Keenan's Book Reviews: Cure by Jo Marchant

Over my lifetime, I’ve observed an increasing interest in the connection between mind and body. It is not a new concept, but it has gained ground and the Cartesian distinction between mind and body has eroded. However, how we are still learning how it works and the extent to which it is effective in the treatment of disease. Geneticist and science writer Jo Marchant explores these issues in Cure.

Marchant considers three areas in which there appears to be mind-body connections that have promise for use in medical settings. First is the placebo effect. Next, she looks at meditation, biofeedback and hypnosis. Finally, she discusses the effects of our viewpoint, especially how increase or reduce stress.

We are equipped with an internal pharmacy that can reduce or aggravate pain, and it can be triggered by something as vague as our expectations. This placebo affect can be as powerful as drugs at reducing pain and some other symptoms of disease, which can make it difficult to test the effectiveness of drugs. Some physicians are starting to change their minds about the placebo effect. Instead of seeing it as a problem that gets in the way of testing drugs, they are seeing it a potential substitute for drugs. The placebo effect has limitations; it can reduce pain and symptoms, but it does not cure the underlying disease or injury. There is also a nocebo effect, which causes pain and fatigue.

Another interesting effect discussed by Marchant is conditioning of the immune system. In some cases, we can prompt the immune system to have a conditioned response; we can train it. After taking a drug, the immune system can reproduce the response to the drug at lower doses. We can strengthen the conditioning by accompanying the drug with strong rituals; repeating the rituals can produce the response to some degree. This holds some promise for improving the effectiveness of drugs and reducing the dose needed to be effective, especially when a drug as serious side effects. I thought this was fascinating.

Our brain is more connected, and in control, of our bodily functions that we previously realized. Meditation, hypnosis and biofeedback can allow people to exercise control over operations of the body that were previously thought to be automatic or even independent of the brain. This includes pain, blood flow, stress response, heart rate variability and vagal tone.

Relationships also have a profound effect on our health. Strong social connections keep us young, and lack of relationships is harmful to our health. Our own compassion for others can reduce stress hormones and inflammation. When physicians, surgeons, nurses and other health care professionals care for their patients as people, those patients receiving the emotional support experience less pain and longer lives.

Marchant shows there is potential for a new way of doing medicine, or room to reintroduce older practices. By slowing down and showing genuine concern for patients, doctors can multiply the effect of their treatment. Teaching people to slow down and pay attention to their bodies, the people they love and the good things in their lives, we can take advantage of the healing capacities of the mind and body. Medicine can be less about dispensing drugs and more about lifestyle and relationship.

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