Introduction To This Page
There are two parts to this page. The first part consists primarily of published medical case studies. Each case provides an example of the power of belief to influence medical and surgical outcomes.
Because the study of the power of belief to influence health and wellbeing infuses my martial art teaching as it did in my clinical practice in mind-body medicine, this entire website addresses the topic in various ways. In particular, the Loving Self-Care page is also an extensive study of the power of belief. However, where part one of this page is primarily focused on the medical aspects, the Loving Self-Care page is more focused on wellbeing.
Part two of this page, following the references for part one, is just a short exploration of the influence of belief on world peace.
Belief In Your Ability To Recover From A Life-Threatening Condition Can Make The Necessary Difference
Positive and negative expectancies by physicians have profoundly positive as well as profoundly negative effects on patient outcomes. A dependent variable that is often overlooked in studies is the expectancy of the physician or nurse who delivers any treatment, even an experimental one. The efficacy of pharmacological as well surgical interventions is dependent to varying degrees on this powerful, commonly overlooked variable.
Lying About Cancer Diagnoses Sometimes Helped Patients Recover From Cancer
When Deepak Chopra was still practicing endocrinology in Massachusetts, he had a female patient in her fifties who was jaundiced and complaining of severe abdominal pains. He had her admitted emergently to surgery for removal of what he believed were gallstones. However, the surgeons discovered a large, malignant tumor that had already metastasized throughout her entire abdominal cavity, including her liver. The surgeons realized there was nothing they could do and simply closed her up. The patient’s daughter pleaded with Chopra to not inform her mother of the cancer because she knew that if her mother believed she had a deadly cancer, that belief could kill her. Although doctors can no longer lie to patients, even though it would help them, Dr. Chopra then lied to the patient, telling her that her gallstones had been successfully removed and he did not say a word about the cancer. He rationalized that the patient only had a short time left and that her quality of life would be better this way. This was not an uncommon practice fifty years ago and many of the unexplained, unexpected recoveries from deadly diseases were probably due to the patient’s belief that he or she would recover.
Deepak Chopra had the shock of his life when the patient reappeared in his office eight months later for a routine physical. Furthermore, she was no longer jaundiced, was completely free of pain, and actually appeared quite healthy, with absolutely no sign of cancer. When she returned for her routine physical another year later, she said the following to him: Doctor, I was so sure I had cancer two years ago that when it turned out to be just gallstones, I told myself I would never be sick another day in my life. The cancer never returned (Chopra 1990).
Prior To Antibiotics, Vaccines, And Modern Medicine, Belief Was A Commonly Used Ingredient Of The Physician’s Treatment
William Osler, one of the most brilliant and revered physicians in the history of medicine, was not one to treat patients based on textbook protocols. He fully understood the enormous power of belief to heal almost any illness. Here is an account of how he treated a bedridden boy, dying of a severe bacterial infection; this occurred about forty years before the introduction of antibiotics.
Dr. Osler had gone directly from commencement ceremonies at the medical school to a house call while still dressed in the brightly colored robe worn by Oxford professors at commencement ceremonies. The patient, a little boy, interpreted the colorful outfit as evidence that this was a doctor with magical powers. The boy later said he believed Father Christmas was visiting him.
Dr. Osler examined the boy and determined he had whooping cough and bronchitis, a condition that quite often led to death in the days before antibiotics. He then sat down on the boy’s bed and slowly hand-fed the boy slices of a freshly cut peach. He told the boy that this was a very special peach that would help him get well.
Osler made daily house calls to the boy for over a month. Everyday, he would remember to dress up in his robe just before going in to see his young patient. Every day he would feed the boy a special freshly sliced peach.
When Osler had left the house after his initial visit, he had given the parents a very grim prognosis for their child. Amazingly, after about a month and a half of these very special daily visits, the boy made a complete recovery. Young children have the advantage of naturally having very vivid imaginations. Osler knew he could capitalize on the child’s imagination, especially after seeing how the boy reacted to the way he just happened to be dressed that first day. For that reason, he put on his full commencement regalia just before each of the daily visits. The peach slices, hand-fed to the boy by Father Christmas had become as powerful a placebo as ever existed (Myers and Benson 1992).
Example Of How Beliefs Can Cure As Well As Kill
In 1957, Mr. Wright, a dying cancer patient of physician Dr. Philip West at UCLA Medical Center, fully recovered from a placebo and then later died when he heard that the drug he had been given was worthless. Dr. West invited his colleague, well-known research psychologist Bruno Klopfer to join him in treating this patient, who had far-advanced lymphosarcoma. All known treatments had become ineffective. Mr. Wright had tumors described as the size of oranges in his neck, armpits, groin, chest and abdomen. His spleen and liver were enormously enlarged. The thoracic lymph duct was swollen closed, and two liters of milky liquid had to be drained from his chest each day. He got to a point where he was only being treated with palliative care.
Despite his near-death state, Mr. Wright still had hope. He’d heard of a new drug called Krebiozen, and discovered that UCLA was one of the medical centers where the drug was about to be tested with cancer patients. However, he didn’t qualify for the program, because the experimenters wanted patients with a life expectancy of at least three to six months. Mr. Wright was expected to die by the end of the weekend. Wright begged so hard, however, that Doctors West and Klopfer decided to give him one injection on Friday, thinking he would be dead by Monday, and then his next dose of Krebiozen could be given to someone who actually had a chance of recovering.
West and Klopfer were in for a surprise! In Dr. Klopfer’s words: “I had left him febrile, gasping for air, completely bedridden. Now, here he was, walking around the ward, chatting happily with the nurses, and spreading his message of good cheer to any who would listen. Immediately I hastened to see the others…No change, or change for the worse was noted. Only in Mr. Wright was there a brilliant improvement. The tumor masses had melted like snowballs on a hot stove, and in only these few days, they were only half their original size! This is, of course, far more rapid regression than most radiosensitive tumors could display under heavy X-ray given each day. And we already knew his tumors were no longer sensitive to irradiation. Also, he had had no other treatment outside the single useless “shot”. This phenomenon demanded an explanation, but not only that, it almost insisted that we open our minds to learn, rather than try to explain. So, the injections were given three times weekly as planned, much to the joy of the patient. Within 10 days he was able to be discharged from his “deathbed,” practically all signs of his disease having vanished in this short time. Incredible as it sounds, this “terminal” patient gasping for his last breath through an oxygen mask was now not only breathing normally, and fully active, he took off in his own plane and flew at 12,000 feet with no discomfort.”
