Monday, January 2, 2017

Intention: Radical Medical Science and Its Consequences

Happy New Year!

There's this thing where people say "Oh man, good riddance to  last year!"

For me, 2016 was a pretty great year. It had its bad moments..., and of course there was the election. That was just a whole lot of unpleasant. Anyway, we ring in the new year, hoping, even intending it to be better than last. We make new year's resolutions, which is a way of saying "I'm going to do better, be better." Intent is what drives new choices. When we aren't honest about our intent, or when we don't fully understand our intent, things may not work out in favor of our resolutions. Our resoluteness seems feckless, and we feel guilty. But if we really understand what we want, we can either accept who and what we are, or work to realign our intentions.

New Year's Eve we had a party, and we were talking about this idea of intention and and behavior change with respect to smoking, and we all agreed that what's really hard about quitting is that smoking is just so great. It's contemplative, these days it's often private (as smokers have gotten pushed outdoors), and it comes with a dopamine hit with every puff.

Get the patch. Use the gum. You still get the dopamine hit..., but you don't get the behavior. It's the act of smoking that makes it so successful. In fact any "addiction" is one part neurochemistry but an equal part behavior. Behavior includes the people you do the habit with, the lifestyle, the "hobby" of it, including all the little gadgets, or brands, or devices that go along with it--whether you're talking about the iconic red and white packaging of Marlboro cigarettes, the craft of marijuana smoking pipes, or one's "works", the syringe and needles of injection drug use.

Yes, I know that many addicts aren't so fancy about such things, but the social aspect (for example, hanging out with other junkies, who may also be your friends) validates my point. Addiction is as much behavioral as it is neurochemical.

Anyway, I'm going to turn my attention to the title of today's blog: radical medical science. I am appropriating this term to mean the medical science advocated by so many thought leaders in what has been called "new age" medicine, in which it is said that the use of intention, directed thinking and belief, creates a new health reality. Self-help guru Anthony Robbins, physician Deepak Chopra, author of guided imagery audio CDs Belleruth Naparstek, and The Intention Experiment's Lynne McTaggart are just a handful of those who argue that nature demonstrates to us that our thoughts can reshape reality.

I'll get to the point here: I happen to think they are right. What I don't know--and no one seems to--is how much we can reshape reality, and how it actually works.

Throughout my recent entries, I have maintained a theme that emphasizes the limits of today's material-based understanding of Nature, and specifically, of our own biological nature and the implications of that for Health and Medicine. In other words, today's science of medicine is based on a model that reduces every aspect of health to a process that can be isolated and understood, and from there we can develop specific therapeutics to fix those processes that are "broken." The problem is, this model doesn't fully explain why some people get sick and others do not. It doesn't fully explain why some people respond well to treatment and others don't.

Environment, genes, and psychological and social stressors do explain, to some extent, some of these differences, but not reliably so. When Tony Robbins urges one to "Change your physiology" he's taking some liberties with the scientific meaning of "physiology" but what he means is essential, since he is arguing that changing the way you think and feel about being physically, mentally, and spiritually in the world will change the way you are in the world.

I've tried this. It mostly works.

My wife had an uncle who was a Hindu monk for many years, and it was told that he developed a tumor in his neck. I was further told that he meditated it away.

Now I've never been able to fully verify this story as medical fact, but it doesn't matter, because there are literally thousands of other stories out there like it. Some people believe that their god will heal them, and he does, or so they believe. Whether it is their belief or not is beside the point, since at its most basic, whether it comes from within or is thought to come from without really rests upon the idea that everything comes from within. To will away a tumor, or to believe that God will do so is, essentially, a belief that there's a force that overcomes the destiny of matter.

I have also seen this not work, plenty of times. There was the Christian Scientist I was asked to see several years ago. CS is a school of religious thought that argues that all failures of the material of our bodies is mere failure of belief. Unwilling to accept any form of "regular" medicine, her home care nurses asked me to see her in her home because they felt that perhaps someone in alternative medicine might be able to accomplish what all the exhortations of the nurses and doctor couldn't. I saw her, tried homeopathy, suggested some simple ways to address the ulcers she was suffering from, yet her belief was firm: God would provide. She died within two months of my seeing her.

Was this a failure of belief or a conflict of beliefs? After all, she could hold a belief in the healing power of God and her belief that she would be received into the afterlife with Him.

In 1978, novelist and essayist Susan Sontag argued that metaphors for illness are unhealthy, and that they impose a kind of guilt trip on the ill person, much in the way that Christian Science implicates the faith (or lack of faith) of the ill. She further argued that to impose such an implication was itself a kind of social punishment: After all, it must be you who failed if despite your will, you died of cancer anyway!

This theme has been repeated by many others writing about their cancer (or other disease) experience. Coincidentally, writer and professor Norman Cousins published Anatomy of an Illness: As Perceived by the Patient, in 1979. After being diagnosed with ankylosing spondylitis (a usually-crippling disease) he fired his doctor and undertook a regimen of vitamin C, healthier eating, and laughter, reportedly checking into a hotel and watching comic movies to improve his mood. He was said to have "laughed his illness away" and outlived his doctor's dire prognosis by more than 2 decades.

In 1992, researcher Lydia Temoshok published The Type C Connection in which she shared her research about the connections between emotional self-repression and risk for cancer development--diametrically opposite to Sontag's attempt to relieve the sick of their "guilt" for having gotten sick in the first place. Research in psychoneuroimmunology has demonstrated that the minds of laboratory animals can be conditioned to make themselves sick, by directly manipulating their immune systems.

A comprehensive review of the research and philosophy surrounding this question is beyond the scope of an online blog. But what I have here is enough to establish a few important points:
  1. The mind definitely influences what happens to the body, whether we mean risk for illness or hope for recovery and cure.
  2. We don't really understand how this works or what its limits are.
  3. Assigning blame to an ill person because of these facts is both unkind and a failure to admit how little we know about consciousness and its influence on health.
It's possible that thought itself may be less controllable than we believe. We are taught that there is the world of the body and the world of the mind. So we have medicine and biology to address the former, and psychology and theology to address the latter. This dualism is, I believe, a fundamental failure of today's medical philosophy.

In homeopathic medicine, the state of imbalance of the "vital force" described by homeopaths itself leads to behavioral abnormalities and disturbances. In short, "mental" illness is both material and energetic and not fully amenable to "self" control. Interestingly this squares with the work of today's neuroscientists, who postulate that those things we believe are our "thoughts" that are under our "control" themselves arise before we could possibly "think" of them. In other words, brain science suggests that volition is illusory: we have a thought before we think we thought the thought!

In nursing science, the late Martha Rogers argued that there was no separation between the body and the mind, that they are co-located in a perceivable body, but also extensive beyond the border defined by the body itself. Nurse researcher Elizabeth Barrett writes about the "simultaneity model" of human existence (and one could ask, of all life forms?) in that what we think, and what we are, materially, in the world, are inseparable, and that a full understanding of human health and disease will elude us until we reconcile ourselves with this fact.

Of course, that makes ordinary medical treatment of our day to day sufferings in The Factory problematic. It also makes our social construction of health and illness difficult for ordinary people to navigate. To say someone "bravely fought" against cancer (and lost), as I read often in the local obituaries could say they didn't "fight" hard enough, or that their aim was untrue, or that they harbored a hidden death wish. But to say that their will doesn't (or didn't) matter seems to contradict our observations and a growing body of scientific research that that suggests it does matter.

How do we understand that? How do we unlock its potential? And how do we do so without condemning those who get sick to guilt and those who do die to posthumous humiliation?

I'll write about this more in upcoming blogs. Happy new year.

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