It is clear that we need our lives to have a purpose, to feel that our actions form part of something bigger than ourselves.
When Julia, a passionate and committed teacher, was forced to take extended leave from work, she had to find activities to fill the gap and to provide meaning to her day to day existence. Going from such an intrinsically fulfilling and gregarious job to a quieter, slower, less social existence would have come as a severe shock. It would have been easy for Julia to slip into a cycle of anxiety and stress leading to isolation and depression.
The amygdala is the part of the brain that begins the response to stress, stimulating the hypothalamus and in turn pituitary and adrenal glands. These glands release the hormones adrenaline and cortisol, which lead to a set of responses in the brain and body that have evolved to deal effectively with short term threats. Together, these are commonly known as the “fight or flight” response. In the short term this includes increased heart and breathing rates and cortisol stimulates the release of glucose into the blood. However, prolonged and excessive cortisol can have more sinister effects. Ongoing stress causes the cortisol to suppresse parts of the immune system and can even damage the hippocampus, the part of the brain which processes and stores memories. Therefore, Julia’s emotional state would have a profound effect on her body, as well as her mind.
It is this link between one’s mental state and physical health that is explored in Jo Marchant’s fascinating new book, Cure: a Journey into the Science of Mind Over Body. In it Marchant explores the scientific evidence behind everything from honest placebos to religious belief via mindfulness, social ties, hypnosis, fake surgery and training one’s immune system.
Her approach might be described as, “open-minded scepticism.” She comes from a scientific background, having gained a PhD in genetics and medical microbiology, and has edited New Scientist and Nature, as well as contributing to the Guardian and Economist. As she makes clear in the book, Marchant does not believe in magic or the supernatural.
H0wever, she realised that the modern sceptic movement has often shunned certain ideas on principle, dismissing claims about complementary and alternative medicine out of hand, rather than engaging with the evidence. This book is a welcome departure from the usual polar arguments which tend to boil down to: “I believe this!” “Well, you’re wrong, and an idiot!”
Marchant also brings her analysis to life. Unlike a purely academic approach that only analyses the design and outcomes of the studies described, or the purely narrative style of anecdotes strung together to support an argument, in Cure she has sought out and interviewed the individuals involved while simultaneously casting a critical eye over the methods and conclusions of the practitioners and academics she meets. The personal stories of the subjects and researchers taking part in the various trials she uncovers bring the data alive. This is wise and necessary; in this field the link between the data and the human experience is not merely interesting, it is integral to the meaning of the research.
She also seems to avoid simply aiming to prove a theory that she held before beginning her journey. Rather, it is as if she has set out to say, “There is clearly something going on here. It’s not magic. So what is it?”
The answers are fascinating, surprising and enlightening. If you were to boil her findings down to some simple advice, some of it would mirror the kind of guidelines offered by mental health organisations: maintain supportive relationships, keep your mind active, focus on the present, practice gratitude. In Cure, Marchant reveals the importance of these aspects of our mental wellbeing to our long term physical health, and how our strongly our physiology is affected by our expectations, beliefs and emotions. Pain can be alleviated by pretend medicines, immersive computer games and hypnosis. The harmful long-term effects of stress hormones may be suppressed by practicing mindfulness, being compassionate, maintaining positive friendships and even prayer. The expression of genes controlling our immune system is affected by our outlook on life and the messages we hear from those caring for us.
Throughout this book Marchant maintains a level-headed attitude towards her subject, balancing scepticism with an openness to what is shown by the evidence. Much of the research she describes is in its infancy, and is still seen among many in the scientific community as a fringe endeavour. However, one can hope that the healthcare system will take increasing note of the evidence linking people’s minds and their health. Optimistically, we may then see some reduction in our Western dependency on medicines and physical interventions simply by acknowledging the importance of human thoughts and interactions in maintaining health. If we can do this without the need of charlatans and quacks, but instead through a rational analysis of the links between the mind and body, all the better.
While initially upset by her unplanned absence from work, Julia soon decided not to dwell on the frustration of her situation. She instead made new friends and strengthened those relationships that provided the most support. She pursued her interests and found new challenges. She embraced the opportunities offered by her situation. She learnt about mindfulness. Realising she was already living in the present most of the time, she decided to try meditating every morning. These choices would of course help her to avoid the mental health problems associated with traumatic experiences. As Cure makes clear, they are also likely to have improved her chances of living a long, healthy life and reducing her chances of developing many chronic illnesses.
When I met Jo Marchant at a book signing after her engaging talk on Cure at the Hay Festival, I asked her to address her dedication to a fifteen year old school student. She thought for a minute, and wrote, “The effect of the mind of the body isn’t mysterious or magical, it’s just biology.”