Tag Archives: focus

Remembered Wellness

I have just completed reading Timeless Healing – The Power and Biology of Belief by Herbert Benson, the founder of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. This is the third book by Benson that I have read in the past month, and definitely the most compelling. About two-thirds through the book I took a break to read the Relaxation Response (also by him) and found that book and this one to be excellent complements to one another with each illuminating the other. If you opt to read one, I heartily recommend reading the other and within a short time period of one another.

REMEMBERED WELLNESS – What it is

What drew me to this book was wanting to understand “remembered wellness”, which many of us might know as the “placebo effect.” The placebo effect is the belief a person has to heal based upon projecting “our intense desire for wellness onto the medicine we take” even if the medicine is just a sugar pill with no medicinal chemical ingredients. In addition, as Benson states “…all of us have the ability to “remember” the calm and confidence associated with health and happiness, but not just in an emotional or psychologically soothing way. This memory is also physical.” Hence, Dr Benson’s conclusion that the placebo effect should be renamed and thought of as “remembered wellness.” To me, the simple act of conjuring remembered wellness is more powerful than the thought of taking a pill called a placebo. As marketers know, there’s much to be said for how something is labeled!

In the late 1990s I was diagnosed with a Stage 1 breast cancer. I vividly recall the conversation with Dr Josephson, the breast surgeon who would operate on my left breast.

Me: Will I die.
Dr J: No.
Me: Will I lose my hair?
Dr J: No.
Me: Okay then, let’s do it!

It is important to know that up till that time I was generally a hard core optimist about most things in life, that I had a head of long, curly, thick red hair, and – most important -– I was the mother of 7 and 14 year old sons.

I didn’t give the conversation much thought again till recently, upon reading this book. Early in the book Dr Benson states what is necessary for remembered wellness:

THREE COMPONENTS OF REMEMBERED WELLNESS

  1. Belief and expectancy on the part of the patient
  2. Belief and expectancy on the part of the caregiver
  3. Belief and expectancies generated by a relationship between the patient and the caregiver

As per my conversation with Dr Josephson each of those items would have a big checkmark next to them. And number 3 was surely impacted by my knowing Dr Josephson as the warm, funny, kind mother of one of my older son’s soccer teammates. (Heck, I knew she went to circus camp as an adult!)

None of this was a placebo – I did have surgery, I did have treatment in the form of radiation, and I did take medicine for five years. However, the surgery and my recovery went smoothly and, after reading Benson’s book, I am convinced that my desire for “remembered wellness” played a major positive part in the process. As the book title suggests, Dr Benson spends a large portion of the book discussing the importance of and science behind the impact of belief.

REMEMBERED WELLNESS – It’s opposite

Turns out there is the opposite side of remembered wellness, the “nocebo” effect. If the placebo effect results in a person believing the best about their treatment, the nocebo effect results in a person believing the worst about their treatment. And what the mind believes, the body does; the body responds to the beliefs we have.

Benson refers to Dr Arthur Barsky, Professor of Psychiatry at Harvard Medical School, who “reminds us that paying attention to a symptom or problem amplifies it while distractions lessen our experience of it.” Barsky is quoted as stating “the mandate for self-discipline and self-control becomes so burdensome and so arduous that it begins to erode our sense of well-being and makes us feel increasingly insecure about [our] health.”

THE BIOLOGY

Regardless of whether a person believes in the placebo or the nocebo effect, in times of perceived stress the brain will cause specific hormones to be released. The hormones, in turn, cause physical responses within the body. The severity of those responses and how they are dealt with, using one or any combination of what Dr Benson refers to as the three-legged stool of medicine (Health and Well-Being is the seat supported by the three legs of Self-Care, Surgery and Procedures, and Pharmaceuticals) is influenced by the belief held by the individual. I found an interesting and information-packed TED Talk by Lissa Rankin from 2012, Is there scientific proof we can heal ourselves? that pulled together much of what I’ve been mulling over in Benson’s books.

Your thoughts and feelings about the daily experiences of your life both originate from and transmit signals to your body, neurologically and biochemically instructing and changing your health. [p 245]

RELAXATION RESPONSE and REMEMBERED WELLNESS

They seem to go hand-in-hand, these two, with the relaxation response preparing the mind – and hence, the body – for positive receptivity for remembered wellness.

