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21.07.2014
When 2013 began, many people doubted if it was possible for Rafael Nadal to win a Grand Slam again. At a time when many had written him off, never did Rafael Nadal feel that he was not good enough to return and take the tennis world by storm once again.
It is not possible to simply come back from a career threatening injury and start hitting the big shots. For a long time, Nadal relied on his physicality and bulk to power ahead of his opponents.
Nadal will end 2013 with an estimated $75 million in his kitty but the figure would probably not excite him as much. Simply believing that a treatment will work may trigger the desired effect even if the treatment is inert – a sugar pill, say, or a saline injection. Science writer Jo Marchant investigated the healing power of the mind for her new book, Cure.
Jo Marchant holds a doctorate in genetics and medical microbiology and has written for New Scientist, Nature and Smithsonian.
While researching the book Cure, science writer Jo Marchant wanted to understand how distraction could be used to nullify pain, so she participated in a virtual reality experiment.
One thing that people often don't realize about the placebo effect is there isn't just one placebo effect. During the first part of the experiment, Marchant sat, without distraction, with her foot in a box of unbearably hot water. But then Marchant put on noise-canceling headphones and began to play a snow-and-ice-themed immersive video game that had been developed specifically for burn patients.
During the course of her research, Marchant also investigated the science behind the placebo effect, hypnosis, meditation, prayer and conditioning.
Even with altitude sickness, for example, if somebody at altitude takes fake oxygen, you see a reduction in … prostaglandins. Some of it seems to have to do with stress and anxiety — if we feel that we are in danger or under threat, the brain raises its sensitivity to symptoms like pain.
The basic idea [of mindful meditation] is that you try to focus on the present moment rather than worrying about the past or the future. There is some evidence suggesting that mindfulness meditation can make us more resistant to infection and that’s everything from winter colds to slowing the progression of HIV and that it gives people a better response, for example, than flu vaccine. With a stress response, the brain and the body are influencing each other in both directions, so if we see a danger then that’s going to make us feel stressed and one of the follow-ons from that is that our breathing is going to speed up. Based on what we've learned about the placebo effect, there is good reason to think that talking to your pills really can make them do a terrific job.
Simply believing that a treatment will work may trigger the desired effect even if the treatment is inert - a sugar pill, say, or a saline injection. Last night, I noticed that I was shivering while having a conversation outside after dinner.
As part of the autogenics training course, we were encouraged to use imagery that calms us in such a way that it leads to a slower heart rate, lower blood pressure, and general relaxation.
This appealed to me because I have used similar visualization techniques since childhood, so I knew that it works for me. Instead of having to stand there for five to 10 minutes picturing myself bundled up in multiple blankets …while drinking chamomile tea…in front of a bonfire…on a hot summer day…I simply told myself “My body is warm and relaxed.” Just like that, my brain switched gears.
My brain has associated the autogenics verbal cues with a feeling of relaxation, and my body reacts accordingly.
Cynthia has practiced meditation most of her life, although she didn’t realize that was what she was doing when she was a child. Cynthia is actively involved in social change movements, and she believes that meditation is integral to healing our society’s collective wounds.
Not only did Nadal believe this but he actually worked towards a goal by planning his comeback shrewdly and easing into tennis games before the big championship at Roland Garros in June 2013. Physical prowess is great but it is Nadal?s mental fortitude that has been the mainstay of his rise to the top of the game.
He couldn?t even fathom how his compatriot Novak Djokovic was able to stick to a gluten-free diet.
For a wide range of conditions, from depression to Parkinson’s, osteoarthritis and multiple sclerosis, it is clear that the placebo response is far from imaginary. This time, when the researcher applied the same burning pain to her foot, she barely noticed it. She says that the healing power of the brain could offer a powerful complement to modern medicine.
I think, first of all, there is some evidence that honest placebos still work, so there are studies in various conditions, for example — irritable bowel syndrome, headaches, hyperactivity disorder — where patients have received placebos but they knew they were placebos and still got a benefit from that.
There was another study suggesting that people with psoriasis responded better to their medication when they also had mindfulness training. If you were to speed up your breathing on your own, you’d probably start to feel a bit more aroused and on edge.
