Healing and the Mind; 102; The Mind Body Connection

HEALING AND THE MIND WITH BILL MOYERS 2/ 22/1993 102 The Mind Body Connection

ACTOR:

Lord, I make my peace with death in this the year of our Lord, 1905. Vain hope. Violent death is commonplace here in....

BILL MOYERS:

"The actor must be going through what he character he's playing is going through," a famous director once wrote. "The emotion must be real, not pretended." Here at Arizona State University's Institute for Studies in the Arts, the actors and actresses practice the famous method.

ACTOR:

"One bullet, well placed can sound like an army. One bomb like a .... "

BILL MOYERS:

Their rage and anguish are no imitation. They have summoned their own grief and anger from deep within themselves and are sharing it with the audience.

ACTRESS:

Words, mere words.

BILL MOYERS:

But this is more than a play. It is also an experiment. The purpose is to find out how a deeply felt emotion can influence the body. Nicholas Hall, a neuroscientist at the University of South Florida, designed this pilot study. Tapping the skills of Method actors to study emotions and the immune system. It's just one part of research being conducted by scientists all over the country who are searching for physical clues to how emotions affect our health.

ACTRESS:

His brain spilled out. Screaming.

ACTOR:

Death by burning kerosene. Club dealt. Dull scissors. There's a wailing wall stretching across the world.

BILL MOYERS:

For thousands of years it has been said that our thoughts and feelings can make us sick or well. Now, scientists are putting that folk wisdom to the test. But you have said that we're on the verge of a scientific revolution.

CANDACE PERT:

Oh I think we're well into it and yes, yes we are.

BILL MOYERS:

What's the nature of that revolution?

CANDACE PERT:

Well the nature of the revolution is to start to incorporate mind and emotions back into ... into ... into science. And the implications for medical practice of course are ... are enormous.

ROBERT ADER:

Why is it when an entire population is exposed to the same set of pathogens, some people become ill and some people do not become ill? What are the other factors that contribute to this?

DAVID FELTEN: Any of us who has ever dealt with a patient, know that a patient's will to live makes a difference. And I don't think there's any physician who would deny that. Yet we don't understand how that works.

BILL MOYERS:

Somewhere in the labyrinth of the body, in the complex circuitry of organs, tissues and cells are clues to a scientific revolution. For centuries scientists and philosophers have separated mind from body. Today, with the help of new technologies like this electronic image-maker, the accepted dogma is being challenged. In this study for example, scientists have found that a state of mind like sadness may have a specific physical counterpart hidden within the inner recesses of the brain.

MARGARET KEMENY:

In fact, when we feel happy or sad or angry, afraid, there are very specific changes taking place in regions of the brain during those emotional states.

BILL MOYERS:

Margaret Kemeny is a psychologist and researcher at UCLA, who has studied the immune system. But how is it that something as ... as intangible as a feeling or a thought can change the chemistry of the body?

MARGARET KEMENY:

Although it seems intangible any time we feel anything, any time we think anything, any time we imagine anything, there is activity in the brain that's taking place at that time. And that activity can then lead to a cascade of changes in the body that can have an impact on ... on health.

BILL MOYERS:

In what ways? How is all of this connected to the health or the illness of the body?

MARGARET KEMENY:

Well for example, the brain you know as you know regulates the heart, the gastrointestinal system, the lungs. And it's only been really recently that we've begun to recognize that psychological states like emotions might very well have an impact on the immune system.

BILL MOYERS:

We're just beginning this trip down this ... this trail, right. No telling where it will lead us.

MARGARET KEMENY:

Historically there was the belief that we could feel even very, very severe states and the immune system was immune to those states. I mean there really was no connection. It was as if the brain and the immune system couldn't talk to each other, it was impossible.

BILL MOYERS:

What the brain and the immune system talk about could prove fundamental to our health. The immune system is our first line of defense against disease. What happens here can determine whether we are sick or well. But scientists had long thought the immune system operated on its own, making us better or worse according to its own laws, with no influence from our minds.

DAVID FELTEN:

We have a wonderful microscope here that has probably the best optics on it of any microscope available.

BILL MOYERS:

Until one day David Felten, a neuroscientist at the University of Rochester saw something through the powerful lens of his microscope that surprised him.

DAVID FELTEN:

We saw nerve fibers all over the place, sitting right smack in the middle of some of these cells of the immune system. I looked at it and thought, what is this? You know everybody says that the nerve fibers are just associated with blood vessels. Why are they out here? So we cut some more sections and looked at some more and there they were again. So we got some other blocks of tissue out and cut them and there they were again. And they kept showing up again and again.

BILL MOYERS:

In layman's term, what was the significance of this?

DAVID FELTEN:

Certainly the thought crossed our minds, geez, I wonder if the nerves might be controlling some of the immune response. But it was almost at that time, dogma, that the immune system is autonomous and doesn't have any outside controls. So we were almost afraid to say

anything for fear people would say, oh geez, don't you know the work of Glucks and his colleagues, or they'd come up with some reference that we had never found and make us look like a bunch of doofus's because we didn't know what we should have known. So here was the great defense system that has a wonderful memory, can generate memory against past insults that have come in and on the other hand, here is the brain that has also a wonderful memory of past experiences. And the two great memory systems we thought were independent, but now it turns out they're not independent. They talk to each other extensively.

