitive actions such as tapping each time you think about the relevant topic," we are told, "you can manipulate your mind."

Oh, okay. Will do!

Weary of gender assumptions

There's an interesting article in the Boston Globe about psychologist Alice Domar and her study of something she calls the "perception deception"--the tendency for women to be very critical of themselves at all times, which can often lead to health problems.

Domar is executive director of the Domar Center for Mind/Body Health in Waltham, Massachusetts; she is also an assistant professor at the Harvard Medical School. She has a new book on this very topic coming out next month, entitled Be Happy Without Being Perfect: How to Break Free from the Perception Deception.

All of this is well and good and informative. But I am growing weary of the way discussions like this proceed along such strict gender lines. Women do this; men do that.

I understand the need to paint in broad strokes. But when I read this article, I find myself emotionally aligned with many of the issues discussed as "women's" issues. This happens to me a lot.

The bottom line is that these matters are not always so clear-cut. It is probably more accurate to talk about feminine and masculine tendencies, to reflect the underlying energy picture informing our emotional realities, rather than "women are like this" and "men are like this."

I am a heterosexual man who happens to have a fairly well-developed feminine side. I know it complicates matters in these sorts of discussions but I am real and I know there are others like me and I wish there could be a way to have these discussions that would include me rather than leave me yet again with the idea that I am some sort of alien being--neither from Venus nor from Mars.

Friday quotation

"When one is pretending the entire body revolts."
- Anaïs Nin

Mind-body medicine in the mainstream media

U.S. News & World Report has an article on a new study that shows that daily stress has an impact on how a woman's immune system responds to the cancer-causing virus HPV, and then an accompanying article featuring a short interview with Anne Harrington, author of The Cure Within, for some perspective on the mind-body connection at work here.

The feeling of stress continues to be just about the only emotional state that we feel okay, culturally, about relating to health issues. And even then it seems we do it at arm's length, continually looking to biology for the "real" reasons something may be physically wrong with us.

Back pain persists; the New York Times is puzzled

"Americans are spending more money than ever to treat spine problems, but their backs are not getting any better."

That's the first line in an article in Wednesday's New York Times, and that pretty much tells you the story.

As strong as the article is on statistics and evidence of the widespread problem, the Times remains as puzzled about it as the medical mainstream whose actions are being tracked, and, seemingly, as close-minded:

"It is not clear why more people appear to be suffering from back and neck pain," writes health reporter Tara Parker-Pope. "It could be because of rising obesity rates, researchers suggested. Or excessive treatment of back problems could lead to more problems."

More accurate it would be to say that it is not clear to tradition-bound western medical practitioners why more people appear to be suffering from back and neck pain. But to other experts--Dr. John Sarno among them--it's very clear. Our culture is in the midst of an epidemic of mind-body disorders. The back pain is largely psychogenic.

But that is not, apparently, for the Times to say, or even insinuate. Had the article left it an unaccountable mystery, we would have been better off. Instead, Parker-Pope passes along two suggestions from her medical sources that are, frankly, unscientific and borderline comical.

"Rising obesity rates"? Someone should tell that to *my* back. And note the ever-popular evasive attribution: "researchers suggested." The obesity witch hunt continues, and it is not, I don't think, unrelated to our medical establishment's inability to absorb the reality of an intimate mind-body connection. I'll save that for another post someday.

As for the second suggestion--the idea that "more people appear to be suffering from back and neck pain" because "excessive treatment of back problems could lead to more problems": um, well...huh? I can understand how excessive treatment of back problems could prolong existing conditions. But how could excessive treatment of people who already have back pain create more people with back pain? That was the original puzzle: "why more people appear to be suffering from back and neck pain."

That American doctors might actually think that this makes more sense than acknowledging the fact that our bodies and minds are connected and influence each other shows us, sadly, how far we yet have to go in moving mind-body medicine into the mainstream here in the U.S.

Friday quotation

"We tend to be particularly unaware that we are thinking virtually all the time. The incessant stream of thoughts flowing through our minds leaves us very little respite for inner quiet. And we leave precious little room for ourselves anyway just to be, without having to run around doing things all the time. Our actions are all too frequently driven rather than undertaken in awareness, driven by those perfectly ordinary thoughts and impulses that run through the mind like a coursing river, if not a waterfall. We get caught up in the torrent and it winds up submerging our lives as it carries us to places we may not wish to go and may not even realize we are headed for."
- Jon Kabat-Zinn, Wherever You Go, There You Are (Hyperion, 1994)

The pursuit of happiness

In Newsweek, an article on how "The push for ever-greater well-being is facing a backlash, fueled by research on the value of sadness."

