The Mind Body Awareness Project

Sickened by a horrific, random act of violence here in Philadelphia this week, I found myself wondering about the effect on the body of being relentlessly exposed to violent images, as so many people are simply by watching TV and movies in the 21st century. I was thinking that surely this exposure via the mind has ancillary effects not only on behavior but on the body itself somehow.

I did some quick Googling and discovered something called The Mind Body Awareness Project. While this organization does not relate directly to my question, it turns out to relate very directly to my tragic inspiration. The Mind Body Awareness Project "is a non-profit organization dedicated to teaching essential life skills to at-risk youth through the practices of meditation and yoga," according to the site.

What happened here the other day was this. Four teenagers attacked a man at a subway station for this reason: they had nothing to do, and just thought they'd go beat this guy up. Turns out he died of a stress-induced asthma seizure. The man was in his late 30s; he was a mild-mannered, hard-working Starbucks employee. Life ended by four young men who would've been called "droogs" in A Clockwork Orange; Anthony Burgess may have had no idea how realistic his dystopian masterpiece might turn out to be. We have raised a sub-species of human being within our midst and I can't believe that the violence we strew so casually throughout our entertainment is unrelated to the existence of people who seem to have had their humanity removed when it comes to the casual use of exceptional violence.

At the same time, I know for a fact there are groups of very good and very helpful people in the world--for instance, the folks behind the Mind Body Awareness Project. Had they been working with the kids who committed this stupid, senseless crime, one man would have been spared a frightening and pointless death.

The incident like the one I've described saddens me to my core, but it does not leave me defeated. We can and must do better than this. Think about the violence you expose yourself to and ask yourself if you can do better than that.

Newsweek on the placebo effect

Here's another mainstream media take on placebos. Sharon Begley acknowledges from the outset how resistant both doctors and patients can be about the very concept of the placebo effect. Then she writes:

"But the fact remains that placebos are at least somewhat effective and sometimes very effective for some patients. Rather than railing against that finding or pretending it doesn't exist, what we should be doing is learning how brain activity that corresponds to the expectation of cure translates into clinical improvement."

I remain rather flabbergasted that so many people would rather ignore evidence that placebos often work than figure out what exactly is going on. How odd that the doctors who require clinical evidence before drawing conclusions on treatment will nevertheless overlook or disavow knowledge of clinical evidence that has proven, over and over, that placebos can and do work under many circumstances. So it's not clinical proof they really want; what they really want, like so many of us, is to have their own preconceived ideas to be continually affirmed.

Friday quotation (on a Sunday)

"What an abyss of uncertainty, whenever the mind feels overtaken by itself; when it, the seeker, is at the same time the dark region through which it must go seeking and where all its equipment will avail it nothing."
- Marcel Proust, Swann's Way

Dr. Howard Schubiner

Dr. Howard Schubiner, one of a handful of doctors who has joined Dr. John Sarno in discussing and treating TMS, has a notable new web site up and running. The site presents a clear overview of TMS, including four video presentations.

The site also has an online course available, for a fee. Whether or not you feel inclined to sign up (the cost is $250), the web site is definitely worth a visit for anyone seeking more information about the mind-body connection in general, and its relation to this condition that has been labeled TMS by Sarno and his followers.

Friday quotation

"If we are open only to discoveries which will accord with what we know already, we may as well stay shut."
- Alan Watts, The Wisdom of Insecurity

New study: back pain largely mind-induced

In the Daily Mail, a British paper, an article about new research that claims that most back pain is not from actual physical injury. (Note that this is no news to TMS sufferers, or followers of Dr. John Sarno.)

The study was specifically looking at trends in health following the reunification of Germany in the early '90s.

Shortly after East and West Germany were reunited, statistics show that 84 percent of West Germans were affected by back pain, compared to 69 percent of East Germans. By 2003, the percentages has just about equalized.

What accounted for the rise in back pain among residents of the former East Germany? "Researchers blame increased exposure to media reports on how back pain could be a severely disabling condition," says the Daily Mail, and quoted the published study directly:

"After reunification, all those 'myths' and misconceptions about back pain being pervasive in Western societies immediately spread to East Germany."

The study claims that only about 15 percent of back pain is actually due to a structural problem of some kind.

The Daily Mail found not too much receptivity to this idea at home, however. "British experts said if back pain is all in the mind, this is only true in a very few cases."

And right here is exactly why so many people seem to reject out of hand the idea of mind-induced pain, because it's often said to be "all in the mind." Neither traditional doctors nor many patients want to be told this because the implication is that the pain is somehow imaginary.

So let's be clear here: when people talk about the mind creating pain, this does not mean the pain is "all in the mind." The pain is still very much in the body.

