The potential of the human brain

is vast, yet most of us never stretch our

own brains beyond a traction of that
potential. The Brain Power series contains a
wealth of fascinating information, exercises and
tips to enable you to understand your brain better
and find out how you can use it to improve your life,
whatever your age. Once you realise what your brain is
capable of achieving, you'll be able to improve your
memory, enhance your intelligence, increase your
creativity and much more.
The Healing Brain focuses on the brain's ability to
influence health and well-being and explains the
mechanisms behind the brain's amazing powers to
promote self-healing of body and mind. The book
reveals how brain power can control pain and aid
recovery from illness. It explains what can go wrong
with the brain and what can be done about it.
And it provides practical ways by which you
can harness the healing capacity of your
brain to benefit your life and health.
 THE BRAIN IS ABLE
TO ALTER ALMOST ANY
BODY FUNCTION
Heart rate can be slowed, the bowel
relaxed and blood vessels opened or
closed, just through thought.
Imagining being warm, for example,
can increase the temperature in a
person's fingers by more
than 1 °C.

THE BRAIN HAS

POWERS TO MEND THE
CUDDLING A BABY
DAMAGE AFTER STROKE
ENCOURAGES IT TO GROW
Although nerve cells affected by
Physical affection causes the
stroke usually die, connections
brain to secrete a chemical called
between surviving cells can regrow,
dopamine which in turn triggers the
bypassing damaged areas. In this way,
release of growth hormones. Babies
the brain can resculpture itself,
deprived of close physical contact
often regaining some of the
with others may therefore be
functions lost immediately
slower to develop,
after a stroke.
psychologically as well
as physically.

IN REGULATING
THE APPETITE THE BRAIN
CAN MATCH CALORIE INPUT TO
THE BRAIN IS THE ENERGY OUTPUT ALMOST PERFECTLY
FASTEST-GROWING
In practice, the region of the brain that
ORGAN IN THE BODY
controls food intake is frequently overridden
In a developing foetus, up to a
by conscious desires for food created by
quarter of a million brain cells are
social and other pressures. But left alone, the
produced every minute. After birth,
brain provokes hunger only when glucose
rapid growth continues. By the levels fall below the optimum level. In this
time a child is two years old,
situation, a person's weight would vary
its brain is nearly as big
less than 5 per cent during their
as an adult's.
entire adult life.
 THE BRAIN
CONSTANTLY MONITORS
EVERYTHING HAPPENING AT THE
BODY'S SURFACE, AND IN EVERY
MUSCLE AND JOINT
By doing this, the brain keeps track of where
the body begins and ends, and enables it to
maintain balance and carry out automatic, as
well as deliberate, movements. Most of this
input is registered unconsciously, but if
it is cut off - by brain injury or
sensory deprivation - the
body collapses.
DURING CHILDBIRTH,
THE MOTHER'S BRAIN IS
FLOODED WITH A HORMONE THAT
HELPS BUILD THE MOTHER-CHILD BOND
AND DULL THE MEMORY OF THE PAIN
Giving birth is painful - so much so that many
women vow they will never put themselves
through it again. Yet most do. One reason is
that the memory of the pain is partly wiped
out by the hormone oxytocin - leaving
only an intellectual (rather than
emotional) recollection of how
bad the pain was.

THERE ARE MORE

POTENTIAL CONNECTIONS CAN HELP TO FIGHT
BETWEEN THE CELLS IN A OFF INFECTIONS
SINGLE BRAIN THAN ATOMS IN THE
The body's immune system
ENTIRE UNIVERSE
responds directly to changes in the
The brain has about 100 billion neurons, and brain. A sad event - such as losing a
each neuron has up to on_e thousand 'docking loved one - can produce a
points' where it can connect with others. If all measurable depletion in the
these connections were made, there would be number of infection-fighting
100 thousand billion information­ blood cells within
exchanging links. In practice, of course,
only a tiny fraction of these
connections are ever
established.

NO TWO BRAINS
ARE IDENTICAL
The brain is so sensitive to its
environment that even identical
twins have visible differences in
brain structure by the time they are
born. These are caused by the
minute differences in nutrients
and sensory stimuli that each
foetus experiences.
••••• ••
•
12

THE MIND-BODY LINK

The relationship between body and mind has occupied some of the
world's greatest thinkers for centuries. Many Western philosophers
concluded that mind and body were entirely separate, and this view had
a strong influence on the development of scientific medicine and its
practice. Today, a more integrated approach is increasingly being
accepted across many areas, from medicine to religion.

It seems obviou that every person ha a mind and a body, and that the brain
is the place where all the activity that we call thinking occurs. But what
e actly is the relationship between these three vital parts of ourselve - mind,
brain and body?Thi may eem a imple que tion, but it i one that ha
puzzled thinker through the age , and they have ome up with a
variety of different an wers. What i clear today, however, i
that th interaction between mind· and body i an impor­
tant key to maintaining good health.
The idea that mind and body are intrin icaUy linked
and therefore cannot be treated eparately ha a long
hi tory in healing. In ancient Greece, for e ample,
people who were phy ically ill or emotionally trou­
bled would vi it one of the temple of the healing
god A clepiu . Here, far removed from the tre
of daily life they would enjoy mu ic, drama and
philo ophical di u ion and focu on diet, fitne
and elf-examination to revive both mind and body.

Descartes and dualism

In 17th-century Europe, however, a radi al new approach
emerged.The French thinker, Rene e arte , known a the
father of modern philo ophy, rejected the idea that mind and
body are unified. Instead, he developed the concept of dualism in

In the epic poems of Homer,
composed in the 8th century BC, the
mind hardly gets a mention. Homer's
characters do not 'think' or make
decisions. Instead, they are instructed
by voices ('my heart told me ... '), driven
by inner tensions, or coerced by a god.
Emotions are also described very
differently from today: rather than
being something in the mind, an
emotion was always located in the body.
A gasp or pounding heart was a feeling.
As in other cultures without a
tradition of writing, Homer's ancient
contemporaries did not recognise the
difference between a thought and the
words that utter it. Mind and body were
thus one and the same to them.
However, as written language
developed, later generations came to
recognise a distinction between the
symbols used and the ideas they
represented. This distinction could be
applied to spoken words, too, and
writing and speech became understood
as expressing pre-existing thoughts. In
effect, 'the mind' was invented by the
ancient Greeks as a place in which
people kept their thoughts, intentions
and desires before e,cpressing them.
 M I ND, BR AI N AN D BODY 13

whi h ntind and body are quite separate. De carte wa

triving to et the knowledge and philosophy of hi day
on new, more olid foundation . To do this he tarted
from scratch, di arding all preconception that could
be doubted. He even pe ulated on whether his whole
life wa a dream or the deception of a malignant
demon. But, by reflecting on hi own thinking he
realised that thi i elf wa sufficient to prove hi ex:i -
tence. He concluded: 'l am, r exi t, i nece arily true a
ften as I put it forward or conceive of it in my mind'.
From thi follow p rhap the be t-known quotation in
all philo ophy : 'I think, therefor l am', or in Latin, Restorative waters Popular in ancient civilisations as today, the
' ogito ergo um'. spa combines physical therapy with mental relaxation, reflecting a
De carte argued that a per n, and indeed the unified approach to mind, health and body.
whole world, con i t of two radically different ub-
tances, mind and matter. Th mind, whi h he aw a the real identity of
a per on, exi ted a a piritual' ub tance' in a piritual phere while the
'.�·o·., ...,.... --�··· �·- ·,.. -.·�-:,..iJ
/ : cus:-i,oN
' .
body a phy ical ub tance, was in a eparate material universe. De carte
'

could not deny that the two ub tance intera ted with each other, THE DOCTOR-PATIENT
ommenting that 'I am not merely pre ent in my b dy a a ailor in RELATIONSHIP
a hip, but I am very do ely united and a it were intermingled with In hospital, patients may be
surrounded by a frightening array
it . But thi revealed the main problem with duali m: if body and mind
of monitors, tubes and charts, and
are fundamentally different, how can they interact or affe t ea h other?
find themselves being spoken about
And what make it po ible for our mind to intera t with the phy ical rather than to, while experts debate
world around u ? their medical condition. This picture
De cartes never fully unravelled the intermingling' of mind and body. reflects the influence of dualism on
Indeed, the 'mind-body problem' ha ontinued to intrigue philo opher healthcare: until recently, the
treatment of the body dominated,
ever ince. Neverthele , the phil ophical separation of mind and body
while the patient's feelings were
emed t b the best theory available, and became very influential
seen as unimportant. But this is
throughout We t rn thought. Like De carte , hri tianity ha often ug­ now changing, with the growing
ge ted the eparation of mind and bod (and the inferiority of the latter), awareness that the patient's mind
encouraging followers t purify their oul by winning control over their is important to the recovery
bodily impul es. In th ontext of religion, dualism remain popular today process. Acquiring an interactive
bedside manner that respects the
- perhap becau e it can provide a ba i for belief in life after death in the
patient as an individual, rather than
face of phy ical mortality,ju t a De cartes believed that after the body die
just a set of symptoms, has
the mind continue to exi t. become an important aspect of a
Meanwhile, alongsid the cientific advance of I aa ewton and hi doctor's training.
contemporarie Western medical ien e wa rapidly developing it
kn wledge of the human body along dualistic principle , analy ing it
much as a ma hine and focu ing on i eparate parts.

Reuniting mind and body

From the beginning of the 20th century, howev r, development m c1ence
and philo ophy began to mov away from duali m, and it has become
increasingly accepted throughout all area f knowledge that mind and
body are inextricably linked. The Briti h philo oph r ilbert Ryle was
14
FACT FILE
THEORIES OF
MIND AND BODY
Onr th1 cltllflrin,
philosoph,rs have tried to find
a way of 1xp/aini"6 mind and
body that accounts for how
dl"9rent this, two aspects of
our s,/ves 111111, whl/1
1Yvtaliff6 how they can still
interact. This, a1Y som, of thl
mo1Y influential attempts:
Occasionalism: Neither mind
nor body affects the other; God
is the one and only true cause.
If someone wills to wiggle a toe,
this act causes God to intervene
to make the toe move.
Double-aspect theory: Mind
and body are different aspects of
the same underlying reality -
typically either God or Nature.
Psychophysical parallelism:
Mind and body are two distinct,
independent entities that run in
parallel like two perfectly
synchronised clocks.
lmmaterialism: There is no
such thing as matter; what we
think of as the body is just the
perception of the mind.
Materialism: There is only one
substance - matter; the mind
can be explained on the basis of
physical laws.
Epiphenomenalism: The
workings of the mind are simply
the effects of physical changes
in the body.
Identity theory: Being in a
certain state of consciousness
and being in a corresponding
physical state are just different
descriptions of the same thing.
influential here: he All together Gilbert Ryle, the 20th­
attacked De arte ' idea century philosopher, argued that the mind
a fundam ntally mi - is not an entity independent of the body, but
taken, famou ly ailing is integral to it. Mind is
them 'the dogma f the
to body as team
spirit is to a team
gho t in the ma hine'. of sports players.
Today, cience i
beginning to show ju t
how intimate the
mind-body relationship
is. New imaging te hnique
are mapping the brain at work,
revealing amazing di cov rie ab ut the
phy ical neural proce e that underlie
mental rate emotions and even
thinking i elf.
In medicine, analy ing the
parts rather than the whole ha
paid off hand omely. It has
enabled medical cience to
onquer many illne se , and
led to people generally l ading
longer, healthier live . lt h
produced an understanding of
the body and the disea es that
affect it that is unrivalled in its
detail and its ucce in diagno i
and treatment. Furthermor , the
evidence-based approach to
a e sing the effectiven · of
treatments i now agreed to be
the ultimate te t of any type of
therapy, We tern r th rwi .
evertheless, there i a growing
sense the t something i mi ing,
and that an integrated approach
may be ultimately more help­
ful way to g t to the bottom of
many health problems.
In rea ingly, therefore,
medical method regard the
mind and the body a
on tantly interacting. For
example, patients uffering
mental illne arc offer d
a range of therapie ,
 M I N D, BRA I N AN D BO DY 15

Scanning the brain New imaging

techniques have revealed huge amounts
of information about the workings of the
brain and nervous system, but many
questions about the mind and brain
remain unanswered.

from physical treatmen like drugs to p ychological approache , uch a

oun elling or p ychotherapy. Health p ych logi ts tudy how biological,
p ychological and ocial factor affect health and illne , and health
p ychology practitioner help individual to make life tyle change that
can improve their health or enable th m to cope more easily with
chronic illn

Drawing on alternatives
Ea tern healing y tern uch a ayurvedic medicine have always a urned
the interaction of mind and body. Ayurveda empha ise that everyone ha
elf-healing potential, facilitated by factor uch a good elf-esteem, a
reali tic under tanding of one's own nature, and the de ire and will to be
well, which encourag a healthy diet and lifestyle, a well as other elf- are
techniques uch a mas age and meditation.
Complem ntary and alternative medicine (CAM) ha become
increasingly popular in the We tern world, po ibly becau e of a
"Health is ... a state of
greater general anxiety about heaJth aero ociety. AM complete physical, mental
therapie u h a o teopathy, chiropractic and herbal medicine have
often fulfilled an important function in providing help and and social well-being,
comfort to people who have not found effective treatment in con­ and not merely the absence
ventional medicine. The potentially damaging ide-effect
of ome potent drugs ha al o led people to turn to alternative of disease or infirmity."
m dicine treatments.
World Health Organisation
Many We tern medical cientists and practitioner n w believe
that the focu on te hnological approache , including the u e f
drugs and ur ery, needs to be balanced by more attention to the individual
as a whole and the role of the mind in health. In the UK, ome medical
chool now give tuden ba ic information on complementary medicine,
and ome complementary therapie ar available in doctor ' surg ri .
omplementary medicine are bringing We tern and a tern healing
y tern together, pointing towards a more holi tic approach to medicine
for the future.
 pro aches
While 'Western medicine excels in treating acute problents, the
holistic approach, long favoured in Eastern healing traditions, ainis
to prevent problems before they cause illness. Holisti t
focuses on the whole person, including Ii
Eastern healing practices and complem
therapies have a long anecdo
benefits. There has

ALEXANDER TECHNIQUE Sitting straight

Alexander adjusts a
As a young actor, Frederick Alexander (1869-1955) suffered from client's shoulder position.
recurrent hoarseness, which his doctors failed to cure. He decided to Today, his technique helps
try to tackle the problem himself and began by watching himself. He thousands to better
noticed that, as he started to recite, he pulled his head back and down posture and
towards his shoulders, raising his chest and hollowing his lower back. health.
The resulting tension in his neck affected the relationship of all his
other body parts: his voice problem was in his posture.
Alexander realised that he only had to think about reciting and his
body reacted with its habitual pattern of tension. He began to practise
'directions' and what he called 'inhibition', in which he used mental
control to stop himself from responding in his automatic, harmful way.
His hoarseness disappeared and his health and well-being improved.
 M I N D, B R A I N A N D B O DY 17

stress. There is good evidence that yoga can

improve fitness, flexibility, strength and stamina,
and have beneficial effects on metabolic rate, lung
capacity and blood pressure.

Ayurvedic medicine
This traditional Indian medical system has always recognised the power
of the mind to heal. Diseases are believed to begin with imbalances in
bodily energy, which create a chain effect of mental stress, unhealthy
living and further ill health. These can be corrected by techniques that
combine mental and physical practices.
Ayurvedic treatment includes diet and lifestyle changes, massage with
oils, herbal remedies and therapies to promote internal cleansing and the
removal of toxic waste. Breathing exercises and body postures derived
from yoga aim to improve physical health,
while meditation is considered essential
to healing and disease prevention.

Western developments
Eastern medicine has influenced
several holistic practices in the West.
Autogenic training, sometimes referred
to as Western yoga, is a system of
relaxation exercises that increases control
over physiological processes. It is
particularly useful in chronic
illnesses, such as high blood
pressure. Other therapies
include Alexander technique;
Bach flower remedies; and
biofeedback (see page 110),
which improves health by
teaching people to respond
to signals from the body.
ING MINDS AND BRAINS
For much of history, the brain has been seen as a mysterious 'black
box': the only clue to what went on inside was what came out of it.
During the 20th century, a variety of approaches were used to explore
how the mind functions. Today, brain imaging techniques are bringing
us tantalisingly close to seeing the workings of the mind in action.

It i difficult to understand how the physical tis ue of the brain can pr -

due an apparently non-phy ical thing like con ciou ne . Mind and bod
(of which the brain i a part) eem o different that it i tempting t gr e
with th 17th-century Fren h philosopher De artes, who on luded that
they mu t be entirely eparate kind of ub tan e. The fir t lue about th
way the brain functi n ame through o-called 'natural experiment ' -
tudie of people with brain dama e cau ed by tr k or head injury. The
an ient Greek phy i ian Hipp rate had n ted that an injury to the I ft
idc f the brain often di rupted peech; hi finding wa onfirmed in
1 61, wh n the Fren h neur Logi t Paul Br ca identified the brain area
re pon ible for pcech production through po t-mortem examination of
tr ke patient .

Bumps on the surface

Many attempt have been made to find a systematic way to mat h brain
and mind . The Austrian anatomi t ranz Gall (175 -l 2 ) wa onvin ed
that human charactcri tic uch a 'amativene • (am rou ne ), 'morality',
'acquisitivene s' and o on, wer · ea h produ ed by pecifi brain ' rgan '
in different area of the cortex - th outer layer of the brain. Particularly
well-developed h ra teri tic uppo edly cau d bump on the kull,
which could be mea ured to give a character reading. Gall d velopcd hi
theor y of 'phrenol gy by drawing up a detail d map hawing the
location of the variou organ , and lling spe ial device to mea ure them.
Head-mea uring became a popular pa time in the 19th century, and many
town in the U A (and in Europe) had their own phrenology in titute.
Phrenology wa , of cour e, non en e: no amount of normal brain devel­
opment could au e dete table bulg on the kull. The di covery of brain
area genuinely re ponsible for certain function - the two main language
area in the left hemi phere - began the di r diting of phrenology
(although intere t in it persi ted), as they were nowhere near the brain
'organ' that Gall had claimed wa re p n ible for language.

Mind theories
Another rea on for th fall of phrenology wa that by 1900, igmund
Freud had <level ped a far mor oph.i ticated method of tudying the
mind - p ychoanaly i . Freud focu d on bringing uppres ed onflicts
and fear to the patient's con ciousne . With its mpha i on uncon ciou
motivation, the method caught the public imagination and fc r nearly half
a entury it wa generally thought to offer the learest modd of the work­
ing of the human mind. Unlike phrenology, p ychoanaly i al o offered
the pro pect of therapy to cure problem
Freud' uc e en ura ed other to seek an explanation of mind
through sy tematic intro pection. However, people' ability to report accu­
rately , nd on i tend on their own perception proved di appointing.
ne 'intro pectioni t laboratory' reported, for example, that pe pie uld
hav · 12 000 en u, I experien e ; an ther )aimed that it wa 44
P ychologi ts became embarra ed by their confu ing findings, and ught
to put their work on a m re ientific footing.
Behaviourism wa a reaction co the pitfall of p ychoanalysis and intro-
pe tion. The behavi uri t regarded the mind a an input-output
machine: in went a stimulu and out came behaviour. ln de ribing th
relation hip between timulu and behaviour, they ignored anything
that wa not ob er vable or measurable. he beha iouri t ra
reached it peak in the 1920s, around the time that early 0111-
puter were being developed. cienti ts ould ee how the e
worked: the machine was programmed with a few rules and
Reading the brain
then fc d bit f .information, whi h the omputer manipulated Phrenology aimed to give clues
a ording t the rule . It wa plausible to a ume that the mind to personality by reading the
function d in a irnilar way. bumps on people's skulls.
In the 1950 and 60s, cognitive p ychology took the behaviouri t A head map showing
prin iple a tep further by empha i ing internal m ntal pr ce the supposed location
of characteristics was
uch a deci ion-making, thinking and language. ognitive p y­
used in conjunction
chologi t were concerned with the rule the brain u e to with measuring devices,
interpret information, but not with the nature of the brain it If. like the one above from
While the appr ach made valuable advance in the tudy of the the 1920s.
20

In 1935, E1as Moniz, a Lisbon neurolo&ist, heard a
lecture by two Harvard researchers who reported
chan&in& an anxious, hyperactive chimpanzee into
a seemin&fy serene animal by cuttin& the
connections between the front and back of its
brain. Without waiting for the lecture to end, he
rushed back to his hospital and persuaded one of
the surgeons there to try this surgery on some
human patients. The results were profound: people
who had been crippled by obsessions, anxiety and
agitation became instantly calm.
Moniz's work prompted surgeons throughout the
Egas Moniz world to perform similar operations. frontal
leucotomy- and, later, the more extensive frontal
lobotomy - were so popular that during the 1940s at
least 20,000 people were treated in the USA alone.
Only decades later did the drawbacks become clear,
and these operations were eventually discarded in
favour of new drugs.
Moniz, meanwhile, had to give up work when he
was shot by one of his own leucotomy patients. If he
had not been so impatient in 1935, he might have
avoided this fate: the part of the lecture he didn't
wait for reported a second experiment in which,
rather than becoming calm after the operation, the
chimp became inexplicably aggressive.

thinking proce , no direct link could be made to the increasing knowl­

Wired for learning Babies have a natural
instinct for language learning, which they use
from a very early age. Artificial neural
networks are now being built to mimic the
way that human brains can learn without
being taught.
edge about the anatomy of the brain. P ychology was, in effect, plit into
two eparate area ofknowledge.
Probing inside the brain
Meanwhile, some cientists continued to probe the brain phy ically. In the
1950 , the anadian neurologi t Wilder Penfield pinpointed area oflong-
term memory by timulating the brain of patient undergoing surgery.
The brain ha no pain re eptor , o operation can be performed
with the patient awake and thu able to report what happ n when
different parts of the brain ar tou hed. Penfi ld di covered that
placing electrodes on parts ofthe temporal cortex (at the ide of
the brain) triggered vivid de cription oflong-forgotten events.
In the la t 20 year , the mapping ofbrain proces e ha leapt
ah ad with the development of te hnique uch a po itron
emi ion tomography (P T) and fun ti nal magn tic re
nance imaging (fMRI). It is now po ible to watch the
workings ofa normal con cious brain on a computer moni­
tor and match the ripple and flare ofactivity to the per on
reports of per eption , thought and cmorion . At the ame
tim , the development of drugs that alter behaviour by targeting
particular r gion of the brain ha helped to fill in the detail of
what is happening at the molecular level.
The biological approach i being upplemented by in ights from
computer ience. elf-learning computer that can adapt their
own circuits have provided a powerful new 'neural network'
model for inve tigating the brain . The e model are tanta-
mount to creating a 'virtual' brain that can be tudied
outside the body. Of cour e, they will never work preci ely
like real brain , but uch y tern are providing fa cinating
clue a to how brain develop over time.
 MIND, BRAINAND BODY 21

Modern imaging techniques can reveal brain activity as well as structure. They
allow doctors and scientists to observe the complex functioning of different
regions of the brain, and to diagnose where damage has occurred. Some methods
use X-rays, some measure brain activity, while others record brainwaves.

CT (computed tomography) EEG (electroencephalography) PET (positron emission

tomography)

CT produces detailed cross-sectional
images of the brain. The CT scanner sends
out an X-ray beam as it rotates around the
body, and uses its internal computer to
create a nigh-quality image. CT scans can
reveal tumours and other abnormalities.
EEG measures brainwaves - the electrical
activity created when large numbers of
neurons fire. Each of the eight patterns
above represents activity in a different part
of the brain. EEG is used to study changes in
brain activity, for ex.ample in epilepsy.
PET scans evaluate the amount of
metabolic activity in brain tissue. The
patient is injected with a radioactive
substance that is absorbed into active
cells. The radioactivity detected produces
an image of active brain areas.

MEG MRI (magnetic fMRI (functional magnetic

(magnetoencephalography) resonance imaging) resonance imaging)

MEG, like EEG, measures brainwaves, but it
does so by picking up tile tiny magnetic
pulses produced along with the brain's
electrical activity.It is a faster scanning
technique than PET or MRI.
MRI scans use magnets and radiowaves to
create brain images. The technique is
radiation-free and one of the safest imaging
methods available.It is used for imaging
the spinal cord as well as the brain.
fMRI measures tile amount of oxygen in
different brain areas, which indicates the
level of activity. Several pictures are taken
every second, so that over time a 'film' of
the brain's activity is created.
 GENES AND THE MIND
Look at a collection of family photographs, and you can see the influence of genes in
shared physical characteristics such as eye colour and the shape of facial features.
Genes are also a known factor in certain illnesses, including heart disease and some
cancers. But when it comes to personality and behaviour, the role played by our genetic
inheritance is rather more difficult to unravel.

Gene are found in idc the nu lcu of e ery cell. They are the et f in tructi ns for making
enzyme - the pr tein that enable ell to function proper! . Although human mo tly inherit
the ame ba i et f genes, the human genome, there are mall variation in the tru ture of
each gen .These inherited variations can re ult in c n iderable diffcren c in the way the brain
of different individual function, be au e pe ifi enzymes are ne ded fi r the production f
neurotran mitters (me eng r m I cule by which brain cell communi ate).

Inheriting characte"ristics
While per onality i hap d by many differ­
,,, ent influence through life, the biological
••,,_
component of per onality - known a
temperament - i pre ent fr m birth, and o is
likely to be influenced by gene . [f you have children,
you probably find that th y eem to develop unique
per onalitie from a very early age, de pite growing up
in a very similar environment. Bue how much of an
adult' per onality i determined by the gene ?
Phy ical hara teri tic , u h a eye c l ur, are
ea h determined by everal g ne , and the ame i
tru of per onality characteristic . o it i not
simply a matter of inheriting a ingle gene 'for'
a particular hara teri tic. In addition, for
behavioural characteri tic , environmental fac­
tor uch a parenting education, life tyle and
diet will probably
have at lea t a
trong an influ­ FACT: The Human
Handing down genes
Genes - made up of the
ence a genetic inheritance. For exampl , a
p rson who inherits gene that make them
Genome Project has
DNA 'double helix' - play usceptible to depre ion may indeed established that a
a major role in
determining personality
become depre ed, but the influence f a human being has
table family and fri nd , a g od education and
and health.
a fulfilling career may well protect the per on. only around 30,000
imilarly, someone who inherits genes that pre- genes about the
dispo e them to anti ocial behaviour might get
into tr uble in an environment with opportunitie
same number
for crime, but might not in another environment as a mouse.
 MIND, BRAIN AND BODY 23

TRY IT YOURSELF
.,,,, ..,,..,,., ,,..., do"" ...

............
• Are there similarities in how members such factors, rather thin genes. But if
of your family dell with problems? Do you can see tendencies that seem to
,_,,, ...,n" ... .....,.,,,.,.
•• mlly1,., ,...,,,., .. ,,,..,

..,,.,.., ,...,.,,,.,.,,,,.
"',..,,.,......,
.,.,,,.,,, ---- ... foUoftl6:
• Do you shire c:ertain mind-sets as I
family? For example. If your parents
never enjoyed going abroad, do you find
that you tend to get homesick when
you're I long WIY from home?
• Do you shire I similw degree of
extroversion or Introversion - do you
enjoy talking to people you don't know
well or do you try to Mid It?
they become Sllf-critical or depr1111d, emerge In different generations Ind
or instead blame drcumstanc:es Ind not branches of the family, there is I good
talaa things personally? c:hlnc:e that these hive I strong genetic
• Do you hive similar Interests? For component.
example, if your mother always
followed fashion, do you find that you
do too?
• Are there any striking - Ind
seemingly IMxplicable - coincidences
such IS JOU Ind I sibling both manytng
I partner with the same OCQIPIIIOn?
Of course, there's no sa,tna 1n1
similarities .... not due to shlrtng
I similw upbr'u,ging or other

with more p itive influence . In short, genes can pre­

dispo e individuals to develop particular behavioural
trai or p y hologi al di rder , but whether they do
go on to develop them is far from certain. �·cusoN
When the 'working draft' of the human genome
wa unveiled in 2001 ienti ts w re urpri ed to
learn that humans have le than a quarter of the How do rellliW of 11MS llld
140,00 gene originally e timated, and the impli- l"Ollllllllt on 1111 pricullr clllrldltislic7 It's 1rk:ky.
but CIA be ffllde througll llllldytng Plftl of
ation of thi finding are till being on idered. Th
ldlnllall llld ......... (IIOIHClental)
low number of gene in the genome ugge ts that th
In bllow, the 1lgure aldl column shows
role of environm ntal factor in behaviour may be the "conmrdlncl' - 11. 1111 Nllllllood of both twins
even gr ater than previou ly thought. There imply lhlrtng IMt lden1lcll twins hM twice IS
aren't enough genes acting in the brain to determine man, ....-111 common • frltlmll twins, but both types
the full range of human behaviour in all i subtlety of twin ..... 11w1,anmen111 flctors to the llfflt IICtlnt.
So CG111111rin1 the IIUNS In the two columns helps to
and complexity. ln tead, a relatively limited et of gene
......... out genetic IIICI environmantll factlOrs: the
i intera ting with myriad environmental influence .
s,-.r the dlllll•a bllwNrl the c:onc:orcllncl tlgure tor
ldentk:ll llld ,,...... the IIIOl'I It thlt the
Genes and destiny c:llnc:t..«adc I ltlonl ... COfflllOlllllt. So
Whil inherited temperament can play a maj r part in hair llld .,. colour n ltronalY Sl8M1ic. whlll fflllllls
mental and phy icaJ health, there are probably a many and brlllt c:ancer n llWlronmenllllJ dalannlned.
-
·-
-
J
ways that you can make your inherited behavioural - - - -. .
haracteri ti work £i r you a again t you. If you ar Fnal'IIII
Eyecablr 995 28

......
born with gene that make you u ceptible to tre for
HlircolN' 89 22
example, you might take thi into account when
95 87
choo ing a career.The thing to r member is that whiJe
Breast CIIICII' 6 3
gene may have a powerful influence on behaviour Mild lllrning dlslbility 94 47
and health, they re by no mean th whol tory - Schlmplnnll 48 13
lifestyle and environment are just a important.
 BRAIN AND 8001) ..

CONNECTIONS

W
e readily associate the mind and brain with
intelligence because we use our brains to
learn new facts and to draw conclusions.
However, the brain is very much more than a tool for
thinking - it is the command centre of the body, and in
this role it strongly influences our health and well-being.

The brain sits at the centre of the labyrinthine empire of

the senses, keeping us in touch with the outside world
through sight, sound, smell and touch. At the same
time it constantly monitors the environment inside the
body, sending instructions through the nervous system
to keep body systems working properly. Every experience
we have - from hunger to heartbreak, from pleasure to
pain, from excitement to illness - is mediated through
the brain and its nervous system. This chapter explores
the brain-body connections that make this possible,
revealing the routes through which the brain exerts its
control over the body.
•
26

INSIDE THE
CONTROL CENTRE
The brain is the control centre of the nervous system, a network that
stretches to the tips of the toes and into every organ of the body. This
system allows continuous, two-way communication between brain and
body: anything that occurs in one inevitably affects the other.

The brain exists primarily to support the body.just like any other organ
uch a the liver or the heart. Thi primary function is often ob cured,
however, by the brain's dazzling capacity to generate omething that at
first glance eems to be guite removed from the body - the con ciou
mind. Yet even consciousness depends on, and serves, the body. ights,
ound , en ations, thought and emotion are the con ciou ly experi­
nced elements of a va t and mainly unconsciou y tern that keep the
body functioning and nables us to adapt to our environment. While each
part of the brain ha a pecific function, none work alone.

Divisions of the brain

The structure of the brain reflects its evolution: the oldest part - the
limbic sy tern - lie deep in ide the brain, whil the most recently volved
area form the grey, wrinkled urface known a the cerebral cortex, the
outer layer of the cerebrum. The cerebral cortex in each hemisphere is
made up of four lobe , with each lobe divided into hundreds of maller
area . ome of the e area receive information from the en e organ and
tran form it into conscious perception . The body is continuou ly moni­
tored by everal cortical areas, which receive and convey information via
the pinal cord and peripheral nerve . The omato en ory cortex, for
example, functions a a 'body map' that corre pond to various parts of the
body. Other cortical areas generate thought and language, and turn the
bodily changes that underlie emotion into feelings.
The limbic y tern lies deep within the brain. Thi primitive part of the
brain contains everal distinct structures, including the thalamus, th hip­
pocampus, the amygdala and th hypothalamu . These tructure en ure
that we react appropriately to any ort of stimulu , uch a thir t or a fa t­
approaching object that we need to avoid. The limbic sy tern also govern
activities that are concerned with self-pre ervation, such as re ponding to
danger, and the expre ion of emotion.
Beneath the limbic y tem i the brain tern, wh re the area that regu­
late basic bodily functions uch a heart rate and breathing are located;
part of the brain stem al o stimulate emotion, attention and consciou -
nes .Attached to the brain tern i the cerebellum - a minature ver ion of
the whole brain - which mainly control movement and coordination.
 Anterior cingulate cortex
Tllis swildlll lltention liltlll'
outwlrds, to wlllt Is lllppelling
outside the bodl or inn'ds ID
----- lllougllls and ........
Prefrontal cortex
Tllis supports higller
human famllls sudl.
pleMing, cruli¥ity, and
the Inhibition of urges.
Motor cortex Somatosensory cortex
Movement instructions Nines from ""' pert of the
n sent from here ID body converge here, bringing
every part of the boclJ. sensory infonnetlon. Eacll
'*"
pert of the body Ills ill own
of tllis cortical ....

Corpus callosum
A bind of tlaut llllt
linlcs the two
Cll'lbrll
hlmisplleres.

_,_. --­
'Tast91' Incoming
11llllnllll
Rlllys IIIIIIIIY
..........
l.a,sdowll ........
SIIISOfY � for ilfonnltion ID the n stores Pll'10IIII and
lhrutlning contM, appropi1111 pert of importlnt IIIIIIIOriel
The seat of conscious Contains 'body maps'
Slllding 'llglt or flWlt' cortex. n 11so dncts and sllullts ollllrs to
ffllSSIIIIS to the body llllfltlon and mocMn
ideas - it draws that respond to
penllllllllt ROrllll
and alerting ... of Illa IIWlls of ewareness. places in tlle tOl'lmi.
images and memories sensory information,
cortex connected witll
together to form and control movement
fem; anger and sadness.
thoughts and plans. and orientation.

Pons
links the medulla will! the
tlalamus. NeM! tracts
linking the spinal cord
anclthecerebralcortu::_�����_:��l!.IJllll!flllil
pass lllrough here.

Medulla Temporal lobe Occi pita I lobe

Extension of the spinal Encodes long-term Receives stimuli from
cord, forming the lowest Cerebellum factual memories. It the eyes and
part of the brain stem. Literlly the 'little also processes sound translates them into
Regulates heart beat brain'. Controls physical and language. perceptions.
rate, breathing and coorclnltion, balance
blood pressure. and .,. movemetllS.
Left brain, right brain The brain's left and right hemispheres are almost
mirror images, each controlling and responding to
messages from the other side of the body. Yet the
two hemispheres work in slightly different ways.
Imagine a pair of twins differences between the hemispheres make each one
who have lived together best suited to particular tasks and, over time, the
all their lives, sharing differences become so entrenched that the loss of a
every thought, sensation and hemisphere in later life is catastrophic.
emotion through continuous dialogue. Each of them
is capable of doing nearly everything the other can Left-right differences
do, but they also have individual strengths - when On the whole, the right hemisphere is good at
faced with a task, the one that is better at that sort making out 'wholes', such as grasping an emotion,
of thing automatically takes the leading role. and the left is better at analysing things, such as
The brain probably evolved as two similar halves tackling a maths problem. In practice, nearly
so that there was a 'spare' brain to take over if one everything in our minds is the result of both right
was damaged. However, as humans developed more and left-hemisphere processing. Understanding a
skills, space started to run out. Nature found a way joke, for example, involves following the plot (a left-
round this problem by placing some of the new­ hemisphere function) ·ng• the point (a
found abilities in just one hemisphere rather than
doubling up.
Sensory information from each side of the body
enters the brain, then crosses over to the opposite
hemisphere. Similarly, signals from each hemispher
cross over to control the other side of the body -
when you raise your right hand, it is your left
hemisphere that controls it.
At birth, both hemispheres contain all th
is required to develop every mental skill - a
young child could lose an entire
hemisphere and still develop
normally because the remainin
one will do the work of a wh
brain. However, minor

Enjoyment or terror?
During a roller coaster ride,
more emotional right hemi
of the brain may transmit
feelings of fear, which the le
hemisphere interprets as
excitement, because
analytically it knows that
you're perfectly safe.
 BRAIN AND BODY CONNECTIONS 29

ARE YOU LEFT OR RIGHT-BRAINED?

Although we all use both hemispheres in our thinking,
most people tend to favour one or the other. Try this
test to see which plays the stronger role in
determining your behaviour:
YES NO
Do you often have hunches?
DD
Guitar genius Rock musician Jimi Hendrix played guitar left-handed
Do you use your hands a lot when you talk?
DD
DD
using a right-handed guitar held upside down. Left-handed people are
often thought to be particularly creative, perhaps because they are can you tell how much time has passed
influenced more by the intuitive right hemisphere. without a watch?

The most obvious difference between the

hemispheres concerns language. In nearly all right­
When you have hunches, do you often
follow them? DD
handed people, and some left-handers, language is
processed entirely by the left hemisphere. Hence, a
stroke in the left hemisphere may well cause
Would you prefer to learn a new dance step
by following the sequence in your head DD
rather than by following a demonstration?
language problems, while a right-hemisphere stroke
is likely to affect the sense of where things are. Do you find algebra easier than geometry?
DD
Language is crucial to our thoughts because most
of our thinking is done in the form of words. While Are you good at getting the gist of what ..
DD ·�•
both hemispheres contribute to our perceptions, people mean when they talk in a language
only the left hemisphere reports them. If you look at you can't speak?

DD
a picture, the right hemisphere will tend to interpret
the content in an intuitive way - the colours may When you look at a picture in a book do you
provoke a feeling not expressed in words. By read the caption before you study the
contrast, the left hemisphere will recognise the image?

DD
colours as 'red', 'blue' and so on, but will not be so
Are you better at faces than names?
moved by them emotionally. Normally, the right

D
hemisphere will transmit its feeling about the
Do you like to complete one task before
picture to the left hemisphere, which then
going on to the next?
incorporates this information into its own view,
'
1.
.•
before turning the overall perception into words.
However, the left hemisphere may misinterpret •, Score:
what the right tells it, as the information received For questions 1, 2, 4, 7 and 9, give yourself an 'R' for any yes

..
will be interpreted according to how the left answers and an 'L' for any no answers. For questions 3, 5, 6, 8
hemisphere sees the situation. If the left and 10, give yourself an 'L' for any yes answers and an 'R' for any
hemisphere is not aware of a threat, for example , no answers. Now add up your total number of Ls and Rs. More Rs
it may report 'fear' messages from the right than Ls overall suggests that you tend toward right-hemisphere
isphere as 'excitement' instead. The two thinking, while more Ls than Rs suggests left-hemisphere
• pheres work together to make the best
ents about the threats and opportunities
• •f
.,..
,,
. dominance. Most people have a mixture of both left and
right styles of thinking.
front the person.
.- l' -�. ,.. .... . -.'=; .... ' . . .
j
...
I , .:�;
'
.. '
...; ;.ll, �.. \
, '. II ' ; . I

. - I
I
I \
"l
30

MESSAGE SYSTEMS
The body has two major message networks - the nervous system and
the endocrine system - which provide the main links between the
brain and body. Understanding how these systems work is a key to
understanding how the mind affects the health of the body.

The n rvou y t m, with its ontrol entre, the br in, pr duce all our
con ciou acts and th ughts, a well a maintaining our uncon ci u body
operation . It keep the heart b ating and the dige tion fun tioning, it
prompt u to breathe, le p, wake and eat, it enables us to walk and it
brings u ight , sounds and en ations. The endocrine y tern distribute
the body' hormones, controlled by the hypothalamu and the pituitar
gland at the ba e of the brain, with far-reaching effe t on our health.