When newspaper reports appeared, announcing negative results from Krebiozen, the patient became confused and discouraged. After two months of practically perfect health, upon hearing these new, negative reports on the drug, he relapsed to his original state and became despondent.
Klopfer, the very imaginative researcher, suddenly saw an opportunity to explore what was really going on. He wanted to find out, as he put it, how quacks achieve some of their well-documented cures. He told Mr. Wright: “Krebiozen really was as promising as it had seemed, but that the early shipments had deteriorated rapidly in the bottles.” He told his patient of “a new super-refined, double-strength product due to arrive tomorrow.”
“The news came as a great revelation to the patient, and, ill as he was, he became his optimistic self again, eager to start over. By delaying a couple of days before the imaginary new shipment arrived, the patient’s anticipation of salvation had reached a tremendous pitch. When I announced that the new series of injections were about to begin, he was almost ecstatic and his faith in the drug was very strong. With much fanfare, and putting on quite an act, I administered the first injection of the doubly potent, fresh preparation, consisting of normal saline and nothing more. The results of this experiment were quite unbelievable to us at the time, although we must have had some suspicion of the remotely possible outcome to have even attempted it at all.”
Dr. Klopfer went on to report: “Recovery from the second near-terminal state was even more dramatic than the first. Tumor masses melted, chest fluid vanished, and he became ambulatory, and even went back to flying again. At this time he was certainly the picture of health. The normal saline injections were continued, since they worked such wonders. He then remained symptom free for over two months.
At this time the final AMA announcement appeared in the press, reporting that nation wide tests showed Krebiozen to be a worthless drug in treatment of cancer. Within a few days of this report Mr. Wright was readmitted to the hospital in extremis; his faith in the drug was now gone, his last hope vanished, and he succumbed in less than two days” (Klopfer 1957).
Mr. Wright was not introspective or self-aware. He believed he was completely at the mercy of his doctors and the treatments. Unfortunately, he believed in what he was told or what he read more than he believed in what was actually happening in his body. Therefore, when reports revealed Krebiozen to be worthless, even though he had fully recovered after being treated with the drug (and the placebo), Mr. Wright believed he was doomed. As soon as he completely lost hope, the tumors grew back and his health rapidly deteriorated until he died. He had not been able to appreciate that the actual cure for his advanced cancer had come from his mind in the form of deep belief (faith) in the power of the drug to cure him. Of course, throughout history, with few exceptions, placebos have only worked when the patient believed it was the drug that had the power to cure. Most people do not realize that it is actually the mind that provides the most powerful medicines.
Beliefs Can Kill
It would be a mistake to think that any of us are very different from Mr. Wright. People of all cultures and levels of education are vulnerable to the power of the imagination. One of my teachers, Dr. Frank Lawlis, related many accounts of patients dying from negative expectancies. For example, he witnessed a patient die soon after being told she had breast cancer. The biopsy reports had just come back and it was clear that they had diagnosed her cancer in an early stage. Breast cancer does not kill prior to metastasis.
However, this particular patient’s mother had just died of advanced metastatic breast cancer, and the patient had cared for her, and decided that she never wanted to have to go through a similar experience. Within hours of being told that she had early-stage breast cancer, to the shock and befuddlement of the doctors and nurses, the patient died of multiple organ failure (Achterberg & Lawless 1998; Achterberg 1985).
Can Deep Belief Cure A Brain Tumor?
Physiological psychologist Jeanne Achterberg tells of a comatose patient admitted to the hospital with a massive brain tumor. The surgeon was unable to remove the entire tumor, but the patient came out of the coma following surgery. The patient was given palliative care but was expected to only live a very short time. She was described as intelligent, but not educated. She had been told about the tumor but to her, tumor was not a word associated with cancer and death. A few years later, she was found to be living a full life, very involved in organic gardening and enjoyed going dancing. Although the patient had been expected to die as a result of only partial removal of the brain tumor, the positive expectancies of the patient served as a boost to her immune system, which, it is hypothesized, went about its work of destroying all of the remaining cancer (Achterberg 1985). In cases like this, beliefs that include a positive expectancy can be life-serving.
The Power of Belief Has Enabled The Immune System To Kill Cancer
Unlike Mr. Wright, whose deep faith was in the external treatment, the following patient had deep faith in her body and mind to help her beat the odds. Internist Dr. Arnold Fox had the sad task of informing one of his patients, a 54 year-old mother of three that she had a very aggressive, inoperable cancer and that she had no more than six months to live. Her bizarre reaction to receiving the death sentence was to smile and to tell her physician: “If you have faith, even as small as a tiny mustard seed, nothing is impossible.” Shocked by her calm, confident response, he questioned her and she replied: “As long as I have faith, I know I can shake off cancer.” Dr. Fox was convinced that positive expectancy could not cure cancer, but he figured that if it made her happy to think that way, that was her privilege. He continued to question her because he wanted to make sure she understood the seriousness of the diagnosis. Her next response was: “That cancer may exist in me but I refuse to believe it will hurt me. I’m healthy and I know the cancer will go away.” Dr. Fox reports that she lived another ten years in good health. He writes: “We doctors can quote chapter and verse on anatomy, biochemistry, physiology, pharmacology, and other scientific subjects, but we are sadly unfamiliar with the miraculous healing powers of the human mind” (Fox 1988).
A Belief Shared By Patient And Physician Is Most Powerful
Whenever both the physician and the patient believe that a treatment will be effective, it will be effective at least seventy percent of the time. This is true even when the treatment is nonspecific. Even when the treatments have been found to be ineffective, they seem to work when both doctor and patient have faith in the efficacy of the treatment (Roberts 1994).
Belief In The Procedure Is Often Equivalent To Actual Surgery
A Houston orthopedic surgeon performed an experiment with ten arthroscopic knee surgery patients who agreed to be in the study but did not know what would actually be done. Five of the patients got the surgery. The other five patients received the usual three incisions but not the knee repair. All ten patients appreciated noticeable improvement in their pain six months later (Evans 1985).