BILL MOYERS:

And that's a revolutionary breakthrough?

DAVID FELTEN:

It's a different way of looking at things. It's ... sometimes the most surprising conclusions are simple. I don't view it as revolutionary. To me it makes ... it's common sense, it's what our grandmother told us long ago. But it ... it makes common sense that things that affect the mind or affect the brain might have an impact on our health.

BILL MOYERS:

What does that mean for medicine?

DAVID FELTEN:

I think a patient has to be a very active participant in their own health. How a patient perceives a situation may be a very important factor over how their body responds, perhaps even their immune system.

BILL MOYERS:

Are you talking about the control I can exercise over my own body?

DAVID FELTEN:

Yes, yes.

BILL MOYERS:

How am I going to get control of my immune system?

DAVID FELTEN:

That's a very good question. That's what we're trying to learn.

BILL MOYERS:

Can the immune system be taught? Can our brain give it orders? Scientists once thought that the only way to affect the immune system was through a drug. But that was before the work of Dr. Robert Ader, an experimental psychologist at the University of Rochester, a pioneer in the once uncharted territory of mind-body science. In a landmark experiment with laboratory animals, Dr. Ader demonstrated that a drug was not necessary to change an immune response. Eight years ago, Dr. Ader's work had a profound effect on the life of a young girl here in Minneapolis. Marette Flies suffers from a disease called lupus. Her immune system has turned against her, attacking the very body it is supposed to defend.

MARETTE FLIES:

When I was first diagnosed, my doctor didn't want me playing the trumpet at all. He said, well it's bad for your lungs, it's bad for your lungs. You know, you shouldn't play at all. You have, God, you have pneumonia this month, why are you still playing your trumpet? And I would just say, well you know, I like to. You know, I like music.

BILL MOYERS:

When the disease first struck, Marette was just 11 years old. Doctors prescribed a powerful array of drugs to control the lupus, but nothing was really working and the drugs had severe side effects.

MARETTE FLIES:

This picture was when I was in like the eighth grade I believe. I was on 80 milligrams of steroids a day because they didn't know what to do. So they picked steroids as the route. And steroids not only made my face look like a ... I swallowed a blimp, but it made my hair fall out. So every morning I went to breakfast and I ... my hair would fall in my food or ... I'd get up and there ... there was hair all over my pillows, like I was 70 or so.

BILL MOYERS:

Her life was in danger.

KARIN OLNESS:

Her life was definitely in danger and so much so that we were thinking in terms of an emergency.

BILL MOYERS:

Dr. Karin Olness was consulted to help Marette manage the pain. When the lupus raged out of control, an experimental drug was proposed. But there was a danger, the side effects were possibly as harmful as the lupus itself. Marette would only be able to tolerate the drug in small doses. Was there any way to enlist her mind to help?

KARIN OLNESS: put in a call to Robert Ader. In his experiment Dr. Ader had given mice sweetened water and a drug that suppressed their immune system. And he continued to give them the sweetened water, but withdrew the drug. The mice reacted as if they were still getting the drug. It was an example of classic conditioning, something few scientists before Dr. Ader believed could be done to the immune system. So the rats were conditioned to act as if the substitute was the real thing. And you thought you could do that with ... with Marette?

KARIN OLNESS:

He had used the very same drug with animals that had lupus.

ROBERT ADER:

And the question was could this not be applied in a clinical situation with a real patient with lupus to reduce the amount of ... the total amount of medication that the child received.

BILL MOYERS:

What did she say to you?

ROBERT ADER:

Essentially she either said or implied they'd virtually given up on the child. Given the alternatives which was a very dangerous drug, I felt that this was probably a ... a reasonable and a conservative way to treat a child that they didn't really have that much hope for at the time.

KARIN OLNESS::

We had an emergency meeting of our Human Subjects Committee to get permission to ... to do this. And then we proceeded the very next day.

LINDA CAROLE FLIES:

Well,

KARIN OLNESS: explained that she believed that the immune system could be classically conditioned so that if Marette was presented with something in conjunction with her medication, like a taste and a smell, that, perhaps someday she would be able to use just the taste and the smell to do the same things that the medicine might do.

KARIN OLNESS::

We know from both animal and human research that taste and smell are most easily conditioned of our senses.

BILL MOYERS:

So what did you decide to give her along with the drug?

KARIN OLNESS::

We thought it should be relatively unpleasant. It should be unforgettable. Preferably something to which Marette had not previously been exposed. We asked a lot of people, including my husband and my mother and people I worked with. We, I remember, tasted various bottles of vinegar. There were all sorts of suggestions. And ultimately we thought of cod liver oil. This is it. Cod liver oil. Brings back all those childhood memories.