The way we think and feel about medical treatments can dramatically influence how our bodies respond. For a wide range of conditions, from depression to Parkinson's, osteoarthritis and multiple sclerosis, it is clear that the placebo response is far from imaginary. It wasn’t really cold, but I couldn’t stop shaking (perhaps in anticipation of today’s blizzard). I no longer felt cold, and I stood outside for quite a while longer without any discomfort. I’ve been combining autogenics (a form of self-hypnosis) with Neurosculpting® ever since, occasionally with clients but mainly as a way to help my mind wind down at the end of the day. For “My body is warm,” we could imagine scenes such as sitting in front of a warm fire, curling up under a blanket, or standing outside in the hot sun. The added bonus now is that, when I sit in meditation for extended periods of time, my brain becomes even more familiar with the specific verbal cues that are used in autogenics. Whereas my ideal days include extended time for meditation, I can draw on those same techniques even while I’m going about my daily activities.
She discovered Neurosculpting® as part of her preparation for a transformative trip to post-earthquake Haiti in 2012. She enjoys bringing Neurosculpting® into spaces that are focused on creating a better world for us all, and providing a safe, nurturing environment for those who desire to cultivate compassion and empathy.
But his sheer hunger to come back and his incredible passion for tennis is evident today as he ends the year as the number one tennis player in the world. Since the injury though, you can see subtle changes in Nadal?s playing style that will help him increase his career.
He has perfected the ability to stay away from all the distractions and rewards to simply stay focussed on his game. Indeed, the sheer humbleness and his child-like happiness at winning is what makes him so adorable. Trials have shown measurable changes such as the release of natural painkillers, altered neuronal firing patterns, lowered blood pressure or heart rate and boosted immune response, all depending on the beliefs of the patient. So, for example, if you take a fake painkiller, that actually reduces pain-related activity in the brain and the spinal cord and it causes the release of natural painkillers in the brain called endorphins.
And, equally, if you calm the breathing down, you’re kind of forcing your body into a more relaxed state and you will then experience probably fewer negative thoughts as a result.
If you play violin for eight hours a day, then the parts of the brain responsible for helping you to play the violin will get larger. I reminded myself that the temperature was tolerable, as I stood there wondering why my body was behaving as if I were standing in the middle of a huge freezer. I like the familiarity of the Neurosculpting® structure, so I have enjoyed playing with ways to combine it with other meditation modalities. All of that said, today I’m grateful to be bundled up at home as I watch the beautiful snow fall outside. In the midst of massive trauma, a meditation she had learned from Lisa Wimberger is what allowed her to navigate an intensely difficult situation on the ground in Haiti. In its own way, her doctoral dissertation is intimately connected to the meditative work that Cynthia is so enthusiastic about.
There is even evidence that some drugs work by amplifying a placebo effect – when people are not aware that they have been given the drugs, they stop working. And these are actually the painkillers that opioid painkillers are designed to mimic, so it's working through the same biochemical pathway that a painkiller would work through. And these are actually the painkillers that opioid painkillers are designed to mimic, so it’s working through the same biochemical pathway that a painkiller would work through.
We can all be conditioned to have different physiological responses to a stimulus like that, and that works not just for salivation, but for things like immune responses. What there’s less research on is whether that feeds through into benefits for the immune system and sort of more physical health benefits, if you like. If you’re thinking stressful thoughts for the whole day then those parts of the brain are going to get larger and other parts of the brain will deteriorate. There is even evidence that some drugs work by amplifying a placebo effect - when people are not aware that they have been given the drugs, they stop working. She was immediately hooked and jumped at the chance to undertake the Tier 1 facilitator training in 2013.
But if a patient with Parkinson's takes a placebo that they think is their Parkinson's drug, they get a flood of dopamine in the brain, which is exactly what you would see with the real drug.
But it's undeniable that the mind influences the body, and some scientists are trying to better understand that relationship so that it can be harnessed in the treatment of pain, inflammatory and autoimmune diseases, heart disease, depression and other problems. So, for example, if you take a pill that suppresses your immune system, later on, if you take a similar looking placebo pill, even if there’s no actual active drug in there, your body will mimic that same response.