Rapid reaction Top sportsmen and women A two-part structure

rely on their bodies' message systems to
keep them at the peak of their abilities.
he nervou y tern con i ts of two interconnected par : th central ner-
vous y tem ( ), made up of th brain and pinal cord; and the
peripheral nervous y tem (P ), a network of en ory and motor nerve.
that stretche throughout the body.Within the , the brain ha a den e
network of omc 1 0 billion nerve cells, or neuron . Most of th e nerve
cell mmunicate only with ea h other, carrying out the a tivity required
to pr ces though , ·n ation , perception , and the uncon cious function.
that und rlie them. he nerve cell form two-way mmuni ation path­
way that k ep each part f the brain informed about what i happening
in the other part

UPTO BIRTH BIRTH ONWARDS

• Seven weeks after conception, the brain's main structures • From birth to three years of age, the brain develops neural
- hindbrain, cerebellum, midbrain and forebrain - are clearly connections at extraordinary speed.
visible. The primitive structures at the base of the human • By the age of six, there are more connections between
brain develop first, reflecting the order in which different cells than there are in adulthood; unused neural connections
parts of the brain evolved. then begin to die back.
• After three months, the spinal cord has formed and the
cerebellum and cerebral cortex are well developed, but
still smooth.
• By six months, the cerebral cortex has outgrown the lower
regions of the brain and starts to form the characteristic
wrinkles on its surface. These ridges and furrows are known
as gyri and sulci.
• At birth, a baby's brain contains as many nerve cells as it
will have as an adult, but has relatively few connections
between them. It looks similar to an adult's brain but the Neural connections Neural connections
cortex is still smoother. at birth at 3 years
 BR A I N A N D BO DY CO N N ECTI ONS 31

In control The nervous and endocrine

systems affect the whole body, regulating
all our movements and bodily functions.

Hypothalamus
and pituitary
gland

How information gets to the brain

A gr at deal f en ory information enter the brain via
12 pair of ranial n rve in the head. These carry me -
age directly to and from the eye , ea , ta te bud and
Pancreas no e. he cranial nerve al antral muscle in the face,
ne k and shoulder . lnformati n to and from all th other
parts of the body i carri d by the peripheral nerve -
which ent r and leave the brain via th pinal cord.
Nerve ignal travel along everal major'up' and 'down'
pathway in th pinal cord. ome of the up pathway
carry sen ory me age on body po ition and p ture to
the brain while oth rs carry information about pain, ba ic
Gonads
(male testes) tau h and temperatur . own pathway in Jud tho e
that carry the brain' in truction for different type of
movement, from fin' movement u h a d li ate manip­
ulation of the finger , to large movement like turning or
bending. The brain gather information continuously
KEY fr m en ory receptor at the end of ach nerve fibre.
• Central nervous The thickne of the peripheral nerve fibre dictates
system how fast they an conduct information. The thi ke t and
• Peripheral fa te t (motor fibre ) connect to mu de and tendons,
nervous system whil the thinn t and lowe t convey information about
Endocrine dige tion and external temperature. Pain- en ing nerve
system fibre are thinner • nd lower than motor fibre , which
explain why you pull your hand away from om thing
hot before you are on ciou ly aware of feeling pain.
32
CREATING EMOTION
That our emotions affect us
physically is self-evident - we
laugh, cry, tremble with fear or
glow with pleasure, depending on
what happens to us. What is less
obvious is that the process also
works in reverse. Your facial
expressions and body posture send
messages not just to other people
but also to your own brain, and the
brain responds by producing the
emotion that the body is signalling.
• You can test this very simply if
you clench your fists, glare and
grimace for a few moments. Now
relax your shoulders and muscles,
and smile. Feel the difference?
We also respond to other people's
emotions in this way. For example,
brain scans have shown that when
people look at photos of someone
wrinkling their nose in disgust, the
cells that produce disgust in their
own brains become active.
The autonomic nervous system
Included in the peripheral nervou y tem i the autonomic nervou
y tern (AN ), who e main role is to keep internal organs, glands and
mu cle w rking appropriately; for exampl , the AN ensur s that the
heart rate i low when the body i at rest and speeds up during exertion.
Mo t of the time we are unaware of the continuou , ubtle changes pr -
duced by the AN . However, if we are uddenly plunged into a new or
chall nging situation, we immediately become on iou of dramati
bodily changes, which r gi ter as feehngs of fear, anger or anxiety.
The mo t famihar example of thi i the fight or fljght' r pon e to fear.
Fear timulate th amygdala in the brain' limbic y tern, whi h trigg r
the neighbouring hypothalamu to end ignal to endo rine gland all
ver the b dy. The gland relea e chemical that activate the nervou
y tern, which in turn peeds up the heartbeat, opens sweat glands and
n tricts me mall blood ve el , typically drainin the face of colour.
Information about these ven i then fed ba k to the brajn, producing a
y le that may ontinue, with the sensation offear.building each time.The
ituation is u ually re olved either by action or by the thinking parts of the
brain ending ignal to the amygdala to quieten its activity.
Neurons, axons and dendrites
All the activity in the nervou y tern relie on neuron . There are dozen
f different type of neur 11, but all have e ten j n - long, finger-like
nerve fibre ailed axons and hort,
branching proje tion from the cell FACT: A single neuron
body alled d ndrites - that enable
them to make ontact with ther can receive information
neuron . from up to 100,000
ontact between nerve ell
take place at 'docking points' on
other neurons, then
the surfa of the dendrit , where distinguish which ones
axon fr m other cells connect with
them. Most nerve cell have one
to react to and which
a on, but often many dendrite and to ignore.
thou and of dockjng points. Axon
actively seek out dendrite to nnect with growing towards their goal.
Axons end out ignals and dendrite re eive them. A ignal con i t of a
wave of electri al harg that tart at the ell body and travels along the
axon. o that the char e doe n t dis ipat along the way, axons are
enca ed in an in ulating overing alled the mye]jn heath. lf thi covering
br ak down - as occur in multiple clero i - the signal are interrupted
and th nerves ann t nve corre t in truccion co the body. ach
neur n works like a tiny computer, takjng in and comparing ignal from
many oth r n uron before deciding whether, and at what ·trength, to 'fire'
and end the ignal on. U ually, they give priority to ignal oming in
from neuron with a hi tory of ending 'reliabl 'infi rmati n.
 Synapse
STRUCTURE OF A NEURON Docking point
where an axon
There are m any different types of from another cell
meets a dendrite ---L�����:;;;;::=S�.\---:�it--�ffl(.
neuron (nerve cell), but they all have
the same elements: a cell body, an
axon and several dendrites. Cell body ----�-.-"°""'o.:::---h'i­
Contains the
Myelin sheath cell's nucleus
Surrounds the

other neurons

Dendrite Neurotransmitters
Extension of nerve cell Convey signals across the
body; receives signals synaptic gap to another
from other nerve cells nerve cell

Chemical messengers - neurotransmitters and hormones

FACT FILE
An axon meet a dendrite at the ynaptic gap. Tn mo t a e , signals are
tran mitted aero the gap by chemical me senger called neurotransm_itters
contained in the tip of the a ·on . When a cell fire , neurotran mitter mol­
NEUROTRANSMITTERS
The brain's main
ecule are released into the ynaptic gap and attach to receptor on the neurotransmitters are:
nei hb uring dendrite. If ther ar en ugh of th m, they trigger a ignal • Acetylcholine: controls
in the body f the receiving cell that travel along its axon to repeat the activity in areas concerned with
pr e . In thi way, a ignal an travel through a huge n twork of cell attention, learning and memory.
forming a neural firing pattern that may repr nt a thought, a feeling or • Dopamine: activates cells
involved in motivation and
a per epti n. ome neurotran rrtitt r , however, have a 'do ing-down'
pleasure. In Parkinson's disease,
effect on neurons: ADA (gamma-aminobutyric acid), for example, pre­ there is a loss of dopamine cells
vents neighbouring celJ from firing and tops other ar a of the brain in the motor area of the brain .
from becoming active, o it produces a quietening effect on the body. • Encephalins and
Tranquilli er and leeping pill work by timulating the neuron that pro­ endorphins: natural opioids
duce ABA. that reduce pain and stress.
• Gamma-aminobutyric acid
Neurotran mitter are not the only chemical me nger in th· n rv u
(GABA): inhibits brain activity
y tem. The hypothalamu regulate the ebb and £1 w of horm nes that and has a sedating effect.
timulate growth, exual dev lopment and egg or perm produ ti n, and • Glutamate: the •workhorse'
thi imp rtant area of th brain is also a link between the nervou y tem chemical that keeps the brain
and the endocrine y tern. Horrn ne relea d by the hypothalamu trig­ ticking over.
ger the pituitary gland to r lea e its own hormone , which travel to the • Noradrenaline: induces
physical and mental arousal and
ovarie and prompt them to produce oe trogen or to the te te to prompt
heightens mood.
te to ter ne produ tion. M t hormonal y tern are cir ular: what hap­ • Serotonin: the 'feel-good'
pen in a gland i transmitted back to the brain, where it ha a further chemical. It produces feelings of
effect on the hypothalamu , which in turn regulate the gland. o although well-being and regulates sleep,
the endocrine y tem i often de cribed in textbook a eparate from the appetite and blood pressure.
nervou system, in reality the tw y tem are interd pendent.
34

INTERPRETING
THE MESSAGES
The brain is constantly receiving information about conditions both
inside and outside the body. It interprets and uses this information to
maintain a stable environment inside the body, despite changes
outside. This complex process - known as homeostasis - is essential
for survival and for keeping the body's tissues in working order.

The human body, ju t like plants or bacteria, can only thrive in certain
condition . Our ba ic survival requirements are a minimum of warmth,
oxy gen, water and food, but w al o hav 1 s obvious need : mental tim­
ulation, attachment to others, amusement and novelty. Deny us the ha ics
and we will soon die; take away the other needs and our health - mental Mothers and babies trigger
and phy ical - wilJ be eriou ly undermined. behaviour in each other that helps
them to bond. For example, an
Homeostasis - keeping the body stable infant's crying prompts his mother
to pick him up. The baby will then
However benign our environment, it doe not give u the things we need
probably quieten down, open his
at precisely the tim we need them. For example, we cannot immediately eyes and follow her movements.
match our energy output, calorie by calorie, to the food we eat, or replace When she touches the baby's
every drop of weat we lo e with a ip of water. Nor can we en ure that cheek, he is likely to tum his head,
we are alway in an environment that i a comfortabl temperature. looking for her nipple. Breast­
Homeosta i ensures that the body' need are met - that we maintain a feeding itself strengthens the
bonding process.
tore of nutrien to fuel action; that ell retain water even when none i
Babies are born with a well­
available from outside; and that core body temperature remain at an opti­ developed homeostasis mechanism
mum level, de pite xternal fluctuations. already in place. A normal newborn
Homeosta i is a whole-body mechanism that work by the influence baby, placed naked on her mother's
of automatic proces es within certain organ and the controlling influen e chest and simply covered with a
of con ciou and uncon cious areas of the brain. It combine information blanket, will maintain her body
temperature just as efficiently as a
from th en es - the ight of water, ay - with self-generated knowledge,
baby in a high-tech incubator.
Homeostasis, bonding and other
Accustomed to the cold Until the 20th century, the native people of survival mechanisms probably
Tierra del Fuego, at the southernmost tip of South America, lived almost evolved millions of years ago,
entirely without clothes, despite being in a climate described during much more dangerous
as 'cold and inhospitable' by the naturalist Charles Darwin, times, to help the human infant's
who travelled there in 1832. This is a striking example of chances of survival.
homeostasis in operation, enabling the human body to
adapt to adverse conditions.
 BRAIN ANO BODY CONNECTIONS 35

�� CUTTING EDGE �� CUTTING EDGE �� CUTTING EDGE �� CUTTING EDGE

APPETITE RESEARCH
For the first time in history, there are
now more overfed people in the world
than there are underfed. Surveys have
shown that obesity is on the increase,
including among children, and
researchers have been trying to find
drugs that might help to combat this
new epidemic. At the other end of the
scale, eating disorders such IS bulimia
and anorexia nervosa are also on the
increase: studies in the 1990s showed
that at least two per cent of females in
the USA suffered from bulimia or
anorexia - and the numbers are rising.
Controlling hunger signals
Research efforts to counteract some of
these problems have focused mainly on
examining the chemical messengers in
the brain that signal hunger and satiety.
Low serotonin levels are known to
trigger binge-eating, and drugs that
increase this brain chemical are
sometimes presaibed for bulimia. Other
molecules that control intake of food
indude the hormone leptin, which
dampens appetite, and substances
called orexins, which stimulate it The
search is on for drugs that will stimulate
the appropriate brain chemicals to malce
disorders such IS obesity and bulimia a
thing of the past.

like feeling thir ty, to produce an appropriate re pon e. Water level

in body cells, for example, are partly controlled by the
kidneys, which absorb water from the blood,
expelling it a urine when level are high, and
con erving it when they are low. A low water
lev I in c II i signalJed to the brain via
nerve cell called o moreceptor , which acti­
vate part of the hypothalamus, producing
feelings of thir t. The con ciou area of the In cold blood
Unlike humans, lizards
brain then take over, directing you to find a
and other cold-blooded
drink. The ame proces occur with food: when you
animals are unable to control
have eat n a big meal, nerv ndings in the tomach wall their body temperature from within.
end signals to another part of the hypothalamus, which creates the feel­ Instead, they have to rely on their
ing of being ati fied. And when blood sugar level fall again, yet another environment to keep them warm,
part of the hypothalamus produces a feeling of hunger and prompts you by basking in the sun, for example.
to find food.

Hormones and bonding

imilar proce e ensure that our social, intellectual and emotional needs
are fulfilled. Attachm nt and mental timu1ation, for exampl , are e ential
FACT: Capsaican - the
for development and urvival, especialJy in infancy, and the human need chemical in chilli peppers
for contact with other continue throughout life. Intimate bonding
behaviour (such as sex and breastfeeding) is associated with increa ed
that makes them taste hot
levels of a hormone called oxytocin, which create feelings of ati faction - interferes with the
and erenity. Th plea ant feelings in turn encourage u to eek out the nerves that send 'feeling
people or situations that produce them, pulling us into ever-closer rela­
tionships with tho e we depend on, or who depend on u . However, full' messages to the
perpetual cuddling would make u vulnerable, o oxytocin-induced relax­ brain. So if you want
ation is countered by bursts of exploratory, outward-looking behaviour
mediated by neurotransmitters like noradrenaline. Hence the balance is
to lose weight, lay off
maintained between the need for social bonding and the need to explore the chilli.
the wider environment .
36

WHAT IS PAIN?
Pain is one of our most useful survival mechanisms. What you
feel as pain, however, does not necessarily match up with what
is happening to your body, because pain is - like everything we
experience - 'all in the mind'.

ometime , stubbing your toe lightly on a chair can make you cry out
in pain, while at other tim you can take a much harder knock and
barely notic . When w are very busy or excited, even evere phy i-
cal injuries may go unnoticed - in fact,ju t occupying your elf with
some mental ta k or inking into a plea ant daydream an redu e
pajn c n iderably.
Amygdala
The reason you don't noti e pain when you are occupied i becau e
y u have to pay attention to information oming in from the en e in Cingulate
cortex
order to b consciou of it. Pain ignal from nerve in the kin joints and
Somatosensory
muscle enter the brain and are regi tered in the brain's 'body map' - cortex
the somato en ory cortex. But this do not automatically produce the
experience of pain. For thi to happen, another part of the brain mu t
bring the ignals to consciou ne by directing attention to them. he area
Spinal cord
re ponsible i th frontal ection of th cingulate cortex, which lie in the
deep groove between the brain' two hemisphere .
This acts a a witch, dire ting attention either
to the outside world or to what is happening
within the body. When it i activated we
become conscious of information - such
a pain - in the omato en ory ortex;
when it is 'off' we are completely
absorbed in whatever i happening in
the world around u

Neuropathic pain
ometime we experience pain even
when there are no pain signal coming in.
This type of pain, known a neuropathic pain,
i 'all in the mind' - but it i not imaginary.

Transmitting the signal

Pain messages travel from nerve endings
'Fast' pain fibres (red) to the brain via the spinal cord.
'Slow' pain fibres (blue)
 B R A I N A N D B O DY C O N N E C T I O N S 37

James is one of a handful of children
who do not have the capacity to feel
pain. The cause of the condition
remains mysterious - it may be due
to failure of the pain receptors, or a
'disconnection' in the brain system
that brings pain to consciousness. His
mother, Ruth, fights a constant battle
to keep him out of danger:
•Jim is very bright, and as sensible
as any four-year-old. But I can't take my
eye off him for a moment because he
has no natural physical fear - he has
never learnt that putting his hand in the
fire will bum him or that tumbling
downstairs may not be a good idea. By
the time he was two, he had broken
both legs, fractured his skull and burnt
his arm severely. Once, he dislocated
his wrist and I didn't know about it
until I put him to bed and he
complained that he couldn't cuddle his
teddy. And because he doesn't feel pain
himself, he finds it difficult to
understand that other children do -
so he tends to play roughly with them.
'The doctors can't do anything about
it, so I just have to watch his every
move and keep explaining to him that
he must take care. I hope as he gets
older, he will develop a better sense of
danger.'

Rather, it i a form of memory. It u ually occur in people who continue

to feel pain even after an injury ha healed. ln thi ca e, the original pain
ignal cau e certain brain cells to fire together and then, over time, to
'wire' togeth r - the re ulting firing pattern i the pain. Norma!Jy th e
links would fall apart when the pain ignals topped, but
in neuropathic pain the link remain etched in the brain,
like any other type of memory. Thi ort f pain i often
"I had to run through a wall of
di tres ing becau e it seem to hav no phy icaJ cau e. fire - literally - to get out of the
How pain helps us house. I felt the flames as I did it
ompared to the complicated brain pro e e that control - but they didn't feel hot - more
pain per eption, the 'wiring' that sends pain ignals to the
brain i relatively imp! .There are two main types of pain like little moist flicks of a tongue.
fibre, b th of which end in receptor that react to damag­
ing timuE like pre ure or heat. Thicker 'fa t' fibre carry
When I arrived in hospital I had to
ignal from the receptor to the brain at high speed, pro­ have five skin grafts on my face.
ducing a harp 'warning' stab of pain: thi i the fir t thing
you are aware f when you hurt your elf, and it alerts you
But I can honestly say I didn't
to the injury. Narrower ' I w' fibre ondu t ignal at feel it happen - not a thing."
I w r peed, and au the aching, throbbing pain that
follow an injury, la ting for hour or even day . nee Jeremy, survivor of a house fire.
pain ignal arrive in the brain, they pas to the amygdala
which acts a a relay tation dir cting pain ignal on to other area .
Although pain i a u ful warning sy tern once it ha done its job of
alerting u to injury, it cea e to be beneficial. Fortunately, there i no need
fc r mo t people to suffer: mild pain can b helped by paracetamol, aspirin
or ibuprofc n, while evere pain can u ually be controlled with the u e of
drugs such a opioids.
38
D es l' res A key function of the brain is to
serve the needs of the body. The
body signals its needs through urges, emotions and desires
that provoke the brain into producing actions designed to
satiify them. But desires can be cotifusing and con.tradictory.
When our bodies want something, they let us know
about it. An empty stomach makes itself known by
producing feelings of hunger, dehydrated cells
produce thirst, constricted muscles make us feel
restless, and desire induces feelings of lust. These
simple appetites and urgings, or 'basic' desires, are
produced by body chemicals that act on the
hypothalamus at the base of the brain, which in turn
sends appropriate signals to the cerebral cortex.
'Higher' desires, like attraction to something
beautiful, are also linked to changes within the brain.
Certain images, for example, may provoke pleasant
memories - not strongly enough to make them
conscious, perhaps, but enough for them to produce
a less intense version of the pleasurable feelings
experienced when the event happened.
CHANGING DESIRES
Get out an old photo album and take a good look
at the clothes you were wearing years ago. The
chances are that you selected them with great
care, possibly even longed for them and saved to
buy them - but what do you think of them now?
Would you wear them today?
Responding to influences
Our basic 'wants', such as hunger or the need for
clothing to keep warm, are responses to bodily
needs, but the way we choose to satisfy them with
particular foods and clothing styles is often dictated
by external factors, such as peer group pressure and
fashion. Most of us laugh with embarrassment when
we look at old photos, because the clothes that once
seemed so attractive and stylish now look dull or
rather ridiculous.
The same can often be said of the things we want
to have in our homes, the foods and activities we
enjoy, and even the people we find attractive. Our
tastes are constantly influenced by changing trends,
and we are often encouraged to hanker after the
latest fashions.
However, human desires are often co
Someone might crave chocolate - yet at t same
time want to lose weight. Someone who hates the
idea of being unfaithful to their partner might still be
attracted to another person. Such conflicts arise
because we can desire things on two levels: we feel
basic, physical urges for things that offer immediate
satisfaction, and we also have complex hopes and
dreams that can lead us to put our instinctive urges
on hold, or even suppress them altogether.
Dealing with conflicting desires
Most of the time it is fairly easy to cope with
conflicting desires: for example, parents will patiently
read a bedtime story to a child after a hard day's
work, even though they might prefer to be relaxing in
front of the television. The reward of the child's
pleasure offsets any irritation caused by deferring
the need to relax. But if a person becomes trapped
in a situation where basic desires are constantly
denied, it can create a chronic state of inner
tension that may eventually take its toll on health .
This is particularly true of unconscious desires.
For example, take someone who looks after an
elderly relative and so cannot go on holiday. At a
conscious level, the desire to take good Qlre of the
relative may outweigh the desire to have • reak, but
unconsciously the thought of a holiday may' rsist,
unacknowledged. The result can be seemin­
inexplicable feeling of irritation that may come
influence the carer's behaviour. Over time, the slow
build-up of stress hormones released as a result o1
the irritation could also lead to health problems.
For this reason, it is important to try to understand
your desires at every level by attending to your
feelings and questioning why they occur. Being
conscious of a basic desire at least enables you to
deal more effectively with the frustration it brings,
and perhaps find some alternative way of satisfying it

"There are two tragedies in life.
One is not to get your heart's d ire.
The other to get it." George Bernard Shaw
SEXUAL ATTRACTION
Sexual desire occurs on two distinct levels:
on one level it manifests as an 'approach
and go-for-it' urge, while at the other it is
gentle, romantic, admiring and usually
focused on a particular individual. Brain
imaging studies suggest these different
types of desire occur in different regions of
the brain, and that romantic desire evolved
much later than the basic sexual urge.
In both men and women, the basic urge
is created by clusters of cells within the
hypothalamus, which is concerned with
emotional activity. These clusters are
moulded early in life by sex hormones, and
those which are most developed have the
greatest influence on the type of person
you find attractive. The individual you
choose, however, is decided by experiences
encoded in the 'higher' regions of the brain
in the cerebral cortex.
Differing responses
The two components of sexual desire are
typically more separate in men than in
women. When men experience 'pure lust', a
primitive brain area called the claustrum is
activated, whereas romantic interest results
in more diffuse brain activation that takes
place in parts of the cortex. In women,
sexual desire is typically of this more
diffuse kind, and this is more integrated
with the basic urge.
40

BODY RHYTHMS
Our bodies are subject to hourly, daily and even longer natural rhythm
cycles. These rhythms dictate when we are most vulnerable to illness,
when a baby is most likely to be conceived and born, and how we
respond to drugs. Developments in our understanding of the body's
daily rhythm - the circadian cycle - have suggested new possibilities
for improving health by getting in tune with our natural body clock.

Animal routines The migration of birds is
determined by the seasonal rhythms that
affect all animals. Humans are less influenced
by seasons, but our internal body clock
regulates our daily cycle of activity.
All bodily functions vary over time in a rhythmi fa hion. ome regular
b dy rhythm , uch a the beating of the heart and the firing of neuron
in the brain, have cy le of le than a e ond. th r are much longer: for
example, there i a yearly y le in e ual a tivity whi h leads to more
babie being born in late ummer than at any other time. indeed, in the
U A, government tati tic how that over the la t year , more babie
were born in Au u t than in any other month.· It i thought that th
in rea ed exual activity in late autumn is due to men having higher
te tosterone level then. o-one i quite ure why this is, although it may
be link d to the hanging amount of d ylight. ea anal ycle are mo t

Body weight at its lowest

Fastest reaction
times

Highest blood pnmure

Sneezing encl MAI allergy symptoms

 B R AI N A N D BO DY CON N ECT I ON S 41

pronounced in other animals wher the annual routine of hibernation,

breeding, nurturing and migration dictate the e entiaJ activity pattern in
an animal' life.

The circadian clock

In hum n , by far the most pronounced body rhythm i the circadian
cycle, which i controlled by the brain. ir adian m an 'around a day' and
de ribe how phy iological propertie , such a body temperature and
blood pre ure, change in a regular ycle f 24-25 hour . The ircadian
cycle run (more or Jes ) alongside our daily cycle of leeping and waking.
It i regulated by a 'biologi al do k', which re pond to ext rnal ue , the
mo t important of which i the level of light.
The circadian clock is situated in the uprachia mi nu I i ( N), a
patch of around 1 0, 00 cell located in the hypothalamu at the ha e of
th brain. The N Lie above the optic chia ma, a major nerve junction
linking the eye to the brain, and connection between the optic nerve
and the N llow ell within the to re pond to ri ing or falling
Daily events Because of the body's
light levels. nward connection between the C and the hypothalamu circadian (daily) cycle, specific body states
tun phy i logi al fun tion a c rdingly. Thu , after dawn ri ing light and illnesses are more likely to occur at
levels tell the N to wake up the b dy.At night, falling light lev I au e certain times of the day.

Sense of taste Menopausal hot Onset of labour Greatest risk of

most acute flushes dying from any
cause
42
FIND YOUR TEMPERATURE RHmtM
The common belief that 31° Celsius Is normal body
temperlture is lnacante - this ftgure Is ICbally an
8V9l'ISl8- Body tempnbn in tact 1'111985 from about
36.S"C to 37.S"C throughout the dly. It Is at its lowest
early in the momina two to three hours belore you
normally walre up, and rises through the morning and
early afternoon to reach a plateau in mid-afternoon, Then
it dips a little and Increases again to peak at around 7pm.
A temperature of, say, 37"C might indicate that you had a
mild fever If measured at dawn, but would be considered
normal later in the dly.
• You can track your own dllly temperature rhythm. Take
your temperature first thing in the morning, before you
Typical temperature fluctuation
37.4 -�-------r--.----..-.-..
36.4
36.2
00.00 08.00 16.00 00.00
Time of day
even get out of bed, and thereafter at two-hourly intervals
throughout the day until bedtime. Do this for several
days and plot the temperatures onto
a graph like the one shown above to see if
you can identify a regular pattern to
the rhythm.
If you are unwell (with a bad cold or
flu, for example) and find that your
morning temperature is less than it was
the evening before, remember that this
may not necessarily mean that you are well
again. It could just be the natural variation
of your normal temperature rhythm - so
you should carry on taking care of
yourself until you are sure that you
have recovered fully.
the N to activate the nearby pineal gland, resulting
in the production of melatonin - the 'darkne hor­
mone' - which help prepare the body for Jeep.
Rest and activity
he circadian rhythm al o include many horter
cycle . ne of the mo t familiar is the rest-activity
cycle, which la ts between 90 and 120 minutes. You
may have noticed that although you tart the day awake
and fini h it a Jeep, you don't ju t become radually
more tired a the day wear on. Many of u exper ience
a dip in energy in the mid-afternoon period, and
although you may feel worn out when you get home
from work in the late afternoon or early evening, it is
quite common to experience a 'second wind' between
8pm and 1 Opm - in fact, mo t people find it almost
impo sible tO fall asleep at this time of the evening.The
I raeli cienti t Peretz Lavie demon trated that there
are Jeep ' ga te 'that open every 90 minute or o. In hi
experiment , he a ked people to tr y to tay awake
or fall a Jeep at 20-minute interval over a 24-hour
period and a a result found thi marked re t-activity
cycle in operation.
Blood pressure variation
Circadian rhythm have important implications for
health and well-being. Bl od pre ure, for example, can
be up to 20 per cent lower in the morning than in the
afternoon. If you have high blood pre ure, it may be
mis ed if the doctor alway measures your blood pres­
sure in the morning. On the other hand, if it i
measured in the afternoon, the doctor may think you
hav high blood pre sure when in fact you do not.
Al o, if you are taking medication for high blood pre -
ure, it i harder for your d ctor to a e h w well the
treatment i working if the natural circadian variation i
not taken into account.
Th daily variation in physiological rhythm al o
mean that many illnesses are at their worst - or are
more likely to trike - at certain times of the day. For
example, heart attack are two to three time more
likely to occur in the morning than later in the day,
partly becau e blood pre ure i rapidly ri ing then.
Blood i thicker in the morning, making it more likely
to form a clot in the blood ve sel leading to the brain
(causing a troke) or the heart.
 BRAIN AN D BODY CON NECTION S 43

Every autumn, some people feel a the patt.n of symptoms is different

familiar sense of dread. They find It from those in dlnical depression,
Increasingly difficult to get up in the which may involve walcing urty and
morning, and often c:nwe comfort foods, loss of appetite.
such as cheese on toast and choc:olate. SAD clepi,ession usually lifts with the
As a result they may start to gain mming of spring. In the winter, the
weight, adding to their miNry. By the symptoms n lrllllble with
middle of winter, they .. feeling antidepms1n11 or light therll>r, whlctl
hassled and despeqte. Involves beln9 ...... to bright M1ltlcill
These are all typical symptoms of light for ..., hours. day lO fflllll up
seasonal afllc:tlve disorder, allo known tor lack of sunllaht. HowM-. for some
as SAO, a torm of clepi,asslon triggered people, the only Plffllllllllt IOlutlorl to
by falling light levels. However, in SAD SAD Is I move to I sunnier dimlte.

Body rhythms and medicine

Becau e the severity of an illne will vary during a 24-hour period, the
need for medication varie too. What i mor , the way the b dy handle
drugs hange v r th our e of the day. T n the ca of medi ations taken
orally, variation in blood flow and tomach acidity will affe t the
amount of drug that i ab orbed, while the rhythms of kidney
and liv r activity determine how long the drug tays in the
body heft r · eing ex reted. Thi ha implication for ide
effects a well as for the drug' effe tivene . For example, if
you take a pirin in the morning, it i more likely to cau e
tomach irritation than aspirin taken at night.
When your doctor instruc you to take a medicine in thre
equal do es three tim a day, this , s ume that your body
re ponses remain the ame all day long. In fact you will probably
ab orb a different amount of the drug each time. Ideally, dose throughout
the day hould be adju ted to take account of your natural b dy rhythm
- thi i th prin iple b hind hronomedicine.

"In prescribing equal doses over the day, your

doctor presumes that your need for medication
is the same all day... this belief is wrong.
In the future, doctors wi I make greater use of
computers to determine the best timing and
dose of medications."
Michael Smolensky, chronomedicine ex.pert
The Russian scientist Ivan Pavlov a secretion that was much easier to
never considered himself a detect than digestive juices.
psychologist, but he has had a This led to his most famous set of
huge influence on the science of experiments. A bell would be
psychology, which was still in its repeatedly sounded just before food
infancy when he began his landmark was placed in the mouth of a dog,
experiments in the late 19th century. which was held immobile in a frame
As far as Pavlov was concerned, he in order to ensure that the bell was
was always a physiologist. His main the only stimulus. The food would
research interests were the function naturally make the dog salivate, but
of the nerves of the heart, the Pavlov found that, with enough
activity of the digestive glands and pairings of bell and food, the
the workings of the higher nervous sound of the bell on its
centres in the brain. It was Pavlov's own would cause the dog
research into digestion that originally to salivate without any
brought him worldwide recognition,
but he is now best known as the discoverer
of Pavlovian or 'classical' conditioning.
This is the process by which we come
to automatically associate events that
have occurred together. In fact, this
work came out of his research
into digestion.
I • ' • JI
ct o
Working at the University of
St Petersburg in Russia, Pavlov
began to observe certain digestive
irregularities in the dogs on which he
was experimenting, which he attributed
to 'psychic' (that is, psychological} causes.
He noticed that some of the dogs would begin
to secrete digestive juices simply at the sight of
the man who usually fed them, before any food
was actually given. Pavlov decided to try to
determine the cause of these 'psychic
secretions' by studying what kind of
stimulus (that is, a noticeable event
or object} caused a dog to salivate -
food being presented.
This he called a 'conditiona
response', as it was
conditional on the bell
having been paired with the food
beforehand. (The effect is now
known as a 'conditioned
response', due to an error
in the original translation
into English of Pavlov's
research paper.)
We now know that
Pavlovian conditioning is
one of the simplest and
most effective ways in which
the brain adapts to its .,_.,.... canclltlol• Under
on
.-=i
..
environment. It is the most llllde to .' .
basic form of learning: even in very
primitive animals, if a stimulus such as
le being
ofsex '
.... .•

food is repeatedly paired with a neutral stimulus (like the bell in relmad.
ha
to
lly .,.
Pavlov's experiment), a response to the neutral stimulus will eventually perform any violent ICIS
result. Pavlov went on to explore in detail the characteristics of bec:luN ha becomes paralysed
by sickness whenever he tries
classical conditioning, experimenting with varying time intervals and - he has c:onclitloned
different types of stimuli. against violence.
While the story is ftctional,
L
a lov's le c a similar aversion technique
based on Pavlovian conditioning
Pavlov's ideas have stood the test of time and his approach to the is sometimes used In real life in
study of behaviour has been hugely influential, setting the new science an attempt to alter some types
of psychology on the road to an increasingly 'objective' approach, of Inappropriate behaviour.
rather than relying on speculation about hidden mental
processes or people's subjective reports of their own
experiences. His ideas have played an important role in
helping us to understand many aspects of human
behaviour. While most forms of thinking involve complex
brain processes, such as language and reasoning, our
brains and bodies are also working together at an
unconscious level all the time. Sometimes this process
can allow habits, anxieties and even physical problems
whose origins seem hidden to develop, and Pavlov's work
has provided insights into why this happens.
Psychological techniques developed from classical
conditioning have been used to treat disorders such as
depression, anxiety and phobias. Exposure therapy, where
the patient learns to live through the unpleasant feelings
associated with the confrontation with a phobic object or
situation, has been shown to be highly successful.
46
TH CONDIITIONED RES
Whenever your mouth waters at the mention ·Of chocolate, or you find yourself working
harder after a few words of praise, you are demonstrating conditioned responses in the way
you ,react to the world. learning by simple association, or 'conditioning', was once thought
by psychologists to be the mechanism that explained most human behaviour. Now, however,
we know that human responses are more comp1ex.
l�CUSON
REWARD VERSUS
PUNISHMENT
Behavioural psychologists have
studied the way praise, punishment
and attention affect behaviour and
can be used to modify it. Disruptive
behaviour in children is often a way
of seeking attention - and parents
can be taught to tackle the
problem by ignoring (that is,
withdrawing attention from) the
worst behaviour and rewarding all
reasonable behaviour. These tactics
often produce results in a very
short time. Punishment may seem
a more obvious option, but reward
has been shown to be a much more
powerful conditioner.
Similarly, if people with minor
health symptoms are 'rewarded'
with too much attention or
sympathy, they can become more
prone to repeated symptoms and ill
health generally. Indeed, doctors
are not always brief just because
they are pressed for time.
SE
We may n t feel that we have much in conunon with Ivan Pavlov' dogs,
which became conditioned to a ociate fc d with th ound of a bell, but
we all have our own learned respon es to our environment that produce
certain bodily reaction and behaviour . A lot of conditioning in human
happens unconsciously and involves a pects of memory that we cannot
verbally de cribed.
Conditioning through experience
Mo t people have had the experience of being sick after eating omething
unplea ant - perhap a u pect mu el in a plate f moul maruuere or
something fatty or green forced on them in childhood - and then had
recurrent feelings of queasiness when exposed to that food again. Human ,
a well as other animal , can form a strong unconscious link between en-
ory characteristics, uch a the smell and taste of a particular food, and the
phy ical con equences of eating it - especially if that con equence i to feel
ick, and the food ha an unu uaJ or novel flavour. The m re t whiff of th
offending food an bring back a wave of nausea that it i almo t impo i­
ble to over ome by consciou effort.
Now known a conditioned taste aversion, thi kind of re ponse prob­
ably developed in mankind's early evolution a a way of avoiding eating
foods such as berries and fungi that might be poi onous. The body and
brain are so strongly 'programmed' to respond in this way that condi­
tioned taste aver ion can be triggered even when the bout of ilJne s ha no
actual connection to the food.This can have unforeseen con equence . For
example, chemotherapy treatments tend to be followed by unplea ant
attacks of nausea and sickness. After a number of treatments, som cancer
patients begin to experience these symptoms simply by entering the treat­
ment room. h.iJdren have sometime been given ice-cream to cheer them
up before chemotherapy e sion - with the unfortunate result that they
become conditioned to feel nauseous in re ponse to ice-cream and it
cea e to be a tr at.
Similarly, our emotional re pon e to things, people and place are con­
ditioned by previou experience . After being tung by a wa p, omeone
might become fearful at the mere ight of a wa p or bee; conversely, if the
sting wa le s painful than previously imagined, the experience might
Jes en the fear. Likewise, someone who has had painful dental treatment
may begin to feel anxiety a soon a they et foot in a dental urgery -
 BRAI N AN D BODY CON N ECTIONS 47

a respon e that can dimini h if they find a dentist they trust.Anyone trying
to give up smoking may have a much trouble trying to break free from
the conditioned re pon e of making in certain ituation as they
hav b acing th phy ical addiction.

Unlearning learned responses

A common feature of depres ion is the belief that
e cape from misery or unhappines is impo sible. uch
'learned helple sne ' is a conditioned re ponse, devel-
oping from a succession of unpleasant events that seem
unavoidable and uncontrollable. Experiences accumulate to
produce a sen e of defeat and pas ivity, even in ituation that
can in fact be dealt with. Children (and adult ) can be
affected by this type of conditioning in their education, if
minor learning failur are handled in ensitively and produce
the feeling that trying to learn i point! . irnilarly, people
who are consistently di couraged by a pou e or partner - even
in trivial i su uch a parking a ar correctly - may uffer recur-
rent feelings of helple ness, with consequences for phy ical a
well a mental health. ognitive behavioural therapy tech­
nique try to reverse the effects of such conditioning by
rewarding positive thinking and behaviour and questioning
the validity of defeatist thought pattern .

Temper tantrum By not rewarding children's tantrums with

attention, parents can develop an effective conditioning process that
punishes bad behaviour and helps to instil reasonable behaviour.
 The bra� susceptibility to
conditioning that, over the
years, we all build up patterns of
behaviour - responses that may have

UNDERSTAND been appropriate at one point in our lives

but may no longer be beneficial. Many of

YOUR
these 'habits' are unconscious, so the first
step to changing th�m is to discover what
they are. Of course, some habits become a

HABITS
recurring cycle: if you avoid talking to
people at parties because you view
yourself as a poor conversationalist,
so when you do

have a clear aim. So take a look r

habits and decide which to live with and
which to change. Here are five ways to get you started
of self-awareness and change.

Have you ever caught sight of yourself in a mirror

and been surprised at some aspect of your appearance -
perhaps a slouch or a tense facial expression? Such glimpses
tend to be caught in mirrors in public places, or in reflective
surfaces like shop windows, rather than in any mirrors we have
at home. But often we might have an intuition about what we
would see in a mirror if there were a convenient one nearby - and
this is why we may sometimes deliberately avoid seeing our own
reflection. Ask yourself 'what would a mirror tell me about my
habits of posture or expression that I do not really wish to
know?' Then ask 'how can I change my habits to make
me feel better about myself - and more comfortable
within my own skin?' This exercise can be
particularly self-revealing.
 BRAI N AN D BODY CON NECTIONS 49

1t
Habits can catch us unawares - we notice our own
pattern of behaviour after, rather than during, the event. One .
. .
SCAN THE ALTERNATIVES .. _·
.
·?J :rt'.
,:� ., -· ...
way to be more conscious of habitual responses, and more likely
Does every day seem to follow the same
to put energy into changing them, is to cultivate the 'habit' of
stale pattern? Are you stuck in a rut? A
flagging them as they happen. Use physical 'props' to help bring
'habit audit' can give you a clearer picture of
invisible habits to the foreground of your attention. For example, if
your habits and their consequences for your
you want to cut down on smoking, resolve to put on a glove every
life. Keeping a diary is immensely valuable for
time you pick up a cigarette for a few days. The act of doing this
this. But you may also find it helpful to observe
will make your habit seem more of an aberration and give you
other people's lifestyles. Look closely and open­
time to change your mind. Even if you opt to break your
mindedly at the ways in which others carry
resolve, you will remember this transgression against
themselves in different situations - doing the
your self-imposed rule. And this in turn will
shopping, playing with their children, and so on.
highlight your behaviour and make you
Admit that your own life is not a fixed norm from
more eager to change it.
which everyone else is deviating: it is merely one
variation among many. Learn from other people.
Try their behaviour patterns for a change,
instead of your own. You may find
unexpected rewards.