In a replication of that study at Baylor College of Medicine, also in Houston, researchers performed sham surgeries on real patients who were expecting knee arthroscopy for treatment of OA of the knee. In the sham operations, the holes for the scopes were made but the scopes were never actually inserted. Both groups of patients were given the same pre-op and post-op treatments. Two years later, it was discovered that the patients who received the sham surgeries appreciated the same level of improvement in pain as well as in function as the patients who received the real surgery (Moseley et al. 2002).
The Diamond And Cobb Studies
One famous set of studies could not be done today for ethical reasons because they exposed subjects to unnecessary general anesthesia and unnecessary open cardiothoracic surgery. In these dangerous studies, the power of belief to heal was proven unequivocally. During the 1950s it was common to treat angina pectoris with a ligature of the internal mammary artery because it was believed that it increased flow to the coronary arteries. Sixty five to seventy five percent of these surgical patients showed considerable improvement. Their EKGs looked better and their exercise tolerance improved. Thousands of patients requested the surgery and the operation gained in popularity. However, many doctors were skeptical despite the excellent results.
Some of those skeptical surgeons designed studies to prove or disprove the efficacy of the procedure. In a set of studies by Diamond and Cobb in the late 1950s, a skin incision was made without actually ligating the mammary artery except in randomly selected patients. Diamond’s patients evidenced a decreased need for nitroglycerine in one hundred percent of the non-ligated patients and in seventy six percent of the ligated patients. These studies proved that the actual ligature of the mammary artery was no better than the simple skin incision.
They also proved that the simple skin incision produced a dramatic and sustained placebo effect. It was these Diamond and Cobb studies that finally, after over ten thousand mammary artery ligation surgeries, resulted in replacing it with coronary artery bypass grafts (CABG). Although this procedure is still standard of care, many patients do not improve from the procedure. It is believed that the beliefs of the patients and the beliefs of the surgeons play a role in who benefits and to what degree (Frank 1975).
The Vineberg Procedure
Another study, twenty years later explored the efficacy of the Vineberg Procedure. During the 1970s, this procedure was performed on fifteen thousand angina pectoris patients in order to improve coronary blood flow. This procedure was more invasive than the previous one and carried a five percent mortality rate. It involved implanting the internal mammary artery into a four-centimeter tunnel burrowed into the myocardium. Although an improvement rate of 85 percent was reported, several investigations demonstrated that neither objective nor subjective measures of improvement correlated with patency of the implanted artery or the establishment of collateral circulation. In none of these investigations did improvement correlate with angiographic evidence of revascularization (Benson and McCallie 1979).
Belief Results In Ninety-Percent Success Rate With Sham Surgery.
A Seattle cardiologist performed a study of angina pectoris patients. Half the patients received the standard of care surgery while the other half received superficial cuts to make it look like they had received the surgery. Ninety percent of the sham surgery patients experienced pain relief (Evans 1985).
My Review Of Side Effects In Placebo Studies
Here are just some of the physiological effects of various placebos given in studies: nausea, vomiting, diarrhea, dry mouth, heaviness, headache, concentration difficulties, drowsiness, fatigue, inability to stay awake, insomnia, weakness, heart palpitations, rashes, epigastric pain, urticaria, anaphylactic-like reactions, decreased libido, increased libido, abdominal bloating, dizziness, lumbar pain, increased and rapid heart rate, euphoria, feeling drugged, incontinence, anxiety, dysmenorrhea, anorexia, acne, blurred vision, and many other symptoms, illnesses, and conditions. Here is what is most important to know: Not one of the patients experiencing any of these problems received any substance that could cause any effect at all. (Berkelhammer 2014)
Asthmatics And Placebos
In an asthma study in which forty asthma patients inhaled saline solution believing it to be an allergen, nineteen developed bronchoconstriction. In another asthma study, 29 asthma patients inhaled saline solution believing it to be an allergen and fifteen bronchoconstricted. Aerosolized saline normally does not create any effect at all. In experiments with asthmatic patients, it has consistently been found that the patient’s belief that an inert inhalant (aerosolized saline) is an irritant triggers bronchoconstriction. In these same experiments, when the asthmatic patient’s belief is that an irritant is an inert inhalant, the patient does not bronchoconstrict. When led to believe that aerosolized saline they were being given was in fact Albuterol (a sympathomimetic bronchodilator) the bronchoconstriction resolved (Luparello et al. 1970).
Independent Replication Of Laver and Luparello Studies
In an independent replication of the studies by Laver and Luparello, asthmatic patients were part of a small study in which the same pharmacological treatment was administered to the same cohort of patients at two different times. A different message was delivered to the patients each time. Believing that what they had just inhaled causes bronchoconstriction, all of the patients experienced actual bronchoconstriction despite the fact that what they had been given was nothing more than aerosolized, distilled water. Later, when they were given the identical neutral substance, but were told that they were being given Albuterol, all of them experienced immediate relief (Butler and Steptoe 1986).
Belief And Heart Patients
A cohort of atherosclerotic, hypercholesterolemic heart patients was divided into two groups. The controls received a placebo and the treatment groups were given lipid-lowering drugs. At the five-year follow-up, the patients in both groups had similar mortality rates. However, the mortality of the most compliant patients was half the mortality rate of the less compliant patients. Here is what is most important to know: The results were equivalent for those who had been taking placebos for the five years as it was for those on the actual lipid-lowering drugs. Again, it was the positive expectancy of all those who took their medications that improved their health, rather than the active ingredients of the drug itself (Coronary Drug Project Research Group 1980).
The Name And Presentation Of The Drug Influences Its Efficacy
The power of expectancy is best illustrated by a conversation between two doctors that was overheard by Norman Cousins (1989) in which he described a discussion between two independent clinical researchers who were comparing their very different results despite using the identical protocol. In the following transcript, notice the very different acronym used by the two researchers, both of whom created an acronym using the first letter of the four medications given to the patients in their studies:
“You know, Bob, I just don’t understand it. We used the same drugs, the same dosage, the same schedule, and the same entry criteria.” (Potential patients in a study must fulfill all the inclusion criteria and must not meet any of the exclusion criteria.) “Yet I got a 22 percent response rate and you got a 74 percent response rate. That’s unheard of for metastatic lung cancer. How do you do it? The other doctor replied: We’re both using Etoposide, Platinol, Oncovin, and hydroxyurea. You call yours EPOH. I tell my patients I’m giving them HOPE. Sure, I tell them this is experimental, and we go over the long list of side effects together. But I emphasize that we have a chance. As dismal as the statistics are for non-small cell, there are always a few percent who do really well.”
