10/10/2012 05:30 pm ET Updated Dec 10, 2012

'I Will Not Be Pleased' -- Your Health and the Nocebo Effect (Part 3)

One key to an entirely new kind of medicine is suggested by the placebo effect. But for this promise to come true, we need to see placebos as part of a holistic system. The placebo effect has already existed for a long time, baffling medical researchers. The fact that a percentage of subjects will always get better when given a dummy drug is real, but the effect is difficult to harness, since it involves deception on the doctor's part. In earlier posts we've covered how the reverse of the placebo effect, known as the nocebo effect, indicates that some subjects also get worse when given a dummy drug.

Put the two effects together, and what you get is a feedback loop that sends positive and negative signals throughout the body. In other words, placebo and nocebo aren't odd, isolated phenomena. They are the tip of an invisible iceberg. To see the whole thing, you must start to reenvision the body itself.

The first step is to see the body as a dynamic process that is fully alive, organic, and intelligent. Outcomes depend on choices, beliefs, expectations, and other events that stream directly from the mind to every cell. Thus, placebo-nocebo is happening all the time. The reason we don't observe them is that the feedback loop that connects mind and body is hugely complex. Hundreds of signals, crisscrossing and often conflicting with one another, create more than one influence. You are the source of every influence; therefore, your body's response to experience is as complex as you are.

Mainstream medicine doesn't yet acknowledge these things. One of the most damaging byproducts of the scientific approach to the human body has been a false sense of determinism. In a machine, the moving parts are interlinked. A series of cause-and-effect is set up, and as the machine operates, each part determines how output follows input. This is true of the simplest machines (push a wheel and it starts spinning) and the most complex (the information you get from a computer depends on the information you put into it). On the same principle, medicine keeps searching for causes that determine effects, whether they be microbes, genes, chemical imbalances, or some other fixed determinant.

The problem is that the body, although is partially resembles a machine, is much more prone to influence than to fixed determination. A few disorders are caused by specific genetic mutations, such as sickle cell anemia, but now we know that genes interact in complex ways that change their output, just as the body interacts in a complex way with germs, sometimes resisting them and sometimes becoming infected. The picture is more confusing than simple cause-and-effect, but on the other hand it is more hopeful, for the simple reason than influences can be altered.

For the promise of preventive medicine to be fulfilled, you have to take responsibility for influencing the dynamic feedback loop that is your body. Even the worst influence, such as smoking, is not determinative. Even the best influence, such as daily exercise, isn't a guarantee. But if you create a matrix of positive influences, the total effect is a state of well-being. Popping a vitamin pill is a tiny event that may or may not benefit you. Well-being is a constant state that creates a benefit every minute of the day. Putting well-being first is the most significant change that everyone can make.

Yet few of us do. We pursue health and happiness in a haphazard, fitful way, for which we pay a high price when negative influences gain the upper hand over time. What are we doing in the meantime? Where is our main focus, if not on well-being? The answer isn't a mystery. People spend vast amounts of time focusing on work, relationships, distractions, escapism, and repressing stress, toxic memories, psychological blocks, and warning signals from their bodies. Well-being doesn't deny work and relationships. Prevention has gotten a bad name for being no fun. The emphasis on risk factors has made health seem like a gamble, with the body as a potential enemy.

To make your body an ally should be your goal, which means including it in your pursuit of well-being. Begin by looking at the menu of good and bad influences, and then decide how to maximize the good and minimize the bad ones. The list of positive influences is very long but worth examining, because it extends so much further than the seeming drudgery of "doing what's good for you."

Good influences:
  • Social closeness, love, bonding
  • Healthy, balanced diet
  • Lack of toxins in the diet
  • Good sleep every night
  • Moderate exercise
  • Not smoking
  • Using alcohol in moderation
  • Satisfying work
  • Play time
  • Self-aware activities like meditation and self-reflection
  • Stress reduction
  • Healing old psychological wounds
  • Forgiveness and compassion
  • Inspiration from poetry, scriptures, and other sources of wisdom
  • Learning new things
  • Making peace with yourself
  • Devotion to a selfless cause
  • Higher vision of life
  • Letting go of excessive control
  • Self-reliance and high self-esteem
  • Tuning in to your body
  • Not forcing or straining
  • Empathy, taking other people's feelings seriously
  • Contact with nature
  • Feeling safe
  • Learning to give and receive
  • Gratitude, expressing appreciation
  • Music, dance, the visual arts
  • Being with children
  • Innocence, openness, a lack of cynicism
  • Not being judgmental
  • Seeing the future with hope
  • Optimism
  • Taking quiet time every day
  • Giving up perfectionism
  • Practicing non-violence
  • Dealing with sources of anxiety and depression
  • Developing resilient emotions, the ability to bounce back
  • Personal growth
  • Service
  • Learning simply to be

No one is asking you to be a saint or even to tick off as many boxes as you can. The point is to expand your sense of well-being, showing you all the dimensions of life that send signals to your body. One could easily call all of these positive influences a kind of placebo, because you expect to be pleased. As for the menu of bad influences, rather than compile a separate list, it's enough simply to reverse everything on the positive list. All forms of toxicity, including toxic emotions, along with inertia, habit, lack of self-awareness, denial, avoidance, and close-mindedness would head the list.

Well-being will be taken more seriously when it becomes synonymous with fulfillment. A fulfilled life requires conscious attention. It includes many goals: developing a mature self, facing your demons, learning to value higher experiences, pursuing personal growth, and more. Whatever your full-time job is, the full-time purpose of your life is to find fulfillment. If you do, there is no better way to have a healthy body.

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