Relaxing with Rob

Return to Wellness

March 29, 2020 Rob Sepich Season 1 Episode 41
Relaxing with Rob
Return to Wellness
Show Notes Transcript

Our beliefs about illness may sometimes help in our healing. These authors share insights on how this occurs:

Rilke's book (Stephen Mitchell translation for Kindle)

Jerome Groopman's Amazon page

Kate Bowler's book

The PLOS ONE study on placebos for IBS

:

[ music ] . Hi, this is Rob Sepich, and welcome to Relaxing with Rob. When you're feeling under the weather, do you fight it, think it's not fair, and wonder, why is this happening to me, and how long is this going to last? Or do you think, hmm, okay, this is too bad, but it's probably temporary, and maybe I can even learn something in the process? Of course, there are lots of other responses, but I'm asking you to think for a moment about your typical reaction, because this can have a big effect on your recovery. And you can change your response. When I'd have a cold, my mother-in-law liked to remind me with something like, "Now Rob, an untreated cold could last for 14 days! But if you treat it, it'll be over in two weeks." Today, I'd like to talk about the power of belief, and how some beliefs can help your body's ability to return to wellness. I'll share some ideas from literature and science as well as a personal example. In Rilke's "Letters to a Young Poet," he asks, "Why do you want to shut out of your life any agitation, any pain, any melancholy, since you really do not know what these states are working upon you?" And a little later in that same paragraph he writes, "If there is anything morbid in your processes, just remember that sickness is the means by which an organism frees itself of foreign matter; so one must just help it to be sick, to have its whole sickness and break out with it, for that is its progress." To me, his lesson here is patience and the opportunity to learn something in the process. Maybe your lesson could be "slow down" or "ask for help" or some other type of self care. For me it was often, "Hmm, the world still seems to rotate on its axis when I'm sick and miss work. Apparently life goes on." It was humbling, but also kind of comforting. But please don't go too far to find meaning in your illnesses. Several authors have cautioned about the dangers in looking for explanations for tragedies and serious illnesses. Most recently, Kate Bowler's best selling book, "Everything Happens for a Reason: And Other Lies I've Loved" does a great job dissecting platitudes, and offers much more helpful responses. At age 35, she was diagnosed with stage IV colon cancer, so she speaks with personal experience. Bernie Siegel, the former surgeon from Yale, would distinguish healing from curing. In our culture, we often think that anything short of a cure is failure. How often have you heard the phrase that somebody "lost their battle" with cancer? You know, Siegel wrote about many of his patients who actually experienced healing even as they were dying. And now let's talk science. I am fascinated with research on the placebo effect. That's the well-established finding that for some illnesses, many of us--often about a third of us--get better after receiving a fake treatment like a sugar pill. So our improvement can only be attributed to our beliefs about the treatment. Deception is involved, but it works. In the U.S., medications that are being developed have to outperform placebos in order to be brought to market--just makes sense. And while it's true that for lots of health issues, one in three do improve from placebos. But when the provider also believes in the treatment, and when there's a trusting relationship between the patient and provider, the effect is even much stronger. Instead of thinking dismissively about the placebo effect, Herbert Benson from Harvard called it "remembered wellness" (I just love that phrase) to indicate that this can be seen as our ability to remember that health is our natural state, and quite often, we can get back to it. How does this relate to stress? Well, as I've said before, short-term or acute stress is not a problem, but chronic stress definitely interferes with our ability to return to wellness. Among other things, it significantly impairs our immune system. We just don't heal very well, or at least not very quickly. I've never advocated for the use of alternative practices in place of evidence-based medical care. But I do encourage the use of some of these like relaxation and mindfulness as adjuncts to more widely accepted practices. For example, with both of my cancer diagnoses, I did not say to my doctors, "Never mind about surgery; I've got some crystals and magnets that should do the trick." No, I was an informed healthcare consumer, an active partner with my team. And in addition to biopsies and surgeries, I changed my diet, used relaxation, music, humor, and a support system. And although I had some pain, I really did not suffer. And I got back to work, barre3, and Zumba much faster than my doctors were expecting. Okay, back to placebos. I'd just like to tell you about two studies. There was a randomized controlled trial published in 2010 in the Public Library of Science (PLOS ONE) on open label placebo for irritable bowel syndrome. In other words, patients with IBS knew they were getting a placebo, compared to a no-treatment control group. What did they find? Are you ready for this? The placebo group had almost a 60% improvement in terms of symptom relief and quality of life. This was the first study to show that deception wasn't even necessary to get the placebo effect. Then three years later (in 2013) a study from Finland that was published in the New England Journal of Medicine addressed the placebo effect for arthroscopic knee surgery for patients with a torn meniscus. At the time, that was the most common orthopedic procedure in the U.S., done about 700,000 times a year at a cost of around $4 billion. The volunteer patients all received anesthesia and incisions and stitches, but some received actual surgery, and others, sham procedures. Patients did not know which. A year later, most patients in both groups said their knees were better. They would choose the same method again, they said, even if it was the fake method. Now today for some people, arthroscopic knee surgery remains an effective procedure. It really depends on the type of injury and who you are. But for others, research is showing: not so much. In the class I taught, we spent much more time than this looking at studies on the placebo effect. But let me just say that I am amazed at how powerful it is. And that's why I do not question other people's beliefs unless I think they could cause them harm. Jerome Groopman from Harvard's Medical School investigated patients' beliefs in order to debunk their false hopes. But instead, he became a convert, and he published a bestseller in support of many of them called "The Biology of Hope." He does an excellent job explaining the changes in our brains and bodies and immune systems that come from hope. For your convenience, I'm placing links to his books as well as Rilke's and Bowler's in the show notes. These are non-affiliate links, so if you purchase something, I don't receive anything. And I also encourage you to purchase from your local bookseller or borrow them from your library. So your mission, should you choose to accept it, involves identifying your beliefs about illness, and if you'd like, modifying them. Remember episode 40, "Edit Your Life?" This is within your power. For example, Rilke's ideas might help you become more patient with illness. Maybe find some self-care practices that could help in your healing. Groopman's research could support your beliefs with science, proving that it's not all in your head--it's also in your immune system. And finally, Bowler's insights might help steer you away from platitudes about life threatening diseases and into some territory that simply rings true for lots of people. Regardless, I would like to thank you for listening, and we'll talk again soon. [ music]