BILL MOYERS:

I remember that. I couldn't eat fish for years after I ... I took cod liver oil as a baby.

KARIN OLNESS::

Marette sipped this.

BILL MOYERS:

Old bad memory.

KARIN OLNESS::

Get it ... I remember ... I remember it worked to get it down fast.

MARETTE FLIES:

So we got ... got it down to a taste and a smell. And she asked me what pleasant smells do I like? And I said, well you know I kind of like the smell of swimming pools. And I kind of like the smell of pot roast. But of course they didn't make those in a scent she said.

KARIN OLNESS::

We opened the bottle of rose perfume at the same time that Marette was sipping the cod liver oil, so actually the whole room was filled with the smell of ... of the pungent rose perfume.

MARETTE FLIES:

The doctor would be shooting the Cytosine into my foot and

KARIN OLNESS: would just be waving the perfume under my nose and I was told to image the rose. And then my mother would force the cod liver oil down my ... my throat. And I had to take three sips of cod liver oil in order for this to work.

BILL MOYERS:

Her body would, put quotes around this, her body would "think" that it was getting the drug and react as if it were, even though what she was getting was your concoction.

KARIN OLNESS::

That's right. That's right. I think in Marette's case, we were not impacting a conscious thought process. We were impacting on those nerves connected from ... from her tongue and her nose to her brain. And the brain in turn sent signals to various parts of her body to respond as if she was receiving the cyclophosphamide.

BILL MOYERS:

At first, Marette received a full dose of the dangerous drug, along with the cod liver oil and the rose fragrance. Little by little she was weaned from the full dosage. And at the end of two years, the dose had been cut in half. Marette had weathered the crisis. Eight years later Marette still has lupus and still takes a milder medication to keep the disease in check, but she no longer needs the fragrance of the rose, the cod liver oil or the dangerous drug. Exactly how it worked, no one can say. Whatever happened, Marette today enjoys a more normal life. How can you be sure that she simply didn't need less of the drugs all the time and that what you really did for her is to take her off something that she didn't need as much of?

KARIN OLNESS::

We can't be sure at all. This is one child, one case. We can't make absolute conclusions on the basis of one case.

ROBERT ADER:

There are many alternative explanations for why this child did well under that chemotherapy schedule. It's also entirely possible that she did well under the reduced amount of drug because of the conditioning. But I can't answer that question. Nobody can answer that question. this is simply a single case study which we hope will precipitate a second case study perhaps and a third.

BILL MOYERS:

When you were working with Marette, do you think you were trying to teach her body or her mind?

KARIN OLNESS::

I really don't see them as separate.

ROBERT ADER:

The mind and the body are the same thing. They're inseparable, but for convenience, because of our own limitations we have divided it up artificially and studied it one little piece at a time rather than as an integrated unit. Our science is compartmentalized, bureaucratized. It reflects our own Ignorance. I'm a psychologist and you're a biochemist and somebody else is a pharmacologist and somebody's an immunologist. We've divided up that pie into pieces that are manageable.

DAVID FELTEN:

The bad news is now we have to start talking each other's language. And heaven forbid that immunologists and neuroscientists in the past ever used each other's language. They'd rather use each other's toothbrushes.

MARGARET KEMENY:

The language we use now prevents us from conceptualizing some of the most important questions, just by virtue of using a certain language to describe the mind and another language to describe the body, languages that don't even have a way of connecting prevents us from seeing that these two kinds of phenomena are actually very similar.

BILL MOYERS:

The mind and the body are one and the same.

ROBERT ADER:

Yes, they are inseparable components of the whole.

BILL MOYERS:

How then do these inseparable components talk to one another? What language do they speak? Candace Pert, a neuroscientist formerly with the National Institute of Mental Health has mapped the chemicals which she believes may carry the messages, the neuropeptides. Now, what is a neuropeptide?

CANDACE PERT:

Peptides are strings of amino acids, strung together very much like pearls strung along in ... in a necklace. And a neuropeptide is a peptide that was first found in the brain, but then later on we found that they were everywhere and that's what really shook everybody up. These molecules are being released from one place, they're diffusing, they're binding and they're tickling these receptors that are on the surface of cells. Every cell in your body is encrusted with receptors of various types.

BILL MOYERS:

Like a satellite dish that's receiving a signal.

CANDACE PERT:

Facing outward like a satellite dish and receiving, putting out their little antenna and receiving what's coming in. Everything in your body as it's running is being run by these messenger molecules.

BILL MOYERS:

What do you mean by that?

CANDACE PERT:

Well the cells have to talk to each other, otherwise the whole organism can't hang together. And the cells have to talk. Now I guess you're going to ask me what they talk about.

BILL MOYERS:

Yeah, I was just going to ask you, what do they talk about?

CANDACE PERT:

It might just be, make a little more of this protein or make a little less of that protein. Or these cells stop dividing because we've got to put our energy into digestion. In a way, one way to think of ... the neuropeptides as we've come to think of them as directing where the body should pay attention, where the body should put its energy. Lay down and relax so you can digest your food, man, or you're going to die. That kind of message. But of course on a cellular level ... there's hundreds of scientists who've mapped where these molecules are and found them in the various parts of the body. After years of studying these various pep tides and studying how they were distributed and their characteristics, we came to hypothesize that these were the biochemicals of emotion.

