Cure: A Journey into the Science of Mind Over Body

A New York Post Best Book of 2016A New York Magazine Best Science Book of 2016 A Mindful.org Top 10 Mindful Book of 2016 A Sunday Times Book of the Year An Economist Book of the YearA Spirituality & Health Bestxa0Mind/Body Book of 2016 “Ms. Marchant writes well, which is never a guarantee in this genre… Second, [she] has chosen very moving characters to show us the importance of the research… and she has an equal flair for finding inspirational figures… the studies are irresistible, and they come in an almost infinite variety.”xa0— New York Times “ Cure is a cautious, scrupulous investigation of how the brain can help heal our bodies. It is also an important look at the flip side of this coin, which is how brains damaged by stress may make bodies succumb to physical illness or accelerated aging… Cure points a way toward a future in which the two camps [mainstream medicine and alternative therapies] might work together. After all, any medicine that makes a patient better, whether conventional, alternative, or placebo, is simply medicine.” — Wall Street Journal “A well-researched page-turner… raises questions about the role of culture, environment and neurochemistry in our responses to treatment—and may very well lead to widespread changes in the ways we practice medicine.” —Susannah Cahalan, New York Post “ Cure is for anyone interested in a readable overview of recent findings in mind-body phenomena, a reliably enthralling topic… A rewarding read that seeks to separate the wishful and emotion-driven from the scientifically tested.” —Washington Post “Research-heavy but never dull, this revelatory work about the mind-body connection explains how the brain can affect physical healing.” —Entertainment Weekly “Marchant is a skeptical, evidence-based reporter—one with a background in microbiology, no less—which makes for a fascinating juxtaposition against some of the alternative treatments she discusses.” —New York Magazine "A thought-provoking exploration of how the mind can affect the body and can be harnessed to help treat physical illness." —Economist “In a wide-ranging and compelling new book, science journalist Jo Marchant explores whether the mind can heal the body… With lively, clear prose, Marchant surveys the evidence for the mind-body connection.” —Science News “Fascinating and thought-provoking. Marchant has travelled extensively around Europe and the US, talking to health workers and ordinary folk, to produce this meticulously researched book… Cure is a much-needed counter to a reductionist medical culture that ignores anything that doesn’t show up in a scan… [it] should be compulsory reading for all young doctors.” — New Scientist “Axa0revved-up, research-packed explication of the use of mind in medicine, from meditation to guided visualisation. Marchant’s nimble reportage on the work of scientists in novel fields such as psychoneuroimmunology and her discussion of placebos are as fresh as her reminders of how stress and poverty affect wellbeing are timely." — Nature “Could my belief that I’m going to feel better in itself heal me? It’s a fascinating question, and one that British author Jo Marchant takes on with aplomb in her new book, Cure .” —Spirituality & Health “Writing with simplicity, clarity and style, and covering an enormous range of material, [Marchant] surveys with grace what we think we know, and what we would like to know, about the mysterious and troubling relationship between our minds and our bodies… [She] is level-headed, always with one foot planted in the worlds of science and reason. Though open-minded, she is rigorous, her gently skeptical tone reassures, and she gracefully skewers quackery.” — The Guardian “Thought-provoking… This new generation of evidence-based mind-body researchers has produced some remarkable findings, which Marchant analyses with elegance and lucidity." —Times Literary Supplement “Jo Marchant makes her case so cogently that it is hard to disagree [with her]… The author has a gift for writing that is both clear and vivid, and communicates complex ideas in a way that is comprehensible and uncondescending… This is surely an area of medicine whose time has come.” —The Independent "A diligent and useful work that makes the case for 'holistic' medicine while warning against the snake-oil salesmen who have annexed that word for profit." —Sunday Times “This is an important book, and one that will challenge those dismissive of efforts to investigate how our thoughts, emotions and beliefs might directly influence our physical wellbeing… The evolving science explored in Cure is intriguing and trailblazing, and Marchant's account of its pursuit is often gripping… There's a lot to this impressive book, and it has the potential to have the same dramatic impact on our understanding of our self as Norman Doidge's blockbuster, The Brain that Changesxa0Itself .” — Sydney Morning Herald "Marchant explores the possibilities of psychology-based approaches to improving physical well-being in this open-minded, evidence-based account… Axa0powerful and critically needed conceptual bridge for those who are frustrated with pseudoscientific explanations of alternative therapies but intrigued by the mind’s potential power to both cause and treat chronic, stress-related conditions."— Publishers Weekly (starred review) "A balanced, informative review of a controversial subject."