The Mind Body Connection

Louise Brown got divorced three years ago. She had not wanted to break up with her husband of seven years and says that at the time she felt terribly depressed. Today, she has pulled herself together but still feels strongly about the divorce. She feels rejected and abandoned.

She also complains of being constantly run-down and tired – always suffering from some minor ailment. “After Bob left me,” she says, “I got pneumonia, and ever since it’s been one thing after another. If it’s not a sore throat, it’s an ear infection. And if someone in the office gets a cold, I’ll be the first one to catch it.”

Howard Hunt is 32 and works for an advertising agency. He enjoys the challenge and competition of his job, but before the launch of a campaign, he feels tense and nervous. He is smitten with cold sores around the mouth and often has bouts of flu.

Could the two have similar causes? Could Louise Brown’s defenses against disease be weakened by her state of depression? Could Howard Hunt become prey to viruses when he is under stress because of looming deadlines? Research on the effects of stress on the body’s immune system suggests there is a connection and is beginning to explain why.

The cortisol effect set Janice Kiecolt Glaser, a psychologist at Ohio University, wondering if she had found an explanation why people under stress could be more at risk to infections than those leading stress-free lives. With her immunologist husband Ronald, she did some pioneer research in psycho-neuro-immunology, a new term for the study of how psychological factors affect the immune system.

The Glasers studied a group of separated or divorced women and a group of medical students before and during their examinations. In both studies blood samples were taken and the subjects filled in psychological questionnaires.

The blood samples were tested in different ways to assess the strength of the immune system. For example, measurements of the levels of antibodies and natural killer cells were taken.

In the first study, 38 divorced or separated women were compared with 38 married women. The women were asked questions rating their state of distress and the quality of their former union. Their controls, the married women, had to describe the quality of their relationship during the last six months.

When the Ohio team matched up the results of the blood samples and the questionnaires they found that the women who were divorced or separated had psychological problems, felt isolated and also had depressed immune systems.

“The stronger their attachment to their ex-husband or the greater their anger at the divorce, the greater the disturbance to their immune system,” says Janice Glaser. But with time and possibly a new relationship, the chances are they will improve. Married women having problems with their husbands also had weak immune systems.

In the study of medical students, blood samples were taken from a group of 75 a month before their final examinations and on the first day. There again the subjects who reported stress, or who were anxious and lonely, had disrupted immune systems.

How to Strengthen the Immune System

Janice Glazer stresses that a lot more research is needed. Researchers have evidence that stress depresses the immune system. Now they will try to find out what sort of events enhance the immune system.

There is already evidence that it is possible to bolster the immune system psychologically. This was emphasized last May at a session on psycho-neuro-immunology held by the American Association for the Advancement of Science.

Dr. Jay Weiss, professor of psychology at Duke University, said: “We strongly suspect that the influence of psychological environmental events cannot be exclusively immuno-suppressive.”

“There are some data that suggest that the organism can actually learn some immuno-enhancing phenomena. I would say that one of the major frontiers is to discover environmental events which, rather than being immuno-suppressive, are immuno-enhancing – possibly even the learning of immuno-enhancing phenomena.”

British doctors are pioneering this research. Two weeks ago the Cancer Research Campaign launched a five-year program to investigate the psychological problems of cancer patients and to find ways of improving their lives by helping families and medical staff cope with their problems.

The project will cost the charity one million dollars over five years. Two groups will be set up. One, in London at the Royal Marsden Hospital, headed by Dr. Stephen Greer, will begin in October. The other, at the Christie Hospital in Manchester, led by a psychiatrist, Dr. Peter Maguire, will begin next January.

“The fears and worries of patients are often made worse because the family and friends of patients are themselves frightened and do not know how to cope,” Maguire says. He is already running several workshops in which he helps medical staff understand the signs of their patients’ anxiety and suggests ways of relieving it.

Greer has shown how these worries can also affect the patient’s physical condition. He looked at the mental attitudes of women who had a breast removed as part of cancer treatment and found that those who had a positive attitude were twice as likely to survive for 10 years as those who were depressed.

Greer intends to look at techniques like those used in American hospitals to help patients psychologically. These include video games in which patients kill off their own illnesses.

At the M D Anderson hospital in Houston, Texas, children suffering from cancer are not only given chemotherapy but also play with a ‘zap ’em’ video game called Killer T Cell. Doctors believe the game, in which the child kills his enemies, the cancer cells, and helps his protectors, the T-cells, will strengthen his immune system.

Maguire emphasizes that the main objective of the five-year study will be to improve the quality of life of patients, but he also hopes it will be possible to increase the patients’ survival rate. “We will be teaching patients cognitive strategies – that is to say, mental tricks to challenge their negative thinking,” he explains.

The project includes the preparation of a handbook of guidelines that could be applied by doctors and nurses to promote understanding of the psychological problems faced by cancer patients.