BILL MOYERS:

Biochemicals?

CANDACE PERT:

The biochemicals of emotion. We were nervous to call them that and it took us 15 years of research before we dared to call them that, but they were found in the parts of the brain that mediated emotion. They control the opening and closing of your blood vessels in your face and the flushes of emotion. They get released during various kinds of emotional states. We wanted to make some kind of sense out of all of this data.

BILL MOYERS:

Are we just ... are we just a circuit of chemicals? I'm looking for a language I don't understand. Emotion.

CANDACE PERT:

I have ... I have trouble myself ... I have trouble myself. I can say that what it looks like to me is that the currency with ... with which mind and matter inter-convert, might be emotions. Emotions might actually be the link between mind and body, if you will. Although I hate the word link, cause it's fences and it's mechanical and it's very Newtonian.

BILL MOYERS:

So we think of emotions as psychological.

CANDACE PERT:

Absolutely.

BILL MOYERS:

But you're saying?

CANDACE PERT:

I'm saying that you know, psychologically yes. Psyche, yes, soul. Emotions are in that realm, but I'm saying I think we found ... all of the scientists have actually found the material manifestation of emotions.

BILL MOYERS:

Are you saying that the mind talks to the body so to speak, through these neuropeptides?

CANDACE PERT:

Why are you making the mind outside of the body?

BILL MOYERS:

That's the way I was raised.

CANDACE PERT:

That's cause you're part of western civilization.

BILL MOYERS:

I mean I was taught that the mind is somehow distinct from the body. It's something in here in the ... in the brain.

CANDACE PERT:

Well that just all goes back to a ... a turf deal that got ... that Descartes made with the Roman Catholic church. And he got to study science as we know it and left the soul and the mind and consciousness and emotions in the other realm. That was the realm of the church. But remember, I am a scientist in the western tradition and I don't use the word spirit. I'm not allowed ... you know, soul is a four letter word in our tradition. You know the deal was struck with Descartes. We don't invoke that stuff.

BILL MOYERS:

So instead of saying, the mind is talking to the body, you would say, I'm talking to myself. I, as a whole person, which includes a sending device and a receiving device, is that what you're saying, that we are....

CANDACE PERT:

I like that. Yes, I like that. That I can ... that, I am talking to myself, that I feel is scientifically accurate at this stage in our knowledge in the 20th century. But to say the mind is talking to the body, is old think. It's like ... and remember, you know when New ... when quantum mechanics came in, it wasn't like Newton was wrong, it's all still right. It's just looking at it in another ... from another point of view.

BILL MOYERS:

The brain is talking to me unconsciously, I mean, or instantly through this reaction in the receptor.

CANDACE PERT:

The me that you say is me you're still thinking it's your brain. The me that's you is your whole body.

BILL MOYERS:

Do that the intelligence is ....

CANDACE PERT:

It's the wisdom of the body. Intelligence is in every cell of your body. The mind is not confined to the space above the neck. The mind is throughout the brain and body.

BILL MOYERS:

So the mind is more than the brain?

CANDACE PERT:

Definitely.

BILL MOYERS:

Then what is the mind?

CANDACE PERT:

The mind? What is the mind? Gosh how frightening. I'm a ... I'm a basic scientist and I'm having to answer, what is the mind? The mind is some kind of enlivening energy that throughout the brain and body enables the cells to talk to each other. And the outside to talk to the whole organism.

BILL MOYERS:

Aren't ... aren't you speaking metaphorically, poetically, when you say that the mind is in the body? See my big toe may feel something, but it can't discriminate if that ... it can't decide if that's fear or anger or happiness or sadness. I have to invoke my mind ... my mind has to come into the play.

CANDACE PERT:

Well maybe you're ... certainly to articulate and to say, I am feeling this and to analyze that your brain is of course coming into ... into play. But ... of course there's many, many, emotional messages that are subconscious, that don't percolate up to your level of knowing them, but they're used just the same to run everything in your body.

BILL MOYERS:

Wait a minute, you're saying ... I... I could take from that that my emotions are stored in my body?

CANDACE PERT:

Absolutely. You didn't realize that?

BILL MOYERS:

I didn't realize that. I'm not even sure what I mean by that. I was just taking what you said, that I call up these emotions, these emotions come rising to ... to the trumpet sounded by my mind.

CANDACE PERT:

Right.

BILL MOYERS:

What's down there?

CANDACE PERT:

Peptides, receptors, cells. The ... states of the receptors, now one thing when we ... when we talked about them being satellite dishes, they're really dynamic. They're constantly ... they're really wiggling, vibrating, energy molecules that can ... they not only change their shape from millisecond to millisecond, but they're actually changing what they're coupled to. One moment they're coupled up to one protein in a membrane, another, they can couple up to another. What that means is it's a very dynamic, fluid system.

