Rallying the Troops Inside Our Bodies

Psychologist Robin Haller, Ph.D., hopes the heartening outlook she strives to inspire in her patients will help her overpower the malignancy she discovered in her breast.

Recovered from breast-cancer surgery, Haller says she feels strong and finds immense solace nurturing her young daughter and son. No one else is going to raise them, she says determinedly.


"I could spend all my time crying and worrying about what will happen to my kids," she said. "And I did do a little bit of that. But it's not helpful. I don't have a lot of energy to spare right now, so why waste it on that?"

According to three decades of research, Haller may be inoculating herself with some of human kind's most potent and as yet arcane medicine — a healthy state of mind. Psychologists and medical researchers are amassing dramatic — albeit incomplete — evidence that psychological factors influence the human body's ability to control the symptoms of — and even survive — life-threatening illnesses.

Group Therapy Increases Longevity

Studies show, for example, that women who undergo group therapy as part of their treatment for breast cancer live longer than those who receive no such treatment.

Research also indicates that men with HIV infection who receive guidance in relaxation or other therapeutic techniques show a delayed onset of AIDS-related symptoms.

Psychologists are major players in this area of study, known as psychoneuroimmunology (PNI). immunological changes in HIV-positive men.

While the public has shown a growing interest in the mind-body connection, PNI science is much narrower, focusing on the relationship between human behavior, psychosocial factors, and the body's immunity to viruses and infections.

The long-held notion that the human immune system operated independently from the brain met one of its strongest challenges in the mid-1970s, when psychologist Robert Ader, Ph.D., and immunologist Nicholas Cohen, both of the University of Rochester, gave laboratory rats a drug that suppressed their immunity, and simultaneously fed them saccharin-laced water. They then discontinued the drug, but found that the rats' immune systems still responded negatively when they drank the sweetened water.

Later, Ohio State University psychologist Janice Keicolt-Glaser, Ph.D., and her husband, immunologist Ronald Glaser, found that medical students, during the stressful exam time, show a decline in the activity of the cells that fight off tumors and viral infections. They've also found that people who are caring for a spouse with Alzheimer's disease show decreases in immune activity.

The Mind-Body Connection

In a study published in 1991, psychologist Sheldon Cohen, Ph.D., of Carnegie Mellon University, injected nearly 400 healthy subjects with a cold virus, and found that those who reported more stress in their lives were more likely to develop colds.

One of the most important examples of the link between psychological factors and health outcomes came from Stanford University psychiatrist David Spiegel, who, along with renowned group psychotherapist Irvin Yalom, M.D., led support groups in the 1970s for women with advanced stages of breast cancer. The groups used a technique Yalom developed called supportive-expressive group therapy. It involves the patients simply expressing their emotions about their cancer in a group setting.

Spiegel decided a decade later to review the women's records, and found that they had survived twice as long, on average, after starting the therapy as a comparative group of patients who had received no such treatment. His findings drew substantial attention from the medical community, and sparked new interest in the use of structured support groups as part of treatment for serious illness.

The Mind and Cancer

"One of the most powerful research findings on cancer survival has to do with social support," said Duke University psychologist James Spira, Ph.D. "Therapeutic groups offer the potential to provide for greater intimate support than even friends and family can often offer."

Emotional Writing

Meanwhile, psychologists and other scientists have found other indications of the link between psychological interventions and the body's immune response. Keicolt-Glaser and Glaser, along with Southern Methodist University psychologist James Pennebaker, Ph.D., found that research subjects who simply wrote about traumatic events in their lives showed a boost in their immune-system activity, compared with control subjects, who demonstrated no increase in activity.


UCLA psychiatrist Fawzy Fawzy, M.D., for example, conducted a study involving a six-week structured group therapy for newly diagnosed malignant-melanoma patients with good prognoses. The subjects maintained greater numbers and activity of tumor-killing cells than the control group did.

Researchers such as Michael Antoni, Ph.D., associate professor of psychology and psychiatry at the University of Miami, have found that asymptomatic HIV-infected men who undergo stress-management training show a slower rate of decline in the immunological cells that the AIDS virus attacks than do men who receive no such treatment.

More Work to Do On the Mind-Body Connection

Despite the rapid development of PNI research, the relationship between the immune system and psychological states remains largely uncharted, scientists concede.

"Psychological factors might affect immunity, but where they affect the immunity that, in turn, affects the disease, is a hard question to answer," said Antoni.

Some worry that the growing knowledge of the mind-body interface can lead to a "blame-the-victim" mindset.

"When we say psychotherapy may prolong survival and provide an increased support system, that's very encouraging," said Shirley Glass, Ph.D., a Baltimore psychologist who underwent breast cancer surgery and chemotherapy three years ago. "But we may also be sending the message that we're holding people accountable for their own prognosis, as if we're saying, 'If you don't have the right course of disease, it's because you don't think the right thoughts or image the right images.'"

The Right Kind of Help

Glass also warned that research on the effectiveness of group therapy in helping people with serious illness should not be interpreted to include self-help groups that aren't led by professionals trained to help people with medical crises.

But experts say psychological help, particularly the kind that offers the right kind of group support, bears no physical or emotional danger. And even if it can't always help some people overcome their illness, it can no doubt help improve the quality of their lives.

"I can spout off 'brilliant wisdom' to a patient, and they'll nod politely and smile," Spira said. "But when another patient says the exact same thing, suddenly a light goes off in that person's head. The patient is going to listen much more intently because these other group members are people who are experiencing the same thing."

Copyright © 1997 by the American Psychological Association. All rights reserved.