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We can all understand the need to believe that our emotions can knock out rampaging, malignant cells. If we think we can manage our emotions and thereby fix our lives (the purpose of therapy), it isn't much of stretch to think we might be able to control our tissue and organs. And we'll pay good money to doctors, therapists, publishers, and coaches to help us entertain this possibility.
Faced with the need to meet strict standards of scientific proof, mind-body medicine is still struggling to establish its empirical foundation. The evidence for a mind-body connection sometimes comes to those who don't anticipate it. Harrington cites the case of David Spiegel, a Stanford psychiatrist. Although Spiegel believed that open, frank talk about physical ailments was beneficial, and he taught simple self-hypnosis techniques to manage pain and anxiety, he disapproved of those like Bernie Siegel who peddled false hopes about the effects of positive and negative attitude on illness. He dismissed the "wish-away-your-cancer crowd."
But then he got a surprise. In his own 1989 study, he discovered that not only did support groups improve mood and coping skills, but the women involved in them lived twice as long (37.6 months as opposed to 18.9 months) as women in the control group, who had no group counseling
So Spiegel found himself in the company of all sorts of alternative practitioners he distrusted. But then things began to unravel. A follow-up study failed to replicate his findings. As of now, Harrington writes, Spiegel remains unwilling to concede that support therapy doesn't extend the life of women with cancer, and whatever its effect on longevity and survival may prove to be, he's convinced that therapy can help cancer patients live more fully and authentically in the time they have left.
That's where Harrington stands, with her good common sense. When she asked one patient in a support group whether it mattered whether she'd live longer, the patient told her no, it didn't matter. She and her group had all learned to live better, and their painful feelings about dying had been eased. As one woman told Harrington, quite movingly, "If you eliminate the concept of time, I guess then you could say we live longer."
One point Harrington underlines is that the history of mind-body medicine is full of spiritual and religious hopes and themes. It's about the stories we tell ourselves to make meaning out of our sufferings. Once people believed their ills could be caused by demon possession. Since then, the vocabulary and metaphors have changed, and Harrington recounts this history in a thorough, vivid way. If people once believed they were possessed by evil spirits, Freud told his patients that repressed impulses caused their hysterical symptoms. You could say that Bernie Siegel's fix on "cancer as character" follows in a tradition begun way before the origin of modern science.
Nevertheless, some approaches within mind-body medicine have a firm empirical foundation. Harrington reminds us of the growing scientific literature that has led to the acceptance of meditation (often by another name) in hospital and clinical programs around the world. Jon Kabat Zinn, the originator of "mindfulness-based stress reduction," claims that without his Ph.D. in molecular biology from MIT, doctors would have been wary about accepting the possible value of Buddhist meditation techniques in a medical setting. Luckily, he was able to show through research trials that this ancient wisdom can help patients manage their pain.
So how do we separate pop fads from the more enduring contributions within mind-body medicine? As a disinterested scholar, Harrington is reluctant to judge, though she makes an exception for Bernie Siegel: if there's a dart board in her office, I'd imagine his smiling picture is front and center. But I think it's safe to say that The Cure Within will make many readers feel a certain humility. Like poor Mr. Wright, I suspect, however willing we may be to defer to the wisdom of various medical authorities (we do it every time we go into a hospital), we want to feel some control over our existence. We want to embrace a narrative that gives sense to our experience. And we wish for a certain amount of certainty about the best course to take, even when it isn't forthcoming. We might first look to science for guidance; but if that doesn't give us what we're looking for, we hope for a miracle.
In the end, as Harrington might say, we want to make sense of our lives in the form of a good, comprehensive story we can tell ourselves. It may not protect us from a dread disease, but as meaning-making creatures, we resist the idea that ultimately our well-being depends on the impersonal whims of the universe.
Richard Handler is a radio producer with the Canadian Broadcasting Corporation in Toronto, Canada. Contact: firstname.lastname@example.org. Letters to the Editor about this department may be e-mailed to email@example.com.