Personally, I don't see what's so hard to understand about this, but it seems to trip lots and lots of people up. They hear about how the mind may create pain and think that means someone's basically making it all up.

In the case of back pain this is completely not true. The pain is real, and really happening in your body. Mind-induced pain is real, physical pain. Just like mind-induced embarrassment can turn your actual cheeks actually red.

Presuming cause and effect--an ongoing theme

"Older men with lower free testosterone levels in their blood appear to have higher prevalence of depression," according to new research in Australia, as reported in Science Daily.

This kind of linking of body chemistry to mental health goes on all the time in our biochemical-crazy age. And there's nothing wrong with linking, but our cultural predisposition is to go immediately from "link" to "cause," and that's where the mishigas starts. Here:

"A total of 203 of the participants (5.1 percent) met criteria for depression; these men had significantly lower total and free testosterone levels then men who were not depressed. After controlling for other factors--such as education level, body mass index and cognitive scores--men in the lowest quintile (20 percent) of free testosterone concentration had three times the odds of having depression compared to men in the highest quintile."

See how the biochemical fact of having low testosterone and the psychological fact of having depression (this would be a straightforward link) is converted--without any evidence--to a cause when it's phrased this way: that men with the lowest testosterone have "three times the odds of having depression." This makes it sound like low testosterone may lead to depression when it's more likely, to anyone who understands the mind-body connection, that it's the depression that leads to the low testosterone levels.

The fact that the researchers talk immediately about the treatment implications of the finding--they want to do a trial to see if treating depressed men with extra testosterone helps them--shows that as far as they're concerned, cause and effect is a done deal: low testosterone causes depression, adding testosterone to depressed men will undepress them.

It's truly hard for me to remember that people think this way, and that those people have been in charge of our view of health, and our health care system, for a long time. They see the chemical sign of a mental or emotional state and relentlessly (and, I contend, harmfully) presume--without an apparent second thought--that the chemistry causes the mental or emotional state.

Even though it is clear to an elementary school student that our mental or emotional state can obviously and clearly cause changes to our bodies. Our bodies are made up of chemicals. There is no reason not to conclude that our mental or emotional states can cause chemical changes in our bodies.

As for the potential for harm: if it's depression causing the low testosterone, there's resume to believe that additional testosterone will root out the depression, while we cannot know the side effects of fiddling with our body's chemistry unnecessarily.

Another mainstream go at the mind-body connection

This time in Parade.

I'm thinking this sort of article is largely a good thing, part of the slow, steady effort that will be required to get the general public, over time, clued in to the reality of the mind-body connection.

So of course there's the typical arms-length introduction--this "may seem like New Age thinking"; note the implication that "New Age thinking" is assumed to be foolish and wrong. And then we're walked through the subject with a focus on extreme examples (the hypnosis subjects told they were touching something very hot who develop a burn blister, for instance).

This gets people's attention, I suppose. To me, it would be much better to talk about, say, how psychogenic back pain is far too often incorrectly approached as a physical ailment (see previous post).

But we'll get there someday. We'll really have to.

Pitcher may be looking for the wrong "something "

The Philadelphia Phillies have a pitcher named Adam Eaton who had a terrible year last year. His record was an average enough 10-10 but his ERA was a league-worst 6.29. Part of his troubles were linked to back problems he has suffered.

This spring was going to be the time for the pitcher to redeem himself, but so far, so not good: he is 0-2 in two starts, with an eye-opening 15.75 ERA.

Note that the Phillies signed Eaton before the 2007 season to a three-year, $24.5 million contract.

Eaton now says he has a back injury again, or maybe it never really went away. He has been X-rayed and examined two times recently; those examinations, reports the Philadelphia Inquirer, "have shown nothing specifically wrong with his back."

And yet he is in significant pain. His conclusion: "There's got to be something there for it to feel like this."

Most definitely there is something there. I might suggest he stop looking for it in an x-ray or an MRI, however. I of course can't possibly know the situation from just reading a newspaper article, but it sure sounds like a good old case of TMS to me.

Look: he didn't do anything specifically to his back this spring, he's just feeling a lot of pain. Examinations are revealing no structural issues.

But stress? Eaton must have it coming out the wazoo. The man is earning millions of dollars a year, but gets the stuffing knocked out of him just about every time he pitches. That's got to mess with his emotional state; all the more so because, as a professional athlete, he is not encouraged to examine his emotional state in any way, shape, or form.

I feel badly for him, and wish him access to the wisdom, ultimately, that will lead to a cure. But in the meantime, I wish him off the mound! (So, okay, I'm a Phillies fan.)

Is depression caused by chemical imbalance? Um, maybe not.

"Biochemical roots of depression challenged," says the headline in an article on the Psych Central web site.

Ideally this should be a headline blazed across every mainstream web site and TV news show. This is a big big deal and it will probably get very little attention because marketplace economics are dead set against it.

