What Medical Advances May Obscure

A possible counterpoint to our book is to say well even if all this is right about psychological influences on health, we'd be much better off devoting our time to finding medical means to prevent its negative effects. For example, in the case reported two posts ago, why not look to block the effects of noradrenalin on the tumour cells rather than using therapy to reduce levels of the hormone? Perhaps we may even hope one day to protect the foetus from the effects of maternal cortisol by pharmaceutical means.

Now surely there something troubling about this? Already in the fourth century BC, Aristotle was pointing out the solution to the second problem, when he advocated in The Politics that one not argue in the presence of pregnant women. Doesn't the path which looks to solve a problem merely by the mitigation of effects rather than by the removal or lessening of the cause seem to miss the point? Would we be happy that a factory pumping out acidic waste into a river, dumps in alkaline solution a mile downstream?

What, then, if medical advances gave the appearance of obviating the need to bring about changes to our mode of living. In the book we discuss how several years ago Dean Ornstein ran a support group for patients who had been through heart bypass surgery. Through meditation and discussion he managed in many cases to have these patients reverse the clogging of their arteries and to increase the blood flow through them. Now this was at a time when it was very common for the surgery to need to be redone after only a few years. Anything which would delay this second surgery would be welcome. Since that time, however, medical advances have meant that such operations do not have to be redone quickly. What do we conclude then? That Ornish-type support groups are no longer desirable? But didn't his successes tell us something rather important about removing the causes of ill health?

'Stress' hormones again

As reported by the BBC, researchers have found that large levels of cortisol crossing into the placenta can cause later mental and behavioural problems like ADHD in children. As we report in our book, it can also lead to dysregulation of the hormone rhythyms in the individual, which has physiological consequences, as mediated for instance by cortisol's effect on the immune system.

Like noradrenalin mentioned in the last post, cortisol is tagged as a 'stress' hormone. I use the quotes since we are critical of the stress construct in our book. The term often is used to avoid confronting particularities of the 'stressed' individual. For example, where in the cases reported in the BBC article we hear that "stress caused by rows with or violence by a partner was particularly damaging", this tends to steer us away from any sociological or psychological understanding of the violence.

More mechanisms for tumour promotion

In our book we explain how one's emotional state may impact on the components of tumour surveillance and suppression. Now we find that further details of a mechanism which promotes metastasis - the formation of further tumours - have been discovered by researchers at Ohio State University. Receptors for norepinephrine (noradrenalin) allow the hormone to act on some tumour cells to produce two compounds which can break down the tissue around these cells and allow them to migrate into the bloodstream. Norepinephrine also stimulate the tumour cells to release another compound that promotes the growth of new blood vessels that feed cancer cells, speeding up tumour growth.

Norepinephrine is one of the so-called 'stress' hormones, whose levels may be expected to rise in emotionally difficult times.

Why Do People Get Ill?

Darian Leader and I are bringing out a book with Hamish Hamilton (Penguin) next month - Why Do People Get Ill?. As the blurb asks:

Have you ever wondered why people get ill when they do? How does the mind affect the body? Why does modern medicine seem to have so little interest in the unconscious processes that can make us fall ill? And what, if anything, can we do about it? "Why Do People Get Ill?" lucidly explores the relationship between our minds and our bodies. Containing remarkable case studies, cutting-edge research and startling new insights into why we fall ill, this intriguing and thought-provoking book should be read by anyone who cares about their own health and that of other people.

Last week we were interviewed and photographed by the New Scientist, and Darian was interviewed by Harpers. Extracts of the book will appear in newspapers and the magazine Psychologies.