The Sickening Mind: Brain, Behaviour, Immunity and Disease. Paul Martin

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СКАЧАТЬ and Cavaliers

      All scientists know of colleagues whose minds are so well equipped with the means of refutation that no new idea has the temerity to seek admittance. Their contribution to science is accordingly very small.

      Peter Medawar, A Note on ‘The Scientific Method’ (1949)

      I am too much of a sceptic to deny the possibility of anything.

      T. H. Huxley, letter to Herbert Spencer (1886)

      Contemporary attitudes towards the relationships between mind, body and disease are strangely confused. On the one hand we have the uncritical acceptance by the public, popular media and gurus of New Age medicine that the mind is both the source and the remedy for the majority of bodily ills. Set against these Cavaliers of mind – body interactions we have the Roundhead sceptics, who either dismiss the connections between psychological factors and physical disease as pseudo-scientific wishful thinking, or else simply ignore them altogether.

      The tenet that psychological factors play a role in causing or curing bodily diseases is, of course, an ancient one – far older than modern medicine. Throughout history people have held deep-seated beliefs in the power of the mind to influence physical health, and down the centuries (until the twentieth century, anyway) physicians have explicitly linked physical wellbeing with mental wellbeing. It therefore comes as no great surprise to us if a major emotional upset such as bereavement, depression, divorce or redundancy later manifests itself in physical form. Our everyday experience, let alone statistical data from the Gulf War, seems to support this view.

      But is this age-old notion of the mind affecting physical health a self-evident truth or merely unsubstantiated pseudo-science? Is it true that we are more likely to fall ill when we are stressed, anxious or depressed? Are individuals with certain personality types more susceptible to colds, allergies, heart disease or cancer? These are questions of profound medical significance. They are also fascinating scientific puzzles.

      In ancient times healers worked on the pragmatic basis that the mind and the body are intertwined. Physical disorders could stem from problems in the mind and mental disorders could be reflections of bodily disease. Accordingly, physicians were encouraged to treat the soul and not just the body, using soothing words to comfort the patient’s mind.

      Ancient Greek medicine placed great emphasis on the curative power of katharsis – the purging and purification of the patient’s soul. Plato and other great thinkers recognized that these psychological charms were remarkably effective in relieving physical ailments. They also recognized that these charms would not work properly unless both the patient and the physician believed in their curative powers.

      Nowadays the supposedly damaging effects on health of anxiety, over-work, job insecurity and loneliness form a recurrent theme in the media, which preaches the message that stress makes us ill. The implicit connection between mental state and physical health seems to be uncritically accepted by an increasingly health-conscious public.

      There has been an explosive growth in alternative and complementary forms of medicine, which tend to emphasize the underlying unity of mind and body. Around one third of the adult population has consulted a practitioner of the alternative medical arts at some time. Bookshop shelves groan under the weight of publications proclaiming the self-help gospel that health is all a matter of thinking the right thoughts and banishing negative emotions.

      The self-help industry and New Age gurus offer us such tantalizing prospects as self-healing through love, thinking ourselves better from cancer, using the mind to heal all manner of dread diseases and, ultimately, reaching that holistic nirvana of health, happiness and self-fulfilment through the power of pure thought. It is easy to see why the sceptical Roundheads can be so dismissive of the mind – body Cavaliers.

      A profound change in the pattern of diseases during the twentieth century may also have contributed to this trend. The infectious diseases that killed vast numbers until fifty years ago have almost disappeared from the wealthy industrialized nations – though not from poorer parts of the world. Their place in the league table has been taken by chronic degenerative disorders such as coronary heart disease and cancer. Diseases of the heart and circulatory system, cancer and accidental injuries now account for more than three-quarters of all deaths. In contrast, infectious and parasitic diseases account for less than 0.5 per cent of all deaths.²

      The causal factors that contribute to these modern-day killers are much more complex than the relatively understandable causes of infectious diseases. We all recognize that tuberculosis is caused by bacteria, but cancer and heart disease are altogether more obscure. It is therefore easier to believe that the mind may play a role in their genesis. Factors as diverse as tobacco, red meat, slothfulness, insufficient fibre, childlessness, salt, pesticides, sunburn and radiation can cause serious diseases, so why not psychological stress or depression?

      But is there any scientific basis for these beliefs? Just because people have always assumed something to be true does not make it so. After all, the earth was at one time assumed to be flat, stationary and at the centre of the universe. This belief appeared to be supported by everyday experience and was universally accepted as a self-evident truth. Yet it turned out to be completely wrong. Folklore, faith and dogma are not always reliable guides.

      In stark contrast to the popular attitudes we have the inherent scepticism harboured by many scientists and doctors towards the notion that mere thoughts or emotions could possibly have an impact on such brutally physical processes as viral infections, coronary heart disease or cancer.

      Scientific research in this field has often been tinged with a largely undeserved aura of crankiness. ‘Psychosomatic’ phenomena carry with them a whiff of self-indulgent fantasy, along with the implication that they lack both substance and scientific respectability. The suggestion that psychological and emotional factors play a causal role in disease is often regarded as an admission that the real (i.e., physical) origins of the disease are not yet understood. As Susan Sontag put it in her 1978 book Illness as Metaphor: ‘Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about the physical terrain of a disease.’

      The belief in an intimate connection between mental state and physical health has had a decidedly rocky history in Western medicine, despite its promising beginnings in the civilizations of China and Greece more than two thousand years ago. By the end of the nineteenth century the overwhelmingly predominant approach to medicine was to focus exclusively on the disease and its identifiable physical causes, such as bacteria. Medical research could get to grips with bacteria, but thoughts and emotions were altogether too ethereal. The patient’s mental state increasingly came to be seen as an embarrassing irrelevance – the province of psychologists and other faintly disreputable types rather than a proper concern of scientific medicine. In later chapters we shall consider why the mind and body came to be separated in Western thought, and how this estrangement of psyche from soma has had such an all-pervasive influence on modern science and medicine.

      Yet even in the late nineteenth century there were notable exceptions to this rule. For instance, in 1884 Daniel Hack Tuke, one of the pioneers of British psychiatry, published the second edition of a work entitled Illustrations of the Influence of the Mind Upon the Body in Health and Disease, Designed to Elucidate the Action of the Imagination. In it, Tuke argued that the mind and body are inextricably linked through physiological processes; and that our mental state consequently affects our physical health and vice versa. State-of-the art research in the closing years of the twentieth century has come to much the same conclusion – and not before time.

      History shows that important ideas can be ignored even СКАЧАТЬ