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M
ind Body Health
 


The Mind Body Guilt Syndrome

© David S. Sobel MD

The following is one in an ongoing series of columns entitled Mind Body Health by David S. Sobel MD. View all columns in series
A woman with breast cancer seeks psychological support from a "mind/body, holistic, imagery" counselor. She is asked, "What negative thoughts and feelings have you been having that would cause your cancer? Why did you need this illness?"

A man develops an irregular heart rhythm. He undertakes radical lifestyle changes: ultra low-fat diet, meditation, regular physical exercise, and psychological counseling. The irregular heart beat continues. He feels guilty and views the use of medications to control the heart rhythm as a sign of personal failure. "I should be able to control my own heart." How much personal responsibility and control we have over health is a complex question. At one end of the spectrum are those who believe the body is a mindless machine. If something goes wrong, it's the responsibility of the medical profession to find some pill, potent, or surgical procedure to fix it. Any suggestion that psychological states may influence physical health is met with derision.

At the other end is an inflated and misplaced sense of total personal control. All you have to do is imagine white blood cells gobbling up diseased cells, and magically your cancer will disappear. If it doesn't, then you just haven't imagined well enough, loved deeply enough, or prayed hard enough. This overzealous belief in "mind over matter" often leads to inappropriate and unhealthy feelings of guilt. It also causes many to miss out on the real benefits of mind/body medicine.

In the Mind/Body Health Newsletter we attempt to present a realistic, balanced view of the importance and the limits of the mind in preventing disease or speeding recovery.

Considering the following points may help to foster a healthy perspective: Health and disease are complex phenomena, usually with multiple interacting causes.

Most illnesses result from a combination of genetic, biological, environmental, behavioral, and psychosocial factors. Rarely is any one of these factors the sole cause of a disease. For example, many people exposed to germs do not develop illness. Many suffer psychological stress and trauma and stay healthy. Our understanding of most diseases is still quite primitive. We know very little about why some people exposed to stressors such as germs and traumatic experiences become ill while others remain healthy.

Bad things happen to good people.
We all know optimistic, positive, giving, and loving people in excellent mental health who develop and even succumb to serious illness. While healthy attitudes and behaviors appear to reduce the risk of illness, they certainly are not guarantors of good health or resistance to disease.

Mind matters, but mind cannot always triumph over matter. Sometimes the biology of disease is simply overwhelming. Your inability to prevent it or recover is seldom due to "negative" thoughts, "bad" emotions, or lack of a right mental attitude.

Even when there is no cure, there is a healthy way to live a disease.

While you are not responsible for causing or curing your disease, you are responsible for taking action to help manage it. Healthy thinking and mind/body techniques may or may not change the biology of your disease or prolong your survival. They can help you maximize your health and functioning and enrich the quality of your life and the lives of those around you.


Excerpted with permission from the Quarterly Newsletter, Mind/Body Health Newsletter. For subscription information call 1-(800)-222-4745 or visit the Institute for the Study of Human Knowledge website.

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About The Author
David S. Sobel, M.D., M.P.H., is a practicing physician in adult medicine and Medical Director of Patient Education and Health Promotion for Kaiser Permanente Northern California. He is physician lead for the national initiative in Self-Care and Shared Decision-Making for Kaiser Permanente. He is coauthor of Living a Healthy Life with Chronic......more
 
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