BILL MOYERS:

And every time they couple, every time they connect, every time they respond one to another, this conversation is carrying messages.

CANDACE PERT:

Yes.

BILL MOYERS:

Chemical messages?

CANDACE PERT:

Chemical messages.

BILL MOYERS:

And my body responds differently according to what cell is getting what chemical?

CANDACE PERT:

Absolutely, you got it.

BILL MOYERS:

There is a way to demonstrate that changes in your

thoughts and feelings directly affect your body. It's called biofeedback. It's a way of eavesdropping so to speak on our own mind-body conversations. This computer measures responses like heart rate, skin temperature and electrical changes on the surface of the skin. Galvanic skin resistance, or GSR, for short. With a little practice these simple physiological processes can be monitored and controlled by nearly anyone.

KARIN OLNESS::

Now, let me ... let me ask you to recite the Gettysburg Address.

BILL MOYERS:

"Fourscore and seven years ago our forefathers brought forth on this continent a new nation, conceived in liberty and dedicated to the proposition that all men are created equal."

KARIN OLNESS::

Go on.

BILL MOYERS:

Now, I know that. Oh, I know that and I just ... it just ... I just ... it ... you ... it disappeared.

KARIN OLNESS::

And ... and your primary response to that was ... was in your heart rate more than in your temperature or your GSR. Although now it's interesting, your GSR jumped down when you took your mind off it for a minute.

BILL MOYERS:

So what does this mean when my heart rate increased?

KARIN OLNESS::

Well ... it increased. You weren't ... you know you weren't exercising. It was increasing solely on the basis of perhaps you had a little bit of stress in thinking about that and therefore you're blood pressure jumped up and your heartbeat a little faster and that was reflected here. And here we find your heart rate coming down again. But you show a lot of stability.

BILL MOYERS:

It ... it means I'm fairly even-tempered?

KARIN OLNESS::

No, for whatever reason your heart rate decided to take a Jump ....

BILL MOYERS:

So I was ... so I was groping for it.

KARIN OLNESS::

You were groping and ... and as you ... as you spoke, your heart rate jumped. I'd just like to ask if you would mind closing your eyes and thinking about something that is a very comfortable place for you, something that's very relaxing. Perhaps some place where you'd like to be or have been and just focus on enjoying that feeling for a couple minutes. That's very nice. Nice and steady. Just look at that pattern for a minute.

BILL MOYERS:

It's a peak in the Rockies with a 360 degree view and not even a jet stream from a man-made object to indicate anybody else's presence.

KARIN OLNESS::

And no deadlines.

BILL MOYERS:

And no deadlines.

KARIN OLNESS::

When you began to speak, you know you jumped a little bit. You obviously probably don't have a great deal of perception of distress, but I would say any time you do, just take a minute and go to that peak. You obviously are even more stable than your normal pattern when you think of that place.

BILL MOYERS:

But see you ... you say this can reveal the mind's connection to the body, but if so, what does it have to do with my health?

KARIN OLNESS::

There is evidence that it's useful for example, for any child with a chronic illness like migraine.

BILL MOYERS:

Mika Crass is ten years old. Several months ago she began suffering from severe migraine headaches. And no drug was able to stop the unpredictable round of intense, debilitating pain. But Mika's doctor offers her a different kind of therapy.

KARIN OLNESS::

We'll use the measurement of the electricity in your skin, Galvanic Skin Resistance. And do you want a hexagon or a diamond to practice with today?

BILL MOYERS:

Karen Olness has taught Mika how to ease the pain by using her mind.

KARIN OLNESS::

Open your eyes or close your eyes, whatever you choose. You can relax and make this hexagon get smaller and smaller.

BILL MOYERS:

As the electrical resistance in her skin diminishes, the design becomes smaller. With the help of feedback from the computer, Mika has learned when her mind is relaxed.

KARIN OLNESS::

Just go ahead and imagine that you're ... playing a tennis game against a very good opponent. And you can imagine that your brain is sending messages to your arms and to your legs so that you hold the racket just right and you hit the ball at exactly the right place. And it's a very good feeling to be playing so well. And you can just enjoy that tennis game in your mind until you've won the game.

BILL MOYERS:

During the past few months Mika has learned that she can exert some measure of control over her body. In ways still unknown to science, the process is healing. In a controlled study

KARIN OLNESS: has demonstrated that children with migraines who learn these techniques can reduce the frequency and discomfort of their headaches.

KARIN OLNESS::

I'd like to emphasize that all of this takes practice. That's why, it doesn't work for everybody. There ... there isn't any magic.

BILL MOYERS:

It seems to me you're trying to tap into their imagination, the children's imagination.

KARIN OLNESS::

It's ... it's fun to ... to ... to watch their creativity.

BILL MOYERS:

Do you have an intuition about where the mind and body meet?

KARIN OLNESS::

I had a ... a four-year-old patient who once asked me, he said--after he had done very well on one of these biofeedback exercises-he said, but I want to know, how does the thinking get down to make my fingers warm? And I said to him, we're not smart enough. We ... we don't know. And I said, but maybe when you grow up, you'll figure it out. And he said, I'm a smart boy, probably I will.

