Choice Theory (20 page)

When we are lonely or frustrated our creative system may also
offer us new feelings. Depressing is the most common but there are also anxieting, headaching, backaching, and other painful feelings. While we cannot reject the feeling—we have no direct control over how we feel—we can try, with counseling or without it, to improve the relationships we have or find more satisfying new ones. This is what my client in chapter 4 was able to do and what Francesca began to think about in the previous chapter.

When our creative system offers us new but destructive physiology, we cannot reject this offering. Unless we know that improving our relationships may actually slow or stop the destructive process, we may suffer great harm. The most common examples of this destructive physiology are the autoimmune diseases such as rheumatiod arthritis. Even though this process is so destructive and so puzzling I still believe there is a choice we can make which could help. I use the general heading of psychosomatic disease to describe this process.

There is no way to predict when these diseases will occur or how much out of control our lives need be for them to occur. We can find out that we have rheumatoid arthritis, for example, only when it appears. But if what I explain here is correct, there is something helpful that we can do on our own or with good counseling at the
first indication
that we are becoming destructively creative. I want to emphasize that nothing I suggest has any chance of doing harm, and I advise anyone with these diseases to seek accepted medical care and to follow their doctors’ advice.

Most doctors believe that adult rheumatoid arthritis is caused by the victims’ immune systems attacking their own joints as if these joints were foreign bodies. Another way of putting it is that their own creative systems are trying to protect these people from a perceived harm. If we could figure out a way to stop this misguided creativity, millions of people who suffer from this disease and a host of other relentless diseases, called autoimmune diseases,
could be helped. They might even be cured if the attacks were caught early enough.

Norman Cousins succeeded in aborting such an attack. As he described in detail in
An Anatomy of an Illness,
^*
when he began to suffer pain and stiffness in his back, he was diagnosed as suffering from an acute ankylosing spondylitis, or rheumatoid arthritis of the spine. If it continued, the doctors told him, he would be severely disabled by a badly bent and painful spine. The pain and inflammation might eventually stop, a common occurrence in the life history of many of these diseases, but the deformity would be permanent.

His doctors told him there was nothing that could be done for him medically and no pressing reason for him to stay in the hospital even during the acute phase of the disease. Therefore, he left the hospital and chose a regime that seemed to lead to what was medically confirmed as a complete cure. What he did had nothing directly to do with his immune system, but it had a lot to do with taking more effective control of his life.

Cousins’s explanation of the circumstances in which he got sick, clearly showed that he had lost control of a significant event in his life. Cousins was an important man who was used to people both listening to and appreciating what he had to say. Yet some foreign officials, vital to one of his many help-the-world projects, ignored him. His picture of himself in his quality world as a well-known, powerful man was severely frustrated, and his life quickly went out of effective control. As it always does when we are frustrated, his creative system got involved. This involvement was not in the thinking or acting component of his total behavior, however; it was with his immune system, a vital part of our physiology. The immune system began to attack and damage his spine as if it were a foreign body.

My explanation of what was going on in the physiological component is that his immune system, whose major purpose is to protect us from outside invaders, such as bacteria, viruses, and poisons, misread his loss of control and wrongly concluded that he was being attacked by a bacterium or virus. When we become sick with a severe infection caused by an invading bacteria or virus, it is accurate to think we have been attacked. I have often heard people say,
I am fighting a bad cold
or
wrestling with the flu.
But people also say,
I
am fighting to save my marriage, my job, my reputation, my beliefs, my way of life.

Because this is such a common way to think, it is not farfetched to infer that what was going through Cousins’s mind was, I’ve got to overcome this indifference to my ideas; I see it as an attack on the important work I am trying to do. Because the immune system reads only the physiology of thought, it can’t know anything about the psychology of that thought or any thought. It may mistake the physiology of the being-attacked thought for the similar physiology of an actual bacterial attack. It certainly seems possible that the immune system is alerted by that thought and begins to hunt for a microorganism that is not there.

Finding no microorganism, but not wanting to shirk its duty, the immune system somehow targets an organ or body part and attacks it as if it was infected with a microorganism. To confirm what I am trying to explain, experiments have shown that a person who is allergic to strawberries may break out in hives when he or she goes into a room papered with strawberry-patterned wallpaper. The hives are caused by an overactive immune system. The pathology in rheumatoid arthritis is almost the same as if the joints were infected by bacteria. Medically, this mystery is called a sterile infection.

For unknown reasons, adult joints seem to be the prime target of the autoimmune system, and rheumatoid arthritis, no matter what joints it attacks, may be the most common autoimmune disease. Other target organs and their corresponding autoimmune diseases are the skin, scleroderma; the kidneys, glomerulonephritis; the blood vessels, periarteritis and lupus; the lungs, adult
asthma; the sheath that covers or insulates the nerves, multiple sclerosis and other common diseases that are too numerous to mention here.

But a feature story in the
Los Angeles Times
of April 4, 1997, reported that medical researchers seem to have discovered a new widespread autoimmune disease in which the immune system attacks the lining of coronary arteries.
^*
The article began: “A subtle but unexpected attack on the coronary arteries by the body’s own immune system may be the cause of as many as half of all heart attacks and coronary artery disease. It also may explain why aspirin is so good at preventing heart attacks.” At the end of the newspaper article, Dr. Valent Fuster, of Mount Sinai Medical Center in New York City, offered this opinion: “Such inflammation may be a response to the accumulation of even small amounts of cholesterol in the walls of blood vessels.” The conclusion I drew from this research and Dr. Fuster’s comment is that the immune system may be misreading this cholesterol in the lining of the coronary arteries, a common, almost normal, accompaniment of aging in men,
as a foreign body.