The rather mindless cultural drive to assure us that we're all supposed to be happy practically all the time strikes me as an insidious symptom of the lack of general medical understanding of the mind-body connection. We treat the body as only body; we treat the mind as only mind.

Working hard to convince everyone that our goal is unalloyed, 24/7 happiness seems to be the emotional equivalent of attempting to gain a bulked-up, Mr. Universe-style physique--neither natural nor desirable for most people, and loaded with unintended side effects for later in life.

Mind Body medicine in Fort Wayne

A 71-year-old neurosurgeon in Fort Wayne, Indiana named Rudy Kachmann has just opened the Kachmann Mind Body Institute within the Lutheran Hospital in Fort Wayne.

Kachmann tells the Fort Wayne News-Sentinel:

"I am an unyielding believer in biomedicine’s ability to overcome most of the challenges presented by a life-threatening injury or pathological process. But I also believe the abdication of treating the whole person, medicine’s detachment from the mind, is a false, outdated dichotomy that scientific discoveries, contemporary needs and economic realities no longer support."

Some day, people will look back upon western medical practices in our time with as much disbelief and distaste as we today look back at medieval "medical" treatments.

In the meantime, three cheers for Dr. Kachmann.

Friday quotation

"As I've watched as well as participated in this process, I've come to believe that virtually all illness, if not psychosomatic in foundation, has a definite psychosomatic component. Recent technological innovations have allowed us to examine the molecular basis of the emotions, and to begin to understand how the molecules of our emotions share intimate connections with, and are indeed inseparable from, our physiology. It is the emotions, I have come to see, that link mind and body."
- Candace Pert, Molecules of Emotion (Scribner, 1997)

The Mindbody Syndrome (Tension Myositis Syndrome)

While I have been interested in mind-body issues for many years, and have read widely in the field (such as it is), the immediate trigger for starting this blog has been my close encounter with a condition known as TMS. Originally TMS stood for tension myositis syndrome; there is a movement afoot to rename it The Mindbody Syndrome, which is more immediately understandable, and manages to salvage the acronym.

TMS is the name for the condition in which your mind converts deep emotional content into physical symptoms. The symptoms--and the pain and discomfort attendent with them-- are very real. Emotions can and do have a real, physical impact on the body.

And TMS makes far more sense than the explanations most American doctors offer for the sort of chronic back pain that is one hallmark of the condition. My MRI, for instance, revealed arthritis of the facet joints of the spine. This was therefore posited as the source of my pain.

The fact that arthritis of the facet joints is a degenerative condition associated with aging, and rather common, and not in fact the cause of any pain in most people who have it, didn't seem to matter. Neither did the fact that the pain I was experiencing managed to be in my hip a lot of the time, although it also tended to jump around from day to day, even moment to moment. All they could quantify was the arthritis. That was their story and they were sticking to it.

It would be one thing if medical people here could more readily acknowledge what they don't know. Instead, all too many of us are treated to arrogant--and ignorant--presumption. The first day I was in physical therapy, I made a tentative general statement about how I have had the idea that my back pain was part of something larger, how it was connected to what's been going on in my life for a long time. The physical therapist looked me in the eye and said, with the patronizing tone of a parent talking to a child: "Jeremy. This is a mechanical problem. We will fix it mechanically."

Is it really so outlandish for me to have suggested that my body could be influenced by strong emotional content in my life? Is the suggestion that the mind can influence and control the body in such a way as to cause physical symptoms really that far-fetched?

Haven't these folks ever seen anyone blush? Haven't any of them ever felt butterflies in their stomachs?

As for TMS, whole books have been written on the subject, starting with the pioneering work of Dr. John Sarno. Dr. Howard Schubiner--one of a handful of other MDs who supports this diagnosis and understands TMS--offers this concise description of what TMS is about:

"Your body is producing pain because it's manifesting unresolved stress, possibly from your childhood, or from stressful events in your adulthood, or from your present circumstances, and as a result of your personality traits (which affects how you respond to stress and how much pressure you tend to put upon yourself)."

At a certain level, it's that simple. But of course there's a lot going on within that description. I suggest watching Schubiner's instructive video on YouTube about TMS for more information.

And I promise not to turn this blog into a boring, ridiculous account of my own condition. But to the extent that my struggles with TMS highlights interesting aspects of the incontrovertible reality of the mind-body connection--and the way that informed doctors can actually work with it rather than ridicule the very idea--I will return to the subject as the story unfolds.

Better Harrington interview

The Boston Globe has one that positions Harrington more reasonably than Salon managed to.