The Pharmaceutical Industry Does Not Want You To Know This: Very Often, The Drug Matters Less Than Your Belief About It.
In 1964, a study was performed to specifically explore the power of belief. Study participants swallowed the identical placebo on three separate occasions. A magnetic tracer was in the capsule, allowing the experimenters to observe physiologic changes. The first time the participants received the inert capsule, they were told that the drug they were being given would stimulate gastric activity. The second time they were told that the drug now being given would make them feel like their stomachs were full. The third time they swallowed the capsule they were told that it was a placebo. As hypothesized by the researchers, the results mimicked the descriptions given to as to what to expect (Sternbach 1964).
The Belief: I won’t make it through the night = Death
One of the most disturbing comments that hospitalists and nurses hear is a statement by the emergently-admitted patient expressing the belief that he or she will not make it through the night. Whenever hospitalized patients announce to doctors or nurses that they are going to die, the medical staff gets worried. This is because, statistically, when patients tell medical staff that they know they are not going to survive the night, they usually are dead by morning. It is not that patients can predict the future. It is that the power of belief can and does kill, which is why a Voodoo curse correlates with the death of the cursed person. This is especially true in hospitalized patients because being in the hospital can be so frightening that patients automatically go into a fear state, which can dramatically interfere with normal executive function.
The various drugs given to hospitalized patients often compounds this problem. When patients in that fear state become convinced that they are dying, they usually do. When patients in that state are told that they have three to six months to live, most comply and die within that time period. When someone has just been given a cancer diagnosis by a physician, the patient almost invariably enters such a deep state of fear that his or her beliefs get amplified and embodied (Simonton 2006,7,8)
What You Believe In Pre-op Influences Outcome Post-Op
In one self-regulation study related to preventing post-operative ileus (common intestinal blockage), forty pre-operative gastrointestinal surgery patients were randomized to two groups. The controls were instructed in how they could clear their lungs post-op. The experimental group was given the following instructions: Your stomach will churn and growl, your intestines will pump and gurgle, and you will be hungry soon after your surgery. All the patients were asked to identify their favorite meal. So that you can get back to eating (individual’s favorite food is named) as soon as possible, your stomach and intestines will start moving and churning and gurgling soon after surgery. GI motility returned in 2.6 days post-op for those in the experimental group. GI motility did not return until 4.1 days post-op for the controls. Because GI motility determined the discharge date, those in the experimental group were discharged 6.5 days post-op as compared with 8.1 days post-op for the controls (Disbrow et al. 1993).
Belief That Your Doctor Will Help You Often Improves The Outcome
Making an appointment with a trusted physician often has a curative effect. One of the most common experiences many of us have had relates to feeling better and actually recovering from an acute medical problem just after making the appointment to see the doctor. Because of the positive expectancy, we begin to treat ourselves as if the problem has already resolved. Another common experience is that of feeling better and actually getting better soon after taking the first dose of a medicine that is supposed to take days or weeks to work. The power of positive expectancies can stimulate your endogenous pharmacy (brain) to become fully activated to synthesize and distribute the perfect drug needed at that moment, with no adverse effects.
Reduced worry about the symptom can account for some of the improvement. Elation related to being treated by someone in whom you have deep trust can catalyze various neurotransmitter alterations that are associated with improved immune function. Also, there is a synergistic healing effect between cognition, behavior, and affect (Berkelhammer 2014).
Addicted To A Placebo
The power of belief expectancy is so strong that in thousands of placebo studies, researchers have discovered very serious side effects from the placebos. For example, people have actually become addicted to placebos, believing them to be narcotics, and experienced all the side effects (Harrington 1997).
Belief In A Drug That Can Elevate Liver Enzymes Catalyzes Elevated Liver Enzymes
There have been cases where study participants developed elevated liver enzymes and actually needed medical treatment to treat the damage done by the subjects’ beliefs that they were taking a hepatotoxic drug (Harrington 1997).
Physicians’ Beliefs Dramatically Alter Treatment Outcomes.
When a physician prescribes a drug or other treatment, the degree to which the physician believes in the treatment has a profound effect on the outcome of the treatment. In three separate double-blind studies, vitamin E was given to treat angina pectoris. Two of the studies were conducted by physicians who believed vitamin E would be a useless treatment for angina. The patients of those two doctors did not experience any relief from the vitamin E. The doctor in the third study whole-heartedly and enthusiastically believed the vitamin E would be effective. The patients of that doctor experienced significant relief, despite the fact that vitamin E has been proven to be a useless treatment for angina. (Davis 1990)
When Meprobamate was first introduced in the 1950s as a tranquilizer, some doctors found it to be very effective while others found that their patients failed to get any effect. To explore these inconsistencies, researchers ran a double-blind study involving one physician who whole-heartedly believed in the drug’s efficacy, and another physician who did not believe in it. Neither the two physicians nor any of the patients knew which pills were the real drugs and which ones were the placebos. In fact, neither the physicians nor the patients even knew they were in a study. The patients of the physician who believed in the drug benefited from the real drug more than they did from the placebo. Interestingly, the patients of the physician who did not believe in its efficacy got no effect from either the drug or from the placebo (Davis 1990).
What made the above study particularly interesting was that neither the drug nor the placebo had any effect on the patients whose doctor did not expect any effect.
Physician Expectancies Are Nonverbally Communicated To Patients.
Harvard cardiologist Dr. Herbert Benson has always taught his interns and residents that when a new medication is prescribed by an enthusiastic doctor who clearly has faith in the drug, the effects of the drug are considerably more impressive than when that same drug is prescribed a few years later by doctors who question the efficacy of the drug.
What a physician tells a patient about a treatment has a big effect on the efficacy of the treatment, but what the physician believes about the treatment has an even more profound effect on the efficacy of the treatment than what is actually verbally communicated to the patient. This is true even when the physician is convinced that his or her beliefs have not been communicated to the patient.