This is strong evidence of what a few doctors, including me, have been speculating for years. In a chapter on creativity in an earlier book,
Take Effective Control of Your Life,
^†
I wrote the following:

What Fuster described as “small amounts of cholesterol” could be part of “the rough spots” I mentioned in the preceding paragraph. The rest of what I describe is the well-known process of inflammation, including the proliferation of clotting elements in the blood. People with heart disease are routinely given anticlotting drugs, such as coumadin, to reduce the circulation of clotting elements in the blood. In recent years, aspirin, an anti-inflammatory drug, has often been added to this regimen. As you can see, I have been thinking for a long time about what part this self-destructive—I call it crazy—creativity may play in coronary artery disease.

When your doctor tells you that you have an autoimmune disease, he or she is trying to tell you it is caused by your immune system attacking the part of the body involved. Cousins couldn’t do anything directly about what his immune system was doing; at that time, he may not have even known this was what was going on. What he did know was that he was miserable and that he thought he could do something about it.

He decided to leave the hospital and make himself comfortable in New York’s Plaza Hotel. He hired some cheerful, attentive nurses; ate great food; and asked his friend Allan Funt to visit and bring videotapes of some of his funny
Candid Camera
sequences, often too risqué to show on television. Cousins watched these videotapes and laughed and laughed. The combination of good food, attentive nurses, good friends, and a lot of laughter gave him the sense that the world need not end because a few foreigners he hardly knew refused to listen to him. He stopped fretting about what had happened and regained effective control of his life, and his creative system stopped pushing his immune system. He quickly became normal; the disease never recurred.

Cousins wrote about taking massive doses of vitamin C and continued to see his doctor. But he took the vitamin C on the advice of Linus Pauling, a renowned physicist, not his doctor. There is no indication that this is an effective treatment for rheumatoid arthritis. But Cousins believed in the vitamin C and made the point that he did more than laugh his way to good health.

Anyone who suffers from rheumatoid arthritis or any other destructive, or potentially destructive, creativity, could attempt to take more effective control over his or her life. But even though what Cousins did seemed to have worked for him—of course, his regimen has never been proved—it is not the only way. I also suggest that when you become aware that your immune system has harmed some aspect of what should be your normal physiology, concentrate on trying to improve the frustrating relationship that may be the cause of what is happening.

Although it seems simple, most people with a psychosomatic disease don’t even think of doing what Cousins did or of entering counseling with a counselor who knows choice theory, which may be easier and equally effective. People who are sick often make the logical mistake of concentrating their efforts on the symptoms of the disease, which they can do nothing about. Instead, I suggest that they give equal time to the relationships in their lives that may not be in effective control.

It is difficult to live in such a way that all our relationships are in effective control, and usually it doesn’t make that much difference as long as some relationships are satisfying. But when you get sick, it is a good idea to review all of them. Some may be more rankling than you are willing to admit. You can review these relationships by yourself; with the help of a friend or family member you trust; with your doctor if he or she can give you the time; or, best of all, with the aid of a good counselor.

To illustrate what a counselor can do, I would like to share with you the most dramatic incident I have ever been involved in as a psychiatrist. It occurred in 1956 while I was working as a resident on the psychosomatic ward of the Wadsworth Veterans Administration Hospital in West Los Angeles. A forty-year-old man
who had been suffering from intractable asthma for the past ten years had been given every known medication with essentially no relief. His lungs were scarred and clogged as if his immune system had been attacking his bronchioles. He could hardly breathe; it was difficult for him to talk, and he had been put on a positive pressure respirator once or twice a week to keep him alive during the attacks he frequently suffered. The medical resident who called me in told me his condition was hopeless, but if I wanted to try to help him, I could see him.

The man’s human relations were nonexistent. He was in the dry-cleaning business with his brother, but he could do so little that they were not on good terms. This hospital admission had lasted six weeks, and the medical staff doubted they could ever get him in good-enough shape to leave the hospital. The man could barely talk, but I was patient and told him that even though it was hard, I was determined to counsel with him.

I saw him for several weeks almost every day, and we gradually got acquainted. He kept telling me it was worthless; he needed good medical care, not a psychiatrist. But I persisted. Several times he had a mild attack of not being able to breathe during the sessions and begged me with gestures to let him go back to the ward, but I told him that even if he couldn’t talk, this was our time together and I didn’t want him to go back until it was up.

He seemed to be doing a little better, and I was encouraged. But then he got an attack so severe that I had to call the respirator crew, who put him on a respirator and wheeled him back to his bed. I got the idea that he was choosing the attack to get away from me and from having to talk about his present life. I decided that when he had the next attack, I would keep counseling even while he was on the respirator, and he could respond with his hands or nod to my comments. The next attack was the worst yet. The respirator crew pumped and pumped but couldn’t seem to get enough air into him, and he turned blue. The respirator crew; the medical resident; and, of course, the patient thought I was crazy. I paid no attention; I continued to counsel and could see his expression get more and more desperate.