OBSERVE YOURSELF

CHANGE HABITS OF FEELING Reauit a close friend or family

member to act as your seaet recorder.
Brief him or her to capture you unawares on
Habits can invade our patterns of thinking and feeling as
video at a party - or to record you on audio
well as our actions. Quickly make a random list of
cassette. Then study the recordings and watch
adjectives referring to Qualities you find admirable in other
for recurrent patterns. Are you usually the one
people - it might include, for example, 'ambitious',
to initiate conversations or do you follow
'thoughtful', 'sensitive', 'mature', 'meticulous', 'funny'. Then
others' leads? Do you give people time to
consider how far these characteristics apply to you. If you admire
reply when you are chatting? Do you use
a quality that you believe you lack, does that not immediately
meaningless phrases like 'you know' or
suggest a pathway for personal development?
'sort or all the time? If you want to
Imagine the growing fulfilment you would derive from being able
change a verbal habit, try thinking
gradually to change yourself into a more admirable person through
through what you want to say before you
your own efforts. Bear in mind that an effective way to mature your
begin to speak - many verbal tics are
feelings is to start by changing the behavioural responses
unconsciously intended to give extra
associated with them. For example, let us say you are reluctant
thinking time. Ask a friend to give you a
to give up a leisure activity to visit a friend who needs a
secret signal if you start to repeat your
shoulder to cry on. You might think of yourself, shame-faced,
habit - whether it is talking too loudly
as inconsiderate or even selfish. But to change this feeling
or too quickly, or tending to
you do not have to work at changing your character - all
stare at people.
that's needed is to reschedule your golf, call and tell
your friend when to expect you.
50

THE NEW SCIENC E OF P NI

PNI stands for psychoneuroimmunology - where 'psycho' means the mind, 'neuro' the
nervous system and 'immunology' the body's immune defences. This new medical discipline
focuses on the mechanisms by which the mind is able to affect the body, and takes a
whole-body approach to these systems, rather than looking at them separately.

PNI began with the surprising discovery that the

body's immune system can be conditioned to
react to things that would normally have no
effect on it. The finding was made by US
researcher Robert Ader when he was
working on conditioning in mice. One
experiment involved giving the mice
cyclophosphamide - an immune
suppre ant that everely reduced
their ability to produce anti­
bodies to invading organisms -
in a accharin-flavoured drink.
What Ader discovered was that
similar effects on the immune
sy tem occurred in conditioned
mice when they were given the
sweet drink on its own, without the
drug. Their immune y terns had
'learned' to respond to the drink a if it
were the drug a ociated with it.
Re earchers began to wonder if they
9 � could pair a drug that boost the
9

• •
immune system with another substance and u e the learned
0
e e ., response to achieve beneficial effects u ing lower drug doses. In

..
a later experiment they did just that. A woman with lupu , an
�9��
0 immune di order that damages joints, skin and internal organ , at

Q �
II
Mind and the years, and her condition improved.
immune system
Emotions, moods and
thoughts can have a
physical effect on the
brain, in turn affecting
the body's response to
stress and illness.
•
fir t took all her do e of medicine together with cod-liver oil and
•
ro e p rfume. ver a 12-month period, he came to need only half
as many do es of medication as expected if the do were alternated
with cod-liver oil and perfume; he continued this regime for five
Influencing immunity
ot o long ago, thi phenomenon would have eemed baflling becau e
the immune y tern and the nervou y tern were thought to be quite ep­
arate. Immunology wa ba ed on cell and molecule fighting invading
organi ms and the idea that these apparently automatic chemical proce e
could be learned eemed absurd.
 BRAI N AN D BODY CON N ECTION S 51

When you feel a cold coming on, the
two things you are least likely to feel
like are having a good laugh and getting
romantic with your partner. But it may
be well worth making the effort as both
these activities can help to ward off
infections by boosting the activity of
your immune system.
Laughter works by reducing the
levels of stress hormones in the blood,
which slow down the immune cells
responsible for searching out and
destroying viruses. Having a cuddle may
also benefit the immune system by
raising levels of the 'attachment'
hormone, oxytocin. This hormone is
produced when people show affection
(as well as during orgasm), and it is the
foundation of the mother-child bond.
Babies who do not get enough physical
affection in the weeks after birth fail to
produce normal amounts of oxytocin,
and that may be one reason why they
tend not to thrive and
succumb more easily
to infections.

Recently, however , biologist have discovered numerous

bridge that effectively bind the nervou and immune ystems into
one complex, interactive whole. Things that happen at the very 'high­
e t' level of the nervou y tern - our thoughts, beliefs and perception
- can affect individual molecule in the furthe t reache of the body , and
vice ver a. Although it eem hard to imagine how difficult period in our
live could affect our ability to fight illne at cell level, re earch how that
this i indeed the case. In one tudy, 40 medical students were a e ed ix
week before their final exam and again during the exam . Their level of
di tres increased between the first and econd as e ment, and the number
and activity of a particular type of immune cell were ignificantly lower
during the exam period. PNI i the cience of discovering exactly how thi
ort of effect come about.

Mind and body pathways

Many of the pathway hnking mind and body have yet to be revealed , but
two routes are well understood. One lie in the wiring of the nervou
y tern: branches of the peripheral nervou ystem have been hown to FACT: A recent study
extend right into immune y tern organ and ti ue uch a the pleen and
bone marrow. ignal ent from the brain to the e areas may timulate or
found that people
inhibit them dir ctly.The econd route is via chemical and me enger cells who were caring
that carry information from one part of the body to another. The variou
type were once firmly a igned to a particular body system: neurotran -
single-handedly for a
mitters and endorphin , the chemical me enger in the brain, were relative with dementia
a ociated with the nervou ystem; hormone with the endocrine ystem; produced fewer
antibodies in response
and cytokine (immune celJ) with the immune y tern. But now they are
all revealed to be part of a single family of mes enger cell , which medi­
ate betw en the y tern a welJ a w rlcin within them. to infection than
The knock-on effect of molecular change from one sy tern to another
explain why a condition uch as depre ion - normally thought of a an
people whose lives were
illne of the mind - can hav profound effe on other parts f the b dy. relatively stress-free.
52

The immune system •anny' has an important battalion of natural killer (NK) cells, whose role is to search
out and destroy mutant or alien cells. NK cells are activated as part of a sequence of hormonal and chemical
changes triggered by injury or disease. The 'alarm signal' that gets them working is a sudden rise in the
stress hormone cortisol.
If cortisol levels stay high, however, the NK cells become
depleted and are no longer so effective. A study of women
with breast cancer found that those whose cortisol
levels remained at a high level survived, on
average, for three years after diagnosis,
while those whose cortisol levels rose and fell
in a normal way survived over a year longer.
The women with high cortisol levels were also
found to have fewer NK cells. Helping to keep
stress - and cortisol - down to normal
levels may be one reason why relaxation
techniques can help cancer patients.

A c mmon herni al hange in people with d pres i n and d mentia i a

Health through talking The links
between the mind and the immune system
revealed by PNI, combined with new
discoveries about brain processes, have
removed much of the mystery and scepticism
that used to surround psychological
treatments like hypnotherapy, placebos
and 'talking therapies'.
drop in the levels f noradrenalin , a neurotransmitter in the brain that
stimulate brain cell and help u to generate thought and perception . A
drop in noradr naline not only cau e mental luggi hne but reduces the
nerve activity that timulates ti ue to keep ertain immune cell ir ulat­
ing . o instead of seeking out and fighting ba teria and viru e , the in, tive
inunun · cell all w infc tion to thrive.
Effects of anxiety and emotion
Anxiety damp down the immune y tern in a imilar
way. The brain r acts to anxiety in the ame way that
it reacts to fc ar, by telling the adrenal glands (situated
above the kidney ) to prepare the body for fight or
f1i ht. The adrenal re p nd by fl ding the b dy
with corti I, which h everal useful effects in an
emergen y: it thickens the bl d, helping to reduce
cata trophic bleeding in the event of injury; it ten es
th mu le in preparation for fighting or fleeing; and
it heighten mental alertness.
But while all thi i happening, the e eryday
busine of body maintenance is put on hold, u h
the tra king d wn and de tructi n f fc r ign
or errant ell , in luding any that won't top
 B R A I N A N D B O DY CO N N ECT I O N S 53

Defending the body Natural

killer cells are specialised white
blood cells that seek out and
destroy infected and mutant cells,
such as cancer cells. They are
summoned to action by a
hormone called cortisol.

Cancer cell

dividing when th y h uld and may therefc re produ e • n er. Anxiety i

certainly not the cause of cancer, but it may in thi way allow a tumour to
e cape destruction at an early tage.
In contra t, po itive m ntal experience can timulate the immune
y tern, helping to keep illne at bay. Laughter for example, brings about
profi und change in many parts of the body - it relaxe the mu cles
in rea e blo dfl w and timulate the pr ducti n f 'feel-good' neur -
tran mitter . Ang r and h tility, n the other hand, rever e the e effects.
Anger i thought to have a n gativ impa t on the body be au e it rai e
the levels of tre hormone , which damage the linings of blood ve sels.
Thi may cau e inflammation and the formation of ar tis ue, lowing
down the pas age of blood and encouraging the formation of clots, whi h
can lead to a heart attack. Feeling angry in appropriate ituation i not
going t au e you harm, but if you can learn to laugh at fru tration rather
than g t up et about them you may be helping your elf to a longer and
healthier life.

The PNI revolution

P I is helping to bring about a quiet revolution in cientifi thinking. In
conv ntional medi al re earch, the fact that many body proce e at a m 1-
ecular level could be reproduced in a te t-tube reinforced the idea of the
body a a machine. Thi appr a h ha undoubtedly been very uccessful in
giving ri e to dru and treatments for many di ea e . However, the more
ucce do tor have had in uring p ifi di rder , the more their
patient em to omplain of non- p ifi pr blem like general tiredne ,
depre sion and varietie of vague maJai that d not mat h the usu. I text­
book d cription of illne e that they have been trained to deal with.
he idea that y tem in th body and brain are linked to form an inte­
grat d whole help u to make en e of this modern epidemic. Treatments
that concentrate lely on the part that need 'fixing' may cure a pecific dis­
ea but ignore other a p of m ntal and phy ical well-being. Holi tic
pra titioners have alway recogni ed thi , and PNT i finally underpinning
their approach with a ienti6 ba i .
 PERSONALITY
AND HEALTH

S
peculation on the influence that personality and
attitude can have on health crops up regularly
in the media. But what are the facts behind the
stories? Does stress inevitably make people ill? Are
happy, fun-loving people less likely to suffer illness?
Are some people condemned to ill health simply
through personality? And is it possible to beat an
illness through positive thinking?

This chapter surveys the hard evidence on the link

between personality and health, and attempts to sort
out the reliable facts from rumour and wishful thinking.
Along the way, it reveals how certain kinds of thinking
can have remarkable healing powers. Cures can and
often do start in the mind, it seems, and our behaviour
and lifestyle choices - many of which are influenced by
personality - have a direct influence on our well-being.
 ••
• •
•
•
•• •
•
••
•••
••
••
•••
••
••
•
•••
••
••
•• ••
••
••
••
••
••

•
•••
• ••
••• ••
• ••
••• ••
• ••
••• ••
• ••
••• ••
• ••
••• ••
• ••
••• ••
•
•••
•
••• ••
• ••
••• ••
• ••
••• ••
••• ••
• ••
••• ••
•• ••
•• ••
•
 CAN YOUR
ERSONALITY
FECT YOUR
EALTH?
earch has shown that psychological factors play an
portant role in many diseases, from heart problems to
ching a cold. Your physical health is often dependent
your state of mind. And this, in turn, is influenced - at
st in part - by your personality.

YI u might be up et if y ur d tor t0ld you that your m di al

problem wa psycho omaric, or war e, all in the mind'. 1t
would m an that the do tor uld not find a phy ical cau e,
and a umed a p ychological cau e. However, p ycho mati
illn i quite real, but i often mi und r toad - partly
because we are u ed to thinking f mind and b dy as
eparate entities. In fact, the word comes from
th languag of anci nt re , where do tor under­
tood that mind (p yche) and b dy ( oma) were
intrin ically conne t d.

Emotions and health

igmund Freud r vived the id 'a of p y ho mati medi­
cine in the late 19th entury. At his practice in Vienna, he
treated many patients who had ympt m with n obvi u
phy ical origin, and called thi condition hyst ria. Hi patients were
ung women from wealthy famili who exhibited dramatic yrnp­
ch a para! i , lo of pe ch, and even epilepti fits. Freud wa able
1 e om of th e patients' problem through p y hoanaly i , revealing
th n re olving inner p ychologi al conflict that had, according to
, brou ht the problems about.
the 1920 , the American phy iologi t Walter Cannon ( ee page 76)
"ed out research on how emotion affe ts the body. It wa annon who
oined the t rm fight or flight' for the\ ay the body react in respon e to
t. Hi re earch led, during the 193 and 40s, to the de elopment of
cho omati movement in medicine, led by Helen unbar and
Ale ander. unbar beli ved that p ych omati medicine ould
mbine th treatment of phy ical, emotional and spiritual uffering.
Meanwhile,Al ander attempted to update Freud' thcorie with the late t
 P E R S O N A l I T Y A N D H E A lT H 57

Although they had been extremely close resumed his heavy work schedule, but
when they were young, brothers Martin six months • he was back in hospital.
and Bill could not have had more This time, the a>nsultant warned that he
different personalities. Martin, 46, was a would have to stop driving himself so
sales director - ambitious, driven and herd, or he would be dead by 50. With
iffll)ltient He was an exercise fanatic, difficulty, and with reminders from Bill
careful with his diet and a IIOlrsmolaer. and others around him, Martin heeded
Bill, 44, was a taac:her. He had WOl1ced the wa"*'II, and made some major
at the same school tor 15 ,ears and changes to his lifestyle.
unlile many colleagues, coped easily
with his wortdoad. At weelaends, he wsit
fishing or Wllldng. He en.io,.d a drink,
kMld food and was a bit owerweight - he
even indulged In the odd c:iglr.
Despite their diftnnces, they got on
well, so Bill was de'lastated when his 'flt'
brother WIS rushed to hospital attar a
heart attack. Martin recovered and

development in physiology. He identified repr ed aggre ion

as a particularly important cau e f p ycho omatic iUnes . FACT: Some scientists think that
Hy teria of the type described by reud i rar ly diagno ed novelty-seeking is controlled by
nowaday . However, there are till medical condition , uch a
chronic fatigue syndrome, for which a phy ical au e i not evi­ the level of a brain chemical
dent. Furthermore, doctors are becoming increa ingly aware called dopamine. The more
that p ychological factor can play an important role in many
other di ea e , u h as thma, eczema, dige tiv problem and
dopamine you have rushing
heart di ea e. around your brain, the more of
The personality factor
a sensation-seeker you are.
Your heaJth i affe ted by how you choo e to live - wh ther or
not you smoke, the kind f food you eat, whether you take regu lar exer­
ci e, or take part in ri ky activitie , uch a dangerou port . ome
re earcher including American p ychiatri t obert loninger, talk of a
pecific per onaJity trait called 'novelty-seeking'. People who have an
abundan e of thi trait are ea ily bored with routine and con tantly earch
for excitement and adventure.They may indulge in ri ky behavi ur , uch
a taking dru or driving too fast.Th y may aJ o take up dangerou por
u h as mountaineering or para huting.A per on who ha little of thi trait
will tend to be rgani ed, wedded to a daily routine and likely to tick
with the ame partner,job and circle of friend . Per onality play an impor-
tant part in making all th life choice .
tudi how that, bey nd the e choi e , there i probably no uch thing
a an overall 'di eas -prone per onality, ju t a there i no evidence that
happy, well-ba]anced people liv longer or enj y better phy ical health
58
THE DANGERS OF A PERFECT LIFE
Recent research has identified a new personality type
that may be vulnerable to stress-related illness. Known
as 'repressors', these people seem to have perfect lives:
they are hard-working, successful, and never seem
anxious or depressed. They pay great attention to detail
- their homes are immaculate and they are always well
groomed. Their weakness, though, is that they cannot
tolerate the uncertainties of everyday life, and see things
in all-or-nothing terms.
Tests on responses to emotional experiences show
that while non-repressors struggle to express the
subtleties and contradictions of their feelings, repressors
typically give a simplistic reply. Repressors show the
same stressed responses as people with over-anxious
personalities, while their immune systems tend to be
weak. Studies also show that heart patients who are
repressors have a higher risk of complications than non-
repressors. It seems that, in
health terms, striving to
eliminate uncertainty
from your life can carry
a hefty price tag.
than tho e of a m re m ro e or nervou di po ition.
However, although it i prob! matic to generali e, it
doe appear that certain p r onality ripes are more
prone to pe ific type f di ea e.
Why i thi ? he main rea on eem to b that your
per onality can affect how you deal with stres which,
in turn, affects both your immune ystem and your car­
diova cular (heart and circulation) y tem. It i known
that in response to stre we produce the hormone r­
ti ol which, if it remain in the body for too long, can
tr igger the build-up of fatty dep its on the inn r wall
of the arterie erving the heart .
Type A, type B and heart disease
There is an established relation hip between per onal­
ity and su ceptibility to heart di ea e. You may be
familiar with the idea of the type A and type B per-
onaliti . BrieOy, typ A people, who are mor prone
to heart di ea e, are typically driven, impatient, ambi­
tious and energ tic. In contrast, type B people take life
more lowly, are mor relaxed and are less likely to
develop heart di ea e.
In the 1950s, two American cardiologists, Friedman
and Rosenman, were running a bu y practice and
wondered why the eats in their waiting room wore
out o quickly. An upholsterer came to fix the eating
 P ER S O N A L I TY A N D H E A LT H 59

yet again, and commented that it wa odd the way the patient would sit
on the edge f their eats, lutching at the armr ts - a if they were anx­ TRY IT YOURSELF
ious to be off a soon a po ible. o wonder the ats kept wearing down
in the ame place.This throwaway remark about the unu ual behaviour of COPING WITH 'TYPE A'
their patien led Friedman and Ro enman to uncover the link between a BEHAVIOUR
restle per onality and heart problem . If you recognise yourself as a type
However, the typ A p r onabty i compo ed of everal different trai . A personality, don't assume you are
going to get heart disease. While
T here i no general agreement on which type of personality i mo t su -
you caMOt expect to transform
ceptible to heart disea e, but ome intere ting tudie hav b en done in
yourself Into a type B, you can at
recent year .A group of m n and women were given a fru tracing anagram least modify your behaviour to
puzzle to olve. W hen doing th puzzle, tho e who had admitted in a que - improve your health and reduce
tionnaire to being more ho tile and u piciou howed much higher ri e your chances of suffering a stress·
in blood pressure than their more tru ting peer . We all know people who induced condition.
get worked up over things that other take ea ily in their stride, and evi­ • The first tip is to choose your
dence ugge t that reactivity in respon e to tressors may be ignificant in battles carefully and stop trying to
th development f hyperten ion - a major ri k factor for heart di ea exert control over minor upsets or
events that are beyond your ability
to change. If you have been given a
'Type C' personalities parking tidcet, for example, just
After h art di ea , cane r is the leading cau e of death in the developed aaiept it gracefully rather than
world. But doe your personality affect your chances of getting cancer? raging or fuming about your bad
There i some evidenc to ugge t that it might, although the link i not luck. Is it really more important
nearly a strong a that between personality typ and heart di ea e. Some than your blood pressure?
p ychologi ts have defined a 'type C' (cancer-prone) per onality, which • Second, if you are an enervetic,
may be characterised as omeone who re ponds to stres with depre ion drt¥ln person, find some -, of
and hopele ne , and mute their negative emotion . Type C are al o letting off steam that is easier on
your cardiovascular system. "hieing
introverted, re pectful, eager to plea e, conforming and compliant.
part in sport. exercise or regular
owever, th tudie that have been done have not taken into account meditation are all beneficial ways
how per onality might affect life tyle - for example, wheth r a type C of calming yourself down. However
per on i more likely to rqoke, for example, which would increase the busy you think you are, it is worth
chance of developing cancer. spending time on whichever
On the other hand there i evidence to ugge t that your per onality relaxation technique wortcs for you,
for the sake of your long-term
type can affect the chances of surviving cancer. Tho e ufferer who deal
mental and physical health.
with the di ease either with a 'fighting pirit' or denial s em to do better
than tho e, like the type per onality, who accept their fate pa sively.
David piegel of tanford Univer ity in the USA di covered that cancer
patients who joined a upport group that fo tered the fighting pirit sur­
vived, on average, 18 month longer than tho e not in uch a group.
However, not only i the data o far incondu ive, there ar al o pitfall
in over-empha i ing the influence of per onality on di ea e. Taken to
extreme, it could re ult in patient feeling they were to blame for their ill­
ne , producing feelin of guilt which would only add to their problem .
If per onality type do influ nee di ea e ri k, then it probably occur
through a weakening of the immune sy tern via tr . Thi could under­
mine the body' defenc and in turn make omeone more vulnerable to
infection. How ver, much re earch till n ed to be done before the influ­
ence of per onality on phy ical health is fully under tood.
 IDEAS IN ACTION
Do you know what sort of person you are? Our personalities
are extremely complex, with many layers and aspects.
However, the British psychologist Hans Eysenck identified
three major personality dimensions. Use this three-part
questionnaire to find out which you are.

DISCOVER YOUR
PERSONALITY TYPE
Personality is a collection of individual and
relatively enduring patterns of behaviour and
interaction with others. Our temperamental and
personality characteristics are what make each
of us unique. Over a period of several decades,
Eysenck developed a model in which he
described three main personality dimensions:
introversion-extroversion, emotional-stable,
and tough-tender. Eysenck saw each of these
as a scale on which most people would score
somewhere between two extremes, and his
three-part model is still commonly used today.
• Although your personality tends to remain stable
over time, you can change your lifestyle and also
alter your behaviour to some degree. An understanding
of your personality type could help you to identify
particular lifestyle and behaviour tendencies
that may have a negative impact on your health.
To discover where you are placed on
Eysenck's three personality dimensions, complete

••
the three questionnaires on this page. Then turn
to the next page to find out how you scored
and what implications this may have for your
health. With determination, you may be able to
use this awareness to modify your behaviour
• Do ,au need 1D ma I lot of
and improve your mental and physical well-being.
Sllf-cantral 1D aut of One highly revealing way of using the
trouble? questionnaire is to complete it yourself
first, and then have someone
I Ant ,au .... c:Mdlll 1D
who knows you very well to fill it
in on your behalf. The differences
thrown up can be quite interesting.
Write your answers on separate
sheets of paper so that your friend's
answers are not influenced by your own.

Doyo thin youareExtrovertlntr

 YES NO
Do you often lose sleep over your
worries?

Are you ever bothered by

unimportant thoughts that run
through your mind for days?

In general, would you say that you

are satisfied with your life?

� Do you see your future as looking

quite bright?

Do you have a great deal of

confidence in your decisions?

Are you often afraid of things and

•
people that you know would not
really hurt you?

Do you often feel ashamed of

things that you have done

•• Do you smile and laugh as much

as most people?

• Do you get very upset if someone

criticises you?

Do you think it's a waste of time

I
going to the doctor with mild
complaints such as colds?

bleTo
62
HOW TO SCORE
Give yourself one point for each 'yes' to questions 1, 3, 4, 8 and 9
and one point for each •no• to questions 2, 5, 6, 7 and 10.
A score of 8-10, means that you are outgoing, sociable, active and
impulsive - an extrovert.
If you scored l-7 you are an ambivert, which means that you have
some of the characteristics of each type, extrovert and introvert.
A score of 0-2 means that you are quiet, controlled, thoughtful and
responsible - in other words, a classic introvert.
EMOTIONAL OR
STABLE
HOW TO SCORE
Giwe JQll'l8lf one point for each .,_. to questions 1. 2, 6.1 and 9
and one point for each 'Ao' lo questions 3, 4, S. 8 and 10.
A san of �1011111111 lhlt you are � emotional and indined
to be ..... te.ful, gull-ridden and generally hamed by life.
A art of W iJldlcllls flirty aver111111110tion1111y. You n
1'1111111111111 WII ..... llllt not COlnpleteiJ Immune to IIICiely.
A san of 0-211111111 lhlt you .. U111111111J lllble,
COllldlM, secure and untroubled by MAii.
Areyou Extrovert ntrovert
Extroverts typically show the following traits: activity,
sociability, risk-taking behaviour, impulsiveness, expressiveness,
lack of reflection and lack of responsibility.
Introverts, by contrast, exhibit more or less the opposite of all
the extrovert's traits to a greater or lesser degree. They are thus
more likely to be cautious and reflective, to be reliable, to
persevere, to be interested in solitary pursuits and to prefer their
own company. Extrovert people may be happier and more fun to be
with, but introverts tend to be more independent and reliable.
Stability makes a person content and generally easy to get along
with. However, emotional people are often more exciting, creative
and artistic than stable people, and U. are more likely to
sympathise with the problems of others.
Emotionaly unstable people are more likely to have personality
traits such as low self-esteem, depression, anxiety, obsessiveness,
lack of autonomy, hypochondria and feelings of guilt People of this
type are sometimes thought by psychologists to be more at risk
of succumbing to physical and mental Illness.

PERSONALITY AND YOUR HEALTH
An enormous amount of research has been carried
out to try to establish links between personality and
health. Although there is little that anyone can do to
change fundamental personality, there is much that
can be done to modify self-destructive behavioural
traits and reduce health risks, such as poor diet, lack
Extroverts may need more balance and moderation in
their lifestyles. They should be sure to get enough sleeo and
eat healthily. There may be a tendency to drink in excess. and
indulge in too much partying and risk-taking behaviour.
Reining in such tendencies could benefit mental and
physical health.
1ona I StableTough Tender?
I
PERSONALITY AND HEALTH 63
of exercise, high-stress activities, and drinking and
smoking. Most people have a mix of attributes, but
if the scores in one of the dimensions are very
high - or if personality factors are leading to
health-affecting behaviours - then making some
lifestyle changes may well be beneficial.
Introverted people are generally shy and often have less
well-developed social skills. They may benefit from some form
of social-skills counselling to help them overcome any tendency
to excessive shyness. Introverts who live on their own should
be careful not to neglect their own physical and emotional
needs. in particular by maintaining important social
contact with family and friends.
64

SYMPTOMS: IN THE MIND OR BODY?

There is a widespread belief that some symptoms are
'physical' while others are 'in the mind'. But mind
and body are linked in a single complex system
- so, if one part of the system is damaged or
malfunctioning, the rest is bound to be
adversely affected.

Illne make it elf known in two way : by

sign - phy ical changes that can be
dete tcd by other people - and ymp-
tom , which are only known to the
person who has them. For example if
you get a cold, your temperature goes
up, your nos'e run and you sneeze;
the e arc ign of illne . In addition,
however, you may feel fcveri h
tuffed-up and tired, and the e feelin
are ymptoms.

Symptoms and signs

Mo t ilJne se produce both symptoms
and ign : n t nly do you feel ill but other
people can ee that you are ill o the quc ti n
f whether the iUnc i 'real' or not doe not
ari e. However, in omc illne e the sign arc either
too ubtle to be dete tcd or the ondition is not yet
under tood, o do tors do not recogni e them. he only way the
illne s manife ts itself i in unplea ant feelings - symptoms, known only to
the sufferer. uch conditi n are ometime aid to be 'all in the mind',
which until recently meant non-phy. ical. But it is now known that there
i no uch thing as an entirely n n-phy.ical en ation: everything we expe­
rience - even our thought - ha a phy ical ba i in the brain.
Take, for example, the condition tinnitus, in which ufferer typically
complain of per istcnt ringing or buzzing in the car. Not s long ago, tin­
nitus was often a um d to be 'in the mind', because it had no ob ervable
ign that ould be detected medical] . In recent year , h wever, imaging
equipment ha been de eloped that can . hO\ the electrical brain acti ity
of en ation uch a hearing.This technology ha shovm clearly that when
tinnitu patient hear a phantom' noi e, the ells in the brain that regi ter
sound di play the same phy ical changes that occur when sound wav
hit the ear. The sounds heard by tinnitu ufferer are therefore no more
imaginary than any other sound - it is ju t that they arc produced by
a different me hani m.
 65

Real feelings from 'invisible' causes Feeling the loss

The condition called
In the ondition known a phantom limb, people report feeling en a­
phantom limb is not
tion (including pain) in an arm r leg that ha been amputated. This
an imaginary
phenomenon was once di mi ed a ome vague p ychologi aJ att3 h­ sensation, but
ment to th mi ing body part. Now, however re earch ha hown that results from nerve
physical ensation can ontinue t be produ ed in the brain neural cells in the brain's
'b dy map 'even in the ab n of input from the body. In other w rd , 'body map'
continuing
if the part f the brain that map the l ft leg i activat d, a per on exp -
to fire.
rien e the en ation even if the leg it elf i not pre ent. The feeling i
identical to when the brain cell are triggered by me age from nerve
in an a tual leg. hi mean there i no difference between 'imaginary'
feelings and 'real' one - they all tern from the ame ur e: phy i aJ
change in the brain.
ometime ympt m an an that do not a ha e a phy icaJ au e .
upp e, fc r example omeone ha an accident during which the uffer
a hipla h injury, a an often h, pp n wh n a car de elerate rapidly.
allowing the incident, nerve in the neck and pine send signal to the
brain cell that regi ter pain in that area. Thi continuou timulation sen-
iti e the c cells, so that even after the injury ha heaJed, they " ill be
in lined to fire at th lea t timulation. The lighte t jolt may make th m
flare up although an examination ould how nothing wrong.
In dfe t, the brain ha learned to produ e neck pain, ven hen
the signal fr m the original our e hav ea d.

,,_,,_ 11• ..,,,,,,., OCt:1111 ..,...,,
Ille lnhl ',ro/M:u' • INl"'6 on IO •
,,,.,, ,,,., " not .... Whll
,,,. ,,.,, Ill • t:Ollfll• of
,,,.,,,,, - • ,.. llllnlllel
l. Sit in a chair, with one friend sitting in nose is, but has shifted location to
another chair in front of you, facing in where your finger is stroking your
the same direction, and the second friend friend's nose in front of you. You have
standing on your right. 'created' a phantom body part!
2. The standing friend should now take
Conflicting signals
your right index finger in their right hand,
The illusion arises because the brain is
and use it to stroke and tap the nose of
faced with two conflicting streams of
the seated friend in front.
information. The hand says that it is
3. At the same time, the standing friend stroking a nose some distance in front,
must use their own left index finger but the nose, confinning that it is being
to tap and stroke your nose, in stroked, feels that it is happening in the
precise synchrony with the usual place - on your face. The brain
stroking and tapping using has to interpret this information in a
your finger of the person in way that makes sense. Both messages
front of you. cannot be right so it chooses between
4. Close your eyes and relax. them. Messages from the hands are
After about 30 or 40 more credible because the fingers have
seconds you will find that far more neurons associated with them.
the feeling of tapping and So the brain chooses the information
stroking no longer comes given by the finger - that the nose is
from where your way out in front.
66

Expectations of pain
Another way that feelings may be produced without obviou cau e i
through e ::pectation. uppo e, for in tance, that your mother uffered from
rheumati m, and as a child you frequently aw her win e when he moved
her knee. Furthermore, you heard that thi type of rheumati m i heredi­
tary. Now uppo e in middle age, when nearly veryon tar t get ome
joint pain, you fc el a light pain in your knee. Mo t people would di mi
it a normal wear and tear, but your fir t thought i likely to be that thi i
what your mother had. rom that moment y u are I oking ut for the
next pain, and any sensation in the knee, however light, g immediate
attention.Attention i known to amplify fee)jn - it make the brain cells
as ociated with the en ation fire more trongly - o what might have be n
a mall twinge can become a earing pain.You may have preci ely the ame
degree of wear in your kne a omeone el e, but your brain reacts more
trongly to it becau e of your expectation . Digital diagnosis Computers can be more
imilarly, people can become s n iti cd to body ignal .A per on who accurate than doctors at diagnosis - perhaps
on tantly looking out at th world, rather than inward , i le likely to because they are not misled by their own
prejudices. In one study in a hospital
pay attention to the ince ant buzz of information that th body nd to
emergency department, the patients'
the brain. mall p in are overlooked, and becau e they are not noticed, the symptoms were fed into a computer, which
brain cell that regi ter them d not b come nsiti d. ln contra t, ome­ then made the right diagnosis in 91 per cent
one who monitor body ignal very clo ely will notice every little of cases; the casualty doctors, by contrast,
en ation, and th brain will rea t 111 re trongly to any adverse sign al. were right in only 45 per cent of cases.
he simple belief that you have a ondition can trigger a tual change
in the body that may produce sign of the illne . Ju t thinking that your
blood pr ure i rising can cau e th blood ve el to on trict, o that

An illness is the same illness
wherever you are, right? Wrong.
Doctors as well as patients tend to fit
signs and symptoms of illness into a
disease pattern they are familiar with
and expect to see - and expectations
differ according to training and
speciality.
In Britain, for example, patients
complaining of breathlessness,
diuiness, tiredness and feelings of
panic would probably be diagnosed with
hyperventilation, a condition in which
blood alkalinity rises as carbon dioxide
is reduced through over-breathing. In
France the same symptoms would more
usually be attributed to spasmophilia -
spontaneous muscle contractions
brought on by magnesium deficiency.
In Germany, the diagnosis would most
likely be vasovegetative syndrome,
caused by a nervous system imbalance,
while in the United States doctors
would probably pronounce 'burn-out'.

wh n your blood pre ure i measured it i indeed
rai ed. The preci e mechani m that cau e thi are not
fully under tood, but it e m that the thought of a
body change feed back from the cerebral cortex
to the limbic area of the brain that produce
that change. Thi is an example of 'top-down brain
pr e ing - con ciou thought influencing uncon-
c1ou pr e e . n rare o ca i n , the body may
erupt in pontaneous lesions. A mo t dramatic example
is the religiou phenomenon of' tigmata', in which
the per on develops ore on the hand and feet in
empathy with Je u ' crucifixion wound (although the
causes of thi are not fully under to d).
Taking control
Ju t a th brain can produce ymptoms of illne , it
can aJ o alleviate them. If you can learn to direct your
attention away from pain and di comfort and be opti­
mi tic about the cour e of an illne , it will probably
cau e le di tr and cl ar up more quickly than if
you expect it to get wor e. f cour e, if you have any
ymptom that are per i tent or ould indicate a eri­
ou illne , the e h uld alway be investigated by a
do tor. But if you try to avoid worr ying, you may find
your elf feeling better without treatment.
- - �- ---�
(JR€4tl l;Lve4
P E R S O N A L I TY A N D H E A LT H 67
CHRONIC FAT/SUE SYNDROME
Sometimes known as myalgic encephalomyelitis (ME),
chronic fatigue syndrome (CFS) is a classic example of a
condition that often has profound symptoms but no signs
that the medical profession agree on. Sufferers feel
perpetually tired, and may be plagued by all manner of
uncomfortable feelings, including muscle and joint pain,
weakness, stiffness, dizziness, insomnia and noticeable
mood changes.
However, doctors have not yet found any clear signs
that identify and distinguish the condition. Some experts
have found evidence of viral action, others have detected
functional differences in the brains of CFS sufferers, and
some maintain the disease is caused by a change in the
mitochondria - the 'batteries' in body cells that produce
energy. Currently, the only diagnostic aiterion for CFS is
the characteristic bundle of symptoms desaibed by the
patient. This leaves the poor CFS sufferer open to the
accusation of malingering - because they have no
objective, measurable evidence of their illness.
-
- --- -- - - - - - - - - --
Hysteria In the 19th century, hysteria was
a common diagnosis, describing a
condition in ivhich psychological
problems were transformed into dramatic physical symptoms. These
curious and debilitating effects are still studied by doctors.
The ancient Greeks thought became central to his theory of
that the womb (husterus) was psychoanalysis. He concluded
a free-floating organ that could that hysteria was caused by
move around the body creating repressed sexual desires and
problems - any mysterious conflicts that were converted
ailments in women were into physical symptoms.
therefore ascribed to 'hysteria'.
Although the notion of a Hysteria today -
wandering womb disappeared, conversion disorder
that of hysteria did not. In the The term hysteria is rarely used
19th century, the condition was by doctors now; in everyday
held responsible for a host of Hysteria demonstrated Jean-Martin Charcot usage, it usually just means a
symptoms in women, including (1825-93) held public performances where patients display of melodramatic
emotional fits, numbness, would demonstrate the clinical patterns of hysteria. emotion. However, the 19th
weakness, sensory dysfunction century idea lives on in a set of
and fainting. conditions known as conversion
A Parisian neurologist, Jean-Martin Charcot, disorders. These are no longer thought to be
studied hundreds of 'hysterical' patients and primarily sexual in origin, or limited to women, but
described how they went through four phases: Freud's basic idea - of physical symptoms caused by
physical rigidity, muscular spasms, emotional unconscious conflict or pain - remains fundamental.
outbursts and delirium. He discovered that he could Conversion disorder is defined as the appearance
induce these states in some of his patients, and held of symptoms, usually affecting movement or the
demonstrations in which women were taken through senses, which cannot be explained by physical
the phases, then miraculously cured. Sigmund Freud disease and are judged to be associated with some
was fascinated by Charcot's work, and hysteria kind of psychological stress. Patients have no

DISSOCIATION - A PROTECTION MECHANISM

Some symptoms of conversion disorder - the modern
term for hysteria - may be caused by the 'dissociation'
of one part of the brain from another. This type of
brain dysfunction is similar to that seen in extreme
emotional trauma, when people may 'cut off' the
conscious parts of the brain from the parts sensing the
outside world. The traumatic event is thus not
consciously experienced, and memories of it cannot be
recalled in the normal way. They may, however, be
triggered in the form of a 'body memory' - a replay of
the physical sensations that were present in the
trauma. The replay of such memories is thought to
account for many cases of conversion disorder.
Dissociation probably evolved as a survival
mechanism - by cutting out damaging sensations, it
leaves the rational part of the brain free to work out a
response. And when there is nothing to be done, it
produces a dreamy, passive, state that would be more
useful than panicking. Women and children dissociate
into this passive state earlier in the course of trauma
than men. Men also dissociate from pain and emotion
but act aggressively before becoming passive.
Dissociation can thus be useful in extreme situations,
protecting the individual from damage.
 PERSONALITY AND HEALTH 69

conscious control over the

symptoms, and are usually
unaware of the underlying cause.
In severe cases, symptoms may
include paralysis, blindness,
deafness and hallucinations. More
often, though, they are vague, and
can include dizziness, lack of
balance or coordination,
headaches, nausea, tics and
tremors, and numbness.
Conversion symptoms often
overlap with another state called
derealisation - the sensation that
the world is distant, unreal or
shifting. Depersonalisation - a
feeling of watching oneself from
outside - is also common.
Female conversion disorder
patients outnumber males by two
to one, and the condition seems
mainly to affect young people who are na"ive about
the way their bodies work. The symptoms often
mimic popular ideas of how a disease might
manifest itself. For example, a patient complaining
of chest pain may be unconsciously terrified of lung
cancer; however, in real lung cancer cases, chests
pains do not appear until the disease is far
advanced, usually after a host of other symptoms.

Root cau e
The symptoms of conversion disorder are not
imagined; they occur because the brain functions
abnormally. A brain scan of a woman who was
unable to move her left side revealed that when she
was asked to lift her left leg, the brain area that
plans action became active, showing that she
intended to make the movement, but this
instruction was not transmitted to the
neighbouring motor cortex, which tells the
muscles to move.
The only data available to the conscious mind
in such cases is that it is trying to move but
can't. Not surprisingly, most patients
erroneously conclude that there is
something wrong with their limbs.
70

THE PLACEBO EFFECT

The body has remarkable powers of recovery, which can be triggered by the mind to
produce a wide range of healing effects. One way of activating this healing potential is to
give a patient a 'dummy' treatment that he or she expects to have a curative effect.
Such treatment is known as a placebo.

Fifty year ago, one of the mo t commonly pre cribed treatment in general medi­
cine wa a ticky, bright pink, trong- melling mixture call d a pecial tonic'. Family
doctor handed out thi my teriou uh tance with grave in truction about exactly
how and when it hould be taken, and encouraged patients to believe that it had
powerful healing propertie . In fact, the tonic was little more than coloured yrup
with no direct curative power . Yet the doctors were till being truthful
when they implied that it could heal. Patients who believed in the special
tonic usually showed improvement and reported fee�ng better.
Thi placebo effect ha been ob erved in e medicine began. Indeed, until the
arly 20th century, mo t pills and potions worked in thi indirect way. The word
'placebo' i derived from the Latin 'I hall plea e' - an acknowledgement, probably,
that placebos were often employed by doctor to 'plea e' their patients.

