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

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СКАЧАТЬ them. It is worth recalling the uncomfortable fact that compelling scientific evidence for the connection between smoking, disease and death was available for many years before it started to be taken seriously. Nowadays the link between smoking and all manner of dread diseases is almost universally accepted. Yet this was not always so. Scientists had suspected that smoking was bad for health long before the first solid evidence for a connection with lung cancer was published in 1950. During the 1950s and 1960s a succession of studies concluded that smoking increases the risks of lung cancer, heart disease and a host of other life-threatening conditions. Nevertheless, governments, the general public and even doctors remained sceptical of these links, and two decades passed before the research started to have an impact.

      Contemporary physicians and scientists frequently dismiss the idea that the mind has a profound effect on physical health. To quote an editorial from a prestigious international medical journal: ‘we have been too ready to accept the venerable belief that mental state is an important factor in the cause and cure of disease.’ Another sceptic, also writing in a leading medical publication, comments that ‘Mental stress is frequently blamed for the generation of organic disease, especially if it is of uncertain or complex aetiology, though without reliable or confirmatory argument … The morbidity of mental stress is commonly widely exaggerated.’ Or consider this trenchant counterblast from a third scientific sceptic:

      During the last quarter of the 19th century many medical men asserted confidently that the stress of ‘modern’ life (i.e., all that gadding about in hansom cabs, paddle steamers, and railway trains) caused general paralysis of the insane [the final stages of syphilis]. Most of us now accept that this view was mistaken. I think that the notion that emotional factors have an important bearing on immunity, or on the cause or progress of cancer, comes into the same category.

      In many respects the scientific evidence for connections between psychological factors and disease is stronger and more consistent than the evidence for certain other medical risk factors which are, nonetheless, regarded as less controversial. The putative links between dietary salt or cholesterol and heart disease are viewed with nothing like the same degree of suspicion and scepticism as psychological risk factors. Yet the scientific evidence that excessive salt or cholesterol in the diet actually cause heart disease in normal people is by no means conclusive. On the other hand, the evidence that psychological factors contribute to heart disease is wide-ranging and convincing, as we shall see later. There is a curious double standard at work here.

      The fact is that most people, doctors and scientists included, find it inherently easier to believe in the reality of apparently simple physical causes of disease (such as cholesterol, salt, bacteria or viruses) than to accept that mere thoughts or emotions can affect our health. Partly as a result of such sceptical attitudes, research into the connections between the brain, behaviour, immunity and disease has, until recently, been remarkably neglected by mainstream medicine and seldom explained properly to the general public.

      Can the starkly contrasting views of the uncritical Cavaliers and the sceptical Roundheads be reconciled? What are we to think when faced with conflicting claims about the mind’s role in disease?

      As we shall see, the scientific truth is subtler than either of these two extreme views. It is also far richer and more exciting. It turns out that the folklore was in certain respects right, while the sceptics were wrong in their sniffily dismissive attitude. Research has uncovered an array of solid, compelling evidence that the mind does indeed play a part in a multitude of disease processes, ranging from commonplace bacterial and viral infections to heart disease and even cancer.

      

Some completely fictitious case histories

      Before delving into the science, let us turn our attention temporarily to storytelling. If it is true that our mental state influences our physical health then this fundamental aspect of human nature ought to have been noticed and reflected in literature throughout the ages. What can we see in the mirror that fiction holds up to the human condition?

      The links between the mind, emotions, behaviour, disease and death have indeed been reflected in the lives of fictional characters over the centuries. The writers describing these mind – body phenomena obviously had no conception of their biological basis, but that did not stop them noticing and portraying the connections. Throughout this book I shall be referring to literary illustrations of the links between psychological factors and disease. But first, let me spell out what these fictional case histories are intended to convey and, perhaps more importantly, what they are not intended to convey.

      I shall use literary allusions because they help to convey complex scientific ideas in a recognizable form. Well-turned examples drawn from literature are more cogent and more entertaining than any medical case history, no matter how supposedly authentic it may be. They also demonstrate the antiquity and universality of many of the concepts that underlie current theories. However, by citing fictional characters or situations to illustrate scientific theories I am certainly not implying that they constitute hard evidence in support of those theories. Fine words drawn from the imaginations of long-dead authors are clearly not the same as scientific data.

      The idea that physical decline can stem directly from mental and emotional decline is a familiar theme in literature. Fictional characters often die from unrequited love, grief, shame or fury. Emily Brontë’s Wuthering Heights, for example, is positively bulging with characters whose mental states lay waste their physical health. Death and disease run riot throughout the book. Let me remind you.

      Believing his childhood sweetheart Catherine has spurned him, the tempestuous Heathcliff vanishes. Catherine, who does in fact love Heathcliff, is deeply upset and ridden with guilt. She consequently becomes mentally unstable and physically ill. Three years later Heathcliff returns. Catherine is torn between her love for Heathcliff and her love for Edgar Linton, whom she has meanwhile married. She breaks down under the mental pressure, shuts herself in her room and sinks into delirium. The vengeful Heathcliff subjects Catherine to an emotional battering which further weakens her health and she dies giving birth, a victim of psychological torment.

      The bereaved Heathcliff determines to achieve his longed-for union with Catherine through his own death. He locks himself in a darkened room and wills himself to die. Four days later a servant enters the room to find his body. Heathcliff’s mind has killed him, as surely as if he had been shot:

      Kenneth was perplexed to pronounce of what disorder the master had died. I concealed the fact of his having swallowed nothing for four days, fearing it might lead to trouble, and then, I am persuaded he did not abstain on purpose; it was the consequence of his strange illness, not the cause.

      Death by shame is the tragic fate awaiting Madame de Tourvel in Choderlos de Laclos’s Les Liaisons Dangereuses, that tale of sexual intrigue among the enormously rich, enormously idle and enormously depraved aristocrats of pre-Revolutionary eighteenth-century France.

      The young, pious and austere Madame de Tourvel is a devoted wife. Nevertheless, she is ruthlessly seduced by a satanic libertine, the Vicomte de Valmont – a man who ‘has spent his life bringing trouble, dishonour, and scandal into innocent families’. Valmont is egged on by the Marquise de Merteuil, his equally amoral former lover. Together they plot their seductions with the cold, unemotional precision of a military campaign.

      Facing stiff resistance from the virtuous Madame de Tourvel, Valmont eventually breaks down her defences by convincing her that he will die from emotional torment unless she surrenders herself to him. Unable to resist his wiles any longer, Madame de Tourvel succumbs and Valmont has his wicked way with her.

      The awful truth is then revealed – Valmont СКАЧАТЬ