Since then she has also completed Tier 2 training and is excited about contributing to the expansion of the Neurosculpting® modality.
My guest, Jo Marchant, is a British science journalist who's written a new book reporting on what scientists are learning about what the mind can do to promote healing and why it can do it. So I think we need to try and understand those things and think how we can incorporate those elements into medical care routinely, rather than, for example, relying on fake pills. She also examines what the mind cannot do and what claims made by alternative medicine go too far.
She has a PhD in genetics and medical microbiology and has written for New Scientist, Nature and Smithsonian.
These actually work to dilate blood vessels and they cause many of the symptoms of altitude sickness. In a lot of research studies when people improve but they've just been given, like, a sugar pill as opposed to the real medicine, it's dismissed as the placebo effect. It didn't do anything, so the fact that you improved - we're just going to dismiss that and write it off to the placebo effect. But now some researchers are trying to harness the placebo effect, figuring, like, if a sugar pill could make some people feel better, what's going on and how can we use that to help them feel better?
Whereas, on the other hand, if we feel that we are safe and cared for and things are going to get better soon, we can kind of relax, we don't need to be so alert to these symptoms.


So can you describe a little bit what this effect is - like, how researchers are trying to harness the placebo effect as something we can use to heal ourselves?JO MARCHANT: Sure, so it's true that in some cases, people would have got better anyway, so there isn't, you know, very much that we can harness there.
But what neuroscientists are finding is that taking a fake medicine, something that we believe to be something that's going to help us, really also has measurable biological effects on the brain and the body. If listeners are familiar with Pavlov's dogs, so this is the idea that a physiologist called Ivan Pavlov conditions dogs so that whenever he gave them their food he would make a noise, like ring a bell for example, and eventually they came to associate the bell with their food and they would salivate just to the sound of the bell. So for example, if you take a fake painkiller, that actually reduces pain-related activity in the brain and the spinal cord and it causes the lease of natural painkillers in the brain called endorphins. So, for example, if you take a pill that suppresses your immune system, later on, if you take a similar looking placebo pill, even if there's no actual active drug in there, your body will mimic that same response. Your body has learned that response and that just happens automatically; it doesn't matter what you believe about the pill. And even with altitude sickness, for example, if somebody at altitude takes fake oxygen, you see a reduction in neurotransmitters called prostaglandins. And these actually work to dilate blood vessels and they cause many of the symptoms of altitude sickness.
So what you see in all these different conditions is that taking a placebo - or to be more accurate about it, our response to that placebo can cause biological changes in the brain that actually ease our symptoms. And that's probably all down to things like just being in a trial, the feeling that you're being helped can have those effects on the brain. So you don't necessarily have to lie to people, but beyond that, I think what we need to do is try and understand what are the active ingredients of placebo responses — whether that's expectation, which is then influenced by all different things, such as your previous experiences with treatment, what you're told about a treatment, how sympathetic your physician is. Like, what explains that the proper hormones are released when people take a placebo depending on what their needs are and what they think the placebo's going to do?MARCHANT: There are lots of different things that are feeding into it.
Just as there are different mechanisms of placebo, there are probably different factors that play in all of them. You know, if we feel that we are in danger or under threat, the brain raises its sensitivity to symptoms like pain. If we see a lot of people around us who are getting sick, we're more likely to feel sick ourselves. There have been hundreds of studies on mindfulness now, and there's very good evidence that it reduces stress and anxiety, and that it reduces symptoms such as chronic pain and fatigue. And there's a good evolutionary reason for that because if people around us are getting sick, perhaps we've also eaten something that might make us sick and we need to be sensitive to that, whereas on the other hand, if we feel that we are safe and cared for and things are going to get better soon, we can kind of relax. So that's very well shown now in the analysis of lots of different studies, and that's in healthy people but also in people with depression or people with serious illness. What there's less research on is whether that feeds through into benefits for the immune system and sort of more physical health benefits, if you like. So this is the idea that - a physiologist called Ivan Pavlov conditions dogs so that whenever he gave them their food, he would make a noise, like ring a bell for example.