What too many journalists miss is the reasonably expansive area between the extremes. They miss, willfully or otherwise, the fact that the mind-body connection is not a black and white scenario with "only physical causes" on one side and "the mind generates all disease" on the other. Writers (such as in the Slate review, previously noted) love to pretend it's black and white, so you get western medicine wearing the white hat and (as the Slate headline had it) "The unscientific allure of mind-body medicine" embodying everything silly and superstitious.

But that's a false and foolish dichotomy. Just because western medicine has a powerful understanding of the physical side of disease does not in any way rule out that the mind can play a very important role as well.

If over time I appear here to berate western medicine, it's not because I don't believe that germs cause disease, or that there aren't actual physical circumstances happening when something is wrong with your body. But there is no way--absolutely no way--that western research can prove its position, and by and large its practitioners, and followers, have no justifiable reason to dismiss the psychological/emotional element of bodily disorders. And yet that's all most of them seem to do.

That's what I've had enough of, and will continue to write about.

Friday quotation

"The body-mind, as a dynamic field of energy, is inherently attuned to the larger patterns and flows of the universe. Out of this attunement emerge sudden and surprising insights, creative inspirations and discoveries, and larger, transpersonal qualities, such as clarit, compassion, joy, or spontaneity."
-- John Welwood, Towards a Psychology of Awakening (Shambala, 2002)

Mind-body medicine in Pittsburgh

From the Pittsburgh Post-Gazette, an article on a new study showing that meditation can help ease lower back pain.

The study was done at Allegheny General Hospital in Pittsburgh, which happens to have something it calls the mind/body/spirit psychological services program.

Dr. Barbara Nagrant, a clinical psychologist who runs the program, is quoted in the Pittsburgh Post-Gazette as saying: "Healing involves mind, body and spirit."

She doesn't sound like one of those rebellious sorts that Anne Harrington is inclined to think mind-body medicine proponents are--people who actually do not want mind-body medicine accepted into the mainstream (see yesterday's post).

So let's just be clear that Professor Harrington aside, there are certainly a lot of real-life, experienced, open-minded people, even some within the mainstream medical community, who not only would like mind-body medicine to be more accepted by the mainstream, but are actively working towards that day.

Anne Harrington interviewed

Salon has an article on The Cure Within, and with it an interview with Anne Harrington.

She appears to approach the topic with a fair amount of open-mindedness; after all, she is writing about the history of mind-body medicine, not passing judgment. So something like is welcome and reasonable:

When do we find ourselves being tempted by or drawn to the other understandings of mind-body medicine? It's often when mainstream medicine lets us down or can't provide therapies. Often around chronic disorders, it doesn't seem to do justice to all the complex ways in which our diseases are more than just diseases, [in that] they're part of who we are. And we need to make sense of them as part of who we are.

I personally feel she's way off, however, with this:

I think part of it [mind-body medicine] will always remain by design and by desire outside of the mainstream because large parts of it want to be the face of medicine that defies what the mainstream says is possible. It wants to resist and rebel and offer alternatives. I think there would be huge disappointment if it were ever really embraced by the mainstream, because it would have ceased to be that rebellious other that people perhaps need.

No doubt this is true of some proponents of mind-body medicine but I feel it's a ridiculous generalization to make. Me, I yearn for this to become mainstream. I hate having to talk to doctors who make you feel like you're from Mars if you suggest that your emotional state is actually an important part of your physical reality. I want it to be mainstream because until it is, the truth of the mind-body connection remains far too underappreciated and misunderstood.

More on The Cure Within

So The Mind Body Blog has launched at the same time that a notable book about the history of mind-body medicine is being published, the previously noted The Cure Within. Serendipitous timing, says me.

The Christian Science Monitor reviews the book.

So does Slate. Get a load of the headline there: "The Psychosomatic Secret: The unscientific allure of mind-body medicine."

Note, for future reference, the noxious tendency of well-intentioned progressive thinkers to have an irrational faith in the power of rational thinking. Very quick they are to link anything that can't be measured quantitatively with that catch-all insult, "magical thinking." Their progressivism and humanity would be greatly assisted if they could let go of this unsupportable, insidious belief that everything that happens to us in every case is 100 percent reducible to chemistry and physics.

The Cure Within

The New York Times Book Review tomorrow offers an informed but narrow-minded review of The Cure Within: A History of Mind-Body Medicine, by Harvard professor Anne Harrington. The reviewer is Jerome Groopman, a physician and a staff writer for The New Yorker.

The review concludes: "Harrington shows us that, whatever science reveals about the cause and course of disease, we will continue to tell ourselves stories, and try to use our own metaphors to find meaning in randomness."

Can't tell whether it's Groopman's or Harrington's bias on display right there: "to find meaning in randomness." The western approach is to deny meaning because western scientists cannot measure meaning. That's their perpetual mistake. The universe appears random when looking at it through filters that cannot perceive meaning.