The power of belief

Any form f treatment an be a placebo, and tho e with the most powerful effects
are g nerally the one believed by the patient to be the most effective type of treat­
ment. Patien who b liev in 'natural medicine' will probably find that their ill can
be t b cured by herb , while tho e who tru t only modern pharmacology will do
better with ynthetic medicine. imilarly, injection are likely to have a greater
Pill or placebo? What is in placebo effect than pills because they are more invasive and so are
the medicine may matter less
than what you believe is in
there. A patient's response to
treatment can be driven to a
considerable extent by what
the patient
expects.
 PERSONALITY AND HEALTH 71

Drugs are tested against a placebo in
order to establish how much of I
treatment's eftlc:tiVWIISS (and side
effects) Is due to patient expectation,
and how much Is attributable to the
drug's direct medicinal effect. These
experimen1s n known as 'rlndomlsed
controlled trills' (RCTs), and only
treltments thlt show I benefit in these
experiments CIII be liclnled. It Is
essentill thlt patients do not know
whether they are taldnG the real trill
drug or I plecebo. Pltients who ISlfN
to tllca part in trills n Informed In
lclvlnce tfllt they ffllY be given I
placebo, and have the option of refusing If it Is a pill thlt is
to continue. being tested, for
Trials work by dividing I number of example, the placebo
patients with similw symptoms into two will look identical to
groups. One group is given I placebo the Niii drug. E.ac:h pill
for a set period while the other Is given will carry I code
the trea1menl for ldentHlc:8tlon
In order to enue tlllt patients do and only It the end
not know which treatment they are of the trial will the
receiving, where posstble the trflls are alloc:ltion of pills to padtnts be
'double-blind' - thlt Is, the doctor l"IV9lled to show who rec:ei¥acl
administering the drugs does not know which treltments. The
whether the patient Is taking the Niii results can then be
thing or not This i,ments the doctor analysed and the efflc:lc:y
from unwittingly Influencing the patient of the drug 1s1•11d.

perceived to be more powerful.

Probably the most dramatic placebo of all i surgery. ln the 1950 ,
when urgeon were more cavalier about patient right , a
group of people with heart di ease were ubjected without
"When we were children
their knowledge to an experiment intended to te t the
efficacy of a particular operation. Half the patients had .,I. in the 1920s, my
"
the p rati n , which involved opening the h t
and tying off an artery, while the other half were
parents couldn't
ju t cut open and ewn up again. Afterwards, the afford the dentist.
patients who had undergone the actual operation
were found to be in no better or wor health than So if one of us had
those who had merely been opened up. toothache, my
The experiment wa repeated by different ur­
geon , and thi time the patients who had ju t been grandmother used to
ut open hawed v n greater improvement than
take a cloth that had been
tho e who had the peration. The impr vements
were con iderable: one patient who had not be n covered in onions and wrap
operated on wa able to run on a treadmill for ten
minute after the treatment, wherea he ould
it round your arm on the
barely manage four min­ opposite side to the tooth
ute before. Hi underlying
condition wa unchanged, that was aching. In those
but hi ability to fun tion days, lots of people believed
improved enormou ly,
and a functional comp - that onions could cure all
tence i generally th
sorts of aches
measure of health it would
be true to say that hi and pains."
health had improved. Stanley, retired accountant, 85
72

Ruth Mdlrfde. an elderty woman with to be put bllck on the old ones. My
chronic � (indigestion), hid doctor explained that the new ones
first-hand lll*ienCe of how were iclentic:al IIICIPt that they
expectations CIR influence I drug's were celled by the generic name
effac:t when her regular prescription instud of the brand name, Incl
WIS changed. were made by I different company.
'A year ego my doctor switched my He showed me the book with all
pils.The new ones were celled the drug names in Incl I S1W he
something else Ind loollad dlflerwlt. As WIS telling me the truth. I know it
soon IS I started them my symptoms sounds funny, but the next day they
came beck, so I went bllck Ind lslled started to work ...•

Placebo-controlled clinical trials

he urgery experiment wa an e ·ampl e of a placebo-conn, lied linical trial - that i , a
tudy in which the effi t f medical tre, tment is ompared to the effect of a placebo
treatment on a 'control gr up. In thi a e, previ u tudie had c mpared patients who
had undergone surgery with other who had received no treatment at all, which had ug­
ge ted that the operation wa u eful. However the pla eb - ontr ll d trial h wed that
the improvement een after the operation \: a due t the patient ' belief that th y had
received effective treatment. The surgi al pro edur · a hown to
give no additional benefit and o wa abandoned.
RESULTS OF A urgery i rar ly te ted again t a pla eb , but all new drugs
PLACEBO TRIAL mu t h w that the ompare favourably to a placeb be6 re the
Placebo trials are used to test all drugs.
The graph here shows the results of a
are licensed. me trial in lude a third group of patients who
typical placebo-controlled receive no treatment at all, and the e trial have pr du ed a vast
c 100 trial, in this case to assess
the effectiveness of the
amount of evidence to hO\, ju t how powerful the placebo effect
an be. n e large trial, involving nearl 400 heart-di ea e
cu 90 antidepressant drug patients over a p riod f five year , found no difference at all in the
paroxetine. Nearly a quarter
80 number of death among tho e wh took a real drug and tho e
Q. of patients who took just a
.5 70 placebo showed improved
who t k , pla ebo. However, there wa an en rmou differen e
� symptoms. - about per cent - between the health f tho e \: ho took their
c
·1 60 5596
pill regularly, \: hether pla ebo or real, and those \ h did n t.
hi strongly ugge t that belief in the pill , a demon crated by
50 keeping to the regime wa more important than any dire t effe t
c of the trial drugs. ( ffe tive drugs show a di tin t benefit over
cu 40
placebo, and a drug that performed no better than a placebo
Q.
30 2496 would not re eive Ii en e.)
cu
� 20
The importance of recognition
c
cu 10 he placeb effect does n t alway depend on patient believing
cu the have recciwd effe tive treatment - imply having ymptom
A. 0 recogni ed and taken eriou ly make an enormous differen e. A
PAROXETINE PLACEBO
tudy of 6 patient who attended their family d tor 6 r re
 P E R S O N A L I T V A N O H E A LT H 73

chr at found that those who felt th y had been treated ympathetically
re over ·d more quickly. A do e of sympathy had generally more effe c, it FACT FILE
eem , than a course of antibiotic .
ome omplementary therapies depend on the placebo effe t for their THE POWER OF
effi acy, but it i difficult to te t chi be au e a placebo elem nt i usually SUGGESTION
built int mplementary treatments. A consultation with a complemen­ Three facts about placebos:
tary therapi t will often involve taking a detailed patient hi tory and • Placebos work best for pain
listening carefully to the patient. It may al involve 'hands-on treatment, relief, migraine, rheumatic pain
like aromatherap , massage or b d manipulation. Th e element are and sea-sickness.
• Eighty per cent of experienced
almo t ertain to ha e a placebo effect, but if you rem ve th m ther may
doctors use placebos, but only
be little f th therapy left to a e .Thi i why it can be difficult (although 16 per cent of junior doctors say
not impo ible) t te t mplementary treatment u ing rig rou they would use one.
ientific mea ure . • Studies show that victims of
industrial accidents recover
The brain-body response twice as quickly when their
employers formally acknowledge
The pla cbo effect i brought about by the a ti ation of different physio­
their injuries.
I gi al mechanism in the body. Pain an be relieved by the relea e f
natural endorphin - morphine-like ub tan e in the brain. he relief of
a pr blem u h a on tipation or irritable bowel yndr me may be du to
ner ou y tern me hani ms that r lax the smooth muscle of the inte tine.
Infection , and p ibly cv n tumour , may be reduced by the brain acti­
vatin immune ystem re pon e .
However, alth ugh phy i I gicall based the placebo effect i ubject to
learning and modification. If, for e ample, y u ha e learned to a sociate
pain reli f ith taking a small white pill, that a ociati n al n can bring
about pain relief whenever you take a imilar white pill - regardless of
what it contain . A I ng a you believe it i the painkiller, it an have ,
curative effe t. I 11 on experiment, p ople were given a lozenge that pro­
duced heart palpitation . When they were later given an inert but
identical-I oking loz nge, their h art rate in reased to the ame
e tent a with the a ti e ub tan e. The placebo effect is thu not
alv ays benign, but tend to pr du the
effect that the patient expect the treat­
mem t have, which may include
unplea ant ide dfe ts. Indeed, the
high level of idc effe ts reported
by man people taking a pla bo
Colour matters Placebo studies have
ha prompted ome re carch ·r to
shown that pink or red pills produce a
que tion the general a umpti n stimulant effect while blue pills have a
that placebo are harm le . tranquillising effect - even if they both
Pia ebo , then rel heavily contain the same inert substance.
on the patient's e rpectation of
the treatment's effectiven
he body imply 'd e what i
expected f it' - whatever that
i in each ca e.
74

THINKING POWER
Your view of the world and what happens to you is coloured by the way that you think.
People who are negative thinkers may be more realistic than positive thinkers on some
issues, but negative thinking can lead to an unnecessarily gloomy view of life. And when
it comes to health, it seems there may be health benefits in adopting a more positive way
of thinking.

Events, even tres fol one , are mo tly neutral in them elve - it i how we
think about them that affects the way we re pond. A job may force
som one to move away from a place where he or she i happy, but the
change may offer the chance to get to know a
new area and make new friend . f course, find­
ing a po itive a pect in traumatic ir um tance ,
"People are disturbed,
such a bereavement, i difficult, but there are till not by events, but by the
difference in the way p ople c pe. A negative
thinker i mor lik ly to tay marooned in grief, v·ew they take of them."
guilt and anger, while a po itive thinker will even­ Epictetus.
tually b able to move on and be thankful for ancient Greek philosopher
happy memories.

Healthy attitudes
The way people per eive everyday events i affected by their thinking
tyle. For e ·ample, if a friend doe not call when pr mi ed, negative
thinker will a ume that they have done something wrong and that the
friend is angry with th m; po itive thinker , in contrast, will probably

Ari you • neptin or• positive
thinker? To find out. .,,... your
rnpon,n In thtl followin, 1iluation1.
• Is your thinking fixed or
changing?
You have had an argument with
someone you are close to and just
discovered that they were right all
along. Do you think 'I always get it
wrong' or 'Well, I made a mess of that,
but everyone is wrong sometimes'?
The first response is negative,
reflecting a rigid mindset. The second is
more positive as it acknowledges that
each situation is different and that
responses can change accordingly.
• Is your thinking global or
specific?
Your bank statement arrives and you
realise that you are unexpectedly
overdrawn and have been charged by
the bank. Do you think, 'I can't believe
this has happened to me - it's so unfair.
I seem to get everything wrong'. Or, do
you think, 'Well, finances never were
my strong point. I'll have to be more
careful in the future.'
A negative thinker will tend to take a
global view and assume that if they get
one thing wrong, tlTen they always get
everything wrong. In contrast, a more
positive thinker will realise the specific
nature of any failing.
• Is your thinking internal or
external?
You have been told that you did not get
a promotion you applied for - instead,
the company have hired an outside
candidate. Do you respond by thinking,
'I wasn't good enough to get that job',
or do you think, 'I always thought they
would bring in someone new'?
Internal thinkers tend to blame
themselves when things go wrong,
while external thinkers accept setbacks
as being outside their control. So, to
enhance your positive thinking, try to
see events as changeable, not fixed;
specific rather than global; and external
rather than internal.
 ume that the friend i bu y or will ring when
they get the hance.
n a more eriou level, the way you perceive
potential threat govern your tress re pon e,
which in turn can affect your health. o doe th.i
mean that negative thinking can make you ill?
There i no overwhelming evidence for thi , but it
doe eem that a person' thinking tyle may play
me part in their tate of health. ondition such
a arthriti , a thma, h ada he and heart di ea e
can all be affc ted by state f mind.
A positive outlook eem to help peopl to
cope better with serious illne e . For e ample,
p ychologi t have found that men who had oro­
nary bypa urgery recovered more quickly if
they had a po itive, rather than negative, outlook
n the ituati n. Th y r turned to normal life more quickly, and when Breaking down It may feel like letting off
a ked ab ut their quality of life ix month on, were till doing well. steam, but reacting with hostility to the
frustrations of everyday life - as the
The health cost of hostility character Basil Fawlty (above) famously did
in the classic television comedy series
Th type of negative th.inking that i Jinked mo t tr ngly to ill-health 'Fawlty Towers' - can actually increase the
- parti ularly heart di ea e - is ho tility. People \; ho are hostil complain chance of stress-related health problems.
a 1 t, are u piciou , get into a lot of arguments and always seem to put the
worst interpretation on other people' behaviour. P ychologi ts at the
Univer ity of Kan a rated 750 men for ho tilicy then followed their
pr gre over many year . They found that tho e with high ho tility core
were more likely to die prematurely. he ame tudy found that pe pie
who are ho tile are al o mor lik ly t lead unhealthy life tyle , being
prone to smoke, drink or use drugs.
A generally ho tile attitude al o ha a more FA . : Norman Vincent Peale, successful
direct effect on health, as it can lead to more
wear and tear n the central nervou y tern
author of The Power of Positive Thinking,
during tre . P ychologi ts gave a gr up a fru - was so disappointed with the first
tracing puzzle t solve (a devi e d igned to
manuscript of his book that he threw it in
elicit a mea urable ere re pon e). Tho e who
had previou ly admitted, via a que tionnaire, to the waste-paper basket - from where it was
being more ho tile and su piciou in their atti­ rescued by his more positive cleaning lady!
tude t other howed bigger increa e in blood
pre ure over the puzzle than tho e with a more positive attitude. ver a
lifetim , the urg in blood pre ure in respon e to normal daily fru -
trati n may well damage the arterie , perhaps etting the cene for heart
di ea e - alth ugh thi link ha not been on Ju ively pr v d .
l n contra t, po itive thinking involve a con tructive re pon e t life's
problem while keeping a en e of per pective. Po itiv think r are le
likely to feel fru trated, helple or overwhelmed by circum tance , and thi
can be very helpful in oping with the tres e of everyday life.
 STRESS AND HEALTH
Stress is the body's reaction to the challenges and threats of the
world around us. Back in our evolutionary past, stress had real
survival value, enabling humans to flee from or combat threats
from wild animals and enemies. Stress can still be crucial in
an emergency, but usually our stress responses merely produce
wear and tear on the brain and body.

trc i often talk d ab ut a if it were mething outside ur el c , but

p ychologi u ' the term to mean our re p n e to mething that may
threaten our well-being and tability. he external cau e of tre are
called' tre or', and practically an thing an be one. It could be a
truly lifi -threatening c cnt, u h a an out-of-c ntrol ar c ming
toward you on the wrong ide of the road; or it might be a minor
everyday irritati n, like a drippin tap or the noi e f an electri drill
oming from the erect. Whatever the di turbance, the brain take in
information from the tre r and by a comple ' intcrpla f th'
PIONEERS nervou , nd endocrine s-
tem , pr du c· a b dily
re pon c to deal with the threat.
The effc t of tre arc mental,
American physiologist Walter B.
Cannon (1871-1945) pioneered stress phy ical and emotional. And if the
research during the 1930s. He observed go on for too long, they can produ e
that when humans perceive a threat, the ill health. In the short term tre
whole organism becomes rapidly make the h art ra e, the palm
aroused and is mobilised to either weat, and br •a thing become
attack the threat or flee. Cannon
fast and hall w. You may fc cl
realised that the response is useful
because it enables people to deal fear, anger or even a trange
quickly with a threat. However, he also sen e f exhilaration. Thi i
concluded that stress can be harmful , II part of the 'fight or flight'
because it disrupts emotional and re ponse fir t de cribcd
physiological functioning, and - if by Walter annon m
prolonged- can cause serious illness.
the 19

Fight or flight
A the name sugge t , the fight or
flight re p nsc equip you either to run
away fr m a threat or to tay and face it.
ither way, you n ed e tra energy, o a oon
a the thal, mu , the brain' relay tati n, is made
av are of the tre or by the erebral c rte ·, it puts
the ympathcti nervous s t ·m on red alert by end­
ing a me . age to the adrenal gland . Th· adr ·nal p ur
ut t, chemical - adrenaline and noradrenaline - , hich
 PERSONALITY AND HEALTH 77

Stress can affect you throughout your
life: children who are bullied at school
suffer enormous stress, and many older
people carry the burden of caring for a
sick relative. However, it is stress at
work that we hear the most about
today. The main factors increasing job
stress appear to be the rapid pace of
change and lack of control over work.
Rapid pace of change
The concept of a 'job for life' is
disappearing in today's workplace, with
a trend towards temporary and contract
work. Some people respond well to the
challenge, while others find the lack of
security frightening and stressful.
Technological change, with the
widespread use of computers, e-mail,
and mobile phones, means that
opportunities for communication and
contact are now limitless. The average
office worker is said to be exposed to
over 100 digitally transmitted messages
a day. This has led to many people
experiencing information overload. Also,
mastering new technology presents
unexpected problems and stresses for
people who had managed without these that allows little room for individual
tools for many years. input. Often, employees feel they are a
mere cog in a big machine, with little
lack of control personal value beyond their specific
Dictated to by demanding superiors, task. However, some more enlightened
busy schedules and long, strict working employers are trying to reduce this kind
hours, many people have little control of stress on their workers by offering
over the work they do. People feel left training, inviting them to meetings,
out of the decision-making process in allowing flexible working hours and
companies with a hierarchical structure generally democratising the workplace.

increa e both your heart and breathing rate to ensure delivery f extra
glu o e and xygen to the mu Jes.Your blood cir ulation alter· t : blood
i diverted away fi- m the dige tive y tern, kidney

FACT: The number of

and kin (which is hy you may turn pal ),
and i channelled toward th mu le .
heart attacks among
Cortisol, the stress hormone
The fight or flight response o cur Dutch men increased
within e ond of being faced with significantly on the
a tressor. It i fc II wed b a second,
lower, w, ve f re p n e that i
day when the Dutch
aused by another tre s hormone, team was knocked
corti ol. A brain cir uit inv lving th out of the European
h pothalamu and the pituitary - the
brain' 'ma ter' gland - end a me age to Football Championship
the adrenals, triggering corti ol produ tion. in 1996.
orti ol provide emergency upplie f gluco e
fuel for the mu cle .
In the hort term, thi se ondar re pon e i u eful. However,
alth ugh th rtis I y tem i elf-regulating, it doe n t alway " ork per­
fectly e pecially under condition of hr ni tre . anadi:m re earcher
Han elyc, w rking in the 1930 , h wed that laboratory rat e po ed to
chroni tre sor uch as overcrowding developed ul er and impaired
immunity. We now know that corti ol i re pon ible for much of thi
damage, acting a a low poi on to the body and brain.
78
FACT FILE
FOUR STRESS MYTHS
1. All stress is bad for you.
No. Without stress, we wouldn't
be able to cope with life's
problems and challenges. We
have to respond to changes in
the world and that inevitably
involves some stress. Without
stress in our lives, we would
never feel the satisfaction of
overcoming problems and
mastering difficult challenges.
2. Everyone gets stressed out
by the same things - noise,
traffic, overwork.
No. Although these stressors
may well cause some annoyance
to most people, the extent of
the stress each person
experiences will be different. We
all respond to events in an
individual way. Some people
adapt to certain kinds of stress
and become used to it, while
others find even the slightest
annoyance too much.
3. People who complain
about stress are just weak.
No. Research shows that stress
has genuine effects on mental
and physical health. Excessive
stress should be dealt with
promptly before it creates
serious health problems.
4. There is a stress epidemic
today.
No. Humans have always
suffered from stress. In fact, the
stressors people faced in the
past were probably far greater
than they are today - at least in
the Western world - including
hunger, war, serious overwork,
poor health and so on. People
today are more conscious of
stress as an issue - they hear
and read about stress far more,
and this has raised awareness.
Identifying stressors
If you made a Ii t of all the things
that au e tre in y ur life, and
then c mparcd it ith a Ii c made
by a friend, it i likely that you
would hare me tre e , while
other would be different. For
example, you might b th be both­
ered by tran port problem , noi e
and cro d , but maybe you tend to
get tre ed by taking on too much
at w rk, wherea your friend might
find it diffi ult to ope with the
demand of family life. What is
tre ful for one per n may not be
for omeone cl e.
Although it can be hard to pre­
dict which ituation and events
will a t a tres ors for different
individual , it i I ar that even
inv lving major adju tmenc - uch
as moving home getting marri d,
or changing jobs - tend to cause
the greate t tre . In the 1960 , the
U p ychologists · i hard Rahe
and Thoma Holmes developed the
ial Readju tment Rating cale, Staying in control Air-traffic control is
in whi h th y a igned diffi rent life one of the most stressful jobs around today.
v nts a rating depending n how This is probably linked to the pressure of
responsibility - a single mistake could be
much tres each produ ed (see
fatal for hundreds of passengers - and to the
pag 82).The value were m a ured way a routine situation can suddenly escalate
in 'life change units' (L U ).A you into a crisis.
might expect, bereavement and
divorce were high up the cale, but more urpri.ingly even positive event
uch a g ing on holiday and the birth of a child were rated as tre -pro­
ducing. Rahe and Holme argued that people who accumulated a high
total of L U over a 12-m nth peri d were more likely to be ome ill.
Although there ha be n little hard evidence to upport thi theory, anyone
experiencing a high I vel of change i ertainly likely to feel ere ed.
Another way of looking at tressor i in terms of ha le ' - a term intro­
duc d by the U tre expert Richard Lazaru in 19 4. Ha le ar daily
annoyan e - uch a lo ing things, or unwanted ocial obligation - that
can, over time, build up and have a corro ive effect on your phy i al and
mental well-being.
Unexpected tre or are oft n harder t handle than pr dictable tre .
A en e of being out of control make the body tre cir uits go into over-
 P E R S O N A L I T Y A N D H E A LT H 79

drive. For example, during the Blitz in World War II, the German air for e
bombed central ondon every night. Yet according to a paper publi hed in
1942 in the medical journal The Lancet, the in idence of ulcer in central
London wa lower than in the uburb , sugge ·ting that the uncertainty of not
kn wing where the next bomb w uld drop au ed more tre s.
While it i widely believed that too much tre ha a bad effe t on health,
it ha be ·n h rd to prove a direct link between tre and pecific illne . But
it ecms likdy that may be that undue tre lead people int unhealthy
behaviour like m king drinking too much and overeating, and thi in turn
cau e health problem . Re ear h ha ho-. n that. d le ho e perience
a lot of tre are more likely to start making, and adults\ ho have given up
may lap e during a tre ful peri d.

Managing stress
Whatever the cau e, y u can learn to lower th tre burden n your elf.
annon and I e viewed the brain and b dy a a ma hine, re ponding pa -
ively to life' tre rs, but the m dern view of tre i 111 re d nami .
Richard azaru puts great empha i 011 the role of apprai al in tre man­
agement. ir t of all, he ay , you hould a e the tre or t under tand wh, t
kind of threat it may po e to you. You may learn by experience, fi r i11 tance,
that a noisy neighbour will quieten d wn after half an h ur r o. Then you
h uld a e -. hat re ur cs you have t deal with the tre r. For example,
you could move to a part of the hou e where the noi e is Jes noticeable, or
arrange to be ut when the di rupti n i u ually at its w r t. What er
re pan e ou choose, taking ome control over a tre ful ituation reduce the
per eived tre .

-- - - --- - -

"R�f fAve4

....
ll*lllst COlll-119 to help him CDIIII
or unexpected IPl)l'Olda. Doctorl to terms with the trlUml of WII',
• 'llln'Ol8" type.
llways suffering from problems
for which no cla'
CIDllld bl found.
80

RESPONDING TO STRESS
It is often said that life is what you make it, and there is some truth in this when it comes
to dealing with stressful events. The way we respond to life's ups and downs depends
very much on personality and experience, but everyone can learn to respond more
successfully to challenging and difficult circumstances.

ften, the str s we experience ha more to do with everyday

hassles - noise, family dispute , money worrie and o on
- than with major life events. The mind tend to
ope with ongoing' tre rs' (th vent or it-
uati n that ausc u to feel tr d) in
different way . ither people become
habituated, or a cu tomed, co sere e
and cea e co be affected; or it a cumu­
late to become what p ychologi ts call
a tate ofchronic tres .
Noi e is a common cau e of
tre . Ifth re i long-term building
work going on near y ur h me,
you probably find it quite tre fuJ
for the fir t few day or o but then
you don't notice it quite o much.
This i an example of habituation.
But if you go on holiday, and the work i
till going on when you return, you will prob­
ably need to habituate yourself all over again. Research has hown that mo t people uffer
fi w long-term h alth effi ts fr m n i e, but thi i 11't true for ev r y ne: older people
and children eem to be mor vulnerabl to the tr s effe t ofn 1se. ne tudy howed that
childr n who lived in the flight path of
an airport performed le well on
problem-solving tasks.
"If you are in a stressful
situation and have the illusion
Coping styles - confront or avoid?
A u eful way of looking at tre you can control it - even if you
re pon e i t c n ider the diffi rent can't your stress reaction will
tyle ofcoping. Wh n things g wrong,
do you try to cackle the situation, or do be reduced." Robert Ornstein, psychologist,
you ju c hope things will improve? and David Sobel, physician
P ychologi t agre that, wh n faced
with a stre fuJ event, most people respond by either confronting or avoiding the problem.
Doctors have ob erved thi in patients who are diagno ed with a eriou illne s. 'Avoidant'
patients will n t eem to take it in - th y will not tell their loved one and may beh, ve a if
nothing ha happ ned. By ontra t, the patient who ad pt a 'confrontative' coping tyle will
want to know all about the iUne and the tr atment option .

There is n ri ht or wr ng coping ty le, but one or
other may be more effe tive in certain ituation . In
general, the avoidant appr ach might be more uc­
ce ful in dealing with hort-term threat :
avoiding trangers whose attitude appear
threatening may be better than onfronting them,
for example. When it comes to a long-term threat,
however - like a diagno is of eriou illne s - then it i
probably be t to face the problem head-on.
Optimism for health
An optirni ti outlo k help people deal better with
tre . A tudy of heart patient· undergoing by pa s
urgery found that the punu u patien re vered
fa ter, and were ba k to a normal life ooner than tho e
who wer more pe imi ti . It eem that optimi ti
people are more likely to adopt a problem- olving
trat gy to ta kle tressful events and will look out for
the po itive a pee of the ituation, which can help to
ea e problem . A cla ic example is the way people
react to being made redundant. Of cour e there are
feelings of hurt rejection and anxiety, but the optimi t
who lo ing hi or her job a an opportunity to do
omething new probably lower the risk of developing
tre -relat d i1l h alth. De pite the diffi ult ir um­
stance , the optimi t (I el in ontrol becau e their
re pon e give them hop and form the ba i for
future po itiv action.
P E R S O NA lI TY A N D H E A lT H 81
THE HARDY TYPE
Have you ever wondered how some people seem to
breeze through life, seemingly unaffected by stress -
even though they have their fair share of problems? Such
people are said to have a 'hardy' personality, an idea that
was developed by psychologist Suzanne Kobasa and her
colleagues from a 1979 study of high-powered US
business executives. Those who were never ill, despite
their heavy workload, were distinguished from those with
poorer health by specific personality traits. Kobasa found
three main characteristics that make up hardiness:
commitment to what you are involved in; a sense of
control - feeling that you are responsible for what
happens in your life; and the ability to rise to a challenge.
No wonder people with a hardy personality cope so well
with what life throws at them.
What stress? Former
US president Bill Ointon
handled the profound
stresses of his position
without any apparent
health problems.
 IDEAS IN ACTION

The causes of stress vary from person to person, but there are certain events that
everyone is likely to find stressful. How we respond to such 'objective' stressors
depends on personality. Based on psychosocial research, the scale shown below
and the questionnaire opposite can help you to evaluate your likely stress level
and assess your coping style.

STRESS ANO LIFE EVENTS

The 'life change unit scale' was originally devised by American psychologists Thomas Holmes
and Richard Rahe in the 1960s. They conducted thousands of interviews, asking respondents to rate
specific events in terms of how much change had to be made to cope with the event The version
below gives the top 25 stressful events from a 1995 update of the scale.

EVENT STRESS VALUE (LIFE CHANGE UNITS)

Death of spouse 119
Divorce 98
Death of close family member 92
Marital separation 79
Loss of job 79
Major personal injury or illness 77
Going to prison 75
Death of a close friend 70
Pregnancy 66
Gaining a new family member (e.g. birth of a child) 57
Marital reconciliation 57
Change in health or behaviour of a family member 56
Retirement 54
Change to a different type of work 51
Marriage SO
Spouse begins or ends work 46
How to score
Child leaving home 44 Add up Ille stress value for
Change in responsibilities at work 43 an, of the Miiis that hM
Outstanding personal achievement 37 hllppened to ,ou In Ille lest 12
Change in work hours or conditions 36 monlhs. A total score of over
150 is COIISiclered high. ft does
Starting a new school 35
not necessartr mean lhlt ,ou
Christmas 30 will become ill, but it might be
Change in eating habits (e.g. going on a diet) 27 time to seek ways of reducing
Change in sleeping habits 26 Ille stress in your life.
Going on holiday 25
 P E R S O N A L I T Y A N D H E A LT H 83

To assess your way of coping with stress, take a few moments to think
about the most stressful situation that you have experienced recently.
T his could be a situation that was difficult or troubling for you, either
because you felt distressed about what happened, or because you had
to use considerable effort to deal with it. Once you have an event in
mind, assess your coping style by responding to the statements below.

As you respond to each of the

statements, keep your stressful
situation in mind. Read each
statement carefully then indicate the
extent it applied in that situation by
scoring it 0, 1, 2 or 3.

1 I did something that I didn't think would work, but at least it

was doing something. D
2 I tried to get the person responsible to change his or her mind.

3 I slept more than usual.

4 I expressed anger to the person(s) who caused the problem.

5 I tried to make myself feel better by eating, drinking, smoking,

using drugs etc.

6 I took a big chance or did something very risky to solve the

problem.

7 I stood my ground and fought for what I wanted.

8 I took it out on other people.

9 I refused to believe that it had happened.

10 I had fantasies or wishes about how things might tum out.

How to score
Add up your scores for questions 1, 2, 4, 6, 7.
Now add up your scores for questions 3, 5, 8, 9, 10.
If your score is higher for the first group of questions, then you tend to favour 'confrontative
coping•. If you scored more highly on the second lot of questions, then you are more likely to employ
'escape-avoidance' as a coping mechanism.
Confrontative coping is typified by positive efforts to alter the situation but involves some degree
of hostility and risk-taking. Escape-avoidance is based on wishful thinking and efforts to
escape or avoid the problem altogether.
84

HEALTH IN SOCIETY
Health can be very much affected by the social situations we experience and
the environment around us, as well as by our individual personalities. In particular,
home and work circumstances have a strong influence on whether people are able
to maintain healthy lives.

We are all individual , and it i through our direct a ociations with one another - whether
friends, relative , neighbour , work colleagues or health profe ional - that we can d the
mo t to help everyone maintain the be t po ible health. But looking at society as a whole can
help to reveal ources of health problems and how they can be dealt with by ocial mean .This
can contribute, for example, to how new homes are built, how office and other workplace
are run, and to identifying which group in ociety need extra support.
There seem no doubt that relative wealth and tatu in society has a dir ct ffect on
th. In general, people of lower ocio-econom.i tatu t nd to have higher rate
t disease, and there is mu h evidence that poverty is tr ful. Re earch on
on group carried out by Robert apol ky in the USA supports thi .
lsky found that baboons with a lower rank in the o ial group had higher
levels of the tress hormone corti ol - probably becau e they w r being
bo ed around by the hjgher-rank animals. They also had lower
levels of HDL (high-density lipoprotein) cholesterol - a state
that is linked to heart di e e becau e 'good' HDL chol terol
help to remove 'bad' (LDL) hole t rol from the blood.

"After my husband died, my

friends and neighbours helped
enormously. At first, people were
embarrassed and didn't know what
to say. Some even pretended they
hadn't seen me. They didn't need
to say anything ... just a wave
would do, to acknowledge
that you still exist."
Eppie, 32, whose husband and both
parents all died after long illnesses
 PERSONALITY AND HEALTH 85

Conditions in society
The relation between health and o iaJ status i not alway traightfor­
ward, however. or example, a recent UK tudy howed that
middle-ranking iviJ servants in Br itain with little control over SUPPORT AND STRESS
their worl<l ad run a higher r isk of heart disea e than th ir uperi­ In a study to assess whether social
or - o far, o predictable. But the study al o howed that those ranked support can alleviate the stress
response, three groups of
below th m wer le tre sed: it eem ther may be a po ition of 'maxi­
volunteers were asked to give a
mum tr ' in the work hierarchy. imilarly, several recent tudie have presentation - a standard way of
shown a higher frequen y of eating disorders ( uch as an r ia nervo a measuring stress. Those in one
and bulimia) in better-off section of ociety. The de ire to be thin, it group brought a friend along for
seems, i more corrunon among teenage girl from a wealthy background. support; people in the second
In ome level is just one part of a complex pi ture here: the family, ethnic group gave the presentation alone;
and the third group had to put up
background and media image are all major influen on how people see
with a aitic being present during
them elve . The mo t 'desirable' body shape depends on fa hion and cu1- the experience.
ture,and a well-rounded figu re has been thought the epitome of beauty in All the volunteers showed a rise
age and so ietie ther than our own. in blood pressure, revealing the
he conditions that ociety impo es on its members can sometime be stress involved. However, those
po itively beneficial. For example, over the last decade, there has been a with a friend showed the smallest
increase in blood pressure, while
widespread drive to redu e moking in public places and to make mo t
those who had to face a critic had
office moke-free environments. ome employers have introduced pro­ the biggest increase. Having
grammes to help staff to quit, or at least to ut down their cigarette support dearly helps to reduce the
consumption during working hours. Any initial re entrnent from mokers amount of stress experienced.
u ually disappears a people come to appreciate the health advantages both
for themselves and othe
 MIND WAYS
TO HEALTH

F
ew would deny that there are benefits for health
and well-being to be found in developing
constructive ways of dealing with anxieties, or
learning to appreciate the pleasurable experiences that
life offers. This may seem like simple common sense,
yet it is not always clear how to go about enriching our
lives in this way. The key to change is in the mind.

This chapter explores mind-building and relaxation

techniques - many of which are used by professional
therapists - that can help us to harness the powers of
the mind. With these techniques and the will to
succeed it is possible to learn how to conquer stress at
home or in the workplace, how to diminish pain or cope
with chronic illness, and how to face up to and beat an
addiction or phobia. The mind is an infinitely versatile
tool that can help us to overcome a whole range of
difficulties. All we have to do is learn to use it.
88

HEALTHY BEHAVIOUR
We are surrounded by information about the health effects of what we do and what we eat.
Most foods have nutrition labels, packets of cigarettes carry health warnings, and even a
bottle of wine may include a message about the dangers of drinking alcohol. Making
reasonable decisions based on such advice is an important way to keep healthy.

Fifty year ago, mo t do tor thought it wa ju t bad luck if a

patient had a heart attack. oday, we kn w that life tyle play ..
FACT: The number of
a huge role in health problem . tudie show that at lea t half extra food calories
of all death from heart di ea e, an er, troke, and lung di -
e. can be attributed to modifiable ri k fa tor , su h a
that a person must
moking, exer i e and diet. eat to gain a pound,
People ar now expected to tak m re re pon ibility for or burn to lose a
pound, is 3500.
their own health. ealthy behaviour really tar in hild-
hood when parents have a
hance to in ti! healthy
habit u h bru hing teeth eating well and exerci ing
regularly. By the age of 11 or 12, u h habits have often
bee me ingrained. Re earch al o how that pra rice in
childhood do affe t h alth I. ter in life. r example, derma­
tol gi ts accept that many case of kin cancer in middle-aged
people are a on equence of over-expo ure to harmful UV
ray before the age f ten. There i also increasing concern
er record level. f be ity in children, thi may cause
heart di ea e in later life.
As children get older their life tyle tend to become
healthy. A teenager , they come under peer pre ure to
moke, take drugs, and away fr m parental direction they may
ub i t on junk food. They al o take mor risk . Near! half
of all m le death between the age of I 5 and 24 are from
road accident , with peeding and alcohol being major
contributing fa tors.

Five good health habits

When the ign of ag · .tart to make them elvc felt - often , round
40 to 45 - many people dis ver a new incere t in healthy bchavi ur,
and a landmark tudy, begun in 1965, ugge that they are wi ct
do o. early 70 p ople in AJameda ounty in alifc rnia were

Fruit, glorious fruit Only a small number of people actually manage to eat
the five daily portions of fruit and vegetables recommended for a healthy
diet. To help you increase your fruit intake, try thinking of it as the
ultimate convenience food - it comes in its own packaging, it's ready to
eat, and it's good for you. You could also seek out unusual fruits to
keep your fruit snacks interesting.
 MIND WAYS TO HEALTH 89

If you don't like sport, or have little time 560

for physical recreation, you can still QI:
improve your fitness by putting more :::,
effort into everyday activities. i 480
Keep a diary for a week and see if you
� 400
ii
can bum up at least 500 extra calories.
You might consider making some

!
changes to your daily routine - such as
cycling or walking instead of driving the
car for short trips, and dimbing stairs 240
instead of using the lift - to reach your
goal. Minor changes like these can make
all the difference. The chart shows how
160
many calories various activities use up
(figures are for a person weighing 80
55kg/8 stone Sib). ACTIVITY

a ked whi h f the foll \ ing fi e g d health habits they practi ed: (1)
leeping even to eight hour a night; (2) not moking; (3) having no
more th n two al oholi drink a day; (4) taking regular exerci e· and (5)
being no more than 1 per cent overweight. Nine year on mortal­ EATING FISH FOR A
ity rat were ignificantly lo er for people foU wing all fi e healthy LONGER LIFE
habi .Tho e v ho practi ed two or le were three time more likely Eating fish reduces your risk of
to have died than tho e v ho practi ed four or five. Those who foll wed all developing a thrombotic stroke
(caused by a clot in a blood vessel
five had far fewer day of illne .
leading to the brain).
It cem it is definitely worth making an ffort t live a healthier In a US study, researchers
life tyle. However wheth r ou do o depend on many factor . ome assessed 80,000 women (aged
people do not like being told how they hould Ji e, parti ularly when it between 34 and 59) for 14 years.
c me to per nal matter like ex , al ohol They found that the more fish they
and diet. on equ ntly, do tor in the ate, the lower the risk of heart
disease. Compared to women who
UK have b en warned by health am­
ate fish less than once a month,
paigncrs not to nag their patients to top those who had fish three times a
moking - one reminder a year i month had a seven per cent lower
enough, they ay. risk; a weekly fish meal gave a 22
It i never too late to adopt a per cent lower risk; two-four meals
healthier life tyle, and e en omebody per week had a 27 per cent lower
risk, while five times or more
who ha been overweight for many
resulted in a 52 per cent reduction.
year will benefit from a change of The beneficial effect derives
di t and me gentle exer i e. from the omega-3 fatty acids in
fish, which reduce the 'stickiness'
E ating for victory Changes in diet forced of blood platelets, making clotting
on the British public in World War II actually less likely. Oily fish such as herring,
produced an improvement in general health. trout, sardines and salmon contain
Fat and sugar were rationed, and people the highest amounts of these fats.
were encouraged to grow as many
vegetables as possible.
90

CREATING WELL-BEING
There is more to life than just having your basic survival needs met and more to health
than just the absence of illness. A sense of well-being, whatever your personal
circumstances, comes from a positive attitude and an appreciation of everyday pleasures.

