Can The Mind Help Cure Disease?

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.