— Kirkus Reviews " Cure represents a journey in the best sense of the word: a vivid, compassionate, generous exploration of the role of the human mind in both health and illness. Drawing on her training as a scientist and a science writer, Marchant meticulously investigates both promising and improbable theories of the mind’s ability to heal the body. The result is to illuminate a fascinating approach to medicine, full of human detail, integrity, and ultimately, hope.” — Deborah Blum , author of The Poisoner’s Handbook and Love at Goon Park “This is popular science writing at its very best. Cure beautifully describes the cutting-edge research going on in the fascinating—and until now, often unexplored—area of mind-body medicine. I would recommend this book to anybody who has a mind and a body.” — Henry Marsh , author of Do No Harm: Stories of Life, Death, and Brain Surgery Jo Marchant is the author of Decoding the Heavens , shortlisted for the Royal Society Prize. She has a PhD in genetics and medical microbiology and has written on everything from the future of genetic engineering to underwater archaeology for New Scientist , Nature , The Guardian , and Smithsonian . She has appeared on BBC Radio, CNN, and National Geographic. She lives in London. Excerpt. © Reprinted by permission. All rights reserved. Chapter 2xa0 Linda Buonanno hugs me as soon as we meet, and shows me upstairs to her small, first-floor apartment in a housing block just off the freeway in Methuen, Massachusetts. Her living space is tidy but densely packed with framed photos, scented candles and an overwhelming preference for the color green. She sits me at the table, in front of a perfectly laid out tea set and a plate of ten macaroons. The 67-year-old is plump with short, auburn hair and a girlish giggle. “Everyone thinks it’s dyed, but it isn’t,” she tells me. She hovers until I try a macaroon, then sits down opposite and tells me about her struggles with irritable bowel syndrome (IBS).She talks fast. Her symptoms first struck two decades ago, when her marriage of 23 years broke down. Although she dreamed of being a hair- dresser, she was working shifts in a factory, running machinery that made surgical blades, juggling the 60-hour week with a court battle and caring for the two youngest of her four children. “I went throughxa0 hell,” she says. Within a year of the split, she started suffering from intestinal pains, cramps, diarrhea and bloating.The condition has affected her ever since, especially at stressful times such as when she was laid off from the factory. Their jobs outsourced to Mexico, the group of women with whom she had worked and bonded was scattered. She retrained as a medical assistant, hoping to find work in a chiropractor’s office, but once she qualified she found that no one wasxa0hiring. When she did finally find a part-time job, she had to give it up because of the pain from her IBS. The condition has destroyed her social life too. When the symptoms are bad, “I can’t even leave the house,” she says. “I’d be keeling over in pain, running to the bathroom all the time.” Even buying groceries re- quires staying within reach of a bathroom, and she lists the local facilities: one in the Market Basket, one in the post office down the street. “This isxa020 years I’ve been doing this,” she says. “It’s a horrible way to live.” Now she has to juggle the condition with looking after her elderly parents— her mother lives alone, while her father, who suffers from dementia, is in a nursing home. Linda’s brother was killed in Vietnam, and her twin sister died of cancer 18 years ago, so she is the only one left to help them.She brightens. “But I travel,” she says. “I go to England, I do every- thing. I love it.” I’m thrown by this statement until I realize that she’s talking about Google maps. I ask her to show me, and we move over to her computer, which sits on a desk squeezed between the sofa and the micro- wave. She fires up the maps program and lands us on top of Buckingham Palace in London.Suddenly I get a sense of how much time Linda has spent in this flat. She knows the layout of the palace intimately, zooming in to try to peek through the windows, then flying around the back to check out the private gardens. Other favorite destinations include the Caribbean island of Aruba, and the celebrity mansions of Rodeo Drive. Sometimes she looks up the addresses of her old workmates from the factory, friends who when they lost their jobs moved away to Kentucky or California, places that because of her IBS, and the demands of her parents, she can never visit for real.Over the years, Linda has, like many patients with irritable bowel syn- drome, been passed from doctor to doctor. She has been tested for intol- erances and allergies, and has tried cutting out everything from gluten and fat to tomatoes. But she found no relief until she took part in a trial led by Ted Kaptchuk, a professor at Harvard Medical School in Boston. It was a trial that would revolutionize the world of placebo research. xa0 • xa0xa0xa0 • xa0xa0xa0 • xa0 “You know I’m deviant?” Ted Kaptchuk looks straight at me and I get the sense that he is rather proud of this fact.1 “Yes,” I answer. It’s hard to read anything about the Harvard professor without coming across his unusual past. In fact it seeps from every corner of our surroundings—the house where he lives and works, on a leafy side street in Cambridge, Mas- sachusetts.I’m