'Quality f life' i a relatively new idea, but it i a on ept that doctors and
p ychol gi t are beginning to empha i e. Modern m djcin ha given us
more year of lifc, but often th e are marred by chroni illne , 1 neline
and loss of indcpenden e. Quality of lifc goe beyond phy i l h alth - it
take in p ychologica1 and emotional factor , too.
veryone know at lea t one per on who ha had bad luck in life or
i in p or health, and yet till een content. What i their e r t?
P y hologi ts have tudied uch people and attribute their vitality to
their ability to nurture their own en e of well-being.
The e people are passion­
ate about the things they do,
whether it be work, rela­
tion hip or hobbi . They
often have a robust
en e of humour,
and do not take
themsel too seri-
ou ly. Happy people
MUSIC AND WELL-BE/NS often look younger
A growing body of evidence than their years, and
suggests that music has beneficial may even be a little
effects for health. In the 19th eccentric - accord­
century, physicians discovered that
ing to two tudi ,
music could affect heart rate and
eccentric people
blood pressure. In the earty 20th
century, doctors in the USA used
music in hospitals to help alleviate
pain. Various scientific studies
followed, and these showed that
music could influence mood,
prolong attention span, relieve
stress and stimulate imagination.
Music is very much a personal
taste, but research suggests that
the most natural tempo for a piece
of music is 80 beats a minute -
about the same as the average
human heart rate. This suggests
that music appeals by tuning in to
our natural body rhythms.
 M I N D WAYS TO H E A LT H 91

Marie and Sue were neighbours who
found themselves in hospital on the
same day for I routine operation. They
were admitted to the same ward and
were glld of IICh other's company.
Marie's bed WIS l)r the window Ind she
could see a big patch of sky Incl the
trees in I nearby perk. Sue's bed was
close to the corridor, furthest from the
window.
The opendions were unMntful.
Both women hid plenty of visitors Incl
they reallved the Slffl8 madicll en.
However, Sue llllded men Plin
medicltlon Incl sleeping tablets .....
the Gplrltiori. Mll'il WIS out of bed the
following day. 'I don't know why you're
doing so much better thin I 1m,' Sue
complalned as Marie drew up a chair for
a chit. 'Must be the view from the
window,' Marie jollad.
Though she didn't know It, Marie
was right. Studies hive shown thlt
patients who hive a plemnt view from
their hospltll Wlrd - of I Pirie. for
eumplt. with some trees or flowers -
l'9CIOVII' faster thin tllOII who hM I
view of somethiig less attrac1M, lllal I
car part or bulldinll, or thole. Ille Sue,
who hM no view at Ill. Some holpitals
are now creltlng gardens In their
grounds with this In mind.

Balancing your life

To create a en e of well-being, it i important t live a balanced life.
or mo t people thi mean a mixture f w rk, family and friends,
per onaJ time and interests and ervice to the wider c mmunity. Having
different role in life - a a parent, a manager , nd • hurch volunteer, say
- ontribute to a healthy en of self. Ho\J ever it i a y for n r le t
dom.inate: if y u have a heavy workload, you ma find it hard to think of
your elf a anything but a worker, while many moth r find that a bu y
family life make it diffi ult fi r them t be anything other than a parent.
ften, the be t way to strengthen y ur ense of worth and purpo e i to
help other . Recent re ear h how that older pe pie \J ho till have an
a tive rol in life - as a carer, or a a grandpar nt, fi r e ·am­
ple - tend to outlive tho e ho no l nger feel u efuJ. A
tudy arried ut in the U A bowed that oluntary work
FACT: Staring at tropical fish
an be very beneficial for health. P ychologi ts monitor d in an aquarium for 20 minutes
2700 pe pie for nearly ten year . Men who did regular
volunteer work had death rate 2.5 time I wer than tho e
can lower blood pressure by up
ho did not. However, there wa n differen e in rate for to ten per cent and produces
w men - perhap becau e many w men already devote a state of calm relaxation.
much of their rime to caring fc r other .
o, d c thi mean being elf-centred is a bad thing? N t at all - in fa t,
m t pe pie ha e diffi ulty finding time for them elve t be al ne and
relax. If we put a ide half an hour a day to read, pur ue a h bby or ju t day­
dream, our general health would pr bably improve. Finding time to think
and de el p a more po itive mind et can al o be beneficial. ome p ople
keep bu y becau e they find their minds churn o er with worry and neg­
ative thought when they are not a rive. It would be b tter fi r them to
refle t on their ach.ievement , however ordinary they may eem.
 IDEAS IN ACTION
One way of creating a sense of well-being that is available to everyone
is to feed the brain with uplifting, pleasurable thoughts and sensory

ENRICHING LIFE
experiences. It is through our
senses that we learn to appreciate
the beauty of the world around

THROUGH THE SENSES us, but, too often, we ignore the

potential pleasure that the senses
can offer. Getting back in touch
with your senses can be an important part of promoting well-being.
Try some of the ideas here and you will soon be reaping the rewards.

BENEFITS OF TOUCH

Touch is vitally important to babies and

children, yet as we get older we often get
out of the habit of touching and being
touched. We do not always kiss our
friends and loved ones in greeting or
congratulation. We might neglect to
offer a hug or touch on the arm to
comfort someone in distress. Often
embarrassment, respect for
people's personal space or fear of
being misunderstood holds people
•
relaxing and pleasurable. In one study, heart
rates were lowered when volunteers were
touched lightly on the wrist by a researcher.
Those who live alone and who do not
exchange touches regularly should try to get
into the habit of touching with friends and
family. There are also some other simple and
effective solutions. Investing in some form of
regular massage - shiatsu, aromatherapy, or
reflexology - offers the life-enhancing
benefits of touch. If you have a pet, you

•
back from touching. Yet touching - of the will probably find that touching, stroking
non·sexual kind - between people can be or talking to it lowers feelings of stress.

-- �-
... .
r,...:' ' ·..
-.� VISUAL STIMULATION
Giving your eyes something pleasant to focus tree - and watch it change through the
on enhances the quality of everyday life. In seasons. A few well-chosen pictures or
one experiment, people who were shown posters can make the inside of your
slides of attractive natural scenes home or your office much more
reported higher levels of positive stimulating. Developing your garden,
feelings, like friendliness and elation, however small, can also be a source of
than when they looked at drab urban visual pleasure. And you can bring
scenes. If your office looks out over a car nature into your home with flowers,
park, or the view from your living room is plants and even pebbles. Walking in

•
of a busy main road, try to position your seat your local park or countryside is
so that you can see something natural, like a beneficial too, and many studies
have shown that exposure to
sunlight improves mood.

USING AROMAS
Smell is probably the most underrated of our
senses. Humans can distinguish around
10,000 different odours - and because the
part of the brain that analyses odours is
intimately connected to emotional centres
of the cortex, smell can really affect the
way we feel. For instance, peppermint
has long been valued as an aid to clear
thinking and recent research suggests
that a whiff of mint can motivate people
• •
before exercise. People often associate
lavender with relaxation, but spiced apple has
As most people know, food can be a regular
source of pleasure and stimulation, and not
LISTENING FOR PLEASURE
Enjoying everyday sounds can enhance the
quality of your life. Natural sounds, such as
birdsong or a running stream, can have a
soothing effect. as can distant voices or a
child's laughter. If you don't have access to a
local park or countryside, it is possible to
purchase recordings of natural sounds, such
as ocean waves, tropical rain, woodland and
jungle noises, and rushing streams.
Water fountain features for the
garden, home or office can provide
M I N D WAY S TO H E A LTH 93
been proven to be even more effective at
putting the brain into a relaxed mode. Aromas
can distract the mind from dwelling on
unpleasant thoughts. Smells can also evoke
strong memories of positive emotions and
happy events, helping us to relax and
achieve beneficial physiological states
like decreased heart rate or lowered
blood pressure. Experiment with the
aromas that you like - such as flowers and
incense - and find ways of incorporating
them into everyday life.
and other spices produce a feeling of
pleasurable sensory stimulation. Chocolate,
just a refuelling exercise. There is certainly which is a favourite treat for many people,
no harm in treating yourself to some of stimulates endorphins and serotonin
your favourite foods every now and production in the brain, which brings on
again. Food and drink can be a great feelings of contentment. Crisp, fresh
pick-me-up - especially if you have the textures will perk you up, while comforting
added satisfaction of having cooked a carbohydrates will make you feel relaxed or
pleasing dish yourself. As recent sleepy. Whatever your favourite food, it
changes in British eating habits should stimulate your taste buds, creating
suggest, curries and other spicy food are a sense of enjoyment.
enjoyed by many people - chillies, peppers
soothing background sounds all day.
•
People also find the sound of a cat
purring very relaxing - research has
suggested that this is because cats
purr at the same rhythm as alpha
waves in the brain. Obviously music
is a great source of comfort,
stimulation and energy. Making some
time to listen to your favourite music
each day can improve your quality of life
with the minimum of effort.
 COPING WITH
A LONG-TERM
CONDITION
Many of us will have to cope with chronic illness at
ome stage in our lives, ranging from high blood
ssure or arthritis to h aring loss or physical
bility. Whatever the diagnosis, there are
ys of adapting mentally.

At any one time, around half of the

population is uffering from a
chronic illne of ome kind. A
we live longer, more and more of
u are g ing to have to learn t
manage a condition for which there
is no ure. ome chronic illne e have little
imm diat effi ct on everyday life - for exam­
ple, high blood pres ure has few obviou
ymptom , but mu t till be regarded a a seri­
ou conditi n be au e it can cau e heart
di ea e and troke. Dy contra t, an illne uch
a Alzheimer' di a will affe t a per on' ability
to live an independent life in quite a short time.

Dealing with a diagnosis

P ychologi ts have harted a general pattern of
re pon e to the diagnosis of chronic iUne . Whether
the illne i life thr atcning, like an er, or n t,
lik arthriti or hearing I , the re pon e can be im­
ilar to that experien ed after a b reavement. Perhap
thi i n t urpri ing, for a diagn i of ng ing
illne s often affect an individual' self-image as a
healthy per on. In the fa e of the diagno i , people
may feel hocked or di tre ed. here might also be a
en e of relief - after months of te ts and un ertainty,
many people ay they prefer knowing what they are
up again t.

Overcoming opposition A determined attitude and

ever-improving technology can help people with disability
or illness not just to keep active but to excel in their chosen field .

. - '
_"'.'
.
.�. .. . ·�
 M I N D W AY S TO H EA lT H 95

� HOW TO....
For thou pnple diapond with a
urious I/Inns, it can bl hard to break
1111 n,ws to family and frlena.
Hown,r, it /1 best to ,et family 1uppott
u urly u po,,lble. Anyone di.,,,oud
with a chronic condition mifhl find 111,
follow/116 point, helpful:
• Be brave, and bring up the subject
yourself.
• Make sure you have the person's full
attention.
• Begin by saying something like, 'You
know I went to the hospital for some
tests recently?'
• Try not to deviate from the subject,
however uncomfortable you feel.
• Do not be afraid to say how you
feel - they will understand that this is
a difficult moment.
• Non-verbal contact, such as holding
hands, a hug, or sitting together may
help you communicate your feelings.
It is difficult to predict how people
will respond to the situation. In the
long term, they are likely to be resilient
and accepting, whatever their initial
reaction, but be prepared for those who
are not supportive: for example, a friend
may find the illness an unwelcome
reminder of mortality and start to avoid
you. However, most people will care and
will want to do all they can to help you
through such a difficult time.

Accepting chronic illness

Eventually mo t people diagno ed with a chronic illness start to accept their
condition. Mo t chroruc illne require patients to do omething for them-
elve : dietary change and quitting making after a heart attack or troke,
keeping to a medication schedule in many illne e , and with cancer,
being watchful for recurrence. Patient who take a realistic and practical atti-
tude are more likely to have a
po itive outcome.
Other i ue affect how people
cop with chronic illn . Studie
how that patient who believe
they can exert ome control over
their illness - usually, by actively
participating in treatment - have a
better chance of recover y:
cancer patien who feel in control
adju t better to the demand of
their condition, a do tho with
rheumatoid arthriti , AID , spinal
cord injury and patient recovering
from a heart attack.
Many people with a chronic ill­
ne s feel that their ense of self i
eroded and that the iUne make
them a different per on. However
difficult it eem , ufferer need to
r ali e that they ar till the ame per on, irre p ctive of their condition. For
example, a man doe not cease to be a loving hu band b cau e he has a debil­
itating illne s. ome people have even found that chronic illne ha ome
benefits, in that it encouraged them to focus on what is important in life.
Many discover that the condition leads them to appreciate each day more and
motivates them to do things that they had previously po tponed.
96
TALKING THERAPY
Most of us find that talking through problems with a friend will help us feel more relaxed
and clearer in our minds. The various forms of psychotherapy can be seen as more formal
versions of this type of communication offered by experienced professionals.
On the couch In a typical portrayal of
psychotherapy, Woody Allen visits his analyst
in the film 'Annie Hall'. Some types of
psychotherapy can take years, but more
recently developed forms can work faster
because they focus on tackling present
behaviour patterns and thoughts.
P y h therapy - sometimes known a talking therapy - can be a power­
ful way f dealing with problems. It can also help p op) to get to kn w
them elv better o that they can ope better with life's challenge .
ometime people feel put ffby the very idea of p ychoth rapy - they
may imagine that they will have to lie on a ou h and be questioned about
their innermo t thoughts and feelings. In fact, mo t talking treatments are
not lik that at all. There are approximately 200 different type f
psychotherapy, of varying degr e of medical and cientific validity.
What the e therapies have in mmon i the attempt to establish a
relation hip - called the therapeutic relation hip - between the individual
and a trained profes ional. Whatever the therapy, it i thi relation hip
between patient and therapi t that is the crucial fa tor in r olving p y-
hologicaJ problem .
Talking to a professional
It may seem a sad r fle ti n on modern o iety that many pe pl have to
pay omeone to talk about their problems. urely a chat with a good
friend, or an older and wiser family member, would be more helpful in a
cr i i ? ocial upport i vital, of course, and it i kn wn to alleviate stre
and keep u healthy. But sometimes a common-sense hat i not enough.
Anyon who has uffered from clinical depr sion or a phobia will know
that being told to 'pull yourself together' or 'ju t do it' by someone close
makes them feel wor e - however well-meant the advice. ften, friends
and family are too lo e to an individual and their prob! ms to offer objec­
tive and useful guidance. A qualified therapi t, while he or he may be
receptive and friendly, will take a more obje rive view.
 M I N D WAY S TO H E A LT H 97

The e day , therapy i given by a wid rang of profc ionals: p ychja­

tri ts, clirucal p ychologists, p ychotherapi ts and c un ell r (who
may or may not have medjcal qualifications), health vi itor and
pra ti e nurs . Standard and trairung vary, so check creden­
tials before you embark on any form of therapy. It i not
unknown for a coun ellor attached to a g neral pra tice to
have had onJy brief training. uch p opl might be good
at h !ping a client to quit smoking or lo e weight, but
th y may not be equipped to help someone offering
from the p y hologicaJ problem that come with a
seriou illne uch as cancer.

Two types of psychotherapy

Freud' theor y of p y h analy i , which he
d veloped toward the end of the 19th century
wa the origin of the fir t talking th rapy. Freud
believed that psychological problems, such a
depre ion, grew out of uncon ciou con£licts arising
during childho d. ome of Freud' patien had phy -
ical di orders, uch as back pain or sp ech problem ,
that w r apparently healed by p ychoanalysi . ln p y­
hoanaly i , the pers n i made aware of uncon ciou residue
of experience through the analysi of dreams and the free asso-
ciation of thoughts. nee in the on iou realm, any
un on cious conflicts lo e their stranglehold ov r the mind.
As p ychology and k nowl­
The right route There are many types
edge of the brain progres ed
of psychotherapy and ways of resolving
during the 20th cntury, two
psychological conflicts, and it is important
that people choose the method most different cho I f psy hoth ·r­
suited to their problem. apy emerged, broadly clas i6 d
98

a the psychodynamic therapies and the supportive therapies.The p ycho­

dynamic therapie focu on gaining in ight into uncon ciou force : they
include Freudian p y hoanaly i , Jungian therapy and humani tic p y­
chotherapy. The upportive therapie - including cognitive therapy,
behavi ur therapy and coun elling - fo u more n on ciou th ught
and feelings, and often involve an element of helping the patient to learn
new behaviour or thought pattern .
In general, the psychodynamic therapie are mor patient-centred, with
the therapi t taking a very non-directive role - ome therapi ts offer very
little in the way of comment or advice. P ychodynamic therapy normally
lasts year , po sibly involving several se sion a week. It i rarely available
through health ervi e . People wh choo p ych dynamic therapie may
e them elves as 'p y hologically minded', or want to get to the root of a
long- tanding problem, u h a hronic anxiety.
For an acute problem, uch as an eating disorder, upportive therapy i
u ually more appropriate. With upportive therapie , there i far more of a
two-way relation hip between the patient and therapi t. he therapi t will
a k more question , may offer opinion, and even a.dvi e (although no
therapi t hould ver tell a pati nt what to d - it mu t alway be the
patient's deci ion).

Group therapies
P ychotherapy i not alway one-to-one: for certain problem , group ther­
apy i more effective. Sharing experienc in a group can be genuinely
beneficial. All too often, people are convinced that no-one understands
to ......
• Wlldl ,-, own NIPOI- - do
what it i like to have their problem, o when they di cover that other
JOU .... 'bind spot' wllen It hare their feelings, it i oft n a great relief. Peopl ufiering from seriou
comes to haing views diffll'
from ,our own? Do you. for
instanc:e, tense up or swltdl on
when 90ll'NIOlll .,. IOffllthlng JOU
disagree wlth?This can be a huge
blrrier to being • good llstlner.
• If JOU find � longing to
int.-rupt. try to rHOa1S on what Is
being Slid.
• Don't offer advice or opinions.
unless aslGld - even thin, think
carefully before JOU speak. 1ly to
be open-minded and .. the
problem from their perspectM.

A problem shared Group therapy has

proved very effective in helping people
overcome a variety of problems, including
addictions and antisocial behaviour.
 MIND WAYS TO HEALTH 99

FACT FILE
Psychodynamic therapies focus on
the unconscious, while supportive
therapies concentrate on conscious
thou,ht processes. Some of the main
forms practised include:
PSYCHODYNAMIC THERAPIES
• Freudian psychotherapy
(psychoanalysis) seeks to uncover
childhood sexual conflicts through the
analysis of dreams.
• Jungian psychotherapy uses
elements of mythology, symbols and
dreams to probe the mind.
• Adlerian psychotherapy fosters
self-confidence by overcoming feelings
of inferiority rooted in childhood.
• Kleinian psychotherapy focuses on
early childhood experiences.
• Humanistic psychotherapy
concentrates on spiritual growth
potential, looking forwards not back.
• Rogerian psychotherapy is client­
centred and non-judgmental, and
assumes the patient is best able to
deal with personal problems.
• Gestalt psychotherapy emphasises
integrating all aspects of experience,
encouraging the patient to develop full
awareness of the present moment.
SUPPORTIVE THERAPIES
• Cognitive therapy aims to replace
negative thought patterns with more
logical and realistic ones.
• Behavioural therapy focuses on
the immediate problem and the
circumstances surrounding it.
• Rational-emotive therapy uses
logic, authority and persuasion to help
the patient give up irrational ideas or
unreasonable expectations.
• Transactional analysis examines
the different roles a person plays in life
(such as 'child', 'parent') and helps the
person develop a more realistic,
constructive attitude.
• Counselling is often directed at
specific problems - such as
bereavement - and involves listening
to clients and helping them to
understand their problems.
• Co-counselling involves an equal
relationship between two people, who
take it in turns to talk and listen.
OTHER THERAPIES
• Group therapy is valuable where
interpersonal difficulties are a key part
of the problem.
• Family therapy is used where
therapy directed at just one member of
the family may not resolve matters.
• Art therapy involves painting,
drawing or sculpture to express
emotions associated with a problem.
• Neurolinguistic programming
(NLP) looks at how we experience the
world and applies this knowledge to
alter behaviours that limit us.
• Life coaching involves a personal
coach who will help the individual to
tackle specific problems. The coach
discusses and monitors progress and
sets goals.
• Eclectic approaches combine
therapies to suit the individual's
character, circumstances and problem.

illne es may meet together under the direction of a nurse or social worker to di -
cu their concern . Family therapy is useful in dealing with childhood and
adole c nt b havioural problems, while couple therapy can help to untangle
the complexitie of a troubled relation hip.

F . Research has
o-counselling takes place between two p ople within
a group who take turn to be therapist and client. If a
per on develop an empathy with the co-coun elling shown that cognitive
therapy is as effective
partn r, the techniqu can be very helpful, without the
co t of a per onal therapist. But the partner mu t tick to
certain rule - no interrupting while the other per on as antidepressants in
i peaking, no giving advice and no pas ingjudgement -
and the e can be difficult to follow. Ob erve your elf when
relieving depression.
you are ne t Ii tening to a friend talk about hi or her
problem . How many time did you interrupt, perhaps to recount a similar
experience of your own?
Mo t people wilJ gain omething from a talking therapy. However for
therapy to be ucce ful, it i vital to match the typ of therapy to the per on
and the specific problem.
100

THE POWER OF REASONING

One of our greatest mental gifts 1s our reasoning ability, which enables us to make
decisions and judgements based on the evidence before us. Cognitive therapy can be
used to harness our mental powers to improve our health and quality of life.

Psych logi t u e the term cognition' to refer to the information-proce ing ability of the
brain. ognition. enable. u t think, remember, analyse, learn and n gotiatc our way through
life. he way we experien. phy i al pain al o depend on ognitive fa tor . If it i a familiar
pain, for example, you might decide that it will pa oon., and by a e ing the pain in thi way
r duce your di tre s. Unpr ductiv way ofthinkjng ar re ponsible for a gr at deal of mental
uffering and even physical ill health. You may know omeone, for example who alway
draws negative con lu i n : if ome ne di agree with them, they alway a ume it is a per­
sonal attack and wa tc time and energy worrying about it.

Discarding negative thinking

The primary purpo e f ognitive therapy i to over ome ingrained
negative attitude of mind, and th reby the ill health that m, y re ult
from thi . The therapy fo u e on en ouraging new way of per­
ceiving and thinking about problem , a a mean of all ·viating
symptom . Aaron T. Be k, who developed ognitive therapy,
wa originally a Freudian p ych analy t.After anal ing the
though and idea of his patients he con luded that
pe ple affe ted b anxiety and depre sion viewed
them elve and the world ar und them in a ne -
tive ay that was not ju·tified by the reality
oftheir ituation.
Beck di covered that the negative m.ind t
ofhi patient had three main aspect , which he
termed 'the cognitive triad'. ir t, they h d a negative
view of them Iv ('! , m n good'). econd, they had
a negative view of the world around them ('nothing
ver goe right'). inally, their attitude toward the future
wa negative ('thin wiJJ never get better').
The aim of cognitive therapy i t break down the e
powerful, interlinked b lief. Rather than attempting to
deal with negative attitude in general, pe ifi elemen of
negative thinking are ta kled by the patient and the therapi t
together. ne fthe fir t things to
Role models Socially be confronted i what Be k called
pervasive images can distort 'automati thinking' - a tendency
how we think about ourselves.
to jump to negati e conclu ion
Cognitive therapy helps people
to realise that being as slim as without thinkin things through.
Barbie or as fit as Action Man is For example, areful analysi
not necessarily an ideal goal. might reveal that omeone auto-
 M I N D WAYS TO H E A LT H 101

maticalJy think 'l am u eles ' whenever things go

wrong , although the per on may not be aware of
making thi habitual response . nc exposed in ther­
apy, however , such thought lo e their power. People
with negative belit:f y tem tend to over-generalise - Cognltlve1hll'lpr treatln8 I
if on thing goe wrong, everything i wrong. , if 52 ,_-old 111111 dlpr111ion who
th y hav an argument with a colleagu at work, they hid not IIICMd from bad for._. I Jal: lacll
chlllln9ld to 1111 ,_. tD door of his
th n as ume that no- ne in the offic like them.
room, but 1111 patient Slid • wouN SIM we,. 8ldl
Cognitive therapy teaches them to con ider alternative Plflislld, and wtullly I flw wn ldlilvlcl.
explanation that are le s elf-centred: if someone i Next, Back encou,-ged 1111 P111tnt to Wiik to 1he 111Xt
rude at work, it may well be becau e that per on room. Each clly. Back bull on the pnwtcu dlJ's
havin a bad day. ac:hiewment by Sitting I MW goal. Back deddlld thlt the
patient should nlWll'd himself with I drink from the
vending mec:hine once he was walking freely ll'OUncl the
Healing through reasoning
ward. For someone who hid been In the grip of profound
Mental h alth problem fuelled by negative thinking depression tlor SO long, this WIS I major ac:llkMmant. By
re pond v ry well to ognitiv therapy. F r example, greduelly extending his 1'11198, the l)llilnt WIS Ible to
omeone who is depressed will be encoura ed to break walk to the hospital 9lffl8S room. In lass thin I week.
the con tant tream of elf-critici m by Ii ting hi or he WIS enJorina the grounds, and I month
her daily su ce se , however small these may be. The lats he WIS Ible to
retum home.
a hie cmems build up, day by day, gradually bringing
the per on ba k into the main tream of life. og111t1v
therapy ha no t method or approa h - often imple
pr, ti aJ exer i e are tried fir t.
Mo t importantly, cognitive therapy facilitate a rea-
oned discu ion that encourage individuals to a e
whether their negative thought pattern are justified.
Wherea psychodynarni therapies empha i e pa t
expenen e and uncon cious motivation, cognitive
therapy n entrate· n pre ent intera tion .

REPROGRAMMING BRAIN CIRCUITRY

People with obsessive-compulsive gas has been turned off, which can be
disorder (OCD) are often ideal repeated so often they undermine the
candidates for cognitive therapy. They person's thoughts and actions.
are plagued by recurrent, unwanted Brain imaging studies have shown
thoughts (obsessions) that create a that there is a specific brain circuit that
state of perpetual nagging anxiety. In is normally active only when we are
attempting to deal with this, they performing routine tasks, such as
typically carry out various repetitive having a shower, making a cup of tea or
rituals (compulsions), which can locking the front door. Usually, this
consume so much time and energy circuit is turned on and off as needed,
that they seriously disrupt everyday but with OCD sufferers the circuit fires
life . The most common compulsions all the time. Treatment with cognitive
are hand-washing and checking rituals, therapy can calm this overactive circuit
such as checking to see whether the down to its normal cycle of activity.
102

OVERCOMING ADDICTIONS
The common image of an addict is of someone hooked on heroin or cocaine. But
most addicts will probably never have seen hard drugs. Alcohol, nicotine and
certain prescription drugs, as well as some types of activity, such as gambling
and even shopping, can all be addictive. Whatever the substance, addictions
can do wide-ranging damage to physical and mental health.
,·
Even when affected by moking-related di ea e , ome mokers ju t cannot
overcome their addiction to nicotine. Heavy drinker can blight th ir live -
'
from relation hip problem to unfulfilled potential at work - through alcohol abu . In ome people,
the drive to keep con urning certain ub tance or to repeat certain type of behaviour i overwhelm­
ing, even when the con equences are di a trou . But what drive thi elf-de tructive behaviour?

The roots of addiction

Addiction - al o known a dependence - develops gradually
"If there was a box of
through a complex interaction between the user, the ub tance chocolates around, I
(or behaviour) and their environment. ep ndence u ually
ari from increa ed tolerance of a sub tance or behaviour: two couldn't stop till I had
gla es of wine in the evening become 6 ur, or the midweek eaten the lot. After
lottery become a unmi sable a the weekend flutter. Once a
raving ha et in, behaviour is profoundly influenced by the cutting out sugar
need for more of the ame.
There are a wide range of addictive ub tan e :
completely for a
nicotine and alcohol are two of the mo t bvi- month, though, I've
ou . ther include painkillers,
limming pill , laxative , and
just lost the craving
illegal drugs uch as cocaine for sweet things."
and heroin. Le bviou
Beryl, 51. who was addicted
to sweet things
 M I N D W AY S TO H E A LT H 103

candidates to add to the li t include caffeine sugar,

chocolate and junk food. Gambling is a major behav­
ioural addiction, but there are a ho t of other arou ing
concern among heaJth e perts, uch as working long
hour , surfing the internet, exerci e, video game , tele­
vi ion and even ex.

Addiction: in the genes?

A knowledge of the brain and of human genetic has
developed addiction ha come to be een as an illne s.
There doe appear to be a genetic factor for alcohol
and m king dependen e. ne 1960s tudy looked at
the moking behaviour of 42 pair of twin who had
been rai ed apart. In 18 pair, both twin were non-
mokers, while 15 pair smoked. OnJy in nine of the
pair did the twin not show the ame behaviour.
This trongly uggests a genetic influence.

Treating addictions
There are various approa h to the treatment of
addiction. M di ation i ometime u ed to tr at ako­
hol, nicotine, hopping and food addiction . Nicotine
pat he , for example, an help to w an om one off
cigarettes, while the drugAntabuse (disulfiram), which
i u ed to treat alcoholi m, replace the en ation of plea ure that the per on gets
from drinking with nau ea. However, fighting the physical addiction is ju t part of
th tory; mo t addicts need to I arn new attitud and pattern of behaviour if they
are to ucced in the long term. BehaviouraJ therapy can be very effective again t
addi tion . ne trategy involve rewarding the individual for reaching certain goal .
Above all, people hould not be puni hed for addiction , but encourag d to adopt
more po itive behaviour that provide the ame p ychologi al reward
without indulging the addiction.

FACT FILE
To orercome an addiction
successfully, there are a number of
states that must be worked throu1h.
1. Acknowledging the problem
Becoming aware of the addiction and
acknowledging it is the first step
towards recovery.
2. Building awareness A period of
honest thinking about the effects of the
addiction and ways to beat it.
3. Resolving to stop The decision to
give up an addiction demands strong
resolution and must come
from the addicted person themselves.
Joining an appropriate group - from
Weightwatchers to Gamblers Anony­
mous - can help maintain the resolve
to beat the addiction.
4. Changing behaviour Establishing
different habits and activities to avoid
situations associated with the addiction
can be crucial in the early stages of
overcoming it. In the longer term, a
new perspective, attitude and lifestyle
should develop.
5. Keeping vigilant For many people,
the final stage of recovery is without
end. Keeping free from addiction
becomes a lifetime process of
reinforcing healthy new behaviours.
104

CONQUERING FEARS
Fear is a part of everyday life. Although it may be unpleasant, it is a perfectly normal
and natural response to threats or danger. However, sometimes fear can become
uncontrollable and develop into a disabling phobia. Fortunately, many fears and
phobias can be effectively treated by psychotherapy and other techniques.

If you believe omeone i following you d wn the treet at night, your

FACT FILE
THE THREE CLASSES
OF PHOBIA
Simple phobias
These are fears of specific objects
or situations, and indude:
• Acrophobia (heights and high
places)
• Arachnophobia (spiders)
• Astraphobia (thunder storms)
• Bacillophobia (germs)
• Claustrophobia (enclosed
spaces, e.g. small rooms or lifts)
• Haematophobia (the sight of
blood)
• Hydrophobia (water, such as
rivers and oceans)
• Nyctophobia (the dark or
darkness)
• Zoophobia (animals)
Social phobia
This is a feeling of insecurity or
fear in specific social situations,
coupled with a fear of being
publicly embarrassed. Social
phobia may include a reluctance
to eat or drink if anyone is
watching.
b dy tar to how the typical fear re pon e: your heart peed up, you
br ath fa ter, your palm weat, your mouth become dry and blood pre -
sure ri e . All of the e chang divert blood to the mu cle o that you have
more energy either to get away from r c nfront the pur uer. Thi 'fight
or flight' re pon e to danger ha obviou urvival value in h !ping u to
deal with all manner of threats, not just imagined talkers on the street.
ur emotional and phy i al re pon e to ituations that we fear can al o
help u to take practical tep . For example, if your home ha been bur Jed,
you are more likely to find the time and money to fit e ure lock to door
and window or in tall a telephone in the b droom in ca e you need to
call for help. While u h practical action can a ure, it i natural to feel a
sen e of anxiety that take a while to di ipate.
But fear and anxiety can get out of hand. Roughly one p r n in ten
uffers from a phobia - an irrational fear of an object or ituati n that may
be harmJe in i elf. Phobias are nothing new: the ancient Greek phy ician
Hippocrate de cribed patien di abled by irrational fear more than 2 0
years ago. 1GngJan1e I of England wa terr ified by the ight of unsheathed
words, and Henry Ill of France wa cared of ca .
igmund Freud, the founder of p ychoanaly i , believed that phobia
temmed from childhood trauma. In ome ca e , this i true: one woman
with a fear of feather traced the problem back to a large feather in the hat
of an unknown woman who leant over her pram wh n he was a baby,
cau ing her to cream with fear. Fear and phobi vary in ev rity. ome
people ju t feel mildly uncomfortable when talking about their phobia,
and will avoid it if po ible. Others will go to any length to avoid the

Agoraphobia
This is one of the most common
phobias, and involves the fear of
being alone in public places or in
an unfamiliar setting.
 M I N D WAYS TO H EA lT H 105

obje t or ituati n be . u e it pr duce u h inten e fear - b d that they

feel th y might be about to die. In the e ca e , a phobia can eriou ly di -
rupt everyday life. People with a fear or phobia u ually have a clear in ight
into their problem and know their fear i exaggerated, so in addition they
often feel a hamed of their weakne

Treating fears and phobias

Behaviour therapy can help people over ome mo t phobia
and fear , and ometimes antidepre ant drugs can be
effective. Behaviour therapy exp sc the ufferer to the
obje t or ituation th y fc ar. here are two ways of doing
this: through fantasy, which is a u eful approach in situation
that cannot ea ily be reproduced, uch as thunder torms, or
by directly onfr nting the ph bia. Fanta y involve th p r n
imagining th phobia object, r viewing it via video, lid or omput r
imulation , while being repeatedly told to relax. Fear and relaxation
cannot be pre ent in the mind at the same time, o the fear should begin
to fade and be replaced by a relaxed feeling.
or dire t confrontati n, there ar
two main approache . ystematic
"The more rapidly de en iti ation expose a fear gradu­
you confront the ally. ff, for example, a per on fear
g ing out at night after being
worst, the faster mugged, th vi tim might begin by
your fear will fade." going out for short periods with
friend , gradually reducing reliance
Isaac M. Marks, psychiatrist n ther until confid nt enough to
walk alone. The alternative approa h,
called 'flooding', is like jumping traight into the deep end of a swimming
pool. The p r on i expo ed to the full extent of their fear - with agora­
phobia, for in tance, they might o to a hopping centre for a few hours.
Flooding demand mor of th pati nt but it yiel qui ker re ult .
How vi r, the patient mu t agree to ee it through - fle ing halfway would
reinforce the phobia.
 There are many myths about hypnosis. It is often viewed as a
stage trick or a type of mind control in which the hypnotist
sends someone into a sleep-like trance, before telling them to
do embarrassing things. However, although the process of
hypnosis remains mysterious to an extent, it is a perfectly
natural practice. Hypnosis is a state of awareness that
:.-......,,.�;..:.-:sw-- goes beyond deep relaxation. In hypnosis, you are able
;,:-i to concentrate very deeply on certain aspects of your
�.. l�w"l.
· surroundings while others fade into the background.
This is a state of mind very similar t9 becoming
.����, absorbed in a book or a film, so reality retreats
from the front of your mind.
All hypnosis is in some way self-induced.
No-one can be forced into a state of hypnosis
unwillingly. The hypnotist is there to help the
patient access his or her own unconscious
mind. Some people enter a state of hypnosis
more easily than others: this is not a sign of
weakness, it just means they can easily
enter into their own inner world. Generally,
younger people are easier to hypnotise than
those who are older.
 M I N D WAYS TO H E A LT H 107

The power of hypnotherapy

During hypnosis, the mind is more open to suggestion.
A hypnotherapist (a therapist who uses hypnosis to
treat problems) can use this to help instil positive ideas
to improve the patient's health . For example, during
hypnosis, it may be easier to accept the idea of giving
up smoking, or to release memories of long-buried
problems that could be a contributory factor in stress­
related ailments like eczema, asthma and psoriasis.
Hypnotherapy is a powerful treatment for anxiety,
eating disorders and phobias of all kinds.
The hypnosis experience
So what does hypnosis feel like? On a first visit to a
hypnotherapist, patients may feel apprehensive,
perhaps wondering if they will emerge from the trance.
Hypnosis has three main stages - light, moderate and
deep. The hypnotherapist begins by asking the patient
to focus on a fixed point and breathe slowly. The
hypnotherapist will then talk the patient through a
routine - perhaps imagining descending in a lift - that
will help him or her achieve a hypnotic state, then
treatment can begin. If treating someone for a smoking
addiction, the therapist may suggest that the next
cigarette will make the patient feel sick. In a hypnotic
state, such suggestions can make a powerful impression
on the mind.
Anyone with a serious medical condition should be
wary of hypnotherapists who do not have a detailed
knowledge of the illness. As with any form of
complementary therapy, people should only consult a
properly qualified therapist whom they like and trust.
SELF-HYPNOSIS
You do not need to visit a hypnotherapist to
benefit from hypnosis. It is quite easy to put
yourself into a relaxed, hypnosis-like state.
• Find a quiet, undisturbed place. Ideally, sit,
rather than lie down, to prevent yourself falling
asleep. Plan the kinds of suggestions you want to
practise - for example, a specific goal, such as
giving up smoking, or releasing tension.
• Take three or four slow, deep breaths, holding
your breath for a couple of seconds then letting
go with the word 'relax'.
• Focus your attention by concentrating on a
point on the wall.
• Tell yourself you are going to take three special
breaths - the first to relax, the second to move
towards hypnosis and the third to be in hypnosis.
• After the breaths, release all tension from your
body by systematically relaxing the muscles from
your toes to the top of your head.
• Now imagine a staircase with ten steps leading
you to a special place. Count down from ten to
one as you descend the stairs.
• Visualise your place, and try to experience how
it sounds, smells and feels.
• Now begin your positive suggestions relating
to the goal of your self-hypnosis.
• When you are finished, count yourself back up
from one to ten, telling yourself you have
enjoyed a wonderful session of relaxation, and
that when you emerge you will feel refreshed.

HYPNOSIS AS ANAESTHETIC
Hypnotherapy can help patients get through pelnful physical
examinations. An American doctor, Mic:hlel Nash, reported the
experience of a patient who had to have a blldder examination
every tlvee months for five years after the removal of a tumour.
He refused a general anaesthetic, and an epidural (a spinal
anaes1hettc) was considered medically dangerous. The first time the
patient was examined, he had to be held down as he struggled with
the pain, which was a distressing experience for all concerned. Dr
Nash decided to teach the patient seH-hypnosis. Before the second
examination, the patient took 60 seconds to prepare himself. Ten
minutes later, the examination was over and the patient reported
feeling none of the pain of the previous examination. And the six
people waiting to hold him down went for a coffee instead.
CREATE Professional therapists and counsellors use a wide range of
techniques to assist their clients. Many of these can be adapted as

YOUR OWN
self-help tools to help us identify mental and emotional difficulties
and work through them towards more constructive ways of feeling,
thinking and acting. Try these exercises as the first steps on the

THERAPY
road to self-analysis and awareness. Anyone with serious concerns
about mental health, should seek professional advice.

Cognitive psychotherapy can help people to identify

and change negative or self-defeating thinking styles.
Negative thought drains confidence and creates
negative emotions - such as anxiety, depression and
anger - which, in turn, prevent us from making the
most of our lives, relationships and work opportunities.
Change the negative thinking, however, and emotions
and behaviour will change too.

Do you have negative attitudes?