And eventually, they came to associate the bell with their food, and they would salivate just to the sound of the bell. And we can all be conditioned to have different physiological responses to a stimulus like that. If you were to speed up your breathing on your own, you'd probably start to feel a bit more aroused and on edge. So for example, if you take a pill that suppresses your immune system, then later on if you take a similar-looking placebo pill, even if there's no actual active drug in there, your body will mimic that same response. And, equally, if you calm the breathing down, you're kind of forcing your body into a more relaxed state and you will then experience probably fewer negative thoughts as a result.
When we're stressed, our brains almost come up with negative thoughts to try and explain why we're stressed, if you like, if you're kind of anxious or worried about something, all sorts of negative thoughts are going to pop into your head, but if you can just calm that down, then that's going to have a beneficial effect on your mental state as well. You know, the body is taking in medication that the brain is being told is real medication.
If you're thinking stressful thoughts for the whole day then those parts of the brain are going to get larger and other parts of the brain will deteriorate. And so the brain is being tricked into secreting the right hormone or doing the right thing with the immune system.
It's kind of an irony because then the very brain circuits that we would need to try and counter that are no longer working as well as they should, so that's why something like meditation can be helpful because just simply saying, "Oh, I'm going to change how I think now. I'm not going to be as stressed now," doesn't really work; you have to change your brain over a long period of time. So you can - there are studies in various conditions - for example, irritable bowel syndrome, headaches, hyperactivity disorder where patients have received placebos but they knew they were placebos and still got a benefit from that. And that's probably all down to things like, you know, just being in a trial, feeling that you're being helped, can have those effects on the brain.
But beyond that, what I think we need to do is try and understand what are the sort of active ingredients of placebo responses, if you like.
So whether that's expectation, which is then influenced by all different things such as your previous experiences with treatment, what you're told about a treatment, how sympathetic your physician is - there's all sorts of things that are feeding into how you'll respond to that treatment. I mean, there's a lot of research on social supports reducing stress and anxiety, for example, which in turn can reduce pain. And if that reduces the amount of painkillers that we need, for example, when we're undergoing surgery, that can in turn reduce complication rates. So the needles are placed in the wrong places and they don't fully penetrate the skin, but the people think it's real acupuncture. And in a group where that was given by a sort of polite but cold practitioner, 44 percent of them said they had adequate relief from the symptoms. But in a group where the practitioner was sort of extra empathic and friendly and supportive, 62 percent of them had adequate relief from their symptoms. So just that element of the care that you're getting from the practitioner, just their sort of change in attitude, had a big benefit for the people that were going through that treatment. That's nothing to do with the sort of physical effect of the treatment itself, just the way that that care is delivered.
What are some of the conditions in each of those categories?MARCHANT: I think this is where it's really important that we have the scientific research rather than just sort of saying a blanket, oh, the mind can heal you, because it really does depend on what condition you're talking about. So placebo effects, and psychological approaches to treatment in general, are very effective for symptoms such as pain, depression, fatigue, nausea - so all those things that affect sort of how we feel. But, you know, for a lot of people those are really serious conditions that blight their lives. And an awful lot of medicine and the drugs that are prescribed are aimed at, specifically, easing those symptoms - all the painkillers and the antidepressant that we take. If we can influence that through mind-body approaches, not necessarily to replace drugs, but in other cases perhaps to maximize the effectiveness of the drugs that we take so we can take lower doses. So there's some really interesting research looking at using conditioning to reduce the drug doses that are required in kidney transplant patients, for example, or patients with autoimmune disease.
If we then look at things where perhaps the mind isn't going to play a large role, physiological processes that we're not sort of consciously aware of often - so things like blood sugar levels or cholesterol levels in the blood. You know, if you've got a serious infection, you probably wouldn't want to rely on a placebo. So when you're under stress, like, your heart beats faster, you're prepared to, like, run and flee. But when you're sitting at a desk and you have a deadline you have to meet, your body is often behaving as if you have to run from a beast, when what you're really doing is having to think and write or sort papers or do math. And then if you're under stress a lot, you're constantly in that state of your body telling you that it has to flee.
