getting to know you

Getting To Know You: shaping the healer within

by Barry Bittman, MD

What do you bring to your physician’s office?

You’re probably thinking about medical records, x-rays and insurance cards. You might be considering a list of medications, notes about past medical illnesses or a diary of events that led up to the visit.

Yet, what I’m referring to is what you really bring¾ the stuff that cannot be separated from who you are.

During a recent presentation at our conference, Speaking from the Soul, Herbert Benson, MD, Chief of Harvard’s Mind-Body Medical Institute discussed the concept that our response to any medical intervention depends principally on our prior experiences that have shaped our beliefs. He proceeded to review the history of medicine in the context of what actually determines the effectiveness of therapeutic interventions.

Essentially medicine less than one hundred years ago had little in the way of scientific foundation. Of interest, however, is the fact that with the exception of serious infections and trauma, most people responded favorably to the medical care of that era. Yet as science and technology evolved, almost every practice of that and preceding times fell by the wayside.

With the development of pharmaceuticals, drug testing soon set the direction for medicine as a science while the “art” began to fade. Improved sanitation and radical breakthroughs in the development of antibiotics conquered devastating infectious diseases that threatened to wipe out every industrialized nation. Sterile surgical techniques paved the way for safe body repair. Childhood mortality rates were dramatically cut and people began to live longer than ever.

Scientists strove to develop treatment strategies that worked regardless of what the patient believed. As a result, the placebo came into being as a necessary means for testing the real drug. If research showed that the real drug produced effects greater than those associated with the placebo, the drug became the standard of care. Yet with the application of a sound scientific method, the baby was thrown out with the bath water.

What is the baby in this case? It is no less than the reliance on our basic belief system that enables us to heal. It is the stuff that worked thousands of years ago. It is also the principal factor that determines our response to modern medical therapies. While you may be doubtful, consider the following:

Dr. Benson presented a fascinating study illustrating that belief or expectation goes a long way in determining outcome. A group of patients who were suffering from pain associated with stomach contractions (spasms) were studied. Each swallowed a tiny balloon that recorded the number and intensity of contractions. Patients were subsequently told that they were about to be given an oral medication to relieve their symptoms. Each person willingly took the drug.

Not surprisingly, what followed was a marked reduction in symptoms for most of the group. You’re probably saying “So what?” Take a moment to consider the fact that each subject actually received Syrup of Ipecac¾ a drug commonly used in the emergency room to induce stomach contractions and vomiting in suspected poisonings and overdoses. Not only did the subject’s belief system reduce recorded contractions and painful spasms, it also countered the known effect of the drug!

Essentially our response to any therapy depends on a number of factors that shape our beliefs and expectations. Some of these have been with us since childhood and are difficult to track. Others are obvious. Consider the following examples:

Your best friend, severely depressed for years, was given Drug A and experienced a remarkable turn around within months. A year later, your doctor suggests Drug A for your symptoms. In addition to the potential neurochemical effects, you are likely to experience a rather positive response to the same drug.

On the other hand, consider a scenario in which your obnoxious boss takes Drug B, and numerous television newscasts report bizarre side effects associated the drug. A few months after hearing those reports, you become anxious and depressed. A visit to your physician results in a prescription for (you guessed it) Drug B. If you make it out of the office without a panic attack (and that is a big “if”) imagine your response to the drug the next day. Despite the opposite effects noted in the above examples, Drug A and B are identical.

In conclusion, while mind and body are inseparable, there’s no degree of belief that could logically substitute for eradicating Polio with a vaccine, surgically stopping the bleeding of an open wound, or filtering blood through a dialysis machine when one’s kidneys have shut down. Pharmaceuticals, surgery and technology have certainly advanced modern medicine.

Ultimately, exceptional “whole person” care requires a synergy of art and science since our beliefs clearly play an important role in our biological responses. Remember, it’s the stuff that you bring to your doctor’s office that makes all the difference¾ Mind Over Matter!