If you answer 'no' to any of the following statements,
you probably hold negative views about yourself:
• I like myself
• I have a balanced view of my qualities and limitations
• I am a good person
• I do not hold unrealistic expectations of myself
• I believe I have as much nght as anyone to the good things in life
• I motivate myself through kindness, not self-criticism
• I value myself

If you indulge in negative thinking, you will probably

recognise one or more of the following:
• Mind-reading - acting on assumptions about what other people are
thinking or feeling. Do you make statements like: 'He doesn't like me',
or 'They probably thmk I've handled that badly'?
• Black-and-white thinking - 1s everything either good or bad, right or
wrong? Do you think things like: '80 per cent isn't good enough!', or 'I
started, so it's bad if I don't finish'?
• Mental filtering - do you 'filter out' positive statements by belittling
your achievements? Do you think things like: 'Anyone could do that;
they are only bemg kind'?
• Extremism - do you make sweeping statements like: 'It's always
me that has to sort things out', 'I never say the right thing•, or 'No one
ever thinks of me'?
Overcoming negative thinking
Challenge any negative views and thought patterns by
objectively looking for evidence to disprove them:
• Check your facts - ask people what they really think rather than
simply acting on your assumptions.
• Think about the times when you 'got things right' - give yourself
credit for what you have achieved, even if it is only part of what you
set out to do.
• Write down three good things that happen each day.
• Beware of using overgeneralising words like 'never', 'always'
and 'nobody' - think of exceptions.
 M I N D WAYS TO H E A LT H 109

HUMANISTIC THERAPY
Humanistic therapy views every person as a unique Identify your ideal self
individual and aims to involve the client as actively In the following Q-sort exercise you should try to be
as possible in discovering his or her own ways of as honest about yourself as you can.
feeling and thinking ('client-centred therapy').
• Make your own set of Q-cards. You could use the qualities listed
The Q-sort method here or devise your own to create a pack consisting of 2�30 cards. To
'Q-sort cards' are used to help people find out which reduce the possibility of personal bias in your choice of qualities, you
areas of their personality to work on. These cards could do the exercise together with a friend, making one pack of Q­
cards for both of you.
have personal qualities written on them, such as:
• Shuffle the Q-cards. Sort them into five piles, putting the cards that
• I am friendly describe you best into pile 1 and those that describe you least well into
• I am unfriendly pile 5. Grade the others into piles 2-4, using pile 3 as a 'neutral' pile
• My outlook is generally positive for traits that seem neither characteristic nor uncharacteristic. Note
• My outlook is generally negative down the qualities that you have placed in each pile. These form a
• I am usually tense picture of your 'self-concept' - how you see yourself.
• I am usually relaxed • Shuffle the cards again and repeat the exercise, but this time
• I put myself first imagine you are your 'ideal self' - the kind of person
• I put others first you would most like to be.
• I am decisive
• I am indecisive Your self-concept
• I am critical
Compare the two sets of results. The qualities of your
• I am generous
ideal self that are lacking from your self-concept
• I have a wide range of interests
• I have few interests represent areas to think about working on. You could
• I often see my friends begin by looking at those qualities in the first two
• I rarely see my friends piles of your ideal self which also appear just one or
• I am open about my feelings two piles below that in your self-concept.
• I conceal my feelings

DREAM ANALYSIS
Dreams often relate to our present preoccupations.
Analysing them can help us to clarify our concerns,
desires and fears.
Keeping a dream diary
Keep a daily diary of your dreams for a short period,
say two weeks. As soon as possible after you wake in
the morning, make a note of:
• The content of your dreams, including the people and places
who appear.
• Significant events in your life in the previous 24 hours.
• Significant concerns about your health, job, relationships and
so on in the previous 24 hours.
Analyse your dreams
At the end of the two weeks, read through your diary and
analyse your dreams as follows.
• Note any dreams that appear to be accounted for by your c:onsclous
waking experiences (for example, a dream of water following a visit to
the seaside).
• Note any links between your dreams and your personal concerns.
These links can be direct (you may dream about being iN or losing your
job) or indirect (if you are worried about failing an exam you may
dream of falling over). Alrf such dreams that recur are likely to
represent issues you should deal with most urgently.
• Did you have any dreams that cannot be accounted for bJ your
waking experiences or concerns? They may express deep-seated or
even unconscious desires or fears - especially if they recur.
110

BIOFEEDBACK
We are not normally aware of our bodies at work, although physiological factors such as
blood pressure, blood flow and heart rate affect our health. The therapeutic technique of
biofeedback provides conscious awareness of unconscious body states, and is a powerful
tool for learning to control stress-related conditions.

Biofeedback give. people the power t influence me a pe ts of their bodily fun tioning that
are of benefit to health. F r example, it is well known that high bl d pre ure i a ri k factor
for heart di ea e. Blood pres ure fJuctuates n tantly in an 24-h ur period, but we are not
normally aware f the e changes. U ing biofeedback, we an learn what it i that rai es blood
pre ure, and what we can do to bring it down again.
In fact, biofeedba k i a kind f learning proc , on i ting of three basi cages. in, the
ph iological function that ou want to ontrol i identified - uch a lowering kin temper­
ature or blo d pr sur ·. e ond, the function needs to be c nverted into a ignal that i easy
to re ognise - su h a a m ving n ·edle on a meter, a Oa hing light or a ound that hange it
tone. In rder to me;i ure and ob erve any ariation in the signal, you need to be nne tcd
to , monitoring machine that ha either a vi ual di play ( uch a a mputer creen) or an
audible output. For example, a tone may be u ed to
Biofeedback
indicate blood pr ure.A the pre ure falls o doe the
training
pitch of the tone. The third tage i reached when you
"I suffered from
A patient observes
feedback from his have learned hat it is that makes the ignal alter in the cold hands. Using
brainwaves on a direction you want - in other word , h w to con­
computer screen. ciou I control our body' respon e. biofeedback, I learned
to warm them up by
Over a number of
sessions, he learns
to control his brain
activity. This can help The brainwave data is
Sensors on the
patient's head pick
imagining them in a bowl
of warm almond
with problems such transformed into a up brainwave data
computer game. By playing and feed it into the
as mood disorders the game, the patient
and migraine. modifies his brainwave
pattern
oil - lovely!
And it really
worked."
Shirley, 39
 M I N D WAY S TO H E A LT H 111

--

OVERCOMl#S CHRONIC DEPRESSION

,1
II .... I ITT/N
,..,.. [U co,-,
I I II I G CI... t.: ....
c ,..,..
III

Doctors in the USA used biofeedback means of the 'reward' of a pleasant· IMPROVED PERFORMANCE
There is new evklenc:e that
to cure a woman of persistent sounding tone. After 34 one-hour
depression. She had been treated sessions, her depression had lifted.
biofeedback may have positive
using psychotherapy and A check-up six years later revealed
effects even when there is not a
antidepressants for over 12 years, but that there had been no recurrences -
specific medical problem. A team at
without success. Biofeedback (by an impressive result, since many
Imperial College London has
monitoring her brain activity in patients with depression do relapse.
succeeded in raising the
response to happy or sad film clips) Since then, a further 20 patients
performance of musicians at
enabled the woman to normalise her have tried the treatment, 18 of
London's Royal College of Music.
brain activity reaction to the clips by whom have improved.
The results suggested that
enhancing specific brain activity
patterns by biofeedback improves
hinking of h w y u felt about your neighbour when he took attention. After biofeedback
your parking pace, for example might mak your bl od-pre ure t ne training the students made fewer
impulsive mistalcas when
rise to a high-pit hed queal. Breathing more I wly and thinking about
performing, such as playing the
your forth oming holiday ma alter it to a plea ing hum. Ev ntually, you wrong note or coming in to the
will learn " hat mental trick work to make the de ired hange for y u piece too early.
vvithout needing the machine. The technique could also be
applied to enhance sporting
How biofeedback works skills. Biofeedback could be
used to improve a golfer's swing,
Biofeedba k be , me popular in the 1960 and ince then ha b en
tor example.
applied to a range of chroni di order , many f them tre -related. lt
began with , tud onducted at the Univer ity of aliforni, involv­
ing people with epilep y. Re ear her Barry terman dis overed that
the brainv ave of pe pie on the verge f a eizure had an abnormally
high level of brain activity. he re ear her de i ed an intera tive com­
puter game where the rccn image wa related to the level of brain
activity. By learning how to ontrol the image n er en, patient
learned to contr I and normali their own brain acti ity pattern . F r
example, one patient's image wa a ro ket and by rai ing it t the top
of the screen - u ing whatever mental trick worked be t - he found
he could norn1, Ii e the electrical acti ity of hi brain when it " a
highly a ti e and thereby avert a eizure. A variety of imilar te h­
niquc are in u e today.

Using biofeedback
Biofeedback ha proved to be ucce ful in treating a wide ran
of condition , including high bl d pre ure, migraine and
R.aynaud's disea e - a circulatory problem in whi h bl
in the han con trice and cau e an a hing, Id en ation. Druxi m
(teeth-grinding) and temp romandibular joint (TMJ) di ord r,
where ten i n in the jaw produces evere facial pain are two tress­
related condition that re pond weU to biofeedba k. In the U A,
biofeedba k (or neurofeedback a it i al o known) i bcin u d to
improve concentration among hyperactive children.
 ITH STRESS
Stress is a short-term physiological
response that aids us in the face
of danger - which ,s hardly a
suitable state in which to live, or
even regularly spend time. Indeed,
too much stress is known to make
us vulnerable to ill-health. To
eliminate harmful stress from our
lives, we must learn how to put our
anxieties in perspective and, above
all how to relax.

It is impo ible to eliminate all tre

from daily life but we can reduce its
ffects. When tre ed, m ny of u are
attracted to variou fi rm of e capism -
notably alcoh I and cigarette , which of cour c
bring erious problem of their wn. A far more
appropriate re p n e is to draw upon r la ation tech­
nique , including not onl u h practice a meditation
but al o ariou aspect of po itive thinking that owe more to
pragmati common sen e than to a tern tradition . The be t olu­
ti n wiU differ from one individual to an ther, and will u ually be found
by per onal experiment.
It i important to reali e that pending time re etting prioritie , a well a
fulfilling I ·i urc interest or even ju t itting quietly wat hing the world go by,
are a ti itie th. t are far from being fruitles or self-indul ent: they arc vital
key to our well-being. If you uffer from tres and take no tep to di cover
the e key , mental anxiety can translate into phy i al ten ion, and after a v hile
y ur health will begin to uffer.

"I used to be a workaholic. I never took any

exercise. I even used to ignore headaches
to get things done, and this left me with
debilitating pain. Now, I'm more sensible.
If I'm tired, I stop work. It's just not worth
damaging your health for."
Elizabeth, 32, journalist

Acceptance and control
When life is not going our way, we might find
ur elve u ing up a great deal of energy in wi hing
that things were therwi e, p rhap pending
energy dir' ting blame towards other people or
fate. But it i elf-evident that we cannot change
what i bey nd our control, only what is within it.
And what cann t be hanged mu t be accepted.
Living according to the c fact require mature,
realistic thinking, a " ell a an accurate a e ment of
the fa tor in life that we can influence. If we ar
tre ed b the difficulty of elling a hou e, there i a
way through the labyrinth: we ann t c njure a buyer
ut of nowhere, nor make the kitchen or garden
bigger; but we can be patient and in the meantime
enj th· friendship f ur neighbour while we till
have it. I ue that only time an re olve mu t n t be
allO\ ed to dominate our entire mental land ape.
M I N D W AY S TO H E A LT H 113
Psychologists use the term 'catastrophising' to describe a
tendency to feel that a situation is disastrous when,
viewed by more objective standards, it is in fact merely
negative or unlucky. A psychotherapist will often tackle
this syndrome by working on a person's coping skills - the
rational ways that are available to us all to deal with life's
commonplace anxieties. Catastrophising works by
'snowballing' problems - two or three difficulties, each
readily soluble, may appear insurmountable when grouped
together. One approach is to train the 'patient' to separate
problems into their component parts, and deal with each
part individually. Making simple, verifiable statements
about the situation can help in this: 'I am sick, but the
doctor has said my illness will not affect my lifestyle'; 'I
will not see my children for two months, but then we will
be spending a two-week vacation together.'
 RELAXING MIND
AND BODY
ation brings clarity of thought and freedom
stress, and is therefore a route to improved
tal and physical health. But we cannot force
process. The best approach is to learn about
classic techniques and apply yourself
ntly to the ones that attract you most.
tion i more than ju t a mood we enjoy
things are going well for u - it i a pro­
state of mind that ideally hould be the
plateau we inhabit in mo t of our daily
ters. For many, however, daily life is quite
posite. The 19th-century American writer
Thoreau once aid that 'the ma of men
of qui t de p ration'.Thi may be eating
a little trongly, but if you are aware of a
nd buzz of anxiety a your habitual tate,
d probably benefit from practising one or
the tried-and-tested approache outlin d o er
g page.
tion techniques can readily be accommo­
ally any daily r utine - even during work
can practi e deep breathing y temati ten ing and
ur mu de , and tretching ex rci e . "YI u might be
· k walk at lunchtime, or by working out in a gym
a team port you wiJJ gain not only from the e er i e
opportunity for your mind to forget it anxietie and
concentrate on the moment. This tate of'mindfulne s' -
rption in her -and-n w experiences - i greatly valued by

e for relaxation
that we are o often 'on the go', there i
e left for reflection. hort period of qui t intro pection have
hown to reduce tre . They help you tay in tou h with your inn r
, and enable y u to put the tribulation of your life in perspective. By
nding fiv minute r more letting y ur emotion , whatever they are,
ub ide and thinking about what really matter to you, you will ome to
e that you have hoi e.You do not have t onform with other people'
opinion if you di agr e with them. hi belief in the overeignty of the
elf ' i a corner tone of modern approache to per onal fulfilment.
 IDEAS IN ACTION M I N D W AY S TO H E A lT H 115

BREATHING

• Breathe in slowly and deeply through the nose to a count of 10, making
sure that the abdomen expands but the chest does not nse. Exhale through
the nose, slowly and completely, also to a count of 10. Repeat S-10 mes.
Counting through each cyde in a concentrated way waH help to quteten
your mind. You might also irnagme yourself Inhaling energy and calm, and
exhaling worry and tension. Repeat this several times a day.

1111 you C111 IINIIIM

ffllntrl - 8 IIIIIIIIMI'
meaningful) .......
medltltfon dlvlca.

MEDITATION

• Weanng loose, comfortable clothing, sit comfortably upnght in a

pleasant place and close your eyes. Breathe deeply from your abdomen.
Then for five minutes - or longer If you wish - Imagine a rachatmg point
of hght behind your forehead. Think of this as an outpounng of
positive energy. Don't worry 1f thoughts also dnft across your
mind - Just let them pass, without trying to influence them.

Tbe optlnun medltlllon performed without

lntlntlon, , impatience or
dislppointrMnt. But thn Is no need to be
anxious If you do experienca suc:11
falllnal: simply bl aware of them.
116

How we stand, sit and move can have a protound effect on our well-being and
energy levels. Many common ailments, such as frequent heldaches or low back
pain, stem from muscular tension caused by bad posture. The most common
failings are slouching, rounded shoulders, arched back and tilted head. More and
more people are coming to believe, in line with Eastern thinking, that the body
has an optimum flow of energy (the Chinese call this energy 'chi'), and that any
blockage in the flow can disturb the harmony of body and mind. Improving
posture is the key to eradicating such problems. It can even help to alleviate
insomnia and depression.

• Good posture depends on the spine, which hould be lengthened and centred.
When standing, your weight should be spread evenly over both your feet, and
your shoulders level. Viewed from the side, there should be a straight line through
your ears, arms, hips and knees to your feet, and a gentle curve
in your lower back. When sitting, keep your knees slightly
lower than your hips: a wedge-shaped cushion can help.
All the following are taboo: slumping in a chair,
crossing your legs, and holding a telephone
receiver between chin and shoulder.

MUSCLE RELAXATION
Muscle relaxation techniques such as tense-and-relax exercises and
stretching are simple to learn and can be practised at any time.
• Tense or clench each muscle tightly for 5-10 seconds, then release it
completely, being consciously aware of the muscle relaxing. Start with the
toes and move progressively up the body to your face and head. After each
tense-and-relax, imagine that the body part has become warm and fluid.
Visualise each element as flowing freely. With practice the exercise
becomes more effective and will induce relaxation more quickly. It can be
particularly useful in getting to sleep.

Loosening tight muscles by stretching is effective for anyone whose job

involves sitting for long periods, or continually using the same muscle
groups. Stretching increases oxygenation and stimulates lymphatic
drainage, which reduces back pain, headaches and indigestion. Reaching
your arms high above your head or stretching your legs with a quick walk
are enough to get the blood circulating more strongly again, and will
reinvigorate you.
 M I N D WAYS TO H E A lT H 117

VISUALISATION
A classic relaxation technique is to visualise an
image or scene that fills you with peace - a bit like
running your own stress-busting movie in your mind.
• Find a quiet place and ensure you will not be
disturbed for at least 10 minutes.
Close your eyes and breathe
deeply, then conjure up a
favourite or idealised place -
perhaps a tropical beach, a city
park, even a golf course. Gradually
build up the details of the scene in
your mind - not only the sights
but also the sounds and smells. Be
aware of the weather - a cool breeze
or warm sun according to your
preference. Retreat to this
inner sanctuary whenever
you need to regain
peace of mind.

YOGA
Yoga (a Sanskrit word that means 'yoke' or 'union') is an ancient Indian repertoire
of techniques integrating mind, body and spirit. It improves suppleness, digestion,
ciralllllon and relaxation. It can also heighten intuition and creativity. At a more
IIDIDUIICI level It provides a way to achieve enlightenment or self-realisation - in

•••*farm to forge a union of the Individual self with the 'universal self.
In the West Is Hatha Yoga, which aims first to cultivate
pastures, or •asanas', and then moves
MIM' ••-----The beneffls are physical,
Sleep and health
Most of us take sleep for granted, i,nless it starts to become elusive.
During sleep, your brain and body enter a state quite different from
being awake - it is not simply a case of 'switching off'. And tvhen
sleep is limited, the impact on health can be significant.
As a society, we probably sleep less now than at which to build glucose reserves, or to exercise little­
any time in the past. Records show that, until the used brain circuits. Other suggestions include the
widespread availability of the electric light in the need to conserve energy - but in fact a body asleep
19th century, people slept for an average of nine continues to use up almost as many calories as it
hours a night. Today, the average is seven hours, does when awake. Whatever the precise reason for
and many people get by on less. But does sleep sleeping, it is agreed that it plays an important role
deprivation have an effect on health? We cannot in keeping us healthy.
survive indefinitely without sleep-11 days is the
record (people can go without food for far longer). "When I was a student, I'd sleep
Sleep, then, would appear to be essential, but there
is still no generally agreed account of why this is till midday at the weekends. But it
so. Some scientists think that sleep is necessary
t,ecause Gf the-body's need
change as you get older. Now I'm
time' In
alwa p by eid,# - and I don't
a o get me up "
 z
z
Z z MIND WAYS TO HEALTH 119

z
z SLEEP PROBLEMS
Sometimes we miss out on sleep due to lack of
opportunity - the demands of a young family, for
example, or an overloaded social life on top of a busy
work schedule. But the quality of sleep itself might be
deficient and this can indicate another health problem.
For example, people suffering from depression may
wake up very early in the morning and be unable to
get back to sleep. Snoring, too, can be a sign of an
underlying problem called sleep apnoea. This is a
temporary cessation of breathing, perhaps hundreds of
times a night. People who suffer from sleep apnoea are
more prone to stroke or heart disease, probably
because vital organs (brain and heart) are
intermittently deprived of oxygen. They are also prone
to daytime sleepiness, which can be dangerous if they
need to drive a vehicle.
Of course, insomnia can occur without any obvious
cause. But becoming anxious about sleeping will only
cause worry and make us less able to sleep. For those
people who worry that they are damaging their health
through a lack of sleep, laboratory evidence has
revealed that insomniacs get more sleep than they
think. What seems like only half-an-hour's sleep over
the whole night may, in fact, be nearer five hours.

Body changes during sleep

Sleep produces changes in our physiological cycles.
Research in sleep laboratories has shown that there is a
peak in the levels of growth hormone when people first
fall asleep. In adults, this hormone is involved with cell
repair, and so maintains the health of skin, bone and
muscle. Another hormone produced in early sleep is
testosterone, which helps to explain why sleep disorders
in men can cause impotence. Sleep also helps the brain to
process memories. Studies have shown that it is harder
to memorise complex material if sleep is interrupted.
120

OVERCOMING PAIN
Pain is simply the way we come to know about damage to the body's tissues, and
the feeling it produces differs according to how the brain interprets it. Our brains can
present the knowledge as anything from intensely unpleasant to just another piece of
sensory information. And we all have the ability to turn the first experience into the
second, whether by using drugs or altering our thinking.

erve di tributed around th body run up the pine and into the brain,
where they are regi tered on the omat en ory rte . It u ed to be
thought that p, in information imply travelled up th nerve pathway and
wa automatically fi It a pain on e it reached the brain, but now a more
omplic ted picnire ha emerged.
W hen you bang your hin your automatic re pon e i t rub it.
'Rubbin it better' work becau e th re eptor and nerve fibre that
tran mit pain me age lie close to tho e arrying en ati n u h a
warmth and plea ant tou h. If non-pain fibre next to a pain- arrying fibre
are timulated, the ign al from the pain nerve are blocked befor they are
con ciou ly regi tered.The pain blockade occurs becau e only one type of
n ation can be felt in th s me area of the body at the ame time.
The 'competiti n fi r on iou nes 'betv.reen painful and plea ant tirn­
uli was fir t di covered in the 1960 b phy iologi ts Patrick Wall and
RonaJd Melzack. Their 'gate control' theory of pain proposed that there
wa a ' gate in the pinal rd \ hich allowed only one type of sen ation to
pa through it at a time. However, recent re earch ugge t that the gate
effect i in fact pr vided by the body' attention y tem.

Attention to pain
An area of the brain ailed the in­
FACT: According to a US
gulate cortex, which lie in th Gallup poll 46 per cent
groove between the brain' tw
hemi phere , can turn attenti n
of women and 37 per
Defeating pain Acupuncture is thought to inward or outward . If methin cent of men experience
relieve pain by stimulating nerves that interfere
with the transmission of pain signals to the
threatening or ex iring i going
on the ingulate cortex wit he
pain on a daily basis,
brain - this is the 'pain blockade'.
Transcutaneous electrical nerve stimulation
your attention away from your and 89 per cent of all
(TENS) also exploits this phenomenon. b dy and redu e any sen ation of
pain. Thi is one rea n why ol­
adults experience pain
dier wounded in battle may feel no pain at the time, at least once a month.
a their mind are ccupied el ewhere. It has even
been reported that up to 20 per cent of peopl who
Of those in pain, only
undergo major urgery report feeling little or no pain half had visited a
fi r hour or day after the peration.
Prol nged evere pain, a may occur in a chronic
doctor in the previous
c ndition such a sciati a, an have a debilitating effect three years to seek help.
 M I N D WAY S TO H E A LT H 121

Meditation can help you dissociate
yourse« from pain. Enn ff Ifs there,
you don't han to suffer too much.
Tiier, are many techniques, so
experiment to find which works bnt
for you. Here are four options:
1. Concentrate on your breathing. Take
long, deep inhalations and focus on the
feeling of each one.
2. Focus on a part of the body distant
from the pain: if the pain is in your
right side, focus on the left; if it's in
your head, focus on your feet. This
technique works particularly well with
migraine: if, for example, your migraine
is on the right side, focus on the left
side of your body, from the neck down.
3. Close your eyes and imagine you are
in some beautiful, peaceful place where
there is no pain.
4. If a pain is so overwhelming that you
cannot focus on anything else, try a
little self-induced dissociation. Close
your eyes, and imagine the pain as a
physical object. Concentrate on exactly
where the pain is, measuring its
dimensions and shape. When its form is
clear in your mind, imagine wrapping it
up in brown paper and tying some
string around it. Then imagine taking
this 'parcel' out of your body, and
placing it a long way away. Place it on
the ground. Then walk away from it.
These types of mind control may
sound too simple to be effective, but
with practice they really can work. If
you succeed, you will find that the
feeling of pain, although still there,
ceases to bother you as much as before.

by reducing a person' mental ability to op with the ontinuou di omfort.

The ufferer an ome to fo u increa ingly on the pain; this make it eem
more and more severe, as each unpleasant en ation i amplified. tudies have
hown that about 7 per cent of people who uffer from hroni I wer-back
pain do not have any readily d t table injury.

The brain's painkillers

The brain produce its own natural painkiller - a group of chemicals ailed
endorphins. The e relieve pain by in rea ing l vels of d pamine, another brain
hemicaJ, whi h enhan e feelings of well-b ing. ther hemicals h lp to
prevent pain from being laid down in the bra.in. xyto in, for example, i a
h rmone that women produce during labour and one of its fimctions i to
reduce the memory of the pain of childbirth.
122

Pain thresholds
en itivity to pain differ from per on to per on and ukure to cultur .You can te t your pain
thr hold by holding y ur hand in freezing water. How I ng doe it take before it tarts to
hurt? And when does it become unbearable? Mo t people cannot manage more than two or
three rninut s. uch experiments have tend d t ugge t that women have lower thre hold
than men, but th findings are difficult to interpret - it may be that men are ocially condi­
tioned to appear brave under uch circum tance , so they ch e t interpret certain timuli
a di comfort rather than pain. ther tudie how that Mediterranean people rep rt pain in
r pon e to a stimulus which northern European de cribe a merely unplea ant. Thi may
refle t a bi 1 gi al difference, or mer ly demon trate that ome cultures en ourage e 'pre ion
while others inhibit it.

Dealing with pain

Hypn i , r laxation, meditation and behavioural modification can all reduce the e perience
of pain by turning a per on' attention away from it.The effect of attention was dramatically
demon trated in a tudy in which patien were hypnoti d before being operated on with-
Breaking the ut anaesthetic. hey w re told th y would feel no pain , but that a 'hidden ob erver in their
pain barrier mind would feel it for them. After urgery, the patients reported feeling nothing. But when
Researchers have the hypn ti t addre sed the 'ob erver', they rep rted excruciating pain. Thi sugge ts that, in
found that sports ome conditi n , we can di ociate from pain, even though it i laid down in the brain.
professionals onver ely, pain can be mad wor e by fear and anticipation. If a per on ha experienced
generally have a
evere pain during a particular procedure in the pa t - having a tooth filled at the denti t' ,
higher pain
threshold than ay - it can create the expectation ( ometime tmcon ciou ) of uffering in the ame way
ordinary people. This again. Thi will mak th, t per on attend more do ely to their feelings next time they go to
is because they
become so used to
experiencing pain
while pushing
themselves to the
limit that they are
able to 'tune it out'.
 M I N D WAY S TO H E A LT H 123

"Taking morphine
doesn't stop the pain,
it just changes your
attitude towards it."
Maureen, 68. recovering from
a major operation

the denti t, and the attention will make the new experien e even m re
painful. In ca e like this p ych therapy may help to un over u h un on­
cious expectation , and give the per on the ability to div rt their attention
from painful timuli in a future ituation.
Refi cu ing att ntion away from pain i a te hnique u ed by practition­
er of y ga, for exampl , who are able to achieve uch feat of enduran e
a lying on a b d of nail or walking barefoot a r r d-hot coal . By
'retraining' their brain through m ditation, th y have managed to redu e
th ignifi ance of pain ignal to a point where they do not e penence
pain in the am way a an ordinary per on.

Pain medication
Although ur en ati n f pain i
very mu h dependent on our
expe tation mental tate and psy­
chological make-up, there i much
that can be d ne medi ally to help
people deal with pain, both hort
and long-ter m. There i a ,,; ide
range of pain-killing - or, more
accurately, pain-relieving - drugs
avail ble, whi h can be xtr mely
benefi ial in many ca e . The e
either act at the site of the pain, or
act in the brain by interfering with
the pathway th, t bring pain to
on i u attenti n. The mo t uit­
able analgesi will depend on the
cau e and nature of the pain, but
if pain i per i tent or e ere, a
d t r' advice hould b ought.
FACT FILE
Painkillers, or anal1eslcs, are
amoni the most commonly
prescribed dru,s.
• Analgesics are classified into
non-opioid - including over·the­
counter remedies such as aspirin
and paracetamol - and opioid,
such as morphine.
• Generally, non-opioid analgesics
are more suited for mild to moderate
muscle or joint pain. Opioid
analgesics are usually used to combat
moderate to severe pain, particularly
when it is internal in origin.
• Aspirin is used to treat headache,
acute pain, painful menstruation and
fever. It is also an effective anti­
inflammatory. It may cause stomach
irritation, so is best taken after food.
• Paracetamol is similar in effect to
aspirin, and is often preferred -
especially in older people - as it is
less irritating to the stomach.
• Of the opioid analgesics, morphine
is the most effective for severe pain,
although nausea and vomiting are
common side effects.
• Other opioids include codeine,
which is effective for the short-term
treatment of mild to moderate pain,
and diamorphine (heroin), a powerful
narcotic drug.
 s
Without pleasure, most of u would f el that our liv s w r
SE
imme sur bly i ov rish d. But did you kno that th pursuit and
experi nee of p easur through 1ental or physic I stimulation can
actively nhanc h alt and w II-being? For some time dentists have
b n inv stig ting how our brains respond to p ea urable stimuli.

It i natural to enjoy lifi and we arc born wanting to exp rien e pica ure
- it i and alway ha been, a p werful motivator fi r human behaviour. In
fact, igmund r ud believ d that the pur uit of plea ure was all that mat­
tered to babie and young children. A we grow into adul , we tend to be
more re trained, but we till pend a great deal of our time - both on-
ciou ly or uncon ciou ly - eeking out enj yment.
ociety normally place limit on the
degree to which the pur uit of pl.ea urc
i tol rated. The drive for modera­
tion tern in part from a cultural
di appr val of elf-indulgen ,
bol tered by a wealth of evidence
of the detrimental effects n
health that too mu h of the
' r ng' sort of plea ure can have
on health - lives ruined through
al ohol or drug addicti n, fi r
example, or phy i al pr blem Pleasure pathways Neurotransmitters
u h a heart di ea e and high dopamine (red) and serotonin (blue) link
blood pre ure cau cd by over­ different areas of the brain in the pleasure
indulgence and m king. response.

The pleasure centre

In 1954, the Ameri an p ychologist Jame Id di ovcred what he
believed to be the brain' 'plea urc centre'.Working on laboratory rat , h
inserted tiny el rrode into an area of the brain dos· t the hyp thala­
mu , which regulat hunger, thir t and temperature. By pre ing a lever,
the rats ould ele tri ally timulate this part of the brain.Ti Ids urpri e,
he found that the rat would pre the lever thou and of time - until they
fell to the floor, exhaust d. They would ev n ign re food and water in
preferenc to the lev r. timulating thi brain area evidently gave the rats
inten e pl a ure.
We now kn w th, t th re is no single pleasure c ntre in the brain but a
number of different area that are linked together in cir uits by mean of
certain neurotran mitter (brain chemical ).Tw of thee neur tran mitters
ar dopamine and r tonin. An intense urge of dopamine - the
'dopamine rush' - i linked t th 'high' experienced when taking drugs

like ocaine; erotonin
provide a quieter feeling of contentment - the anti­
depre ant flu xetine (Pr za ) and other related drugs
work by raising level of erotonin in th brain. Peter
Kram r, a p y hiatri t in the U A, ha found that ome
people with mild d pre i n experien e plea ur for
th fir t time in year after taking Proza
Pleasure and health
Plea ure can influence well-being in one oft\; o w, y
first in a preventative way to promote good phy i al
and mental health and to pr te t again t illne ; and
ond, in a urative way to aid the pr ce of unwind­
ing and help r pair the harmful mental £feet of
unplea ant experien e . Re arch how that experi­
en ing plea ure lead to a reduction in tre hormone
u h a corti ol, and contribute to a strengthened
immune re p n e and therefore gr ater re istance to
disea e. Even imply remembering happy events an
give th immune tern a b t.
A ording to th p ychologi t Rob rt rn t 111
there are two main hannel for tapping into the plea-
ure cir ui of the brain - sen ual and mental. en ual
pleasure give immediate gratifi ation, while mental
ones are lower-a ting and more ubtle, and include
experien e of loving r lation hip or the ati faction
of a job well d ne. veralJ, Ornstein' re ar h ha
h \; n that the happie t and healthi t p ople are tho e
wh take pie, ure in even the imple t things.
M I N D WAY S TO H E A LT H 125
CUTTING EDGE �� [UTT/NG EDGE
THE PUZZLE OF ANHEDONIA
Whereas hedonism is the pursuit of pleasure, anhedonia
literally means 'loss of l)leasln'. Someone with anhedonia
gets no pleasure from a baby's smile, cuddling a pet, or
eating a wonderful meal; beautiful countryside provokes
no more pleasure than a derelict urban environment and a
sunny day has much the same impact as a grey rainy one.
Anhedonia was first desaibed in the 1890s, but it was
not until 1980 that psychiatrists decided it was evidence
of mental disorder (although it can occur in the absence
of depression). It is regarded as a key sYfflptom of
depression and can be very distressing. Social anhedonia
- lack of interest and pleasure in social interaction - may
be an early warning sign of schizophrenia.
Targeting anhedonia
Anhedonia is an area of increasing interest, with
researchers looking for its origins in changes in the brain.
Scans of people with depression hive revealed a smaller
hippoc;ampus, lesions and a different brain metabolism.
At the Institute of Psychiatry in London, volunteers who
had been diagnosed as having depression and anhedonia
were shown film dips that normally induce pleasure, while
undergoing fMRI scans. Comparing the scans with those
of healthy people who responded positively to the films
revealed different areas of brain activity in those with
anhedonia. It is hoped that this will lead to new
treatments that target spec:fflc parts of the brain.
126
• Li e5 pleasures
Pleasure is a matter of personal taste, because we all enjoJ' di
things, but it is also an experience we have in comnion that
part of the emotional vocabulary of all cultures. A genuinely ealthy
lifestyle is one which involves embracing pleasure, not rejecting it.
Most people engage in activities that they find
pleasurable - such as reading, listening to music,
taking holidays, or eating out. Such experiences help
people to cope with the stresses of modern life and
improve psychological well-being. There are five
principal categories of activity that give us pleasure:
things that heighten enjoyment; things that counter
stress, anxiety or depression; social encounters, such
as meeting up to play sport; activities that are a
regular feature of everyday life that we might look
forward to, such as a tea break; and those regulating
arousal or mood changes, such as enjoying an
alcoholic drink.
Seeking pleasure
The pursuit of pleasure dictates much of what we
do in life. We are attracted to things, people and
situations that give us pleasure. For example, we
make choices about food and drink primarily for
taste rather than nutrition. It is not surprising that
the pleasure state is linked with biologically
important behaviour, such as eating and sexual
activity: it is of evolutionary importance that human
experiences involving food and sex should produce
feelings of pleasure, which will make us more likely
to seek out and repeat the experience. (Of course,
not all pleasurable acts are biologically important,
and not all biologically important acts are
directly pleasurable.)
egulati1 g pleasure
The level of sensory stimulation at which pleasure is
at its peak has been called the 'bliss point' by the
Australian psychologist Robert McBride. Rather than
overindulging in a state of bliss, we possess in-built
regulatory mechanisms that help us to maximise our
enjoyment by moderating our
consumption of the things we enjoy.
These mechanisms should not be confused
with conscious and culturally constructed feelings
of guilt, which can trigger stress hormones.
This self-regulatory 'pleasure principle' helps
us to sustain a balanced diet and prevents us
from excessive consumption of pleasure foods, like
chocolate. For such substances to remaift.nigbly
enjoyable, they must be consumed infrequently as
'treats' - if the pleasurable event is experienced too
often it becomes repetitive and loses its freshness.
Delaying gratification allows for greater expectancy,
which enhances the pleasure when it arrives.
Research suggests that feelings of
pleasure are caused by the release
of endorphins in the brain. Some
addictive drugs work by locking
on to endorphin receptors in the
brain, but it is of course healthier and safer to get
an endorphin rush by means other than_....,,�
The work of psychologist Robert Offlllll
that the happiest and healthieSt paoplf
who take pleasure in even the sirnotest
The strengthening of the body'n! M11iir11F;.S �-........
responses that occurs as a result of
experiencing pleasure suggests
that the enjoyment of life's
small pleasures may have a
cumulative effect over a
longer period, which benefits
health. Even fantasising
about pleasurable things
can be useful. Happiness,
it seems, really is
a state of mind.
 HEALING
THE BRAIN

T
he brain possesses a life-long capability to adapt
to new challenges and circumstances. This
chapter looks at ways of giving the brain its best
chance to retain its powers. During adult life, the
number of neurons in the brain slowly diminishes.
However, the connections between brain cells - which
provide the physical basis for everything we know, think,
feel and do - are constantly evolving. While these links
are made most rapidly when we are young, the brain
never stops refining its connections - strengthening old
ones and creating new ones as it learns from experience.

Protecting the brain from physical damage, taking

regular mental and physical exercise, and avoiding
substances and activities that can harm brain tissue are
just some of the ways to ensure your brain stays in good
condition. Your brain is your most precious possession:
by taking good care of it you improve the likelihood of
enjoying a long and fulfilling life.
--
-
130

YOUR BRAIN NEWBOIIII

THROUGH LIFE
Although our brains become more complex during the course of our
lives - primarily by forming millions of connections between nerve
cells - most of the brain's structure is already present at birth. The
greatest change, and the most rapid growth, occurs in the first couple
of years of our lives.

At birth, after a normal nine-month ge tation, there are around the ame
number of neuron (nerve cells) pre ent in a baby' brain a there will be
in adulthood. Mo t of the e ell wrn not be replaced if they die, although
th re are a few exception . For example, the et of nerve cells in olved in
mell and ta te in the olfactory nerve are continuou ly replaced through-
out life. However, the number of neural connection betw en brain cell
i relatively mail at birth and it i not until a hild i around ix year of
age that the den ity of neural connection will be about the ame a in
adulthood. In thi way, the learning that take place in early childhood ha
a chance to hape the growing brain.
During the fir t year of life, there i a ma . ive increa e in the brain' ize.
By two year of age, the ize of th brain and the relative proportion of its
parts are ba ically the ame a tho e of an adult. The brain of a typical full­
cerm infant weigh 350g (12oz) at birth; 1kg (2lb 4oz) at th end f the
fi t year; 1.2kg (21b 11oz) at age 6; ab ut 1.3kg (31b) at puberty; and about
1.Skg (3lb Soz) at adulth od. The virtual trebling of brain weight during
the fir t year i a growth rate unique to human , owing to the fa t that ail
human babie are born with relatively immature brain - if the brain was
any larger, the baby' head would be unable t pa through the m ther'
birth canaJ. The rapid increa e in ize i mainly due to three hanges: the
rowth of pre-e i ting neuron ; produ tion of the many upporting glial
cell between the neuron ; and a thickening of the heath (myelination)
around the axons that link neur n together.

Mental development
In early childho d, many important change ur 111 the brain that
explain the way we behave, remember and think about ur elve . In gen­
eral, the proce of mental maturati n t rt in th more pnmmve
cru ture in the middle of the brain and continue upwards and outwards.
For example, young babie di play imple emotional rea tion owing to
a tivity in the limbic system (whi h i inv I ed in in tinct and mood), even
thou h they are not yet con iou of their motion . Ider babie develop
the ability to recogni e and under tand imple patial relation hip , uch a
when adults play 'peek-a-boo' - hiding an bject and urprising the baby
 H E A L I N G T H E B R A I N 131

when it reappear . Thi occur when the parietal cort x (the outer, ide
ABE 13 part of th brain) bee me active. The frontal lobe al o become active
during the fir t year, o that a baby will tart to make imple deci ion ,
uch a choo ing between two toy .

Language and memory

uring the cond year, development in Wernicke's area (a part of the
cortex on the left ide of the brain) enable a child to begin to under tand
poken language. ome month later, increa ing maturity of Br ca' area,
which i ituated close by, aUow the child to tart to peak. hi i why
children are u uaUy able to understand what i said to them before they
can speak them lve . It may al o partly explain why, around the age of
two, toddler are prone to fru tration and even tantrum - they d n't yet
have the verbal abilities to explain what they want. However, this i u u­
ally a brief period of ju t a few month , and children then g on to
develop impre ive verbal kill in a very hort time: by the age of six they
wiU have a large vocabulary and, ven more impre ively, b able to under-
tand and u e the majority of grammatical rul - u h a reating plurals
and u ing pa t, pre ent and future ten e , without even being aware of
what they are d ing.
ne rea on why mo t of u annot remember much of our fir t two or
three year of life i becau e the hippo ampu - where the brain tore
long-term memorie - doe not mature until then. However ome em -
tional e, p rienc from early childh od may be cored in the amygdala,
which may be functi ning hortly after birth - although the e will only
ever be recalled a emotional tate • rather than e, plicit memorie . The
fact that our earlie t con ciou memorie generally date fr m th age f
two or three may al o be connected to the development of language and
the emerg nee of a en e of elf-awarene , whi h occur from around 18
months of age onward

""' ':'
- �;rr· "" . .. ' . �� ',-·----, �
···
-.., "11'4�.._ �""'��
r
:
..-

' ..
FACT FILE . �
..:.'/ · .. � · ·. ·.. .
. �·"i· . ...
..
.. .. . .

AN AGEING POPULATION • The number of people aged 100 or

Today, people in the developed world over in the UK:

are livint lonier and retainint their
health better than any previous
ieneration. This is demonstrated by
the dramatic rise in the proportion of
older people in the population in the
last few decades:
• The number of people aged 80 or
over in the UK:
in 1961: 1 million (1 per cent)
in 1991: 2.2 million (4 per cent)
in 1951: 271
in 1971: 1185
in 1991: 4400
in 1997: over 8000
in 2001 (estimated): 12,000
• The greatest age ever attained by a
person that can be verified by reliable
records was the 122 years reached by
Jeanne,Louise Calment, a French
woman, who died in 1997.
132

Puberty and young adulthood

Puberty i a vital time f, r brain development, but the hypothalamus
(whi h i entral to the body' end rine and nervou ystem ) mu t
mature before puberty begin . Although small amounts of ex h rm ne
circulate from the time of birth, during childhood the e appear to inhibit
the hyp thalamus. At puberty the hypothafamjc cells become le s en itive
to 1::x hormone and o new hormone - gonadotrophin - are relea ed,
which timulate the pr du tion of te to terone by th te te in boy and
oestrogen by the ovarie in girl . The ex hormones are th n allowed to
reach high enough level to timulat the growth of econdary x char­
a teristic and to upport mating behavi ur.
ertain ar a of the brain do not ,nature for many year . or example,
one rea on that chi_ldren often ha e a hart attention span may be due to
the fact that the reticular formation (at the ba e of the brain) does not fully
develop until puberty r even later. imilarly, the rea on that younger
adults are often more emotional and impul ive than older people may be
becau e of the relatively late dev lopment of prefrontal I be area , wher
rational pro essing of emotion take place.