So why is that bad for your body?MARCHANT: Well, from an evolutionary point-of-view, the fight-or-flight response is a great thing. If you're in a situation that requires an immediate emergency response, as the name says, you know, if you need to run as fast as you can, if you need to fight with an attacker, we need this response. But the problem is that when we get into a situation where we're worrying about things all the time, that response is switched on long-term. So, for example, the raised blood pressure - that's useful in the moment if you need to respond to a physical threat. But if that's raised all the time, then that can damage arteries and that can contribute to heart disease, atherosclerosis, that kind of thing.
If sugar is released into the bloodstream, over time that can contribute to obesity and diabetes.
And one of the most damaging things that fight-or-flight does is it triggers a branch of the immune system called inflammation. So again, in a sort of emergency situation, that's quite a useful thing to have switched on. And what should happen is that it just gets switched off again after quite a short period of time. And then it can start kind of eating away at the body's tissues, if you like, because it's quite nonspecific.
So a lot of these conditions like arthritis or multiple sclerosis, it's - inflammation is what's driving that. What are researchers learning now about how we can control the mind's response so that the body isn't triggered to be in this persistent flight-or-fight response when we're under stress all the time but we don't need to be running or fighting?
What's the premise there in terms of how meditation might address the kind of stress - chronic stress - that we're talking about?MARCHANT: Well, there are many hundreds, probably, of different kinds of meditation. And the basic idea there is that you try to focus on the present moment rather than worrying about the past or about the future.
And by focusing on the present moment, we become more aware of our thoughts, and just to see those as fleeting thoughts rather than getting carried away in ruminations about, oh, wish I hadn't said that the other day, or how am I going to prepare for this meeting tomorrow or, you know, even thoughts such as oh, you know, I'm no good at this, or, you know, I haven't got any friends, or, you know, negative thoughts like that and worrying about them. And there's very good evidence that it reduces stress and anxiety and that it reduces symptoms such as chronic pain and fatigue.
And that's in healthy people but also in people with depression or people with serious illness. So there is some evidence suggesting that mindfulness meditation can make us more resistant to infection.
And that's everything from winter colds to slowing the progression of HIV, and that it gives people a better response, for example, to flu vaccine. He's a police officer, and he was diagnosed a few years ago with multiple sclerosis around the same time that his first son was born.
And as you can imagine, that was a horrifically stressful thing for him to be diagnosed with this terrible progressive disease at the same time as he's just becoming a new father. He'd never really heard of mindfulness meditation, but he read about it and tried it just to cope with the stress of his condition.
And the way he explained it to me was that when you have multiple sclerosis or a condition like that, a lot of the agony comes from worries about the past.
You know, he was thinking, oh, I used to love walking in the hills and I'll never be able to do that again.
And worries about the future - he worried that he was going to go blind and then he wouldn't see his kids grow up. He worried that he was going to have to suffer unbearable pain - I mean, really terrible concerns that he had. And what mindfulness meditation did for him was to help him to not follow those chains of thought and focus on each moment as it came and even enjoy each moment as it came.


You know, when he was playing with his kids, to just really enjoy that for what it was rather than letting it be ruined by all these thoughts about, oh I won't be a good father further down the line.
Or, if he had a physical challenge, like trying to climb the stairs, rather than letting that become overwhelming and then thinking, oh, will I be able to do this next week or next month or next year, just taking those stairs one step at a time - just accepting each moment along the way. And he said that through doing that, he believes that his well-being now is better than it's ever been in his life, including before he was diagnosed.
Would you explain the premise of biofeedback and some of the different mechanisms for practicing it?MARCHANT: Yeah, so the idea with biofeedback is that you have some sort of display where you're hooked up to a monitor, and you can see your body's physical functions - whether it's your breathing rate or your heart rate or your skin temperature. And so it's just meant as an aid to try and get yourself into to whichever physiological state you're trying to get into. Like, you have evidence, like, my blood vessels are dilated and my fingertips are warmer, so the meditation or the breathing or whatever I'm doing to try to get to a calmer state is working.
