Mind Over Matter

Literally, mind over matter would refer to psychokinesis, the capacity to move objects by mind power alone. There has never been any evidence that this is possible and any claims to the contrary are usually extremely untrustworthy. The popularity, however, of ‘alternative’ cures in medicine is widespread and popular and, despite lacking any credible rationale, people often seem to benefit from them. Most alternative medicines have no scientific basis. Homeopathic medicine, for example, is often so dilute that it contains no molecules of ‘active’ ingredient.

Acupuncture and reflexology are based on bizarre, ancient theories with no anatomical logic.

Despite that, many people swear all by these methods.

Suggestion is a powerful force. ‘The Placebo Effect’ (literally “I shall please”) refers to an alleviation of symptoms due to the belief that one is being treated and the expectation that one will get better (in addition to any physical properties of the medicine). Placebos range from dummy pills and sham surgery to encouraging words, like “you should be better in a couple of days”. They are routinely used as controls in the evaluation of treatment and are often extremely effective. Placebos are not the same as no-treatment or ‘wait-list’ controls in that they usually give some degree of added value. Other components to the Placebo Effect that clinical trials usually try to minimise include the doctor-patient connection and assurance that the medicine has ‘clinically proven’ potency. There is also regression to the mean; patients usually seek help at times of peak distress and so they are likely to improve simply on the ‘law of averages’ and because the crisis point has been reached.

Subsidiary tools are also useful in conjunction with placebos. Symbols of medical authority, such as diplomas on the wall, white coats and stethoscopes, enhance the placebo effect. Warm coloured pills are better as stimulants and cool-coloured pills are better for anxiety and insomnia. Pills work better when they are large and expensive and two is better than one. Capsules are more effective than tablets, while injections beat both. In spite of all that, not everyone responds to placebos and they are ineffective for certain conditions, such as blood poisoning. Apart from the placebo, state of mind can have a significant effect on health.

Individuals who respond most to placebos are high in optimism and, if people believe there will be an effect, there often is. In general, feelings of well-being reduce overall mortality and, by contrast, negative life events such as divorce, the death of a loved one, the loss of a job, catastrophes and earthquakes can have negative health consequences.

Psychogenic factors affect the ability of the immune system to fight off various diseases, including cancer. Research has found that patients who had suffered neglect or maltreatment when younger are at greater risk of their disease returning when they face a major current stressful event. The reason appears to be that many diseases are normally contained by the immune system, which may be impeded by life stress. Chronically stressed people are also more likely to contract a cold when exposed to the virus, because their immune functions have been depressed.

A procedure that attempts to mobilise psychological factors in the treatment of disease is called ‘guided imagery’. Patients are helped to focus on dream-like scenarios that induce feelings of safety, relaxation and happiness. Another procedure different to guided imagery is to have patients imagine their immune system attacking their disease. These approaches can be supportive in reducing pain and distress, but they have less impact on physical symptoms and there is no evidence that they can actually cure any serious disease. Another psychological treatment is biofeedback. A fundamental principle of learning is that knowledge of results is helpful. Biofeedback works on the theory that if people are able to monitor their own physiological processes with devices, such as the EEG, ECG, skin conductance or skin temperature, they are better able to take control of them. There is abundant evidence that this is a useful adjunct to therapy for conditions such as anxiety, panic and age-related diseases.

Psychological treatment is also important for problems with a psychological cause.

Conversion disorders are conditions such as paralysis, blindness and amnesia that are apparently psychogenic. Conversion disorders are so-called because psychological stress is presumed to have been ‘converted’ into a physical disability. Placebo treatment might be effective, but it is also usually necessary to have extended psychological treatment. Hypnosis is one very effective treatment for this type of disorder, as it can be with many problems.

Hypnosis provides a powerful example of the power of suggestion and its effects go beyond simple role-playing. Again, hypnosis cannot make any material difference to physical ailments, but it can work with psychological ones. For example, patients may be told they can make speech with confidence or that their cigarettes taste foul.

Mind and body are clearly intertwined and few disorders are purely physical or mental. For example, peptic ulcers were once thought to be entirely due to stress, but then it was found that 80 per cent involved the bacterium, Helicobacter pylori, and would respond to antibiotics. Psychosomatic effects are real, not illusory. Their action can be observed in the brain and they have a powerful impact upon people’s health. They need to be studied in order to control their harmful effects and to harness them to people’s benefit. It may not always be ‘mind over matter’, but mind certainly does matter.