When J. Mostyn Davis was working as a family practitioner at Geisinger Medical Center in Pennsylvania, he prescribed what he mistakenly believed to be a long-acting appetite suppressant to patients; those patients appreciated a long-term effect of the drug. He later read that the drug is actually only a very short-acting appetite suppressant. However, he continued prescribing the drug in the same way, without telling any of his patients what he had learned. Suddenly, his patients were finding the drug to only be effective for a few hours. He was shocked and perplexed about the change in the pharmacological effect of the drug on his patients, none of whom could have known anything other than what he had originally told them about the drug having long-lasting effects. He finally concluded that he must have somehow been nonverbally communicating to his patients that the drug was now short-acting (Davis 1990).
A new anxiolytic was tested against a placebo in 1955 by physicians who were very excited about the newly released drug. Side effects included nausea, dizziness, heart palpitations, and abdominal pain. The placebo groups experienced the identical levels of side effects as in those receiving the real drug. One of the patients in the placebo arm of the study developed a severe skin rash that resolved immediately upon discontinuation of her taking the placebo. Another patient not only developed sudden onset abdominal pain, but also developed ascites within ten minutes of taking the placebo (Beecher 1955).
A patient with intractable asthma was treated with what the physician believed to be a powerful new experimental asthma medication. Lung function improved and the patient was enjoying significant symptom relief. The patient’s improvement was more dramatic than even the pharmaceutical company had predicted, so the physician began to wonder if possibly the unexpectedly positive results could at least in part be due to the patient’s own strong belief in the efficacy of the new drug. To test his hypothesis, at the next appointment, he treated the patient with a placebo instead of the new experimental drug. The patient later returned to the office, complaining that the drug stopped working, and all his symptoms had returned. This proved to the doctor that it was the new experimental drug and not the patient’s belief in it that had catalyzed the healing (Ornstein and Sobel 1987).
However, that doctor’s hypothesis was later disproved when he contacted the pharmaceutical company to request more of this new wonder drug. At that point, the company informed the physician that what he had believed was a new experimental wonder drug was actually a placebo (Ornstein and Sobel 1987).
“The history of medicine is actually the history of the placebo effect.” —William Osler, M.D.
Do Ingredients Even Matter?
Over the centuries, medical prescriptions included animal dung, lizard blood, frog sperm, crab eyes, and countless potentially deadly substances. Patients actually got well on these and hundreds of other useless and dangerous substances. The reason patients recovered was because what they were actually being administered along with the noxious substances was hope. Surprisingly often, when the patient trusts the physician and the physician believes in the treatment, the patient develops trust in the treatment and recovers. This trust in the healer and in the treatment may be the most powerful active ingredient (Shapiro 1961).
How You May Be Able To Save A Life With No Medical Training
One day, Norman Cousins saw an ambulance rushing in to the Rancho Golf Course behind his home in Los Angeles. He walked out to see what had happened and could see that a golfer had suffered a major heart attack. By then he noticed that the paramedics had him on oxygen, a 12-lead EKG, had dropped IV lines and were already administering a heparin lock. Cousins noticed that although the paramedics seemed to be doing a great job, no one was talking to the poor guy. He noticed that the guy was ashen and was trembling. The paramedics were working systematically and methodically but were saying nothing to comfort the man. Cousins, concerned that the extreme panic the man was experiencing could easily kill him, then leaned over and as he reports: I lied to the man. I put my hand on his shoulder and I said, “Sir, you’ve got a great heart.” He opened his eyes and he looked at me and asked, “Why do you say that?” I said, “Well, I can see on the EKG that you’ve got a wonderful heart. What happened is that it’s been very hot out here today. You’ve probably gotten dehydrated here on the golf course and that upset your balance of sodium and potassium that provides the electricity your heart needs. But you’re in good hands now. In a few minutes you’ll be at UCLA Medical Center, one of the best hospitals in the world. You’ll be just fine.” Cousins kept his eye on the heart monitor and saw that within seconds of his having talked to the guy, the EKG began to improve. Within just two minutes, the patient’s heart rate had slowed to under 100 BPM (Cousins 1989).
It is quite possible that Norman Cousins, not a physician, saved that man’s life simply by administering hope.
Physician’s Words May Commonly Be More Lifesaving Than Any Procedure!
Surgeon, Dr. Bernie Siegel concurs with Norman Cousins, and has said: I know people are alive today because I said to them: “You don’t have to die.” Siegel taught medical students and residents that instead of telling patients that they only have a few months and to prepare to die, tell them: You can be someone who beats the odds; let’s teach you how (Siegel 1986).
Incorrect Belief Saves Man’s Life
Cardiologist, Dr. Bernard Lown wrote of an account of a patient he treated whose massive heart attack had irreparably destroyed his heart. At that time, there was no effective treatment that could save the man’s life. On rounds, this medically unsophisticated patient overheard Dr. Lown tell the house staff that the heart had a wholesome gallop. This patient had no idea that a wholesome gallop actually portends a very bad outcome. Despite the irreparably damaged heart, the man recovered unexpectedly and returned several months later in excellent heath for a follow-up visit. During that followup visit he told Dr. Lown that he knew he would get better when he overheard the doctor explain to the house staff that day on rounds that there was a wholesome gallop. To this patient, wholesome gallop was equated with a healthy horse that still has a lot of kick in him (Cousins 1983). The patient’s very strong positive expectancy, created by his mistaken belief about what a wholesome gallop actually means, served to improve physiological functioning and restore his heart.
Deep Belief In One’s Recovery Has Led to Remarkably Unexpected Recoveries.
Some of the most impressive examples of the power of the mind to catalyze a cure come from the carefully scrutinized and respected documents from the International Medical Commission at Lourdes in France. The commission has records of numerous validated cases of sudden, complete cures of a multitude of very serious and life-threatening medical conditions, including many forms of cancer in people who had either refused medical treatment, or for whom no effective treatment existed.
Researchers have hypothesized that some forms of prayer, extremely deep religious faith, and some forms of very deep meditation lead, in certain people to a greatly enhanced immune function as well as greatly enhanced self-healing abilities in general (O’ Regan and Hirshberg 1993; Hirshberg and Barasch 1995). Two of my mentors, Dr. Jeanne Achterberg and Dr. Frank Lawlis taught that the curative element was always some type of altered state of consciousness or major shift in one’s way of living in the world. In some cases, it involved a type hypnosis. Yet, despite my training with Achterberg, Lawless, Erickson Foundation and Academy for Guided Imagery, I was never taught and never even heard of a way to help anyone use trance to successfully and predictably cure any life-threatening condition.
