Thus was born a new science: psychoneuroimmunology. The infelicitous name makes sense when you break it down: Your thoughts and feelings (psycho) affect the chemicals in your brain (neuro), which affect the hormones that fight disease or replicate viruses (immunology). Psychoneuroimmunology. New research centers began to spring up—at Harvard, Ohio State, the University of Rochester, and the University of Miami, and one named after the man himself, the Norman Cousins Center for Psychoneuroimmunology at UCLA.
The research flowed quickly, and showed that nonphysical things like thoughts and emotions affect our bodies at the cellular level, just as surely as do genes or lifestyle or the medicines we take. Emotions—particularly depression and stress—are linked to heart attacks.
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They suppress the immune system as it tries to fight the flu.
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One’s thoughts and attitudes affect the course of cancer,
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and the recovery from breast cancer.
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Emotions even affect how long one is plagued by the skin condition psoriasis.
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As I investigated these findings, I stumbled upon a researcher who has found evidence that
spiritual
thinking may be the most powerful mental antidote of all. I flew down to meet Dr. Gail Ironson at the University of Miami and a patient of hers whose spirituality seems to have kept AIDS at bay.
God and HIV
“It was March 4, 1994. About two-twenty p.m.,” Sheri Kaplan recalled. She smiled wanly. “You remember those things.”
A few days before she lost the illusion that life is long, Sheri had walked into a health clinic near her home in Miami. She was in her late twenties, embarking on a new romance, chuffed with life.
“I said, ‘Give me every test. I’m going to do a complete physical checkup so I can feel good about myself.’ ”
Sheri strode into her doctor’s office a few days later. The doctor looked down at the table, reluctant to meet Sheri’s eyes.
“I knew. You can feel the coldness in the air as soon as you walk in. It was fear in the air. And when I sat down and she told me that my test results came out positive, I said, ‘
Noooo.
What are you talking about?’ And she goes,‘Yes, Sheri, the test results came out positive.We checked and then double-checked. It is confirmative—you have HIV.’ And I don’t know what else she said after that. Her lips moved, but nothing came out. I could have cut my fingers off and wouldn’t have known it, I was so numb.”
Her questions waged a rapid-fire assault:“Who did this to me? How long have I had it? Will I be able to keep my job? Will I get married? How am I going to tell my mother? My father? Will people point fingers at me? I’m twenty-nine years old—
how long am I going to live?
”
When I met Sheri in December 2006, more than a dozen years had passed since that moment. A slim forty-two-year-old, she had wavy red hair and a tanned, freckled face. She wore no makeup, and didn’t need to, with her intense blue eyes and wide smile.
She chatted unself-consciously as a researcher at a University of Miami clinic drew several vials of blood. They compared notes on CD4 cell counts, viral load, and a battery of other measures that were the lifeblood of those initiated into this dreaded disease. Every six months for nearly a decade, Sheri has dropped by the clinic to meet with Gail Ironson, a doctor and professor of psychology and psychiatry. Twelve years after her diagnosis, Sheri has somehow beaten the virus into submission. She remains healthy and has never taken so much as a pill for medication. The question that drove Gail Ironson was:
Why?
Why do some people with HIV never get sick?
Sheri’s personality holds some clues. She’s pugnacious. She refused to surrender to the disease. Instead she opened a nonprofit support center—“where people can laugh, and fall in love, and meet people, and have a life after HIV.” Under her determined management, the Center for Positive Connections expanded from a nine-by-twelve-foot room to a 3,500-square-foot facility with a half-million-dollar budget and nine employees.
But something more was at work than a renewed purpose to life. An indefinable current, a
pneuma,
gave lift to her goals. Sheri’s was not a traditional God—she was raised Jewish but believes in reincarnation—but a living, breathing entity who served as a copilot to steer when she could not see straight for the terror.
“At first I thought, How could God do this to me, make me the leper of society?” she said. “Then I realized, I was chosen. The message was, I was chosen so I could help create social change, so I took this as my role. I realized God didn’t want me to die, or even get sick.”