We know that mental focusing techniques that elicit the relaxation response quiet the mind and the body to a more substantial degree and with greater speed than any other means. We know that the experience seems to clean the slate of the mind, making it more receptive and creative. And we know that the experience feels very spiritual to some people, and that spirituality agrees with them, producing better health. [p 213]

Spirituality is a highly personal feeling. People experience and seek out spirituality in their own way, in their own time, and to varying degrees. Spirituality is separate from  religious belief, though it can definitely be a major component of religious belief. It is not so much religious belief that impacts the magnitude of the impact of remembered wellness as it is simply a belief in something, in other words, some sort of spiritual belief.  For more about spirituality and health, visit the University of Minnesota’s Earl E. Bakken Center for Spirituality & Healing Taking Charge of your Health & Wellbeing website, which I found when doing a search for What Is Spirituality.

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Norepinephrine

Norepinephrine is both a hormone and a neurotransmitter. When released as a hormone in response to excitement, which can include both positive and negative stimuli, norepinephrine also helps in cementing memories caused by the excitement.Norepinephrine’s role in responding to excitement may sound similar to Epinephrine, which I wrote about in my previous post. It turns out that norepinephrine is epinephrine that has reached the brain.

When released as a neurotransmitter, norepinephrine helps carry messages across synapses. It also plays a role in retrieving memories, according to this Science Daily 2004 article about research at the University of Pennsylvania Medical Center. Norepinephrine is also useful in telling the brain to shake, rattle, and roll in an attempt to make the brain alert and focused. However, too high levels can be a cause of aggression. Serotonin, dopamine, and endorphin, working as a trio, can help balance high levels of norepinephrine and somewhat control the aggressive behavior.

You can tinker with a 3D model of norepinephrine at the 3Dchem site, which focuses on chemistry, structures and 3D molecules and is maintained by Dr Karl Harrison from the Department of Chemistry at the University of Oxford. Folks with Parkinson’s have a decrease in production of norepinephrine. Marilee Sprenger, citing Wurtman & Suffes, 1996, notes that “Norepinephrine and dopamine, sometimes called the alertness chemicals, are produced when tyrosine reaches the brain. Tyrosine is found in protein.” That’s certainly a plug for having proteins in the diet. There will be more on what makes for a “really good brain diet” in a future post.

Dopamine

Dopamine functions both as a neurotransmitter and a hormone. It helps control physical movement and also helps regulate information flow to the higher levels of the brain, thus having low levels of dopamine may impact working memory and ability to focus. You might know someone who takes Ritalin. Well, that is a drug which is sometimes prescribed for people who have difficulty focusing because it counters the low levels of dopamine.

When tripled up with serotonin and endorphin, dopamine balances out high levels of norepinephrine, which can cause aggression. These three neurotransmitters also release into the brain when stimulated by exercise (think of a runner’s high, for instance), listening to music you like, smelling smells you enjoy (like freshly baked cookies), and receiving positive feedback, so you can understand why dopamine, serotonin and endorphin are thought of as the “feel good” chemicals. 🙂

There is a down side, though, to having naturally produced “feel good” chemicals in the brain. External elements often influence us and how we feel, and some of these elements can have negative effects on the body, such as too much alcohol or indulgence in other types of drugs. This is where addiction comes in to the story, as you can read in this University of Texas at Austin article.

From the Surfari wiki (which I co-authored with a colleague): Did you know that your brain is about 80 percent water? To keep it alert, it is good to drink water throughout the day. Another type of food that feeds your brain is protein. Protein provides amino acids, which help produce dopamine and norepinephrine. Sources of protein include yogurt and cheese (hey, this sounds like dairy products!), animal foods (chicken, meat, fish and eggs), and for those of you who prefer vegetarian foods (beans, lentils, nuts and seeds).

In Parkinson’s’ disease there are decreased quantities of dopamine which result in physical movements that are constant and jerky. An insufficient quantity of dopamine is also associated with Schizophrenia. The pharmaceutical L-dopa can sometimes help neurons to continue producing dopamine.