Importance Of Hope
In an analysis of over four hundred cases of unexpected complete spontaneous remissions from serious life-threatening diagnoses, there was only one common denominator between all these patients who beat the odds. Every one of them had somehow developed the belief that they could get well. Sometimes it followed a visit to Lourdes, other times it followed a psychic surgery treatment by the Brazilian healer known as John of God, and many other times it followed a visit by someone who had previously been at death’s door and then made a full recovery.
More than two million people with advanced diseases visit the healing shrine at Lourdes every year because they have heard or read about countless numbers of people who experienced spontaneous remissions following their pilgrimages to the spring at the shrine. Dr. Jerome Frank describes what goes on at the shrine every afternoon, throughout the year: “The sick line up in two rows. Every few feet, in front of them, kneeling priests with arms outstretched praying earnestly, leading the responses. Nurses and orderlies are on their knees, praying too. The Sacred Host is raised above each sick one. The great crowd falls to its knees. All arms are outstretched in one vast cry to Heaven. As far as one can see in any direction, people are on their knees, praying.” He goes on to say: “This faith explains the spontaneous remissions of disease and improved bodily functions experienced by some, as well as the increased sense of hope and improved morale that even the uncured take home with them” (Frank 1978).
Later he writes: “There is no denying that religious shrines unleash powerful healing emotions of hope in the pilgrim. One cannot attribute this to any particular religious faith or object of worship, since all religions can cite instances of these seemingly magical cures. The more likely explanation is that the cure results from the individual’s state of mind—his expectancy (Frank 1978).
What Dr. Frank, as well as researchers in fields such as psychoneuroimmunology have concluded is that there is no supernatural, mystical, or magical force that does the healing. Rather, it is an extremely deep faith in one’s ability to get well, which goes far beyond a simple intellectual understanding that recovery is a possibility. It must be deeply experienced in the body rather than in the intellect.
Do Faith Healers Cure People of Disease?
Throughout history, there have been large numbers of people who have experienced unexpected improvement and cures from life-threatening conditions in various cultures from around the world after being seen by various types of faith healers or shamans. It is not the faith healer who heals; it is the patient who heals by his or her faith in the faith healer. The real healer is the recipient, who unintentionally self-induces the healing. The recipient commonly goes into an altered state of consciousness, beyond the intellect. In the recipient’s very receptive trance state, the words and behavior of the faith healer are taken in by the recipient on a very deep level. When this expectancy relates to a message to get well, the psychophysiological effects are sometimes powerful enough to create spontaneous healing (Murphy 1992; Simonton 2002).
The Physician Who Hired A Faith Healer To Heal His Patients
One hospitalist was particularly confused and frustrated by three patients who were failing all medical treatments. Figuring he had nothing to lose since these patients were dying, he called in a faith healer who performed twelve distant-healing sessions on the three patients without their knowledge. This resulted in no change in their conditions. The physician then approached each of the three patients and enthusiastically told them that a very exceptional faith healer would be working on their behalf during the next three mornings.
This was actually a lie because the doctor had actually dismissed the faith healer when he previously failed to improve the condition of any of the patients. However, these three patients believed in and trusted the doctor, and were quite pleased about what they had been told. This time, all three patients showed very dramatic and rapid recoveries. One week after these dying patients were told that a faith healer was working on their behalf, they were all well enough to be discharged. One, who had been near death just one day earlier, actually got out of bed after what she believed to be the first healing session (Ornstein and Sobel 1987).
Remember, the patients showed no improvement when the faith healer was doing his work and only recovered after the faith healer was fired, whereupon, the doctor lied, telling them the faith healer would be working on their behalf. It is clear that what cured the patients was their very deep faith in the faith healer, not the faith healer himself.
An Endogenously Produced Antiemetic
This is a case of another one of those experiments that would never get past a modern IRB (internal review board). In 1950, physician Dr. Stewart Wolf performed an experiment with a group of women suffering with particularly severe morning sickness. The women were all told they would be receiving a new and powerful antiemetic, yet the drug he intentionally gave them, as an experiment in the power of suggestion, was syrup of ipecac. The patients’ trust in the physician and in the power of this supposed new drug was powerful enough to not only counteract the emetogenic effects of the ipecac, but their N&V actually abated (Harrington 1997).
Dr. Wolf performed a number of case studies at that time. In one, a patient with Parkinson’s disease was given a placebo but was told he was receiving a drug. His PD symptoms disappeared. As soon as the effects from the placebo wore off, Dr. Wolf put the same substance into the patient’s milk without his knowledge. The substance this time had no effect.
In another study, 133 of Dr. Wolf’s depressed patients were treated with a placebo. Twenty-five percent responded so well that they were kept on the placebo. When a group of patients were given a placebo instead of the usual antihistamine, 77.4 percent of them experienced drowsiness, which is a normal side effect of antihistamines (Wolf 1974). (In the early 1950s, just prior to the introduction of tricyclics, antihistamines such as chlorpromazine and imipramine were used to treat depression.)
A Meta-Analysis of Fifteen Separate Placebo Studies
A meta-analysis of fifteen placebo studies involving 1,082 patients revealed that thirty-five percent of placebo-treated patients with a wide variety of diagnoses consistently evidenced satisfactory relief whenever placebos were substituted for the regular medicine. Those fifteen studies included patients with a range of medical problems including severe postoperative wound pain, headaches, various forms of degenerative arthritis, low red blood cell count, low white blood cell count, hypertension, allergies, and many other diagnoses (Beecher 1955).
Endogenous Drugs For Severe Mental Illness
As a testament to the power of placebos, psychotic patients with schizophrenia and delusional disorders were randomized to trifluoperazine (an anti-psychotic) or to a placebo. The results of this double-blind study were so shocking to the researchers that the study was repeated with a new set of psychotic patients and with different dosages of both the trifluoperazine and the placebo.