MARGARET KEMENY:

We know that the physiology is there. But we have no way to even speculate almost on how a particular thought about a particular physiological event could get to that cell for example and alter it. However, it doesn't mean that it's not possible. That's why recent work, recent scientific work is really geared towards trying to make that final link in the chain.

CANDACE PERT:

I think almost all neuroscientists and immunologists would agree that messenger molecules and their receptors are the molecular physiology of the body.

CANDACE PERT:

Now we're mapping these peptides, receptors and ... and other messenger molecules.

BILL MOYERS:

What does all this have to do with my health?

CANDACE PERT:

Everything. I believe it has everything to do with health, because these are the chemicals that run your body. They run your digestive system, they run your immune system. The monocyte, which is one of the prime cells in the immune system, has on its surface these receptors for these biochemicals of emotion, for the various peptides. And they use these receptors to wander throughout the brain and body. And move ... let's just say the body for a moment, and they ... it tells them where to go, and, where they go they also orchestrate the entire response of the immune system.

BILL MOYERS:

What does this have to do with healing, these little things wandering around in there?

CANDACE PERT:

Well if you cut yourself or bum yourself, within seconds these monocytes come out of your bone marrow, go right to the site of the injury and begin to remanufacture and restructure the body fabric.

BILL MOYERS:

And that happens naturally?

CANDACE PERT:

It's happening...

BILL MOYERS:

Instantly?

CANDACE PERT:

It's happening while we ....

BILL MOYERS:

Spontaneously?

CANDACE PERT:

... speak. It's happening in ... you probably had five little things happen in the last ten minutes while we were talking, where monocytes went to the rescue.

BILL MOYERS:

I see that when the body heals a wound or cuts off the blood that's flowing from a ... from a wound, but I don't understand it in terms of the emotions.

CANDACE PERT:

Well I don't understand it either. I mean what I understand is the fact that those .., the fact that those chemical.... I mean there's no doubt in my mind ... it's been proven 10 ways to Sunday that those receptors are on those monocytes and that they travel according to them and that they or ... and that their functions are orchestrated by these molecules. How ... the implication in my mind is that emotion has the potential to play a role in this process and influence this process.

BILL MOYERS:

Can our moods and our attitudes physically affect our organs and our tissues?

KARIN OLNESS::

I believe they can because I believe that moods and attitudes come from this mind realm, ultimately transform themselves into the physical realm which have to do with you know, how well your liver is working and how your heart is going and whether your blood' vessels are occluding. You know I never get a cold when I'm going skiing. You know you ... on some level your emotional state.... You know ... you know all the data. There are way more heart attacks at 9 a.m. on Monday morning than there are in any other time of the year. Huge death peaks in Christians on the day after Christmas. And huge death frequency peaks in ... in ... in Chinese, the day after Chinese New Year. I mean....

BILL MOYERS:

Suggesting.

CANDACE PERT:

Suggesting that emotional ... that fluctuations in emotional status are directly influencing the probability that the organism will get sick or be well.

BILL MOYERS:

Well that's a kind of conventional wisdom, isn't it? A sort of a folk wisdom that we've known for a long time, but ... where does this trail lead us in regard to emotions and health?

CANDACE PERT:

It leads us to that the chemicals that are running our body and running our brain, seem to be the same chemicals that are involved in emotion. And that says to me that we'd better pay more attention to emotions with respect to health.

BILL MOYERS:

Emotions and their effect on the body are notoriously difficult to study. How can a scientist isolate and specify a feeling?

MARGARET KEMENY:

Method trained actors are actually perfect for this kind of study, because what they do for a living is get themselves into emotional states. And we're interested in knowing what takes place in the body during those emotional states. The actors study is really designed to look at whether short-term emotional changes, whether feeling happy for 20 minutes, or feeling sad for 20 minutes, can have an impact on the immune system.

BILL MOYERS:

So you looked at an actor who imagined opening night.

MARGARET KEMENY:

Right.

BILL MOYERS:

That he was on the stage, he was being applauded. And....

MARGARET KEMENY:

He was exhilarated and happy because he had done so well and we found the exact same pattern in him, during the happy state as we saw in him during the sad state. There was an increase in the immune system in the number of a particular type of cell, actually an enhancement of the immune system. And then, once the actor got out of the negative state, or the positive state and was sitting quietly for half an hour, the immune system went ... went back to normal. It's very interesting that in both these states, one very negative in a certain way and one very positive, we find the same outcome in the immune system.

BILL MOYERS:

I know scientists don't leap to conclusions, but could one tentatively conclude from this that ... that we're discovering that states of emotion, even sad states of emotion have a positive effect on our bodies?