The older brain

B tween the age of 20 and 75, it i timated that an averag of 50, 00
neurons die ea h day. In a healthy person, thi los adds
up to roughly 1 per cent of the original neuronal
complement. By the age of 75, the physical weight of
the brain i about nine-tenth of its maximum and
blood flow through the brain ha reduc d by aim t
one-fifth. A lo s of neurons doc not ncce. arily mean
a comparable lo s of function, how er - om los

The term 'dementia' covers a FQUP concentrate, follows, together with

of diseases that affect the normal
functions of the brain, causin1
memory loss, confusion and
personality chan1es.
• Some degree of dementia is thought
to exist in about 10 per cent of people
over 65 and 20 per cent of over·75s.
Alzheimer's disease - a progressive
form of dementia - is diagnosed in 80
per cent of these cases.
• The main symptom of Alzheimer's is
intellectual impairment, the first
indication being defective short-term
memory. Loss of other intellectual
functions, such as an inability to
personality changes.
• It is a myth that Alzheimer's disease
only affects old people. Although
usually diagnosed later in life,
particularly over the age of 70, initial
signs may appear as early as the mid·
30s. Early diagnosis may help prevent
further problems and many symptoms
can be treated with modern drugs that
boost neurotransmitter function.
• Evidence suggests that Alzheimer's
patients who keep mentally active can
maintain their thinking abilities.
Reading, writing and attending adult
education classes could all help.

"It put Mum under so much
stress. It's like having
another child to look after.
Sometimes though you have
to laugh. I mean, Gran really
believes I want to steal her
underwear!"
Lizzie, 16, whose grandmother
has Alzheimer's disease
Mental gymnastics Keeping the brain
active throughout life, from youth to old age,
is vital. Playing cerebral games such as
chess is an ideal way to challenge the brain
and maintain healthy neural networks.
H EA L I N G TH E B R A I N 133
may be compcn ated for by the formation from viable neuron
of new branche of nerve fibre and by the production of new
ynap e . Thu , by learning new things and olvin problem we
can maintain or even improve brain fun ti n - new connections
are created whenever we learn omething ne'v , but if we do n t
timulate our brain the conne tion will become d pleted. A
we get older, ur brain do become le s adaptable, but neverthe­
le , there are n known lirnits to the amount of information we
can store or the amount of learning we an enj y thr ugh life.
ne reason why p ople sometime feel le apabl ' a th y get
older i be au e, in the We t, there i often a belief that ag ing
cau e a d cline in intelle t. In c ntra t, elderly hine e people
are held in high esteem, valued for th •ir life-I ng knowledge and
wi dom.A 1994 tudy found that a group of ld people in hina
performed mu h better on memory te ts than an equivalent U group.
he r ear her on luded that negative stereotype about ageing can
become self-fulfilling prophecie - in ther word , the low expectation of
elderly Am rican meant that they were not in Jin d t ontinue with
a tivitie that would help them to maintain good memorie .
Differences between the sexes
There are some ex differen e in ageing: overall, men lo e their brain
ti ue ear)jer than women and lose more of it. Thi particular! applie to
th frontal and temporal lobe - area concern d with thinking and feel­
ing. hi ould a ount fl r ome of the per onality changes that oft n
chara teri e older men, uch as irritability. W, m · n n the other hand, tend
to lo e brain ti ue in the hippocampus and pari tal area - where mem ry
and i uaJ- patial abilitie are located.Thi could e 'plain why ome elderly
women have diffi ulty rem mbering things and finding their way about.
·-··
.........,,,. --­
., ....-
TRY IT YOURSELF
___ -"'
..... s. How old do yQII think other people
belinlyo11n?
,.,,,,,.. You will probably Ind 1hlt YGII IIM
diffarent 11111 tor some or Ill of thlle
questions. but this IPPll'lnt
lnco11sist11q is quil9 normal.
Generally. from the age of about 20
onwns, we USU111J delaibe ourselves
• falling younger thin we actually are
- Ind thlt applies even to people In
1helr 70s Ind 80s. This could suggest
1Mt dnnologic:ll 191 is ralltively
unimpor1lnt when It comes to taldng
lbout the 'Wiii being of your brlln.
_ IDEAS IN ACTION
When it comes to keeping your brain fit, the adage 'use it or lose it' applies. The
questions below are aimed at helping you decide how well your brain functions in
seven key areas. Answer them honestly and see what you score in each category.

HOW FIT IS YOUR BRAIN?

If you have only one 'yes'
answer in any category
(or none at all), you may
want to build up your mental fitness in that area - so check the suggestions for
activities to help you develop your brain power. But remember, we are all better
at some things than others, so don't expect to excel in all areas. YES NO

VISUAUSPATIAL SKILLS
Do you usually see pictures in your mind's eye when you read
a book or listen to a piece of music?
DD
Do you have a good sense of direction? DD
Do you find it easy to 'see' visual illusions?
DD
You can improve your visual and spatial skills by:
• Doing the map reading on a long car journey or to somewhere new - see if
you can plan the route and navigate to your destination.
• Joining a sketching or life-drawing class and learning how to represent
what you see visually.

Are you good at convincing someone of your point of view? DD

VERBAL SKILLS Is a verbal sense of humour one of your strong points? DD
•
Do you find others ask your advice on grammar, spelling,
or the meaning of uncommon words?
DD
You can improve your verbal skills by:
• Becoming active in a group or society that interests you; having to put across
your point of view to a group will make you think how to present it.
• Taking up writing short stories, poetry, or even letters to friends; this will help
you to develop ways of expressing your thoughts and feelings in a creative and
evocative way.

Do you prefer logical ways of looking at life? DD

LOGICAUMATHS SKILLS Are you good at working out what legal documents mean? DD
Do you quite enjoy doing arithmetic and mathematics? DD
You can improve your logical and mathematical
skills by:
• Challenging yourself with puzzle and problem-solving books.
• Not always using your calculator but practising your mental arithmetic
skills while at home and at work.
 HEA L I NG TH E BRA I N 135

YES NO

Can you catch a ball with one hand? DD

BODILY/MOVEMENT SKILLS Do you find dance steps easy to learn? DD
Are you reasonably good at sports? DD
You can improve your bodily and movement skills by:
• Taking up a game like tennis, badminton or table tennis and playing against
partners of a similar standard.
• Joining a keep·fit, line-dancing or other dance class - not only will you get
fit but you will also improve your coordination.

MUSICAL SKILLS
Can you tell whether your favourite artists are playing or
singing simply from their sound?
DD
Do you find it easy to keep to the rhythm when dancing?
DD
Can you remember the melodies of songs after just one or two hearings?
DD
You can improve your musical and rhythmic skills by:
• Joining a music appreciation class.
• Learning to play a musical instrument, or joining a local choir - it won't matter
if your voice is not very strong as it will develop in time.

INTERPERSONAL SKILLS
Do you often find yourself naturally seeing things from other
people's points of view?
DD
Are you good at not giving away your feelings?
DD
Do you find you can anticipate what people will say or do?
DD
You can improve your interpersonal skills by:
• Trying to find different ways of understanding why someone
has behaved in a particular way - irrespective of its effect on you.
• Considering how your words or actions might affect someone.

Do you find you can usually explain how your own feelings arise?
DD
INTRAPERSONAL SKILLS Do you find it easy to change yourself when you realise that change is
needed?
DD
Do you especially like 'psychological' films or novels that focus on
people's motives and emotions?
DD
You can improve your intrapersonal skills by:
• Sharing your reflections about yourself with someone who knows you well -
they may have a more objective viewpoint.
• Reading self·help books that focus on emotions such as anger or anxiety that
you eKperience frequently.
136

LIFE EVENTS
Throughout our lives, we encounter significant 'life events'. While every person is unique,
there are certain occurrences that will be experienced by nearly everyone - such as
forming close relationships, changing jobs and coming to terms with bereavement.
Reactions to such events can have a major bearing on mental well-being.

Re earch ha found that there arc widespread similarities in how people

FACT FILE
BENEFITS OF MARRIAGE
• Married people tend to live
longer, and be healthier
(mentally and physically) and
happier than unmarried people.
• Men benefit most from
marriage. This is perhaps partly
due to men having fewer
confidants outside marriage and
because wives can provide
emotional support.
• Couples who live together
before marriage are more likely
to divorce later, or be more
dissatisfied with their marriages,
than those who don't cohabit.
rate the up et cau ed by ignificant life event , regardJe s of differences in
age, gender and religion. For e ample, events u h a marital eparation,
divorce and bereavement are all ranked a highly tre ful.
Marriage and parenthood
Tw ignifi ant life events which tend to o ur in early adulthood are
marriage and parenthood. The va t majority of adults marry at I a t on e,
and resear h show that marriag ha both p y hologi al and physi al ben-
fits. A U study found that twice a many married people de ribed
them elve a being 'very happy , compared to tho e wh had never mar­
ried. adly, about 40 per cent of marriage in the UK - and even m re in
the U A - nd in divorce, with rate being highe t during the fir t five
year of marriag and peaking again after 15-25 year . f ourse, for ome
people, divorce can be a relief from an unbearable ituacion.
Parenthood u uaJJy tarts when people are in their 20s or 30 • nd, in
We t rn ocietie , is exp�rienced by about 90 per cent of people. Having
a hild can vary more in personal impact and meaning than any ther life

psychoanalyst Erik
Erikson, we all go
through eight stages
of psychosocial
development, each
stage involving a
central personal or
social relationship.
Erikson believed there
is much variation in
how people cope with
each stage, and that
this influences how
they cope with
subsequent stages. Age 0-1 Stage 1 is Age 2-3 Stage 2 is Age 4-5 Stage 3 is Age 6-12 Stage 4 is
characterised by trust characterised by characterised by characterised by industry and
in self and others. increasing independence. showing initiative. working hard. Social focuses:
Social focus: mother. Social focus: parents. Social focus: family. school, friends and home.

Childhood: Erikson's stages 1-4

 H EAL I NG TH E B RA I N 137

event. he Amer ican p ychologi ts Jeffrey Turner and

THINK AGAIN!
DonaJd Helms ugg t four rea n why many people
have children: to e>..1>erience a en e f a hievement;
to give and receive love; to fulfiJ cuJtural xp ctation ; THE EMPTY NEST SYNDROME
Some parents, especially mothers, have in the past
and to gain a en e f importance.
reported a period of depression when the youngest child
grows up and finally leaves home. This may have been due
Unemployment and retirement in part to society's view of women primarily as mothers.
Another cr itical life event i unemployment. Thi may However, recent research suggests that most parents
lead to an iety and depr ssion, and there can be today do not find their children's departure from home a
damag to elf-e te m, e pecially if the rea on for distressing time - far from it, in fact. Many report that it is
a liberating experience, and they welcome
unemployment i felt to be per nal incompetence,
the new opportunities
or if redundan y occur with littl or 110 warning.
it brings, such as a
Another major factor i the reduction in o ial upp rt closer relationship with
owing t the lo of contact with olleague . o their partner, returning to
counter u h pr blem , it i important for anyone who education and pursuing
is made r dundant to keep a ti e and to eek the help hobbies and interests.
of friend and profc ional . With po itive attitude
redundan y can even lead to new and ti.mulating opp rtunitie , uch
a m ving into another area of work entirely.
Retirement, whi h usually happen in late adulthood i u ually anti -
ipated, and experien ed without too much p y hological upheaval. There
i often an immediate feeling of r lea e and celebration - a 'honeymoon
p riod' - but there is al o a danger that thi may b followed by emptine s and
fru tration if po itiv tep are not taken to adju t . It i important t d vel p a r ali tic and
flexible view of life' alternative and t become actively involved in a new lifestyle, by pur-
uing personal interests, for example, r getting involved with the community.

Age 13-19 Stage 5 is Age 20-30 Stage 6 is Age 30-60 Stage 7 is 60 + years Stage 8 is
characterised by the characterised by a commitment characterised by productivity characterised by the
development of identity. to intimacy. (for self and society). gaining of wisdom.
Social focus: peer group. Social focus: friendship. Social focus: household. Social focus: humanity.
Adolescence and adulthood: Erikson's stages 5-8
138

PSYCHOLOGICAL DEFENCES
To cope with what life throws at us, we develop 'psychological defences' - patterns of
behaviour that can lessen our anxieties in response to what is going on. These defences
are often automatic and unconscious, but are vital in allowing us to get on with our lives.

igmund Freud, the father f p y hoanaly i , de ribed

Sigmund Freud (1856-1939)
A fundamental part of Freud's
approach to the mind was the
division of the mind into three
parts: id, ego and superego.
Freud believed that the ego -
the conscious, rational part of
the mind - developed defence
mechanisms to protect itself
and to reduce anxiety. Today,
psychologists talk in terms of
'coping strategies' rather than
defence mechanisms.
p y h 1 gi al d fen me hani m which we all
employ to protect our el e from thoughts and e pe­
rience that ould be p ychologically damaging. or
example, denial prevent u from thinking about
unwanted, thr at ning r otherwi unplea ant itua­
tion r feelings. In everyday life, and in mall do es,
thi can be useful - su h a not dwelling on the po -
ible danger when riding a motor ycle. A rea onable
level of denial allows u t remain optimi tic and ab)
to cope in mo t cir um tance . metime however,
denial can be unhelpful: for example, when a heavy
drinker won't admit that he or he has a problem.
Another defence mechani m i repre sion - pushing
down into the unc n iou unac eptable fear or
wi he . A gain, in moderation, thi i ne_e ary for p y­
chological survival. If we were on tantly aware of all
the traumas and tragedie that e have experien ed,
then we would find it h. rd t get on with our live .
R.epr ion allow u to ope, even after traumati
event uch a bereavement. A with denial, too

Ah, that's better! I know I shouldn't Louise, where are

smoke, but I'll probably be hit by a car those reports? They
before cancer should have been
gets me. ready hours ago.

7:JOam: DENIAL John skips breakfast
and instead lights up his first cigarette of the
day. In refusing to acknowledge the long·term
health consequences of his smoking, he
doesn't accept the reality of his situation.
8:JOam: REGRESSION John is late for
work. He feels aggrieved at being told off,
but rather than explaining why he was
delayed, he reacts by reverting to sullen,
childish behaviour.
1 OOpm· DISPLACEMENT Still upset by
the dressing-down he received earlier on,
John snaps at his secretary. He has displaced
his bottled-up anger about his boss to a less
threatening target.
 H E A L I N G T H E B R A I N 139

THINK AGAIN!
Hiroshi Azuma, a Japanese
psychologist, has suggested using the
advice from old Japanese proverbs to
help accept things we cannot change or
control. Examples include the following:
• Willow trHs do not pt broken by
piled up snow (being flexible prevents
us from being 'broken').
• To loSII is to win (giving in to
someone shows the superior traits of
self-control, tolerance and generosity).
• TrUII tolerance Is to tolerate lhll
intolerable (some things that are
'intolerable' are facts of life).
By applying these principles at home,
at work or in social situations, we could
perhaps protect and improve our
relationships with others.

much repr ion an be harmful, but mo t of the time, our mind are very good
at protectin u , enabling u to forget pa t even and 'move on'.
ther Freudian defence mechani m in Jude ublimation, pr �ection,
rationali ation and regres ion. ublimation i the redirecti n of unacceptable
th ughts r impul es into acceptable actions: for example, going t the gym or
digging the garden after an argument rather than venting the fru tration on
meone 1 . Projection i the mean by which a per on attribute their own
unplea ant thoughts or impul e to another individual - for example a parent
who i afraid f heigh rnight say to a child 'you w n't like that roller oa ter,
it will make you i k!', thu avoiding the potentially unplca ant experien e. In
rationali ation, threatening idea and explanation of behaviour are replaced by
non-threatening one - a per i t nt gambler might convince him elf he i
doing it to in money for hi family. Finally, r gre ion mean reverting to an
earlier stage of p ychol gical development when under tre - in other word ,
bee ming more child-like, uch a an older child tarting t a t younger when
a new baby rrive in order to get more of the parents' attention.

... and I just couldn't concentrate

because I was worried about
Mum going into hospital for
her knee operation.

3:00pm RATIONALISATION Over coffee
John tells a friend why he failed his driving
test the previous week. But his apparently
rational explanation does not give the real
reason: he failed because he was unprepared.
6:00pm. SUBLIMATION After work, John
heads for the sports centre. He uses his
anger and frustration over his unsatisfactory
day at work to convincingly beat his
neighbour at squash.
8:30pm: PROJECTION At a drinks party,
John feels socially awkward. He projects his
own negative feelings onto the other people
there, and blames them for not wanting to
talk to him.
140

DAMAGE AND REPAIR

The human brain, like the rest of the body, can be damaged in a variety of ways - through
physical injury, or disease, or genetic inheritance. Yet the brain has remarkable powers of
self-healing and adaptation, and is often able to regain its function after damage.

As we go through life, our brain can be physi ally affected by influen e fr m in ide and out­
side the body. While the brain i equipped with prote tive me hani m ( ee page 146)
om ·time the e ar n t quite n ugh. ometime , too, brain do not get the be t tart in life,
a ertain geneti di eas (tho e pa ed on through the gene ) an affc t the brain. amage
to the brain au ed by genetic problems i often apparent at birth r in earl hildh d.
all uch damage i inherited: it 111, y be au ed by chan e mutation , r pr bl m in th way
the geneti material from perm and egg ombine at onception u h as in Down's syn­
drome. When genetic di ea e are inh rited, it may b many years before the ymptoms are
noticed - a , for example in Huntington's disca e, which often d e n t appear until the
per on rcache the 3 or 40s. ome di ea es that au c neural damag may have a
genetic component but arc not dir ctly inherit d - for example, multiple s lc­
ro I and AJzheimcr's di ca e.

Damage through life

ver 90 per ent f people over 65 how little dcterio­
rati n in mental abilitie , and even very late in lifi
nerve cell in the brain eem capable of forming new
connections with other neurons. hi ontinuou
building of conne tion between brain cell i what
happ n during life! ng learning, a11d it is a power­
ful argument for the importance of education
throughout adulth d.
It is true, however, that certain mental abilities, su h
as being abl to olv new problem , eem to ollcc­
tively decline omewhat lat r in life. The e abilitie ,
referred to by p ychologists a 'fluid intelligence' , may
be affected by a natural proces f redu ed effi icncy in
the functi ning f brain ell as we get ld r.There arc
veral the ries ab ut why thi d terioration oc urs
in the brain a well as the body. ne recent theory
fo use on th role of mitochondria. he e 1niniature
'energy generator 'exi t in most human ell , p ducing the energy
required fj r general ti u maint nan e and sp ciali t u age, such as
the needs of mu le cell . It is known that decrea ed mu cle u e re ults
in fewer mitochondria in the cell , which in turn leads to a de reased
mu cle capacity. Future re earch will perhap determine whether a similar
proc ss of dimini hment o curs in the brain. If that pr ve to b th a e, then it may
be pos ible to find way to top or v n reverse the age-related d line in energy production
by ex r i ing the brain.

Allhoufll boxln, cont/nun to I»
popular, mny flllOPII IHI that an
activity wtlole main objectin is to
injure one� opponent - and if possible
,,,,,,., hi• unconscio111 - is
unacceptable In a clrillud society.
For these reasons, professional boxing
has been banned in some countries,
induding Sweden, Norway and Iceland.
Despite stricter medical supervision
in recent years, professional boxers are
still regularly disabled by brain damage
sustained in the ring, and the 'punch-
FACT FILE
THE DANGERS OF
ALCOHOL
• Short-term harmful effects of
alcohol on the brain include
dehydration of nerve cells and
functional problems such as
temporary loss of memory.
• Chronic alcohol abuse may
lead to major personality
changes including a decline in
intellectual abilities and social
skills, as well as severe
memory loss (amnesia).
• Approximately half of all
motor vehicle fatalities in the
developed world are alcohol­
related. In the UK, 0.8g/litre
(80mg/dl) is the maximum
permissible blood alcohol level
for driving; levels are lower in
other countries.
• Alcohol is involved in about
30 per cent of all suicides and
plays a particularly significant
role in adolescent suicide.
• Excessive drinking in
pregnancy can cause foetal
alcohol syndrome, leading to
problems in newborn babies.
H E A L I N G T H E B R A I N 141
drunk' syndrome (post-traumatic
encephalopathy) continues to occur.
Amateur boxing also involves repeated
blows to the head that can cause short
and long-term brain damage, in spite of
the widespread use of headguards.
As numerous medical reports from
around the world have shown, any shuffling gait and parkinsonism, a
severe blow to the head causes syndrome with symptoms and signs
concussion and the death of brain cells. resembling those of Parkinson's
There will also be cases when, as a disease. The former world heavyweight
result of head injury, the nerve fibres champion Muhammad Ali is the most
separate. This leads to dementia, a slow, famous sufferer of this syndrome.
ther ur f brain dam< em Jude physical injury; infection; expo-
ure to toxic ub tan e (in luding drugs nd alcohol); and inadequate
nutrition uch a vitamin deficiencie . All of th e fa t r an au dif­
ferent degree of damage, depending partly on individual u ceptibility.
Among neurological disea e , multiple sclero i (M ) i the mo t
ommon uch di ea e in young adults, affe tin the central nervous
y t m. The main problem i the br akdown f the myelin h ath around
nerve fibres. hi low down and interrupts normal ignals betwe n
nerve cell typically cau ing a gradual deterioration of sen ory input to
the brain - for e, amp) , lo of vision owing to optic nerve damage - and
movement diffi ultie . How v r, the di a e i not alway progre ive, and
treatments are available to help with the ympt m , in luding many
complementary therapie . omc people with M have found cannabi
helpful, and re earch n ub tance contained in cannabis is continuing
with the hop of developing a u eful - and eventually legal - drug.
Re-establishing connections
When neuron are de troyed, by whatever mean they cannot be repla ed
by n w nerve ceU . However, the human brain i very adaptable and, in the
event of damag to me neur n , new onne ti n fr m other urviving
cell can grow thereby taking over the functi n of mi sing c 11 and
bypas ing area of damage. Thi i the means by which stroke victim an
ometime ver ome, or at lea t reduce, the physical disabilitie that a
troke ha cau ed ( ee page 144).
he formation f new onne tion 111 the brain i • hieved by the
growth of dendrite and axon from nerve cells. he maller bran h - the
dendrite - gr w out of the celJ body, enabling each neuron to conne t to
hundred or even thou ands f ther . a h neuron also ha at least one
a ·on, which can b anything fr m a fra tion of a millimetre in length to
a metre or mor . Dendrites receive ignals from other cell , wh r as a on
142
1. CONNECTIONS
INTACT

Surviving
neuron
Helllng ........... .
partkullr ........ Oii crlllini •
....... 1111Dr11M IIWinll..... D Is
............. whit elamenla
2.NEURAL you wish ID induda in ,u garden. This
DAMAGE OCCURS oflln ......... " coune. Oii Ille current
stale ",.... 9ll'dln and how n,ch
effort you wa to put into transforming
Damaged it. Here .. six elements that ,OU may
�------ axon wisll ID felbn.
3. REPAIR
TAKES PLACE
Collateral sprouting
The surviving neuron
attracts an aKon branch 11lil 11111111111t ...- 1*1 GI Ille 11111111111
"°"' .. ..._.,...,.,
from a nearby undamaged ...., • illlllJ • nuld bea mctu.y
neuron h 1111 .......
......,,,1,,,1111-c1-..111c11g
,OU N1J fronl tlll l'llt GI Ill ...... to I -
Regenerative sprouting or blndl, perllrps blneltll I pergola.
The damaged aKon regrows
to hnk up with the next
neuron
APGldorllllll-ain...._tlll
........, GI I prden.1111 IOUlld GI Wlllr ls
IOOCNnl and ...., ... to ..... UIWlnlld IIClisel
Making reconnections After the death or injury of brain cells, new connections can be '"""ouaide 1111 prden.
made in two ways: a neuron can redirect its existing axon to a surviving neuron (regenerative
sprouting), or a neuron can grow an additional axon branch (collateral sprouting).

end ignal to other cell . When nerve ell are damaged, it i therefore
calllill-............,
1111 collul In tllil 1*1 GI Ille oar- nuld be
blues, ....... .
w1i111. PIIIIII CIDUld lndudl .......... fsns,
po ible for other neurons to take o er their fun tion by tabli bing new lllgonils, llld.., ...... Rultlint .....
wil Clldl tlll breea llld 0-. I .......

......
conne tion . The quality of connection in the brain i crucial. When a nallnl ............ trees prowlde
slllde llld..., llelp to ...... alt surraunclillg
nerv cell end a ignal along it axon to another cell, the peed of the
ignal depend on the diameter f the axon and the thi kne of the
myelin heath that urrounds and insulate it. In a healthy per n, the
A wooden ardlwlly wil llllp to ...... 1111
peed of nerve nduction can be up to 220 mile per hour (350 km/h). CICllamc,lllift na fnllll 1111 l'llt GI 1111 garden.
However when th myelin heath i damaged, a occurs in M , then the An .-di Is I simple, elegant shape that
empt1sl111 lrlnslliall, llld passing tllrough
nerve ignals low down or may be prevented fr m rea hing their de ti­ it wil encourage ,OU to enter I IIIOrl rllDed
frame of mild.
nation altogether.

Glial cells: a supporting role Tum one pert of ,ac,r garden ii*> an aru for
growing herbs. Not only wil lllese be fragrant
Apart from the neuron , oth r ell in th brain - particularly th glial cells and useful for coolcing, but tiler can llso be used
- have an important upporting r le in keeping the brain functioning. lo lrelt various alments. For mmple, mint and
fennel lid digestion; camomile promotes restful
here are appr ximately ten times a many glial cell a neur n , and th y sleep and helps sldn problems; llld llwlncler and
l'OSeffllrY ease heldaclles.
are gr uped int different type , each with p cific function . ne type
form the myclin heath around axon , acting a in ulators to peed up
nerve ignal . Another type, the ma rophage, i parti ularly u eful when
In conlnlst lo Ille aru for quiet contemplltion,
damage occurs becau e it help remove the debri of dead cell . A third tllil is somewhere lo ut outside or erar1lill
type, the a trocyte , help to protect neuron by' panging up' any ex e ive friends. n cou1c1 be enhanced by 11y1ng • Pltio
for a table and cllei11 or building 11*11Q11,
or toxi hemi al , n ur ing that neuron have a healthy environmcnc. lf a or by lncludlng plants and flowers that hM
neuron is damaged, astro yce will in rea e in izc and number and rel a e stimulating colours sudl IS ,ellow pansies,
orange ffllrigolds, red-hot poters, scarlet
chemicals to aid neural growth and repair. dallllas and IIISlurtiums.
 HEALI NG THE BRAI N 143

The idea of a healing garden is to create a haven of peace and beauty. The benefits of such a garden are
becoming increasingly recognised, as people realise that relaxation in a spiritually restful environment can
maintain mental well-being and even enhance recovery. The therapeutic effects of plants have been known
about for thousands of years, and modern-day healing gardens should be filled
with plants and flowers that stimulate the senses with their
fragrance and colour. With a little effort, any ordinary
garden can be transformed into a healing
garden. This is one possible design,
incorporating some of the features that
are believed to be beneficial.
144

LIFE AFTER STROKE

Stroke is one of the commonest causes of brain damage. However, the effects of stroke
are not, as was once assumed, necessarily irreversible. Brains - even older ones - are
incredibly 'plastic' and, with the right encouragement, they can rewire themselves to
compensate for the damaged part. Research has shown that the brain can generate
new connections after a stroke and recover some of its lost abilities.

trok oc ur when a major blood ve cl in the brain bee me bl eked, r

rupture . Thi reduce the uppl of blood and oxygen to the brain ti ue,
kiUing brain cells. Even a brief interrupti n to the blood flow can decrea e
brain fi.in tion. If the interruption la for more than a few e onds, cell
are destroyed cau ing permanent damage to that area f the brain.

Varied effects of stroke

The ffe t of tr ke depend on the "The widespread
am unt f ti ue damaged and th
r gion of the brajn in v hich it o cur .
misconception that
W ith ome stroke a few moments of nothing can be done
dizzine r pain i all that the victim i
awar of. But a maj r tr ke an kn k about stroke is
out a large part of the brain.pr ducing being swept aside as
radical change in a person' b haviour
or abilitie . A stroke in the area that new prospects for
control movement, for e ample, may
paraly e a limb r ven on ide f the
prevention, acute
body. A troke in Broca' area in the treatment and
left hemi phere will disrupt p ech
while ne further ba k in Wernicke'
rehabilitation come
area wiU au e problem with under- to the fore."
tanrung language. Fr nt-brajn damage
often re ult in per onality hange , Scrip report on stroke, 1998
uch a depre ion or, conver ely, per­
manent optimi m. Damage to the
temporal lob may remove a ver ifi type f kno I dge, uch a
names of peopl, and places, v hile a troke deep in the limbi y tem may
eradicate per onal memories.

Recovery and regrowth

Re overy after troke can be low, ruffi ult and ometime nly partial.
However, it appear that healthy brain ti sue can often tak ov r the ta k
of damaged adja ent region . Re earch u ing magnetic re onance imaging
(MRI) t find out which parts of the brain take over from damaged area
i helping to preruct how much recovery i p ible and whether rehabil­
itation i worthwhile. In the r i ht circum tances, and with the right

New,,,,,.,,.,,,,,...• l#lpllf6
llrOlr• rldl• to ,_ loll abl/llJn.
,,,,,,,,. ,,.,..,,, imlolrN t:Olollr
,,,,.1a,
ltCOfll/tlon, ltllllld Mid word
.,,.,,,;lalion, Mid •lWllfl.
'°"""""°"'·
rtlllt n -,,,.;, on �
Developed by a jazz drummer, and
recognised by the Swedish medical
establishment, rhythm therapy has been
FACT FILE
PREVENTING STROKE
Factors known to increase the
risk of stroke include high blood
pressure, high cholesterol, old
age, diabetes, obesity, a
previous 'mini-stroke', heart
disease, smoking and heavy
alcohol use. While some factors
(such as age) cannot be
changed, there are ways to
reduce the risk of other factors:
• Have your blood pressure
checked regularly, and take steps
to keep it in the normal range.
• If you are diabetic, ensure
that your blood sugar is well
controlled.
• Don't smoke.
• Lower your cholesterol by
reducing your intake of fatty,
high-cholesterol foods.
• Exercise regularly (but check
with your doctor first).
• Drink only in moderation.
H EA L I N G T H E B R A I N 145
shown to enhance short-tenn memory, what the colour symbol ls while
improve movement control and help performing the corresponding
impaired speech. movement in time to the rhythm.
Patients learn sequences of music A major advantage of rhythm
and movements, beginning with easy therapy is that it's fun, allowing the
sequences and gradually inaelSing the brain to be dlallengecl In an enjoyable
complexity and speed. The therapist way. And it seems to wort: the all-round
helps them to tollow the sequences, activity stimulates the growth of healthy
using colotnd symbols that represent new connections, creating alternative
cflfferent parts of the body. Patients say paths around damaged areas.
attitude and upp rt, dramati improvements can be mad in quality f
life. Wherever the damage occur the brain ha an in-built capacity for
elf-repair, and on f the primary ways of trigg ring thi is thr ugh ther­
apy. Thi can be either phy ical or mental, but th aim of all therapie i t
encourage the development of new connection . n a large cale the e
new connections lead to whole brain area taking n task pr>viously car­
r ied out by damaged ar as. In ome people ith language problems, for
e, ample, the brain reorganises itself o that the right hemi phere take over
the ta k f proce sing word . Thi is m r likely to happen in women than
men because a gre ter pr portion of w men already ha e langu ge abili­
tie in both brain hemisph re , in tead ofju t ne.
The extent to whi h the brain an rewire
itself depend largely on age: the
younger the brain, the more readily
it reco er . owever stimulation
pra tice and novelty can 'excite'
even older brain . Whatever your
age, the m r · a tiv y u keep
your brain, th more hance it ha
f mpen ating if it i damag d.
Self-repair The area affected by stroke is
vividly shown up on this MRI scan, with
affected tissue coloured red. In some cases,
the brain is able to re-establish connections
and regain abilities that were lost.
146
PROTECTING YOUR BRAIN
The outer part of the brain - the cerebral cortex - is responsible for the brain's higher
functions: consciousness, thinking and interpreting the senses. The delicate tissue of
the cortex is extremely vulnerable, so nature has provided protection on three levels:
physical, chemical and biological.
Delicate structure The brain
sits within the hard, protective
covering of the skull. Other
mechanisms that serve to shield
the brain from damage include
the meninges membranes and
cerebrospinal fluid.
It is hard to over tate the importance of protecting the brain
from injury. Apart from the obviou immediate damage
cau ed by blow to the head, sign ificant harm an
o cur whi h i n t noticeable until much later.
Repeated blow to the h ad, a o cur in boxing,
for example, can cause brain damage, and recent
re earcl, how that a history of head injury
an be a ri k factor for Alzheimer's di ea e.
Physical protection
The main phy ical protection of the brain
i provided by the cranium , or kull,
which on i ts of cveral plate f bone
joined together. The e are typically only
a few millimetre thick but they u ually
provide ufficient protection again t day­
to-day kno k and fall .
me a tivitie require extr physi al
protection for the brain. Helm ts help
to minim.i e the effects of forceful blow
to the head, whether the potential ri k
comes from riding a bi ycle or m tor­
cy le, working on a on tru tion it , or
engaging in pastime uch a rock-climb-
ing. Mo t afety helmet today are made of
oft poly tyrene urroundcd by a rigid helJ
of pla tic or fibregla . A helmet . h uld be
replaced immediately aft r an ac ident, even if
there are no visible sign of damage. Protc tiv
helmets hould be w rn whenever there i a risk
of physical injury, but there ar limit to th p tecti n they provide. ince
the brain is fairly fluid in consistency, it can ea ily be damaged by being
hak n within the kull, as often happen in road ac idents.
Chemical protection
ature ha provided the brain with protection fr m many poi
hcmical in the form of the blood-brain barrier. his acts like a filter t
keep harmful ub tan c out of the brain and con i ts of glial cells (which
 H EA L I N G T H E BR A I N 147

mak up th bulk of the brain

ti ue) wrapped around the tiny
blood ve sel in the brain. The bar­
rier i o constructed that molecule Lucy, a 15-year-old student, used to before I hit the ground. At first I didn't
mu t effectively pas through two hate it when her mother told her to know what had happened, but when I
erni-permeable membran to wear a cycle helmet. However, an took my helmet off and saw the huge
accident soon changed her mind: dent in the top, I realised that could
tran fer from the blood to the brain.
'I didn't like to wear a cycle have been my head with a hole in it! At
U eful hemicals - oxygen, carbon helmet, because I didn't think it the hospital, the doctor said
dioxide and most fat- oluble mole- looked•.. cool. But I'm really glad there's no doubt that the
ule - an readily pas through th now! A few months ago, I was helmet saved my life, or at
blood-brain barrier. Alcohol can cyding along when a car suddenly least saved me from
al o pa s through, which i why pulled out in front of me. I serious brain damage.
couldn't avoid it and went flying Now I always wear
exces ive drinking over many years
over the handlebars into another my helmet, even on
an damage the brain and lead t car. My head hit the door handle short trips.'
p ychological problem .
The adult blood-brain barrier is
permeable to certain ubstance which the brain needs for health
( uch as odium, pota ium, and chlorid ), but i n t permeabl
to large mole ule , uch a protein . he blood-brain barrier in
children i le well developed, however, o young brain
are more sen itive to certain toxic water-soluble
compound , such as those of mer ury and lead.
Thi i why the u e f lead - for e ampl in
paint, water pipe and petr l - ha been bann d
or re tricted in many countries.

Biological protection
The brain and pinal ord are comp! tely urrounded
by three protective membrane layers called the
meninge , which are bathed in a clear watery liquid
called cerebrospina1 fluid.
D pite the prote tion offc red by th meninge and
the blood-brain barrier, th brain an till b infected
by bacteria and viru - the herpe simplex viru , for
example. The e infection can cause inflammation of
the brain (en ephaliti ), with typical ymptom f
h ada he, fever, izure peech diffi ultie , confu ion
and even oma. Good hygiene 1nea ure - such a care­
ful hand-wa hing - help to prevent the pread of
infection from per on to per on, and modern drugs
an targ t pe ific infi cti n on e diagn sed.v redu e
th ri k of uch infi ction arising in the fir t place,
health profes ionals recommend that all children
receive vac ination for common infection such as
mea le , mump and rubella (German mea le ), all f
whi h carry a ri k, albeit mall, of brain damage.
Menin1itis is an inftlction by bacteria or viru1t1s Ill thtl
menin11s membranes surroundin1 thtl brain. n is
pottlntlal/y fatal and early dtllection is vital. The main
symptoms art1:
• High temperature
• Severe headache
• Stiff neck
• Photophobia (extreme sensitivity to light)
• Nausea and vomiting
• A blotchy red skin rash that does not fade when a glass
tumbler is pressed against it (in bacterial meningitis only).
Anyone suffering from these symptoms - which can
occur in any combination, and are not always all present -
should be treated as an emergency, requiring urgent
hospital care.
148

MIND MEDICINES
The brain has a delicate balance of complex chemicals
which can be altered by everyday substances, such
as caffeine, as well as by over-the-counter and
prescribed drugs. Some of these mind medicines are
beneficial, but they all need to be taken with due
care, whether they are natural or synthetic.

T hroughout the world e ery day milli n of cup of tea and

coffee are ipped, and millions f can of cola are drunk.
h drink all Ont, in affeine - a mild timulant that arou e the
central nervou y tern, increa ing alertne . While thi effe t can
ometime be u fut, especially if it i ne e ary t tay a ake, m, ny
experts argue that people generally on ume far more affein th n
i g od for them. In ome cas , ex c s caffeine is r spon ibl for
p y h logi al problem uch a re tle nes , nervousness, anxiety
and insonuua. y mpt m of too much affcinc
include a flu hed face and cardiova cular problem ,
u h a a rapid pul e and palpitation . Becau e
caffeine i addi tive, people oft n find that they
experien e withdrawal effe ts, in luding a
la k f energy and headache , if th y top
drinking affeinated drink . A a general guideline,
it i ad i able to limit caffeine con umption to two or
thre cup f c ffe , day ma imum - with preferably none
at all being con um d in the lat afternoon or e ening
to avoid lcep di-turbance.

Conventional medicines
Medi ine that affe t th mind in Jude
"St John's wort
painkiller (analgesic ) and antidepre ant . has been shown
A. pirin (acetylsalicylic acid) was di covered in
1 53 in Germany, although imil. r plant-ba cd
many times to be
ub tan e have been u cd for centuries. Tod y, more effective than
it remain one of the afc t and m t effe ti e
drugs for relieving mild pain, although om placebo for mild to
people arc sen itive to its irritant action on the moderate depression, and
toma h. Paracetamol i often u ed a an
alternative painkiller to a pirin, mainly be au e as effective as standard
it i le irritating to the tomach. However i
main di advantage lie in the danger of
antidepressants. However,
verd sc, which can cause seriou irreversible safety is important."
liver damage. Wherea a pir in (and other n n­
ster idal anti-inflammatory drugs) top pain Edzard Ernst, Professor of Complementary Medicine
 H E A L I N G T H E B R A I N 149

impul e travelling from the ite of the injury to the brain, paracetamol reduce the
p rception of pain in the brain it elf. Like para etamol, more p tent painkill r
u h a morphine and other opioid drugs al work by h nging the w y we
think and feel about pain .
Mo t pe pl b om depre ed at ome time in their Jjve , e pecially after
bereavement or other lo , and thi i on idered t be a normal human reaction
which will heal in time. However ome people become lini lly depr ed for
n apparent rea on, and may benefit from pre cribed antidepr ants. Thes
drugs re]jev the major ympt m of depre sion, allowing the individual to
cope better and perhap benefit fr m p·ychol gical therapie· that may be
available in conjunction with the medicine. th r mind m di in include
anxiolyti , uch a the benzodiazepin' drug diazepam (Valium). The widely
pre ribed drug an all iate pecifi anxiety tate but dose mu t be kept I w
in order to redu e the po ibility f id effe ts.