Gail Ironson has been studying people like Sheri Kaplan for more than a decade, looking for clues to longevity. Her hunt began in the mid-1990s, when Ironson, who trained at Stanford and the universities of Miami and Wisconsin, launched a longitudinal study of people living with HIV. She noticed that a rare group of people fared much better than others. Back then, before the most effective drugs were developed, the average life expectancy for those diagnosed with AIDS by opportunistic infection was a year and a half.
“But many of our people were alive seven, eight years past diagnosis,” Ironson said.“And we were looking for both psychological and immune factors that might be protecting their health. And we found both.”
The long-term survivors were less depressed. They were better at coping. They were more proactive, finding the best doctors and the best research. Ironson could have predicted all these characteristics: studies have long indicated that your attitude—whether you curl up on the ropes or deliver a counterpunch to the kidneys—often affects the course of a disease. But Ironson noticed another, unexpected trait among her long-term survivors.
“People kept talking about how spirituality was important in their lives,” she said. “If you ask people what’s kept you going so long, what keeps you healthy, often people will say ‘spirituality,’ or ‘my relationship with God.’ I mean, there were many other things that came up, but spirituality came up a lot as a moving force in people’s lives.”
Ironson began to zero in on spirituality as a predictor of how fast the disease would progress. First, she compared those patients who felt embraced by God or abandoned by God, and tracked two biological measures—CD4 cells and viral load. CD4 cells are a part of the immune system that helps fight off tumors and viruses such as HIV. The HIV virus also attacks CD4 cells, so as the disease makes inroads, it knocks off more and more of these fighter cells.Viral load is a measure of how much of the HIV virus is in one’s system; the higher the viral load, the sicker the person becomes.
Ironson found that people who felt abandoned by God after their diagnosis lost their CD4 cells at a rate 4.5 times faster than the people who relied on God to cope with the diagnosis; their viral load also increased.
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Let me repeat that astonishing statistic:
Turning to God rather than rejecting God appears to boost your immune system and stave off the disease nearly five times as effectively.
Next, Ironson looked at people’s “view of God.” Do you believe God loves you or that God is punishing you? She found that people who held a positive view of God maintained those CD4 cells twice as long as those who did not. And people who believed God loves them maintained the cells three times as long as those who felt God did not love them.
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Ironson compared one’s spirituality and view of God with a battery of other items that affect the course of the disease, including the mother of all predictors, depression. Depressed people saw their CD4 cells disappear twice as fast as those who were not depressed. But if they embraced a spiritual outlook on life, that more than offset the bad immunological effects of depression.
“I find that extraordinary because depression is the most consistent, reliable predictor of how people do with illnesses, and not just HIV,” Ironson told me. “People who are depressed are much more likely to suffer a second heart attack or die. People diagnosed with cancer who are depressed are much more likely to have a recurrence and have a poorer disease course. So depression is a very well-established psychological factor, and to find another psychological factor that may potentially be
more important
is very surprising.”
Ironson and her researchers looked for alternative explanations as to why spirituality might be related to better health. They ruled out other explanations through statistical analysis. They controlled for age, education, gender, and race—even church attendance, which has been linked to longevity. They controlled for psychological variables such as optimism, life stress, depression, and coping.
“We wanted to determine whether there is some independent contribution of spirituality
over and above
other psychological constructs that other people had looked at,” she said.
“And what did you find?” I asked.
“We found that spirituality still predicted a significant amount in disease progression.”
“Just so I understand it,” I said, “you found that if, say, someone wasn’t taking their meds and was depressed, they could still do better if they were spiritual than if they weren’t spiritual?”
“Yes. Now, I’m not in any way suggesting that people shouldn’t take their meds,” she added, laughing. “This is really an important point. However, the effects of spirituality are over and above. So whether people are taking their meds or not, spirituality was still related to slower disease progression.”
She paused a beat, to let the idea sink in. “Spirituality is our most powerful predictor to date.”