MARGARET KEMENY:

I think we are too embedded in the notion that stressful experience, that exposure to negative life events and feeling badly always has a negative impact on our bodies, on our physiology. And we've tended to forget that there are a whole host of different kinds of reactions we can have to experience. One reaction to a loss is a grief response that's usually characterized by a lot of sadness. Another reaction to a loss is depression, where it isn't really sadness. Often depression is a very empty state that is not characterized by emotional experience. And they feel, very different I think. And it is possible that grief may have a positive impact on certain systems and depression may have a negative impact.

BILL MOYERS:

Which means that we're not as able to fight a disease if it occurs in that state.

MARGARET KEMENY:

Now that's a link that we would all like to make and it's a very important link, but we haven't yet made it. We're in an area of science that we're really only beginning to understand, but it's possible that the experience of feelings per se, the experience of sadness, fear, happiness is healthy psychologically and may even be healthy physiologically. Certainly the actors study suggests that as a possibility.

BILL MOYERS:

So that if we could learn to alter, voluntarily our emotional states, we might be able to have some positive impact on our body's ability to ... to fight a ... a disease, an infection, a virus.

MARGARET KEMENY:

Now we don't know if that's true right now. Although there is some data suggesting that for example group therapy and other kinds of therapies have an impact on the immune system. But we're only beginning to scratch the surface of that really important question.

BILL MOYERS:

From all over the country people suffering from heart disease have come to a pioneering program in Oakland, California, hoping to save their lives by changing the way they live.

MAN:

When it all started? Oh yeah, you know I was feeling pretty good and I couldn't believe they turned me down for the insurance.

WOMAN:

That you had a 12-year history of heart disease, is that correct?

MAN:

Your first heart attack was about what, '86?

MAN:

'86, five years ago.

MAN:

Yeah, in October?

BILL MOYERS:

The possibility that heart disease can be reversed by changing behavior was demonstrated for the first time in a study directed by Dr. Dean Omish. Exactly what did your study show?

DEAN ORNISH:

Well the coronary arteries feed the heart with blood. And over time they can get clogged up, much like rust building up in a pipe over a period of years, with cholesterol and other deposits. Now until recently it was thought that that process was only going to get worse over time. What our research has shown is that in the majority of patients who went through our program, the blockages could actually begin to unclog. They became less blocked. The blood flow to the heart improved and the chest pain as a result diminished markedly. In our study there was a 91 percent reduction in the amount of chest pain that most people had.

RODNEY BRIMHALL::

I lived for three or four years after my first heart attack with absolute, abject denial that anything happened. It was two or three years before I even looked at my own cardiogram, which I'm perfectly qualified to ... to interpret. And when I did look at it, I said, yes, you had a heart attack.

BILL MOYERS:

What do you do for a living?

RODNEY BRIMHALL::

I'm a cardiologist.

BILL MOYERS:

A cardiologist?

RODNEY BRIMHALL::

Right.

BILL MOYERS:

I mean this is like bringing coals to Newcastle, isn't it?

RODNEY BRIMHALL::

Well you see, but I was a good old southern boy before I became a cardiologist and....

BILL MOYERS:

And what does that mean?

RODNEY BRIMHALL::

Well ....

BILL MOYERS:

You're talking to one.

RODNEY BRIMHALL::

I know, but that means you ... you grow up with biscuits and grits and fatback gravy and....

BILL MOYERS:

Chicken fried steak.

RODNEY BRIMHALL::

Chicken fried steak. Everything was fried.

BILL MOYERS:

Why do you think he's here now?

JOYCE BRIMHALL::

Because this last go around in April, he almost didn't make it.

BILL MOYERS:

Oh yeah?

JOYCE BRIMHALL::

That's right and I think it was a real eye-opener.

BILL MOYERS:

You mean he almost died.

JOYCE BRIMHALL::

He almost died, yes.

RODNEY BRIMHALL::

I really have nowhere else to go. I mean conventional medicine has given me bypass surgery, they've given me pills to take. I did that for a period of eight or 10 years. And my coronary disease continued to progress. Now I'm going to continue with the medications, I'm going to continue with diet, I'm going to continue with exercise, but I feel really that I've got to get some control over my disease by using my mind.

DEAN ORNISH:

Okay, real slow. Swing down, up. All right now since it's the first day what we'd like to go is nice and slow, get you started with some general walking.

BILL MOYERS:

For all these victims of heart disease, Dr. Ornish hopes that the next ten days will be just the beginning of a new and healthier way of life. That includes moderate exercise. Along with an austere, low-fat vegetarian diet that skeptics charge is too demanding for most people to practice.

WOMAN:

And visualize it in your mind's eyes, perfectly healthy and strong. Yet peaceful and relaxed.

BILL MOYERS:

Dr. Ornish also insists on enlisting the mind to help, through meditation and group therapy.

RODNEY BRIMHALL::

And without the wall or without the fence ... we're naked, we're naked you know. We're ... we're very vulnerable. And I'm ... I don't think I want that.

DEAN ORNISH:

It may seem hard for people to believe that such simple ideas as sharing feelings or eating a low-fat vegetarian diet or doing meditation or walking could have such powerful effects, but they seem to do that. You know we tend to think if breakthroughs of medicine in our culture as a new surgical technique, or a new drug, so we have a hard time believing that these simple, ancient, inexpensive approaches can be so powerful. But we're finding that they often are.

