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Psychosomatic Medicine in The Economist

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I thought that the following article was very interesting and shows that the medical world is finally catching up to what we've known all along. I had to reread it a couple of times, but, when I did, it was very well worth it. It's from a quite good newsmagazine called The Economist.

Think yourself well
You can. But it helps to think well of yourself in the first place
Dec 8th 2012 | from the print edition

THE link between mind and body is terrain into which many medical researchers, fearing ridicule, dare not tread. But perhaps more should do so. For centuries, doctors have recognised the placebo effect, in which the illusion of treatment, such as pills without an active ingredient, produces real medical benefits. More recently, respectable research has demonstrated that those who frequently experience positive emotions live longer and healthier lives. They have fewer heart attacks, for example, and fewer colds too.

Why this happens, though, is only slowly becoming understood. What is needed is an experiment that points out specific and measurable ways in which such emotions alter an individual’s biology. And a study published in Psychological Science, by Barbara Fredrickson and Bethany Kok at the University of North Carolina at Chapel Hill, does precisely that.

Dr Fredrickson and Dr Kok concentrated their attentions on the vagus nerve. This nerve (illustrated right, in an early anatomical drawing) starts in the brain and runs, via numerous branches, to several thoracic and abdominal organs including the heart. Among its jobs is to send signals telling that organ to slow down during moments of calm and safety.

How effectively the vagus nerve is working can be tracked by monitoring someone’s heart rate as he breathes in and out. Healthy vagal function is reflected in a subtle increase in heart rate while breathing in and a subtle decrease while breathing out. The difference yields an index of vagal tone, and the value of this index is known to be connected with health. Low values are, for example, linked to inflammation and heart attacks.

What particularly interested Dr Fredrickson and Dr Kok was recent work that showed something else about the vagal-tone index: people with high tone are better than those with low at stopping bad feelings getting overblown. They also show more positive emotions in general. This may provide the missing link between emotional well-being and physical health. In particular, the two researchers found, during a preliminary study they carried out in 2010, that the vagal-tone values of those who experience positive emotions over a period of time go up. This left them wondering whether positive emotions and vagal tone drive one another in a virtuous spiral. They therefore conducted an experiment on 65 of the university’s staff, to try to find out.

They measured all of their volunteers’ vagal tones at the beginning of the experiment and at its conclusion nine weeks later. In between, the volunteers were asked to go each evening to a website especially designed for the purpose, and rate their most powerful emotional experiences that day. Dr Fredrickson and Dr Kok asked their volunteers to consider nine positive emotions, such as hope, joy and love, and 11 negative ones, including anger, boredom and disgust. They were asked to rate, on a five-point scale, whether—and how strongly—they had felt each emotion. One point meant “not at all”; five meant “extremely”. In addition, half the participants, chosen at random, were invited to a series of workshops run by a licensed therapist, to learn a meditation technique intended to engender in the meditator a feeling of goodwill towards both himself and others. This group was encouraged to meditate daily, and to report the time they spent doing so.

Dr Fredrickson and Dr Kok discovered that vagal tone increased significantly in people who meditated, and hardly at all in those who did not. Among meditators, those who started the experiment with the highest vagal-tone scores reported the biggest increases in positive emotions. Meditators who started with particularly low scores showed virtually no such boost.

Taken as a whole, these findings suggest high vagal tone makes it easier to generate positive emotions and that this, in turn, drives vagal tone still higher. That is both literally and metaphorically a positive feedback loop. Which is good news for the emotionally positive, but bad for the emotionally negative, for it implies that those who most need a psychosomatic boost are incapable of generating one. A further (as yet unpublished) experiment by Dr Kok suggests, however, that the grumpy need not give up all hope. A simpler procedure than meditation, namely reflecting at night on the day’s social connections, did seem to cause some improvement to their vagal tone. This might allow even those with a negative outlook on life to “bootstrap” their way to a mental state from which they could then advance to the more powerful technique of meditation.

Whether, besides improving general health, the mechanism Dr Fredrickson and Dr Kok have discovered helps explain the placebo effect remains to be investigated. But it might, because part of that effect seems to be the good feeling engendered by the fact of being treated. More generally, doctors in the ancient world had a saying: “a healthy mind in a healthy body”. This sort of work suggests that though this proverb is true, a better one might be, “a healthy mind for a healthy body”.
 
Glad to hear you liked it, tarala.

There were a couple of comments on the original article that I thought were really good as well:
Prasad Kaipa said:
Growing up in India, I have been constantly told that you become what you think and feel. In some traditional families, we were even told that each time we think positive and appreciative thoughts, there is a higher chance that we might make those come true. You see, there are guardian angels who randomly bless thoughts -- in case they catch us thinking positive, we are in luck!
In my own research and consulting for past 22 years, I found that when we are optimistic and see possibilities and opportunities instead of predicaments, our attitude shifts and we see data points that support or help make those come true. Reverse is also true and when we are down, we don't even try even if there is a fair chance for us to succeed. Considering that stress engenders many diseases including diabetes in my case (no family history and have been regular in exercise for a while), our thoughts and feelings have significant influence on our well being.
i commend what these researchers have done and believe there is much more work to be done in this area!
Prasad Kaipa

Jaysrin said:
I am in agreement with Prasad Kaipa and my own experience growing up in India has been similar. The fact is, modern medicine finds correlation between "negative behaviors" (stress, overwork, incursion of work into family time, etc) and ill-health but the opposite is one that most physicians fear to discuss or encourage. On the face of it, the logic is compelling: if bad behaviors can cause bad health outcomes, would not good behaviors alter them?

Tragically, most "modern" physicians continue to heap ridicule or shrug their shoulders with barely concealed contempt when patients themselves suggest alternative approaches. Thankfully, however, there is a minority that continues to have an open mind. Dr. Dean Ornish at the Preventive Medicine Research Institute in San Francisco is one such who has demonstrated superior outcomes based, at least partially, on the notion of "being well". So it's good that Drs. Fredrickson and Kok have found further confirmation and opened the doors to new lines of inquiry.

Ancient practices, carried over across centuries, could be thought of as extremely long drawn clinical trials and there is dire need to explore and connect many such notions or ideas from across the world to modern practices and systems. A good deal of this is possible once today's practitioners get over their fear and loathing of things they have not been taught in med school.

CHANDRASEKARAZAD said:
Deep down what it means is that, barring infections and other external influences beyond your control, you can be healthy with healthy thoughts. All the three basic parameters of good health; good sleep, good appetite and good bowel movements are in your control. Dependence on external sources like drugs, stimulants, and rave parties for pleasure disturb your biorhythm and yield exactly opposite results. Diminishing returns in terms of pleasure lead to excessive pleasure-seeking activities leaving the body and mind disconnected; neither knows what you want. Enjoying simple pleasures like a family dinner, good music, a good book, a friendly conversation and the joy of sharing; these are the best medicines handed down to us by generations before us. They knew what they were doing.
 
I like the ease of that, "You can be healthy with healthy thoughts." Makes it all rather simple, doesn't it?
 
Wow, an article from The Economist. Pretty incredible! Psychosomatic approach is going places.
That's the nice thing about being right ;) When you're right, eventually the rest of the world needs to catch up. :)
 
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