While scientists might balk at the idea that “God” has anything to do with HIV progression, they readily agree that your
thoughts
affect your body. Here’s how it might work with HIV. Stress hormones that make your heart race and hands sweat, such as cortisol and norepinephrine, accelerate how quickly the HIV virus can replicate. Ironson said her research has shown that the stress hormone cortisol is lower in people who score high on having a “sense of peace” through meditation, belief in God, and other spiritual practices. She has found that norepinephrine is lower in people who score high on “altruism” and compassion, another component of spirituality.
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In other words, Ironson connected the dots from a patient’s spiritual beliefs, to the chemicals in her brain, to the immune system.
Her patient Sheri Kaplan put it this way: “I have the power to control my mind. That’s one thing that I can control, before it gets to a physical level or an emotional level. So if you can nip it in the bud, you can stop anything from moving forward into a direction you don’t want it to. If I visualize the virus not being there, the virus is not there.”
“You’re saying you can overpower the virus with love or good thoughts like washing it out of your body?” I asked her.
“Oh, yeah. Washing it out—I do that every day in the shower. I watch the virus go down the drain.”
Scientists would differ with that conclusion. The virus is still lurking in Sheri’s body. But tell that to the HIV, which has failed to make an inch of progress since the day it invaded her life.
Is Anyone Up There?
Neither Sheri Kaplan’s story nor Gail Ironson’s research claims that there is a God who puts a restraining hand on the HIV. It is the
belief
that there is a God who guides, not abandons, loves, not punishes, and occasionally intervenes to cause the miracle. This keeps everything in a closed—and safe—loop. The materialist can argue that the power to affect one’s own body originates in the mind of the believer, not from an external or supernatural source. In other words, the skeptic can point to a material mechanism, and there’s no need for a God to fill in the gaps.
So now let’s launch into far more turbulent scientific waters: the prayer studies. The premise of these studies is that one person’s thoughts (or prayers) can affect another person’s body. The vast majority of Americans believe in the power of prayer, and spend a lot of time demonstrating that belief, whether in church, or the hospital room, or as part of their morning devotion. And why not? It’s all mind over matter anyway, right?
Apparently not. I soon learned that conflating prayer (for someone else) with the mind-body connection amounts to scientific blasphemy. Prayer and positive thinking may
appear
to share some characteristics, scientists told me, but that is a mirage. It is a little like equating the opening scene of the movie
Saving Private Ryan
with actually losing your leg on Omaha Beach in the D-Day invasion. They seem to portray the same sort of event, but in reality everything is different, including the mechanism by which they are experienced—pixels of light on a movie screen versus a physical bullet shattering your thighbone.
I asked Anne Harrington at Harvard to explain why some scientists embrace the mind-body connection in one breath and repudiate intercessory prayer in the next.
“It’s a gigantic leap. It’s a whole different ball game,” Harrington said.
When talking about the mind-body connection, science can explain the mechanism in which a person alters his own experiences through prayer and mental discipline.
“But with interpersonal prayer, you’re making, at least potentially, a metaphysical claim—a claim about the nature of external reality. You’re arguing either for the existence of invisible mysterious forces—which science doesn’t know anything about—which somehow emanate from the praying person to the person being prayed for. Or you’re making an argument for a miracle, for an intervention into a disease process that would not have happened otherwise. I think it’s a very big step.”
One of the first scientists who dared to test God (and the wrath of his colleagues) was R. C. Byrd at San Francisco General Medical Center. In the late 1980s, he monitored nearly four hundred patients admitted to the coronary care unit for heart problems. Half the patients received prayer from Christian intercessors, the other half received no prayer. The patients knew they were in the study (they signed consent forms) but no one—not the patients, not the researchers—knew who was receiving prayer and who was not. This eliminated the placebo effect, in which a person who thinks he is receiving a healing agent (a drug, or, in this case, prayer) actually improves—not because the drug (or prayer) is effective, but because the patient
believes
it is.