I mean, if you've been chronically stressed for years, you might not know what it feels like to be relaxed. Whether that's more effective than, say, meditation or simply just sitting still and slowing down your breathing - because just slowing down your breathing, perhaps five seconds in, five seconds out, is a very effective, quick way of just calming the body down and reducing the stress response. When we left off, we were talking about how biofeedback and meditation can reduce stress, thereby helping limit the damaging physiological effects of stress.
Why is that kind of slow, measured breathing and various forms of - part of various forms of meditation - why does that work physiologically? Like, what do researchers know about why that has a calming effect?MARCHANT: Well, with the stress response, the brain and the body are influencing each other in both directions. So if we see a danger, then that's going to make us feel stressed and one of the follow-ons from that is that our breathing is going to speed up. If you were to speed up your breathing on your own, you'd probably start to feel a bit more kind of aroused and on edge.
And equally, if you calm the breathing down, you're kind of forcing your body into a more relaxed state. When we're stressed, our brains almost come up with negative thoughts to try to explain why we're stressed, if you like. If you're kind of anxious or worried about something, all sorts of negative thoughts are going to pop into your head. If we're chronically stressed over a long period of time, then that changes what the brain looks like in scans. So there were certain areas of the brain - the amygdala, for example, which is involved in sort of fear and our kind of initial sort of emotional response to a threat.
But in animals, you can actually see that where if you take a group of rats, say, and subject them to stress, you will see the amygdala grow over time.
So it does seem to be a sort of cause-and-effect thing rather than just people with larger amygdalas get more stressed. And then there are other areas of the brain, such as the hippocampus and the prefrontal cortex, that are more to do with sort of rational thought and planning that get smaller over time. So there are studies showing that if a group of people meditates, the amygdala then becomes a smaller and the hippocampus and prefrontal cortex become larger.
If you play violin for eight hours a day, then the parts of the brain responsible for helping you to play the violin get larger. If you were thinking stressful thoughts for the whole day, then those parts of the brain are going to get larger and other parts of the brain will deteriorate. It's kind of an irony because then the very brain circuits that we would need to try and counter that are no longer working as well as they should. So that's why something like meditation can be helpful because just simply saying oh, I'm going to change how I think now, I'm not going to be as stressed now doesn't really work.
You know, you're going to have to exercise regularly over a long period of time to see that change in your body.
And not just because many of them are addictive, but also because people often don't like how they feel with the painkiller. You know, around 16,000 people die in America every year through overdoses of prescription painkillers.
And there are several lines of research that are telling us that there are so many other factors that feed into pain. It's not just the kind of chemical pharmacological issue if you like that can be dealt with with drugs. There are - as well as sort of the physical side of pain, there are psychological factors that feed in - social factors, cultural factors even. So, for example, if you look at placebo research, that's showing us that placebo responses are very strong in pain. If someone does feels cared for in a trial and feels that they're doing something that is going to make them feel better that is incredibly good at relieving pain.
And placebo responses are so strong now in pain that the drug companies are actually finding it very difficult to beat those effects with new painkillers.
So, for example, there's a line of research using virtual reality to deal with pain in serious burns patients.
And burn patients can be inside the snow world as they're having their wounds treated and, you know, the dressings changed and things, which can be incredibly painful. And trials show that that reduces their pain by 15 to 40 percent on top of what they're getting with drugs because often the pain is such in these patients that even though they're on the maximum safe amount of drugs, they're still in terrible pain.
Luckily, the day I went, the electric shock equipment wasn't workings, so I didn't get the electric shocks. But this is something that felt like a very intense burning pain on my foot when I just experienced it on its own. And then you put on the goggles and the noise-canceling headphones and you're in this ice canyon floating through it.
It was - I could kind of tell it was there, but I just wasn't really interested in attending to it is the only way I can describe it. And if you've got something that's really commanding your attention, there's less attention left over for experiencing the pain.
So just playing a normal videogame would probably help a bit, but it's not as good as this immersive experience. Actors always talk about, you know, when they do the whole show must go on thing that when they're on stage they're not feeling the pain. So can you apply what you learned from virtual reality as a distraction from pain into the real world?MARCHANT: Yes, absolutely. I think a lot of people with chronic pain get caught in this cycle where because you're in pain, you don't go out and do things and enjoy activities because you're worried about the pain.