BILL MOYERS:

When you look back at your data, can you decide what was the major determinant in the reversal of the heart disease?

DEAN ORNISH:

No. You just ... if you take a group of people and you put them on a diet, it's not just putting them on a diet, they're ... they're also being part of a group. The group itself is very supportive. That really manages stress better than just about anything. You're giving them a sense of meaning, a sense of empowerment, a sense of control over their lives. All of that plays an important role.

WOMAN:

And then exhale slowly and just relax into the position. Drop your chin to your chest and just let gravity do the work. Take some sighing breaths. Aaah. When you take a deep breath, it sends a signal, an electrical signal up to the brain to relax all the muscles in the body. We also change the brain chemicals through the course of the class. Each thought ... that we think has a biochemical effect. And we start to be more aware of what we're doing with our thoughts and increase the endorphins and enkephalins. The hormones in the brain associated with relaxation, serotonin are increased. So we're going to our local, closest pharmacy, the drugstore in our brain and changing the brain chemicals to achieve a more relaxed state.

DEAN ORNISH:

When the mind begins to quiet down an individual can begin to experience more of an inner sense of peace and contentment and well-being. You know on one level heart disease is a physical illness with physical problems. But on another level it goes beyond that. There's an emotional heart disease if you will.

BILL MOYERS:

Are you talking about emotional heart surgery?

DEAN ORNISH:

Well you can say it's a different kind of open heart surgery. We're asking people to open their heart in ... in ways that go beyond just op ... splitting open their chest.

RODNEY BRIMHALL::

I feel totally ... not in control of my own life. I feel that my ... my entire life is controlled by other people. My family. My patients. My wife. My mother. Oh that's getting into the psychol ... the psychiatry part of it.

MAN:

You know the only relief I have? It's watching stand-up comedy. That kind of lets me breathe a little better. I wait till late at night and I watch stand-up comedy, which channel that it's on. I just scan the T.V. channel till I find it, then I will get a feel few laughs, then I can go and end my day. I don't know, maybe if someone says ... someone else say something, maybe I can put my pieces together.

DEAN ORNISH:

It began as a support group in the way that most support groups are. Helping people stay on the diet. Exchanging recipes. Shopping tips and so on. But it evolved into something else. There are a number of studies that has shown that people who feel isolated have three to five times the mortality from not only cardiovascular disease, but from all causes, when compared to people who don't feel that way. And what I'm learning from these patients and these participants is how important it is to address these deeper issues. The issues of isolation and loneliness, chronic emotional stress, which in some people can manifest as heart disease and in other people, as other illnesses.

RODNEY BRIMHALL::

This thing runs away with me at times and if I don't learn to control it the same as I control my arm and my hand, it's not going to be my friend. I think really the mind is the master organ and it controls everything else.

BILL MOYERS:

That really astounds me, the possibility that group support could literally, and I mean literally have an effect on the body that would be positive in fighting a disease.

MARGARET KEMENY:

Well I think it ... it is because it sort of flies in the face of a lot of medical wisdom at this moment, which does not put much credence in the psychological condition of the patient. And I think we have to really question that now because it really does appear that there are these linkages between our psychological state and various biological processes. We have not yet taken that final step though and this is a very important final step, which links those changes in biological processes to disease outcomes.

DAVID FELTEN:

I think it means that we have to pay attention to the patient directly. We have to care about how that patient perceives what is going on, even though we know what the disease is or we may know more factual details, how the patient perceives the situation may be important.

BILL MOYERS:

In this textbook you wrote, I notice the epilogue is called, "A Personal Perspective." "Although it is tempting for the basic scientist to ignore or deny that which cannot be explained on a mechanistic level, I am one such basic scientist who has been touched personally by the example of my mother, a courageous woman who faced life crippled with polio and beset with medical problems." But what did you learn about the healing powers of the mind from your mother?

DAVID FELTEN:

I think I became very interested in neurological disease from being aware of the fact that my mother had polio and from seeing that this was an affliction of the motor system of the spinal cord and brain stem, and I became very interested in the nervous system from that. And then I watched this very tough person fight back time and time again. She had congestive heart failure, she had pulmonary problems. She would get these horrendous bouts of pneumonia where you would just swear there wasn't a chance she would pull through this. And many of the physicians would just say, no way. And she'd grit her teeth and stick her chin out and say, I'm not ready to go yet. And she'd somehow fight back from it. Now whether or not we can invoke any of these connections to explain that tough, courageous determination, I don't know. I certainly don't understand it mechanistically. But I understand it at a gut level.

BILL MOYERS:

You mean you don't understand the triumph of the human spirit as far as....

DAVID FELTEN:

That's right. I can't explain what neurotransmitters, from which neurons and which parts of the brain interconnect where to make it happen, but it happens. I wish I knew. I'm insatiably curious to know. I'd love to know what goes on there, but we just don't know that yet. We're working at it. And it's piece by piece that's falling into place.