Here are the results: In the initial study, the patients on the real drug evidenced a 32 percent improvement and the patients who had received the placebo did even better, showing a 35 percent improvement. In the second study the dosages of both the trifluoperazine and the placebo were doubled. Both sets of patients showed greater improvements at the higher dosages. This time, the patients receiving the actual drug showed a 67 percent improvement, but what was even more shocking was that the placebo-treated patients showed a 72 percent improvement (Frank 1978). Why did the patients do even better when they got a larger dose of the placebo? This is most likely due to the belief on the part of the patients that they were getting a stronger dose. It may also be due to the belief—nonverbally communicated to the patients—that there would be a more robust response.
Retinal Surgery And Belief
In a study of a group of patients about to undergo surgery for detached retinas, each patient was prospectively rated according to their hope and expectations related to the surgical results. One surgeon, blinded to the pre-op ratings, did all the surgeries and performed them in the same O.R. The patients, who had faith in the surgeon and faith in their own ability to cope with the surgery, had the best results. The researchers concluded: “What determined the best results was the patient’s trust in the surgeon and his methods, an optimistic outlook toward the treatment, and other psychological variables that, taken together, may be called an attitude of positive expectancies” (Frank 1978).
Surgical patients have fewer complications when they expect a positive outcome.
Studies performed in hospitals around the world all reveal that the positive or negative expectancies of surgical patients directly correlate with the quality of surgical outcomes. Negative expectancies correlate with higher complication rates and positive expectancies correlate with lower complication rates. The most anxious patients prior to surgery have more post-op complications than patients who deeply believe that they will have a good outcome.
Patients whose surgeon read a brief statement written by the patient preoperatively tended to have good outcomes. The statement was often something as simple as: I will awake from surgery feeling well and hungry, or something directly related to the surgery itself, such as: The tumor will easily come out cleanly and completely (Evans and Richardson 1988; Furlong 1990; McLintock et al. 1990; Steinberg et al. 1993). When surgeons engage in conversations intraoperatively, many patients can hear and process the comments while under general anesthesia. Complications are more common when those comments are related to something going wrong or involve any negative comments about the patient (Cheek 1959; 1966).
Intraoperative suggestions that the patient will recover rapidly and feel comfortable following surgery were given to 1500 surgical patients. Seventy percent of the adults and all of the children in this study unexpectedly needed virtually no pain medication postoperatively (Wolfe and Millet 1960).
In another hospital, anesthesiologist Dr. Donald Hutchings (1961) delivered the identical positive statement to 200 surgical patients while the patients were under general anesthesia. The statement he delivered to the 200 patients was: You will heal promptly and well. You will awaken from the anesthesia as if you had been asleep all night, feeling rested and refreshed. You will have no pain at the place that was operated on. You will eat well and sleep well, enjoying your hospital stay. You will urinate easily and move your bowels regularly. Again, seventy percent of the adult patients needed no post-op pain medication. Also, the patients were more comfortable, more cooperative, and actually healed faster.
Beware Of The Power Of Reading The Drug Package Insert
The power of our beliefs and expectancies is such that the act of simply reading the drug package insert, which lists all the possible side effects of a drug we are about to take serves to dramatically increase the odds of actually experiencing those side effects. The beliefs and expectancies we hold about any drug we take are quite often more powerful than the actual pharmacological effects of the drug.
A deep expectation that we can get well quite often results in actually getting well because like all strong beliefs, it has corresponding emotional states, and those emotional states all have physiological correlates that often catalyze healing (Simonton 2008).
The mind has the power to make us sick and the mind has the power to make us well. Most of this happens unconsciously. Mr. Wright recovered from cancer twice because he believed deeply that the drug given to him would cure him. He relapsed and died when his belief changed and he became convinced he would die.
Variations of that event have occurred thousands of times, throughout the world, throughout history. Through mindfulness-based, mind-body practices, we can develop the skills to see all our beliefs as nothing but insubstantial mental constructs, which then gives us vastly more choices in how to respond to what life throws at us.
Physicians are trained extensively in the hard sciences. When a patient with an irreparably damaged heart, or someone with advanced metastatic cancer, fully recovers without medical intervention, or with what was commonly agreed to be insufficient treatment, that can be very disconcerting for physicians. Physicians are trained to solve medical mysteries. They are very uncomfortable with the ineffable.
There are hundreds of published cases of patients making full recoveries where all physicians involved with the case were in full agreement that recovery would be out of the question.
Most physicians appreciate that the beliefs of the patient, and even his or her own beliefs about the patient’s prognosis, do have some influence on the patient’s outcome. But most are frightened by the prospect that the patient’s beliefs can be more powerful than any medical or surgical intervention. This is understandable because they are not trained to work on a deep level with the patient’s beliefs.
Even a large percentage of psychotherapists are not trained to work with beliefs in that way. Although the power of belief to create healing and health is a professional fascination of mine and although I trained with the experts in that field (O. Carl Simonton MD, Laurence LeShan PhD, Jeanne Achterberg PhD, James S. Gordon MD, The Erickson Foundation, Academy for Guided Imagery, and many other sources), I have no answer as to how to improve treatment of medical patients in ways that could help them use their minds to cure themselves of deadly diseases.
My belief is that if you combine various mind-training practices to cultivate and practice mindfulness-based mind-body self-empowerment, self-efficacy, self-compassion, and loving self-care with optimization of exercise, sleep, diet, and relationship habits, you will improve your odds of staying healthy and recovering from serious illness. There are no guarantees, but optimal self-care will certainly improve your odds.
My personal belief regarding what to do if you get diagnosed with a deadly disease and fail existing medical treatments is that at that point, you have nothing to lose in going to see a faith healer, shaman, or other mystical healer if you are well enough to go. But keep in mind that it will not help if you don’t have a very deep belief that it will help.
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The Effects Of Beliefs On World Peace
The Danger Of Being Indoctrinated With Beliefs From An Outside Authority
Mindfulness-based, mind-body self-empowerment practices lead to the ability to go inward and to have a relationship with ourselves based on loving self-care. Mindful Biology, the creation of my colleague with whom I teach this work locally at the College of Marin, trains us to get to know ourselves. This is different from getting to know about ourselves. Through Mindful Biology, we get to live in the full experience of being. Put another way, we develop the ability to live in harmony with our inner subjective experience, which allows us to learn about life from within. This involves coming home to the body, which is extraordinarily healing, since we live in bodies. This way of life leads to the ability to objectively observe beliefs as they are created by the brain. This acute degree of self-awareness helps us to see beyond thoughts and ideas, seeing them for what they are, nothing but insubstantial mental constructs.
