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Medicine

The relationship between emotions and illness requires more research.

What is sometimes called “the mind-body connection” has been a disreputable area of medical science for years. It shouldn’t be. The field suffers from base origins and false friends. Norman Cousins published an influential account in the New England Journal of Medicine in 1976 about his battle with a mysterious collagen disorder. After none of his physicians could understand his autoimmune disease, Mr. Cousins claimed, he recovered by quaffing vitamin C and maintaining a “positive attitude” by watching comedies on TV. Although these results were never reproduced, the idea took off: Mr. Cousins’s tale was very appealing to proponents of alternative medicine because it dismissed doctors and suggested that patients might heal themselves. By the late ’80s, those who believed in the mind-body connection hypothesized that serious diseases could be caused by “negative attitudes” like insufficient self-love.

All of that is so much magical thinking. But as Jerome Groopman, professor of medicine at Harvard Medical School, writes in “The Biology of Hope” on page 54 of Acumen, Volume II — Issue 1, all physicians accept that there is a biology of fear, anger, and depression. Why shouldn’t hope also have a physiological aspect?

Indeed, there is one ready example, supported by centuries of physician observation, of how emotions can cause physiological changes: many people, even in the extremis of pain, will feel relief if they believe that a placebo is an opiate. Recent research has confirmed that patient expectation is sufficient to release endorphins in the brain that interrupt the transmission of pain signals in neural pathways.

Less well understood is how the placebo effect can diminish the effects of Parkinson’s disease. Yet research has shown that patients who have been conditioned to expect a dose of dopamine will find their muscles less rigid and their motions more fluid, even if they only receive a placebo.

Hardly understood at all is how a hopeful attitude to recovery may affect the immune system. Recent studies have suggested that resilient characters produce less cortisol in response to stress than do depressive personalities. Since too much cortisol can suppress the immune system, it is just possible that happy people recover more quickly than others.

Much of this is speculative and tentative. But the relationship between emotions and sickness deserves further study and should no longer be ashamed of its misconceived beginnings.

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Leaders

Medicare: How we can really reform the nation’s health care system for seniors.

» Medicine: The relationship between emotions and illness requires more research.

Business: Create a more efficient supply chain for drugs.

Policy: We must strive to make science more open—and honest.

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