asked to remove my shoes as I enter, and offered a cup of Earl Grey tea. Persian rugs cover the wooden floors, and proudly displayed in the hall is a huge brass tea urn. The décor is elegant, featuring period furniture, modern art and shelves filled with books—rows of hardbound doorstops embossed with gold Chinese lettering next to English volumes, from The Jewish Wardrobe to Honey Hunters of Nepal . Through the win- dow I glimpse the nuanced greens and pinks of a manicured ornamental garden that might be more at home in Japan.Kaptchuk himself has gold rings, big brown eyes and a sweep of gray- ing hair topped by a black skullcap. He likes to quote from historical man- uscripts, and his answers to my questions are accompanied by long pauses and a furrowed brow. I ask him to tell me his own version of the path that brought him here and he says it started when he was a student and he traveled to Asia to study traditional Chinese medicine.It’s a decision he attributes to “sixties craziness. I wanted to do some- thing anti-imperialist.” He was also interested in Eastern religions and phi- losophies, and the thinking of the Chinese Communist leader Mao Zedong. “Now I think that was a really bad reason to study Chinese medicine. But I didn’t wanted to be co-opted, I didn’t want to be part of the system.”After four years in Taiwan and China, he returned to the U.S. with a degree in Chinese medicine and opened a small acupuncture clinic in Cambridge. He saw patients with all sorts of conditions, mostly chronic complaints from pain to digestive, urinary and respiratory problems. Over the years, however, he became more and more uncomfortable with his role as a healer. He was good at what he did—perhaps too good. He would see dramatic cures, sometimes before patients had even received their treatment. “I would have patients who left my office totally differ- ent,” he says. “Because they sat and talked to me, and I wrote a prescrip- tion. I was petrified that I was psychic. I thought, Shit, this is crazy.” Ultimately, Kaptchuk concluded that he didn’t have paranormal pow- ers. But equally, he believed that his patients’ striking recoveries didn’t have anything to do with the needles or the herbs he was prescribing. They were because of something else, and he was interested in finding out what that something was.In 1998, Harvard Medical School, just down the street from Kaptchuk’s clinic, was looking for an expert in Chinese medicine. The U.S. xa0National Institutes xa0of Health (NIH) xa0was opening a center dedi- cated to funding scientific research into alternative and complementary medicine. Although tiny compared to existing NIH centers investigating cancer, for example, or genetics, it promised to be a useful new source of research dollars for Harvard. “But no one there knew a thing about Chinese medicine or any kind of alternative medicine,” says Kaptchuk. “So they hired me.”Rather than study Chinese medicine directly, however, he decided to investigate the placebo effect, to find out whether this could explain why his patients did so well. Whereas Benedetti is interested in the molecules and mechanics of the placebo effect, Kaptchuk’s focus is on people. The questions he asks are psychological and philosophical. Why should the expectation of a cure affect us so profoundly? Can the placebo effect be split into different components? Is our response affected by factors such as the type of placebo we take, or the bedside manner of our doctor?In one of his first trials, Kaptchuk compared the effectiveness of two different kinds of placebo—fake acupuncture and a fake pill—in 270 pa- tients with persistent arm pain.2 xa0It’s a study that makes no sense from a conventional perspective. When comparing two inert treatments— nothing with nothing—you wouldn’t expect to see any difference. Yet Kaptchuk did see a difference. Placebo acupuncture was more effective for reducing the patients’ pain, whereas the placebo pill worked better for helping them to sleep.This is the problem with placebo effects—in trials they are elusive and ephemeral, rarely disappearing completely but often altering their shape. They change depending on the type of placebo, and they vary in strength between people, conditions and cultures. For example, the percentage of people who responded to placebo in trials of a particular ulcer medicationxa0ranged from 59% in Denmark to just 7% in Brazil.3 The same placebo can have positive, zero or negative effects depending on what we’re told about it, and the effects can change over time. Such shifting results have helped to create an aura around the placebo effect as something slightly unscientific if not downright crazy. But it isn’t crazy. What these results actually show, says Kaptchuk, is that scientists have long gotten their understanding of the placebo effect backwards. When he arrived at Harvard, he says, the experts there told him that the placebo effect “was the effect of an inert substance.” It’s a commonly used description but one that Kaptchuk describes as “com- plete nonsense.” By definition, he points out, an inert substance does not have any effect.What does have an effect, of course, is our psychological response to those inert substances. Neither fake acupuncture nor a fake pill is in itself capable of doing anything. But patients interpret them in different ways, and that in turn creates different changes in their symptoms. Read more