Natural options
he t John' wort plant (Hypericu111 pc,forat11111) ha been u ed a a herbal rem dy for
depre ion sin e the time of the an ient Gre ks, who believed that it could driv out evil
pirit , and it i once again gajning in popularity. ative t urope and Asia, the plant ha
tiny leave , which contain oil glan , and five-petalled yell w flower . t J hn' wort al o ha
anti eptic and nti-inflammatory propertie , and i used in both hine e m di ine and
homeopathy. How v r, it hould be empha i ed that t John' wort i a potent ub tan e:
people hould alwa he k with th ir d tor before u ing it, e pe ially anyone taking
other medication and women wh are pregnant or br a t-f; eding.

1. MAOls (monoamine-oxldase ln.'libilm)

The first MAOI was cllsc:oYered In the 1950s, whln I tuberallosls drug WIS found
to hive llltideprasslnt properties. Reselrch suggasted it prwted the
brellcdown of monoemines (ldrwllline, IIOl'ldrenlllne, serotonin 1nd other
neurob'Mlsmitta) in the brlln. Modem MAOis include phenelzine. lpronilzld
and tnln,k.ypromine.
2.1ncyclic:s (and other rellted dnlgs)
N ITS OF EXERCISE
It is well known that physical exercise is good for health - for
example, it reduces the chances of developing heart disease.
What is less well known is that exercise can also improve
psychological well-being by reducing anxiety and depression,
and boosting self-esteem and the ability to cope with stress.

Ever yone can expcri nee improvement in mental energy through exer­
ci e, whether they arc normally active or not. If undertaken regularly,
exerci e appear to offer a u eful and practi al way for pe pie to redu e
anxiety. ne tudy in 199 I ked at the link between e. er i e and m d
by omparing male amateur athlete with men wh w re relatively
inactive. The results showed that, hortly after cxcrci e
essions, all the men reported increa ed mental vi our and
exhilaration; howe er only the athlete (who e er i ed
mu h m re) rep rted de rea e in an iety.

Benefits of exercise
Although it i well documented that e erci e an provide
mental b nent , it i n t alway cl ar h w or why thi happen .
F r example, it may imply be that e ·er i e diver ur attenti n away
from things that arc troubling u . n a physiological level, it may be that
increa ed phy icaJ activity cau e more blood to circulate around the brain,
both upplying e ential nutrients (in luding gen) and removing waste
produ ts ( uch a arbon dioxide). Re ear h ha e tabli bed that inciden e
of d pr ion may be due to a low level of the ncurotran mitter erotonin.
o instead of taking antidepres ant drugs u h a fluo etine (Prozac) to
increa e the am unt f erotonin available in the brain, regular e er i c
uld pr vide the er t nin bo t required.Thi i ne of the idea behind
a public health initiative in the UK kn wn a 'exerci e 11 pre cription'. Jn
thi cheme, people are given vouchers for acces to lei ure centre or

THINK AGAIN!

REASONS TO BE ACTIVE
In the UK, seven out of every ten men and eight out of every ten women do not
take enough exercise to maintain their health. But for some people, exercise has
become so much part of their way of life that they no longer think consciously
about the health advantages of the activity. Researchers who studied people over
a six-month period found that once people got into the habit of taking exercise
regularly, the experience was self-reinforcing. This may mean that the mood­
enhancing effects of exercise - once experienced - are the most important factor
in determining whether further exercise is taken, rather than the health benefits.
 H E A L I N G T H E B R A I N 151

appointments with health and fitne advi-

or . he hope i that more people will be
encouraged to exer i e regularly and that, in
the Ion ter m thi will benefit the nation' FITNESS MADE SIMPLE
phy icaJ and m ntal health. • If you are feeling tired or
Th mental benefit of exerci e apply depressed, go for a brisk ten­
wh ther th a tivity i individual or team­ minute walk. You should find that
ba ed. However, participating in a t am p rt you feel better and are more able
to cope with what you have to do.
ha the added advantage of ocial conta t.
• Try to fit in three sessions of
ociali ing after the e ent, and di cu ing the moderate physical activity per
'a tion afterward , can pr vide an added week of at least 30 minutes each.
form of rela ·acion that erves t counter If possible, space these out
any build-up of tre . ome peopl , h w­ throughout the week - every
ever, prefer to exerci e alone or to pur ue other day, for example. Gradually,
the duration and frequency can
le formal activitie than team sports.
be increased.
Among the mo t popular pastime prac­ • Find an exercise you enjoy - you
tised today are hill-walking, runnin are far more likely to stick with it.
and cycling, a welJ a a tern di ci- • Remember that it is important
pline su h a yoga and Tai chi. not to exercise too strenuously or
try to do too much too soon.
Always check with your doctor
Exercise addiction? or a qualified fitness trainer
In addition to health benefit , before starting a new programme
ome form of exerci e can pro­ of activities.
du e a feeling of elation - a
'high'.Th r i e idence from
tudie of marathon runn r that inten e e erc1 e can au e mo d­
elevating chemical called end rphin to be relea cd in the brain,
and the e can remain a tive for up co three hour . Thi m help
to e ·plain the plea urable, and po ibly even adclicti e, nature of
a tivitie uch a running and winunin,...
A tr ng link ha even been ugge ted between phy -
al fitne s and xual nergy. A urv y by U
therapist Linda de ViUer of women aged
1 -45 found that after they had exer i ed
three time a week for three month , 0
per ent aid they had more exual con­
fidence, and 25 p r cent exper ien ed

F CT: People
m rcased exual de ire. hi may b
becau e a workout can timu­
who exercise regularly late the relea e of the
hor m ne te to ter ne,
generally experience less whi h in rea e, ex drive
tension fatigue, anxiety in both men and women.

and depression than those A general improvement in

energy and elf-e teem
who do not. may als be a factor.
Brain-enhancing foods
To keep your brain healthy, a good balance of nutrients
- proteins, fats and carbohydrates, plus vitamins
and minerals - is essential. T he right balance
in your diet can protect your mental faculties.
Proteins are vital for the brain since neurons, like all a useful sour,ee
our cells, are made from them. Proteins are made of energy, most
from chains of small molecules called amino acids. experts agree
There are 22 amino acids, of which eight - the that they should
essential amino acids - cannot be produced by the comprise no more
body and they must be obtained from food. Good than 30 per cent of
sources of protein include beans, nuts, eggs, milk our calorie intake.
and cheese, as well as fish and lean meat.
Vegetarians and vegans prove it is possible to live Carbohydrates a d
healthily without meat or even dairy foods, so long the brain Packed with energy
as a varied source of protein is maintained from, Carbohydrates provide Carbohydrates - f und in
wheat products such as bread
for example, pulses and cereals. energy and as the brain
- are an important source of
Fats insulate nerve cells in the brain and other uses up around a fifth of energy for the brain
vital organs - in fact, about one third of the brain the body's energy
is made from fats. The two types of dietary fats, requirements, they are very important for mental
saturated and unsaturated, are classified according functioning. People should try to eat more complex
to their chemical structure. Vegetable fats are mostly carbohydrates - found in foods such as grains
uns�turated, and are particularly important because and pulses - and minimise the intake of simple
some of them are used to make essential messenger carbohydrates, especially refined sugar. Complex
molecules such as prostaglandins. Animal fats are carbohydrates take longer to digest, so they release
mainly saturated and, in excess, can contribute to their energy gradually, providing ongoing energy and
heart disease and other problems. Although fats are stamina. Simple carbohydrates are digested quickly

TRYPTOPHAN
Tryptophan is an essential amino acid and it is widely taken as a
natural, non-addictive antidepressant sleeping pill. This is because
tryptophan - along with vitamins 83 and 86 , and magnesium - is
used to make the important neurotransmitter serotonin, which aids
sleep. Tryptophan tablets take about an hour to work, so are often
taken in doses of SOOmg, along with the other supplements, an hour
before bedtime. Natural sources of tryptophan include bananas,
dates, peanuts and protein-rich foodstuffs such as eggs, cheese, milk,
fish and lean meat. This may be one reason why some people
instinctively like milky drinks before they go to bed. Tryptophan is also
believed to reduce anxiety, tension and sensitivity to pain.
 H EALI NG THE BRAI N 153

and can cause too much sugar to be released into the bloodstream.
This sudden rise in blood sugar is countered by the release of insulin.
The brain is thus alternately flooded and starved of essential glucose,
which may lead to unpleasant and potentially dangerous symptoms,
including dizziness, anxiety, headaches, thirst, mental confusion
and sleepiness.

Benefits of vitamins
Vitamins are essential for many chemical reactions in the body, so
vitamin de iencies can cause illness. While all vitamins are necessary,
some are larly important for mental functions, especially the 8
vitamins. Vitamin 81 (thiamine) helps to make the neurotransmitter Full of goodness Avocados contain
acetylcholine, making it vital for maintaining an efficient nervous vitamins A, B and c. aswell as essential
system. Prolonged "encies of vitamin 81 can produce mental amino acids.
disturbances, and there is some evidence of 81 deficiency being
associated with lower levels of intelligence.
Supplements of vitamin 83 (niacin) can be effective for migraines Good fats Oily fish provides
and headaches, and it has been used to treat schizophrenia. 85 essential fatty acids, especially
(pantothenic acid) contributes to acetylcholine production and is omega-3, which helps prevent strokes.
believed to boost memory. Vitamin 85 is also required by the adrenal
glands, and so is sometimes known as an 'anti-stress vitamin'. Vitamin
812 is needed to make DNA and it helps to form the myelin sheath that
insulates nerves; 812 deficiency can cause mental disorders.

Dietary minerals
Many minerals are needed for a healthy brain. Minerals are derived
from the earth and so, like most vitamins, can be obtained directly
from plants or indirectly by eating meat. Calcium, usually associated
with healthy bones, is needed by nerves, muscles and blood, as is
magnesium. Potassium and sodium work together to maintain water
balance and nerve and muscle impulses. Since people often consume
too much sodium, they may need more potassium to counterbalance
this, from fruit (such as bananas),
vegetables and whole grains. Zinc -
one of the 'trace elements', minerals
that are essential in very small quantities
- is necessary for good mental functioning.
Extra zinc may be needed if people have too much
iron in their diet, or if zinc levels are depleted by
stress, alcohol or smoking. Other trace
elements needed by the brain include
manganese, copper and selenium.

Healthy nerves Bananas provide

potassium,which helps to maintain the
activity of the nervous system.
 IDEAS IN ACTION
EXERCISING
YOUR BRAIN
The brain, like any other organ of the body, needs
regular exercise in order to function well and stay
healthy. There are many activities in daily life that
will keep you mentally fit and boost your
brainpower, whatever your age. Four areas of
mental activity that are particularly important
to all-round mental fitness are language and
number skills, reasoning and creativity.
Do you like adding new words to your
vocabulary - or do you stick with familiar words
and phrases? Increasing your vocabulary is one of
the simplest and most effective ways to keep
mentally alert - and it's something that others will
notice as a sign of intelligence. If you get into the
habit of looking up the meaning of new or
unusual words, you'll soon become more precise in
your use of language generally.
• Start by treating yourself to a good dictionary, you
might like to buy one that gives the derivation of words,
as well as their current meanings, as this will show you
where their original meaning comes from.
• Check the meaning of words you think you
know - you may be surprised! As well as
keeping your brain working,
thinking more about your
choice of words will improve
your abilities as a communicator.
• Read books by more
literary authors, perhaps from
an earlier period, as this will
gradually instil an intuitive
sense of good grammar.
Do you regard mental arithmetic as something
you gladly left behind with your school days?
Everyone can afford a calculator nowadays,
but going back to using your head - or
pencil and paper - for dealing
X with figures is a great mental
exercise that anyone can do.
• When you next go to
o the supermarket, keep a
running total in your
head of what your
shopping is going to
cost. To make this
easier, you can round
the cost of items up or down
to the nearest pound. Either
way, this will help you budget, as
well as providing a keep-fit
exercise for your brain.
• If you're tempted by
some of the points
schemes that supermarkets
and other businesses use to keep your custom, do
a quick calculation to see if you're really saving
money. For example, if the supermarket five miles
away offers you one point for every pound you
spend, and you need 100 points to get a pound
back, that means a £15 shopping bill will produce
only a 15 pence bonus - hardly worth the petrol.
• If you go abroad on holiday, you'll have ample
opportunity to keep your brain fit with
mental arithmetic. Try to find a quick
and easy way to estimate currency
conversions. For example, if you are
visiting Spain and there are 250 pesetas
to the pound, you can convert from
pesetas to pounds by doubling the
amount twice, then dividing the result by
1000 (because 1000 divided by 2 twice
equals 250). Combining several simple
arithmetic operations like this is often
easier than carrying out one complex
one, so see if you can come up with your
own numerical strategies.

Do you think you are a logical thinker? Are you aware of
what makes the difference between a logically valid
argument and an invalid one? Sharpening your logical
skills will help you to appraise infonnation from all areas of
life, and will help you to get your point across in
discussions. While you may not always have all the facts at
your fingertips, developing a critical way of thinking helps you
to spot fallacious reasoning and will keep you - and others -
mentally alert.
Many people assume that an argument is logical if the
conclusion seems sensible. In fact, all that matters in
logic is how the conclusion is reached, not what it is.
A logical argument consists of one or more initial
statements, or 'premises', followed by a
conclusion that follows directly from the
premises. For example, if a friend says he thinks
Pam Ayres is a good poet because her verses
rhyme, and that rhyming verse is the criterion
for good poetry, then his argument is logical as
the conclusion follows from the premises, even
if you don't agree with it. But if you read that
genetically modified foods are bad for you
because they are produced by multinational
companies, the conclusion does not follow
from the premise so the argument would
not be logically valid.
• Next time you read a newspaper, see if
you can analyse which arguments are
logically valid and which are not. For
invalid arguments, supplying
missing premises may make
them valid. Looking for these
extra premises helps to
reveal the hidden
assumptions that the
article is based on.
H EALI NG TH E BRAI N 155
CREATIVE SKILLS
Do you think of yourself as a creative person - or do
you feel that you are not 'artistic' enough? Everyone
has the potential to be creative and millions every day
demonstrate it through activities such as cooking or
gardening, creating delicious tastes and special places
using their imagination and experience.
• Creativity can't really be measured, but
psychologists see originality of ideas and the
number of possible solutions to a problem as
important components. This is the basis of
the following exercise: take a simple
everyday object, such as a paperclip or a
house brick, and write down as many possible
uses for it as you can think of. If you do this
with a group of people, scores can be allocated
on the number of unique ideas each person has
(ideas that no one else in the group has thought
of). Don't be shy of making wild and wacky
suggestions - you're not expected to put them
into practice!
• On a more practical level, try applying your
imagination to your leisure activities. For example,
if you are cooking a special dinner, try including
just one dish based on a recipe you have invented.
If it's good, you'll have made something new and
delicious. If not, it won't spoil the dinner, and you
can use your creative powers to improve the recipe
for next time. Remember that creativity is a matter
of trial and error, as well as leaps of imagination.
156

INDEX
Dlood-brau1 barrier 146,147 hroni fangue syndrome (CFS) 57,67 scxual 39, 68
131ood pres,ure 17,66, 67 hroni 1llne 17 sublimation of , 139
ntroUing 111, 145 coping with 15. 9 95 uncon 1ous 38
fluctuaong 42.110 hron med, 11,e 43 Development.bram 30. I 3
lugh 17.59,94 1rnd1an cy le 41 · 3 O,abetes 145
A 131ood sugar 145. 152-3 lint n, 13,11 I D,agno,is 14, 66
Abdominal bre>thrng 16 llody rhy,hms 40,41 lonmger.Robert 57 breakmg the newi: 95
A «yl holinc 33, 153 and medicine 43 o-coun,ellmg 99 coping with 94
A upuncture 120 srt alio Cireadi•n cycle ogn111ve behavioural 1herapy 47, 63. D, m nd.J hn 95
Add,crion 102-3 Dondmg, mo1hcr-mfant 34.35.51 %: stt also ll hav,oural therapy; Diet 12.17. 22. 145
Ader,Rohen 50 Doxmg 141 Cogmtl\·c psychology 19 carboh) dratc I 02. 152-3
Adknan psych therapy 99 Dr:nn damage Cogmnve lhera py 9 -IOI • I 08: stt also fat 50. 4. 89, 145, 152, 153
Adrcn2line 76.n and ageing 132, 133, 140 ognitivc bchav,oural therapy fi•h 89
Ageing 131. 132, 133. 140 and die<141, 152-3 old-blooded annual 35 fruit a11d vegetable, , 153
Aggrc , n 57 genClic 140 Colds, beanng 51 h,b,c 88
Agoraph b,a 104 and mfection 141, 147 mplcmentary and alternauvc healthy 15, 152-3
All 95 rnjury 141. 146 medi inc (CAM) 15, 16 Jllnk food 88. 102-3
Alcohol 63, 75. 79. 145 prcvennng 141, 14 7,152-3 for depres,ion 148-9 nunerab 153
add,ro n 102. 10 repau of 140-2, 144-5 effectiveness of 16. 73 poor 57. 63
health rt k of • 9, 141, 147 scroke 14 ·5 for MS 141 protein 152
Alexander, Franz 56 and IOXlrlS 141,147 and placebo effe t 73 VllJllllll 141, 153
AJexandcr 1ech111quc 16, 17, I13 13ram deve lopment 30. I 3 onditioncd rcspon e 45, 46--47. 113 Dieting 35, 85. 88: srr also Eaung
Ab. Muhanunad 141 Bram funcoon 18. 20 ond1uon1ng cbsorder,; Weigh, los.,
J\hcrnative rned1 inc srr 111 depres.s,on 125 d.mi al (P-,vlovi,n) 44. 45 Disca,c srr lllne,s
mplement.Uy and ihenunve reprogran11111ng 101 1mmunr-system O Dmociarion (,8
medicine ( AM) 13ram henmphcrC\ 26. 27. 28, 29 un o� iou 46 from pai11 121, 122
A.lthenner's cbsea.se 31,94, 140, 146: ,,, Uram annmg 14. 15. I .20-21 1101ct 38, 97 D,vor e 136
alu, Dementia depr «ed panen 125 Doctor-panent n,bnon hip 13; "' •IJo
Am gdab 26, 27,32, 37.131 stroke v,clim 144,145 9 Thenpeuu rebnon hip
Anacsth�ia.hypnosis in 107 Oram stem 26, 27 D p>mmc 33,57, 121, 124
Ancient Greece 12,56, 68,74 IJrain <tructure 20. 2 27,28, 30, 31; Double-aspect ,heory 14
Anger 53,63; sr, also l losnlny set al,a erve ell Down's syndrome 140
Anhedonia 125: srr al,a Depre 1011 IJrain waves 16. 21 Dream analys, 97,109
Anorc,na n rvoSJ. s« ang d1 rders modifying 1 I 0. I1 I .69 Drugs 15
Anndepremnu 105, 14 . 149. 152 u�a.sl nnccr 52 94-95 addicuon I 02, 103
MA ls 149 Breastfeeding 35 analgc,,c 123, 148, 149
natural 14 9, 152 lln-,1l11ng an1i-inflam111atory 148, 149
SRls 125, 149 e er, 16. 17. 113. 115 behav,our-alt<rmg 20
tricydic 149 regulation of 26 and psy hosoc,al factors 84-85 ben1odi»epi11<"< 149
Anx1ery 63,137, 148 IJroca. Paul 18 reduction 125 and body rhy1hm 43
ondition d 45, 46.47 Droc2s area 131, 144 ounscllmg I 5, 97, 98, 99 ,II gal 75.125.141
and diet 153 Uru ism 111 ouple therapy 99 mood-altcrmg 148-9
dTccts on unmune system 52.53 IJuddhist Mcditanon 16, 114 rash helmets l 4Cr7 natural 123. 14 -9. 152
tr ,imem 96,98, 100, 104, 149 IJulmua srt Ealing di<0rder rcanv,ry 27.29, 99, 155 <ide cffecu of I .73
Appetite'" Desires: Hunger Uurn u1 66: srt also hrom fa1igue .T cans 21 lecpmg pills I 52
Aroma 93 syndronte srr also Anod prew.nc,; Med1c111e
D
Aroma,hcrapy 73, 92
An 1herapy 99
Animus 31, 75
c ffcme 148
D,nger, rcspondmg to 26: stt al o Fight
or flight respon<e
D11almn LI,18
I w1bar, Helen 56

A rhma 57,75.107 ncer 52, 53, 73, 95 D,yhght ch,ngt., 40, 41, 43 E
Am:noon fighong 59,95 Defence,, p ycholog, al 80. I, 83, Eastern hcalmg systems 15, 16. 115
br.im regulau n f 26. 27 psych ,hcrap for 97 138-9 Eaung cbsorder, 35, 5,9 : sn also
10 pain 12 I, 122, 123 mk factor< 8 l rmenna 51, 52, 132; su als.o D1cung; Food
«eking 46 trealmem 46 Al2.hc1mcr' d1�c�sc ccencnclly 90
span 132 anccr-prone per;on;a.liry 9 Oendme 32,33, 141 Eaema 57. 107
Autogeouc Lra1mng 17 .annabi 141 Dc111•l 13 Educau n 22
Axons 32,33,141,142 an non. w..J<er 56.76. 79 Dental 1rcaunent 46.47. 106 aduh 132, 140
Ayurwd.ic mcd.icme 15. 17 ard1o"a cular S)'Stfnt 58. 59; srt alsn Depcrsonah,anon 69 Flectroencephalography (EEC) 21
I!cart d1sNse: tr ke Depression 22.H.63. 97.137 mouonal mb,hty 60-63
B arcer ch ice 23 b1ofecdb>ek for I 11 Emouon 12
8:ach flower rrmed1n 17 Caring role 38.51, 91 drug tn-at11mm (, r 148-9, 152 creanng 32
!Jeck, A2ron T. I00, I arastrophismg 100. 113 and phy,1 •I 11ln 51, 52.59 expremng 26
I) hav1our ntr l nen u i.ystem srt ervou P')' holog,ral tre>nnenu for 45, 100. and ,lines< 5 53, 56,62
healthy 60,8 9 �ystem 116 nq,.,uve 53.59. 63, 75
h,gh-nsk 56.57, 63. crebcllum 26.27 <John's won for 148-9 Fmpry n t ,yndrome 137
modifymg 45, 60,63.122 Cerebral cortex 26.39, 132 ,ea,onal 43 nceph•lius 147
problem,.adol ent/ch,ldhood 47. C rebrum 26.27; scr al,o Uram 211d troke 144 ndocnnc sy rem 30, 31, 33; srr •l•o
99 hennsphere, sympt mi 125 Hormones
Behav,oural therapy 98, 99, 105:'" hanges. ere, of 77.78. 2, 136-7 Dereahsanon 69 Endorplun 33, 51. 73, 121. 126: m
also ognmvc bch•vioural therapy Charcot.Jcan-Marnn 68 D ane<, Rene 12. 13.14, I also Neuro1r·.1n rmtte-rs
Bchav,oumm 19 'hemotherapy 46 Deme, Energy babnre 17
lkhc .power of 70. 71. 73:'" also Chilli pepper, 35 ba.11 38. 39 Energy Oow 116
Pbcebo ffcct h1ropracti 15 conOicting 3 . 97 Envuomnent
Diofecdba k 17, 110--11 Chlolesterol 84 higher 38. 39 ad>pnng 10 26
Uhndn .hy,trrt al 69 hnstiani1y 13. 16 repres,cd 68 and hr�th 23.57.60. 8, 89;'" also
 I N D EX 157

L,fesryle; arure/nunure dcb;tc cnvuonmenul anflucn cs 011 23. 57, K Menu] illnc 14, 15;sttalsohnx,cry;
Ep,lqxy 21 60, , 89 Kleuuan psychotherapy 99 Depression; 0; Phob1,s;
b, feedba k f. r 11 I genetic mOuences on 22, 23. 140 Kramer. Peter 125 ch,zophrem,
Ep,phcnomcnaltsm 14 Health p ych logis 15 Message sy tems stt Endocnne y,;tem;
nkson. Enk l 6 Heart atucks 42. 53, 77 L crvou.s tern
Ernst, Edurd 148 rcco\>-cnng from 95 Language 18, 27 Mcubolic me 17
Exercise 16 Heart disease 57, 75. 89 acqmsition 20. 131 bra1n 125
lxndits o 59, 63, 89.113, I 45 and hfesryle disorders 97 M,gramc 111. 153
breathing 16.17, 113, 115 and personality typ< 58, 59 improving 154 M1groti n 41
habu:s 57, 8. 89 psychosocial factor< 5 role of left and right hcmisphen, 29 Mmd 12
mcnul 133, 13 5, 140. I 54-5 su also ard1ov:1scubr s ystem and stroke 144, 145 higher limct1on of 19, 27.3 . 9
and sleep 119 Heart me, rcgubting 26 ugh«r 51, 53 as a machine 19
Stret hmg 113, 114 I ldping others 91 Lavie, Peretz 42 Mmd-body hnk 12-15. 26, 50
Exposure therap 45 HcndrL,.j1n11 29 Lazarus.R1ch•rd 78. 79 Mind-body pathways 26, 51-52
Extrover,,, n 3. 9, 60, 63 Herbal medmne 15. 17. 14 9 Learned helpl n 47, 59 Mindfulness 114
Ey,cnck. Hans 60 H1bcnut1011 41 Leisure 112.113 Mmdsct 23. 91, 100
H1ppocampus 26. V. 131 Lcucoton1y, front.al 20 Momz, Egas 20
F I hppocratcs 18. 104 Life cho,ccs 57 Mood 130
Family therapy 99 llobb,es 90, 91 Life coachmg 99 altering 14 9
1--cn, O\'erc'.OIIUU� 10 5: Kt "lso llolm, approach 14, 15. 16-17 su also L,fe events 136-7 mb,ltry 63
Anxiety P y honcurounmunology L,fe mge< l 7 Jtt aho Em tion
I ,ght r flight response 32, 2, 56. 76. H Imes, Th ma, 82 Life after death 13 Mortality 13
77. 104. 113 Ii me IN 3 35 Life change um<> (L U ) 78.82 MRI annmg 21, 12
htne>s 12, 17, 89 Homer 12 L,f,....tyle 15, 16. 22, 23 Stroke VICtll11S 144. 145
bmn 134-5 Honn nc 30.31. 33 hanging 17, 63 stt olso IMI\I
Fie 1b1hry and bond,ng 35 and health 57. 60, 8, 89 Muluple lcro<is 2. 140, 141, 142
mental 139 growth 119 ternage Mus,c. hcal1h benefit of 90, 93, 126,
phys, .1 17 ex 39.132 unhealth • 75, 8 135
Fluoxcanc (l'rou ) 125. 149 �r also trc hormone-s l ight set Da) light hange, Myalg,c cnccphalomyclm (ME) 67
fMRI =nnmg 20. 21, 12 Hosnliry 53, 59, 75; stt also Anger Light tlierapy 43 Myelm sheath 32, 130. 141.142. l 3
Fontana, I avid I 15 Human Genome ProJcCt 22, 23 L1mb1c system 26, 27, 32.130
Food. cnJoymg 93, 127; stt also Diet I lununi,11 psychothcr.tpy 96, 98. 99. Lmenmg for pleasure 93 N
Fn,e-;assooauon 97 109 L, mung skill \18 ash, M1clucl l 07
fn,ud. ,gmund 18 Hung<r 35.3 Lobo, my.6-onul O .uur.il exper11ncn 18
,nd conO, t 97 I IL,uun111on\ chse e 140 ung turc 14
,nd defence me ham m 138 H 'P<ra tiv1t I I I cap• 11 17 heahng power of 91, 92
and h) tena 56.57, 68 Hypertension stt UI pn,ssun,, h,gh d�.l.S(' /nurture debate 22, 23
and phobia I 04 HypcrvenuJauon 66 sr� also 'Breathing exercises pleasures f 91.92, 126
aud pursuit of pleasure 124 ll)'PllOthcrapy 106 7. 122 Lupus 50 Ncgat"" 1h111k111g 74. 75, 100. 101, 10
l·reud»n psychoanalys, 98. 99 Hypotluwnus 26. 27, 41. 132 Lmt 38 Ncr� dis 32.33, 130
l·ncndship 127; Stt also ·oc,al ,upport role in basic urgn 35, 38. 39 connecuom 32, 133. 141. 142. 145;
role in 1gh1/ll1ght 32, 77 M
G Hystma 56. 57, 6!H\9 M2gnea resonance 1111agmg s« MRI
,ag.,. Phineas 19 scmn111g
,all, Fran2 18 Magoetoencephalography (M G) 21
Gambling 102. 139 ldcnuty theory 14 MMrngc 136
amma-a111111obutync ac,d (GA UA) 33 l llness M,rriagc guuuncc 97
Garden. healing 142-3 :i U((' 16 Massage 15. 17. 73, 92 mamtainmg health of 153
Genes chrome 17 Matcnatism 14 peripheral (PNS) 30. 32. SI
and addict1on l 03 cop111g w,th 9 9 Mrd1ut1on see Drugs cural netw rk mod I
and health 22, 23. 140 d,agnos" 14. 66 Mcd1cmc eurofccdb•ck srt ll,ofecdback
and pcrso1nhty 22, 23 and emotion 50-53, 56. 62 conventional 13. 15, 14 9 curolrnguisu programnrn,g (NI i>)
c....ult psychotherapy 99 prcvcnnon ofl7, 141, 14 7, 152-3 Eastern 15, 16. I IS 99
'Ghost 111 1he nu h,nc' 14 p,ych somanc 6, 7. 97 ev,dcncc-bascd 14 cumm; Ht Nerve cells
Chai ell 142, 146 rec<>1,�11t1011 of 72-73 hcrb•l 15. 17. 14 9 eurotran untters 22, 33. 51, 124. 125:
Gluum:uc 33 signs 64. 6<> hohst,c 14. 15. 16-17 srt o/.so Accrylchohnc; Dopam111c;
Group therapy 98, 99 �yrnptom-.. 64 We<t<rn 13. 14, 16, 17 oradrenal1nc: croton1n
Growth horm 11es 119 Imm.1tcnahs111 14 stt als<1 Drug< 'feel-good' 53, 124, 125; sttalso
,,11lt 59 Immune syuem 50 Med,uuon I . 16. 112. 113.115 Endorph>n
boosting I. 53, 125. 126 Ayum:di 17 cwton, fqac 13
H and me,• 50 -53, S . 59 Buddhist 16 Nolle polluuou 79, 80
lbb1ts 48, 49 lnd1gest1011 57. 72 and pam control 122, 123 Noradmultnc 33. S.52. 76
ch.ing111g 4 . 49 lnfc 11 n< 51, 73 and type A bchavtour 59
hcal,hy 8 . 89 brain 141. 147 Mdatomn 42 0
undenundmg 49 h1Jury pttwnuon 14 7 Mcluck. Ronald 120 )bcs,ry 35, 89
Happmc« 125. 126 Insomnia set 'Jeep problems Memory 119 hildhood 8
Head.ch 75 ln1clhg.,11ce 132. 133, 153 and ageing 133 bses ivc- ompuhl\'c disorder ( I) )
and diet 153 Ou1d 140 devcl pment 131 63. IOI
Hr.d nyury 141. 146 lntrospccuon 19, 114 encoduig 27 Occasionahs111 14
Hc.1hng lntrovemon 23. 59, 60, (,3 loss 141. 144.145 Olds,Ja111e, 124
nund m 13. 16, 17, SO I muble bowel syndrome 73 of pam 37 Opti11lli111 67. 81, 138. 144
power of nature 9 I. 92 sex di{l'creoces 111 133 rg:, m 51
I tcm< 15, 16, 115 J Meningms 147 Orm<cm, Robert 80. 90, 125, 126
Ilealth Jung,an ther:ipy 98, 99 Mem..ll devdopmcnt srr Ur.un O<tcop,thy IS
dc6111t1on 15 Junk food , 102-3 drvclopmcnt Overbreathmg 6(,
158

vereatrng 79; Jtt a/Jo Enmg disorders Prevention. di.case 17, 141, 14 7, en ry 1n£ rmauon 31 T
Qv,,rwc,ght ,er Obesity 152-3 S<-nsory pie.sum 91,92, 93. 125, 126 Talking therapy 52,96-99
O ytOCUl 9, 35, 51.121 l'roJect1on 139 rot nm 33.35. 124, 152 Tast(' aver'\1011, condmoned 46, 47
Pro:t.il· srt Fluoxeune ·xual behaviour 35, 51 Ttcth
p l'soriasi 107 Seylc. Hans 77.79 brushing 8
Pain 120-3 P, choanaJys,s I , 19.97, 98 haw,George Bernard 39 gnndmg 111
mcnd111g to 120-1,122. 123 Freudian 97, 98, 99. 100 h1atsu 92 Temperament 22, 23, 60
back 97 stt a/Jo P,ychothcrapy hopping addiction 103 Temper untrunu 47
of h,ldbirth 121 Psychodynam,c therapy 98.99 Shyn s 63 Temporo1mndibular JOllll (fMJ)
controlhng 37.107, 120, 121 Psychology kin can rr 8 disorder I I I
d1<roc1ati.on from 121, 122 cogmm·e 19 letp 89, 113, 118-19 Tension, muS<ular 16, 38, 59. 112
c,cpecm,on f M, 7 . 122, 12 obje ti,•e approa h to 19,45 gores 42 Testosu:rone I 19
inability to fed 37 Psy honeuro1mmt1n logy (I' I) 50-53 problem< 67, 116.119.14 .152 Thalamus 26. 27
jo1111 67 l'sychoph ,cal parallelism 14 lecp,ne<s 153 Theropeunc rclrnon,h,p 96, 97, 98
neuropathic 36.37 Psychosomanc ,lines e 56, 57.97 moking 75. 79 Th111km1, styles 74 75
and pl,cebo effect 73 Psychotherapy 15,96-99 add,cnon to I02.103 au10111otic 100, 101
senunon 31,3 37 set al<o Psycho,n•IY>" banmng 5 global 74
1hrc hold< 122 Puberty 132 and health 57.88.89.145 2nd health 75
Pamk,ller< str Analg«1cs Pumshmcm 46 qu1tung 47. 49.97, 107 m1crnal/cX1cmal 74
Parenthood I (....-7 Sobel, David O ng,d 74
l'aren1111g ,rylcs 22 Q Soc,,I phobia 1<1-1 ser al.)" eg,.1t1\.'t'/Po11uve tlunk111g
P,rk1mon ·, di<easc 31. 141 Q- rung 109 Social kill, 63. 135 Thmt 26. 35.38.153
Pavlov, Ivan 4 5, 46 Quaht) ofhfe 'XI Soc,al mu 4.85 Thoreau. Henry 114
Pe-air. ormm Vm em 75 Social upport nem rks 84,85,137 Thought
Pcnfidd.W ilder 20 R Solnudc 127 e111ergence f 12. 13
Perfrcn ru<in 58 Rahe.R,chard 2 Somatos nsory cortex 26. 27 free-:as ocuuon 97
Personaluy 19. 22 Rand 1111sed controlled maJs (R T ) Spa_,m ph,ha (,6 Tmnirus 64
(.,P('ncmc 1110uences on 22. 23 71, 72 pcech <tt Language Tm·dnes, 53. 67
and health 56-59, 63 RauonaJ-e111011w therapy 99 p1egd. David 59 Top-ti wn pnxes,mg (17
and lift<ryle 59 Rauorultuuon 139 pmal cord 26.36 Tou h.benefit of 92, 95
queiuonn,ure� 60--62 Raynaud' dJ,easc 11I 111JUry 95 Toxin�
and ,lrc�<!i 58 R,·asonmK power 100-1 Sp,rnuality 13.16 ,n the brain 141, 146-7
Personality traits/type, 58.59, 60, 61. improving 155 Sub,liry, emotional 6(� removal of 17
63 Reeve. Chrmophcr 31 'umin;t 17 Transarnonal anal} ,s 99
conformist 59 ReOexology 92 tem-cdl therapy 31 Tr;anscut;meou. ele Lrial nerve
eccrntnc 90 Regression 139 1orm;u1, l.larry 111 m111ula11on (f NS) 12()
cmononal/mblc (,0, 61, (12.63 Relaxauon 16.17. 53, 59, 91 ugm;u;a 67 Tr•um• 79
eMrown/111<rovcn 60, 62, 63 and canct'r 52 cn,ngth 17 childhood 104
hardy 1 mu< les 116 trc« 12, 17. 38 Trypc phan 152
hosule 53, 59,75 and pam 122 and bemg m control 77. 79.81. 84. Tumoun: src ..anccr
n,prcssor< 58 and phobias HIS 85, 113 Twrn scud,« 23
rcstl«s 38,59, 14�
risk-takmg 56, 57,63,88
�usp1ciou., 59
and sires., 112, 113, 114 17
1cch111ques 11 17
Religion srr pmroahry
chrome 80
habi11mion to 80
and healtl, 5(1-53, 76-79
u
Un erumry, me<s of 58,79
t0ugh/tendcr 60, 62, 63 ReprK\ion 68, 138, 139 ,dcnnfying 78 Unco" ious 18.26. 45, '18
type A. rype B 58. 59 Rest-acnv,ry cycle 42 ma.nage-mem 79 JCC'Ct:.S-111g I 06
rypc 59 Rcstle"C<ne<s 38. 59, 148 m •ths 7ll conduioning 46
Phantom lnnb 65 Rcnremem 1.n and rcb.xanon 112. 113,114 ronfl1e1 56.97
l'h,lo ph 12-14 Reward 46, 47 n,spon<e 10 59.75, 8(HlI t!emes 38
Phobia, 45. 63, 96, 104 Rhcunmo1d arthritis 95 and social <mu 84. 85 hab," 48
dnen,m�cion 105 Rh •thm therapy 145 "'· cpnb,hry 10 2J. 81 Unemploynu:nt 137
Lrea11111,1 105
PhrcnolO!(Y 18, 19
Pitu1ury i,:Jand 30,31. 33.77
Ri<k-,aking 56,57.63. 88
Roi;,·mn psy hothcrapy 99
Role model, I(�l
of uncena111ty 5 . 7'-J
anrl v1tam1n U 153
workload I 13
v
Valium 149
l'b ebo effe 1 70-73 R le, Gilbert 13, 14 Str«s hormone, .18,58 Vaso,·('gt'tJ.ttve ,yndroml" 67
"de effects 73
Pleasure 90. 124-5. 126-7
anti health 126
s t John', won 148-9
atlrcnalmc 76, 77
com,ol 52. SJ. 77.84. 85. 125
Stretch111g 11J. 114; '" a/Jo Yoga
V 1ma.h auon 117
V 1ta111111, 141. 153
Vo,ccs, hearing 12
mcmal 125 apolsky. Robert 84 rrokc 29.42 Volumary work 91
reg11b11ng 126
<eek111g 124. 126
•nery.heaJmg power of I.)1, 'J2
• luzophreni, 125, 153
overconung 141, 144-5
preventmg 88. 9.145 w
,,,,,,,,., 91.92.93.125. 126 Sc,an , 120 ubl11na11on 38. 139 W,11, J>a1nck 120
<imple 125.126.127 ·,·asonal afft-ctive disorder ( AD) 43 ·ug,r ,ravmg I02 Weakness 67.68
survey 127 df-analy is I 08 9 ug1,,·,11on, power of 70. 71. 73; stt Weight loss, c un dbnK for 97 ·"' a/,c,
PN1 stt P,ychoneuro1nu11unology Self-blame 59 a/.<o Pla cbo effect D1e11ni;
Posmvc thinkm1, 74,75.91, 112 Self. are 15.42 upport group I 03: '"' also Group Well-berng 16.9V-')t.112.121
anJ 1111munt" sy�tem 53 'elf-concept 95. 109 therapy crea1111g 92 93.125.126
rewardmg 47 'elf-nm "'" IOI Suppornve therapy 98, 99 Wem1<k<' area 131
and sdf--e<tecm 63 Self-esteem 15.63,1.JS. 96 upradua nuc nude, (S ) 41.42 Work/pby balance 91. 113
Po<1tron en11ssion tomography (PE • If-fulfilment 114 ympathy 73
scans 20,21 'el f -healing 15 ym ptoms 64-6 7 y
l'ost-rraunun mes, disorder 71.J lf-h pnOSJ< I07 controlling 67 Yoga 16. 123
Posture 16, 17. 116; stt a/soAlex,nder elf-knowledge I 5, 38, 49 rccognmon of 72-73 bencfil< of 17, 117
1ech111quc;Y"h"' clf-prest"rV2UOII 26 ynaP'< 33 We)tern 17
Prayer I(,: m• a/Jo Med1m1on Sensanon-scekmg 56, 57 stt fllso Srretchmg