When we lack the ability to observe the brain’s parade of thoughts, those thoughts lead to the creation of beliefs about self, others, and situations, which exert a powerful effect on our behavior. Most of our actions throughout the day and throughout our lives tend to grow out of our beliefs.
Most of us were indoctrinated as young children with the beliefs passed down to us by the authority figures in our lives. Those authority figures predominantly included parents and other caregivers, teachers, and members of the clergy. In most cases, they held the belief that their beliefs were the correct ones and that they were doing the right thing in indoctrinating us in their beliefs. The problem with this is that as children, we were taught that these cultural beliefs, especially religious beliefs, were all we needed. Most of the people (all adults) I worked with in mind-body medicine were dependent on an outside authority whenever they needed guidance. Indoctrinating children with the belief that their religious beliefs will guide them can be very comforting to a child. Unfortunately, as adults, they find themselves dependent on that outside source to the detriment of their inner experiences. In encountering others whose religious beliefs seem contradictory to our own, we can easily feel our beliefs are threatened. This has had catastrophic effects throughout history and continues to do so. The us and them mentality is one result of living by a dependence on beliefs from an outside authority.
It is not so much about whether the beliefs are based on fact; it is that living according to beliefs to which we have been indoctrinated is orthogonal to the development of the ability to develop true self-efficacy, self-empowerment, and self-knowing.
Below, I will explore how this affects us on a global, individual, and relationship level.
On a global level: The most obvious example of the worst damage caused by blind acceptance of and obedience to unhealthy beliefs can be seen by looking at the way rigid, unquestioning, acceptance of religious beliefs have catalyzed genocidal crusades throughout history and on every continent. Regardless of where we live in the world, most of us believe our beliefs are the correct ones and that the world would be better off if everyone shared our particular beliefs. It is this rigid, unquestioning, ownership and acceptance of religious beliefs that has and will continue to create genocidal catastrophes throughout the world. Harm does not result directly from the beliefs themselves, but rather from our blind, unquestioning acceptance of them as truths. Blind acceptance of unhealthy beliefs as truths leads to unhealthy behavior. Our brains spew out thoughts that lead us to create critical, judgmental and divisive beliefs as a normal part of the human condition. Only when we courageously question our unhealthy beliefs, especially those espoused by a recognized authority, do we have any chance of avoiding unhealthy behavior.
Politics, nationalism, and religion seem to be the three categories of beliefs that carry the most charge and to be the topics about which we are most unwilling to question our beliefs. Think of all the religious and political leaders throughout history who have been assassinated. The assassins were not necessarily sociopathic or mentally ill, at least no more so than were ordinary, law-abiding German citizens who committed countless atrocities during the Nazi period of their history. Those otherwise decent citizens were simply individuals who were blinded by their failure to question their beliefs. In that case, it was perfectly understandable because after many centuries of scapegoating of the Jews of Europe every time anything went wrong, by church and religious leaders, ordinary German citizens of the 1930s were easily able to fall prey to the new form of progressively extremist and ubiquitous propaganda infused into German society by a new authority. In fact, at that time, the same propaganda was being perpetuated by America’s Henry Ford, who propagated it throughout the U.S., in Germany, and wherever he did business.
Any of us, in any country on the planet, in any time period, are fully capable of committing atrocities against any group of people who have been marginalized by an authority such as our own government or church. Extremist and divisive beliefs have and always will exist. However, genocide and assassinations usually result only when those beliefs are propagated by those in authority and then blindly accepted as truths.
On an individual level: Blind, unquestioning obedience to the beliefs we hold about ourselves, as with religious beliefs, also hold the potential to cause enormous harm. Again, it is not the belief itself, but rather our blind acceptance of and obedience to it that results in any harm. The difference is that the harm in not questioning self-deprecatory beliefs is predominantly to ourselves. Unquestioning acceptance of self-deprecating beliefs commonly cause us to live very limited lives and prevent us from ever reaching anything close to our full happiness potential. These beliefs commonly hold us hostage throughout our entire lifespans. As with religious beliefs, long-standing beliefs about ourselves appear to us to not be beliefs at all. In other words, we mistake them for reality, for the truth. Even though many of our unhealthy core beliefs could often be easily disproven by someone who knows us well, we commonly fail to question those beliefs because we fail to recognize them as beliefs. The automatic default is to take our beliefs to be factual.
Even when a psychotherapist or someone who knows us well points out that one of our healthy behaviors serves to effectively disprove one of our most damaging, self-critical beliefs, we are commonly unable to take in that information at first. One of the reasons for this is that the neural networks supporting our deep, long-held beliefs make even the questioning of them anathema to us. Even when someone provides objective, observable evidence to disprove one of our self-critical core beliefs, the new evidence needs to be processed over a long period of time before we are able to truly free ourselves from the grasp of that long-held belief. The new and complimentary evidence-based information can actually be too jarring and out of sync with our long-standing, unhealthy self-identity.
Most of us go through our entire lives living in a prison created by our minds, the specifics of which are determined by the nature of our beliefs about ourselves and the world. There is always a door leading out of that prison. However, the ability to open that cell door and walk to freedom is created by our courage to risk doing something very new and frightening, which is to stop acting in accord with our self-limiting beliefs.
On an Interpersonal Relationship Level: We all form beliefs about our partners, family members, friends, and everyone with whom we interact. Most of the time we are unaware of many of the beliefs we hold about other people, especially those closest to us. Our behavior, when in that person’s presence, commonly reveals the nature of those beliefs. If we believe someone is a certain way, we will interact with that person accordingly. When we fail to question the validity of our beliefs about that person, which means our interactions with that person are seriously informed by those beliefs, the depth of that relationship will be limited.
For example, our ability to communicate our inner feelings to someone we believe is disinterested or incapable of really hearing us will be hampered by that belief. By working to identify those beliefs and then taking a risk and acting as if we did not hold that belief, we can create new possibilities in the relationship. Putting the belief to the test may on some occasions prove conclusively to us that there is no hope of improving the relationship. Whatever the result, the process of courageously testing our beliefs about the other person can be very self-empowering.