And then you've got nothing else to do really but then worry about the pain, which in turn makes it worse because you're focusing on it. And this is something that's coming through from placebo research as well, researchers doing brain scans on people who are experiencing placebo responses to painkillers.
And you do see very similar changes in the brain to what you'd see if someone was taking a painkiller. So you see changes in the prefrontal cortex, parts of the brain that were involved in decision-making and sort of attitudes. And their conclusion is that just feeling that you're doing something about the pain and having a placebo actually makes people less afraid of the pain and more willing to go out and do things and live life and enjoy it.
And that's not - you know, that's not something that you get directly from the painkillers. And if we can understand the power of that - because then you can get that cycle, then you can get out and start doing more and have other things to distract you.
So obviously, I still want to be aware of any problems that might indicate serious illness that - where I need to get that checked out.
But, you know, if I have a headache or a tummy bug or I, you know, feel like I've got flu and I'm fatigued, it kind of makes me perhaps not get as anxious and worried about that. Instead of thinking oh no, I've got a headache, there's nothing I can do about it, this is going to take up my day, I feel as though I have a certain amount of control over how that affects me, so I can kind of imagine those endorphins flooding into my brain.
I don't take placebo pills, but I might go for a run or distract myself or do something else, and just imagine that sort of improvement that I want to see. And, you know, it's - that's not a miracle cure, but I feel like that enables me to continue with the life - my life and have some control over those symptoms.Another one is with my children. I'm very aware of how they can pick up on suggestions from me, positive and negative, about how they might be feeling.
Just asking questions, I'm aware of how that actually sort of might plant the suggestion of that with them.
Or if I'm, you know, giving them medicine or putting cream on, or even just giving them a hug or kissing something better, I really try and make a big fuss of that and tell them how that's going to make them feel better. And, you know, even if I'm just - if my son's grazed his knee and I'm kissing that better, I kind of see that as actually having a real therapeutic effect for him. You are kissing him better because if he feels comforted and cared for and that it's OK, that it's being dealt with, there are going to be those endorphins released into his brain, and he is going to feel less pain. So I kind of do feel like I have a role to play in how they experience these symptoms.And then in terms of stress as well, researching this book has really made me see that stress isn't just something that affects us mentally, but it's having feed-through effects into our physical health as well.
So I'm trying really hard to stay on top of that, and I feel like the research has kind of given me some of the tools to do that in terms of focusing on the people around me. Maybe that appeals to some people, but it's not something that - you know, I've tried it in the past, but it's not something I do regularly. But in terms of trying to be mindful and just find times throughout the day, whether it's when I'm going for a run or doing housework, or even if I'm just playing with my children, just making sure that I'm in the moment and focusing entirely on them and not, in the back of my mind, running through what am I going to do later? In the United States, there's - you know, we now have Obamacare, there's private health insurance and there's, you know, insurance a lot of people get if they're full-time employees from their employer, which they usually have to pay a lot for in addition.
But the way medical care is going in the United States right now, I think a lot of doctors are feeling pressure to spend less time with patients and to see more patients. And that is counter to the kind of care you talk about in the book, where comforting words, positive feedback, encouragement can lead to a more calm, positive attitude that can promote healing, at least in many conditions. And so I'm wondering, like, in England, is that kind of issue - is there that kind of issue, too, that doctors don't necessarily have the time to provide that kind of reassurance and comforting care to patients?MARCHANT: Yeah, absolutely. But I think the average - if you're going to see your primary care physician, the average appointment time in the U.S.
So there's not a great deal you can do in 10 minutes apart from write a prescription, and there is - I do think that there's - that might likely be counterproductive.There is a study in acid reflux disease, for example - it's just a small study, there isn't that much research on this so far, but it was comparing appointment times.
So patients who got 18-minute apartments versus 44-minute appointments, and showing that the ones with the longer appointments, that their symptoms were relieved dramatically more those with the short-term appointments, even though they were all receiving either a placebo or a homeopathic medication. We need to be applying this evidence-based approach not just to drugs and whether they work, but to all the other elements of care. So appointment times and attitude of doctors, the words that doctors use when they are telling us about the treatments.



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