Scientifically what's going on here is no new news at all. There has yet to be any conclusive, clinical proof that chemical imbalances "cause" depression. None. It was a theory that gained footing in the '60s but 40 years later, the Diagnostic and Statistical Manual of Mental Disorders, continues to tell us, in no uncertain terms, that the cause of depression and anxiety is "unknown."

Authors of a study quoted in the Psych Central article suggest that the media has played a large role in passing the chemical imbalance theory along as fact, fueled in large part by how apparently successful certain drugs were in alleviating depression.

Only--uh oh--it turns out the drugs don't work so well after all. Some recent studies have questioned how effective these drugs actually are. One study published last month suggests that most of the perceived effectiveness of several of the most common SSRIs (Selective Serotonin Reuptake Inhibitors, often prescribed for depression) is due to the placebo effect.

All of this, to me, relates to an incredible, largely unexamined bias in our day and age towards treating our bodies reductively, particularly when it comes to biochemistry and genetics. It's like every Valentine's Day when there are articles in the newspaper about the chemistry of love, quoting scientists talking about whichever chemicals that get secreted in the brain when we are in love. And the underlying presumption much of the time is that the chemical is somehow causing the feeling of love.

Western scientists truly have an irrational faith in the fact that the chemicals cause the emotions. That's how the "chemical imbalance causes depression" arose so naturally.

It rarely seems to occur to clinicians that the emotions may be causing the chemicals. That's because western scientists have such a hard time accepting the idea that the mind can impact the body so flagrantly. (Once again, I would ask: hasn't any of them ever blushed? Or seen someone blushing? Of course the mind can affect the body!)

And so with depression. No doubt a depressed individual does in fact have some chemical imbalances associated with that physical state. But all these years later there is no evidence to show that the imbalance comes first.

And here's the crazy dead-end of reductivist thinking anyway: even if the imbalance *did* come first, what then? We still wouldn't know what caused the imbalance. So the chemical imbalance theory is pointless before it even starts.

Yet it lives, and this small notice on a psychology web site is probably not enough to alert the world about how naked this particular emperor truly is.

Pain eased by more expensive pills--study

"New research shows that people who thought they were given a pricier painkiller reported less pain than those who believe they took the same drug at a discounted price."

Story on WebMD.

I also heard about this on NPR this morning, and the report there focused on the implications of the cost factor, as does this WebMD story. As one of the researchers asks, "How do we give people cheaper medication, or a generic, without them thinking it won't work?"

Two groups in the study were given sugar pills. One group was told the pills cost $2.50 each; the other was told they cost 10 cents each. Of those who took the "more expensive" pill, 85 percent experienced reduced pain when subsequently subject to an electric shock, while only 61 percent of those who took the "cheaper" pill felt their pain had been eased.

It seems to me there are many more important unanswered questions here than how do we give people cheaper drugs without undermining their effectiveness. Such as: why do we prescribe chemical substances at all when sugar pills often work just as well, as long as people think they're real drugs? Or, even: how is it that our bodies can heal themselves under the power of suggestion?

Newsweek interviews Domar

And now, Newsweek has an interview with Alice Domar, author of Be Happy Without Being Perfect: How to Break Free from the Perfection Deception. Domar is identified as "a pioneer in the study of stress and its effect on the body"; the interview here is substantive.

Note that just because I am discouraged at the strict gender presumptions (see previous post) doesn't mean that this isn't largely and legitimately a woman's issue, and an important one. And just because I, although a man, identify with some of the issues at hand, doesn't mean I don't understand that gender can, still, play a factor in the discussion. The body image problem, for instance, which Domar identifies as the "number one" perfectionist issue, most definitely--and sadly--affects many, many more women than men.

Body image problems are a particularly insidious form of mind-body disease. A woman with a body that may literally be healthy, although perhaps larger than she believes is "attractive," feels ongoing and maybe increasing stress about this perception. This in turn can cause actual physical health problems.

I read about a study once that showed that fatter women who lived in a culture in which fat was not socially stigmatized were far healthier than the same-sized women in the U.S.--far less prone to heart disease and other conditions we associated with overweight bodies. That's rather eye-opening; the implication is that some of the health problems we here automatically ascribe to the simple fact of being "overweight" may be much less straightforward than the traditional medical establishment--not to mention the diet industry--would have us believe.

This sounds like the subject of another post. And, in any case, if I can turn up the details of that study, I'll come back with more concrete information.

Friday quotation (on a Sunday)

"The universe was not made in jest but in solemn incomprehensible earnest. By a power that is unfathomably secret, and holy, and fleet. There is nothing to be done about it, but ignore it, or see it."
- Annie Dillard, Pilgrim at Tinker Creek