Читать книгу The Mind-Body Cure - Bal Pawa - Страница 17

People with a fixed mindset assume that ability and understanding are concrete and fixed, so they don’t try to change. They often assume that their DNA is their destiny—they were either born with health or they weren’t—and therefore believe they don’t have control over their health outcomes. This “what’s the point?” attitude to changing behaviors for health is a form of illness mindset. A defeatist attitude, we now know, can lead to disease and even failed treatments. In other words, fixed-mindset individuals sabotage themselves before they even start. They don’t commit to changing their lifestyle because they have a core belief that nothing will help.

Why does nothing work on those patients? It’s called the “nocebo” effect. Individuals contribute to their illness by subconsciously creating chemicals of self-destruction. They convince themselves that nothing will work, so it often doesn’t. How many times have people with cancer learned they have six months to live, and they do, while others refuse to be boxed in and outlive their disease or even beat cancer?

The main differences between the two mindsets of health and illness are our belief in the permanence of intelligence about our health state, our ability to adapt to any change in environment, and the knowledge that our circumstances do not define us. People with a health mindset are open to growth and change with opportunities for improvement. They can adapt to new information and adopt new behaviors; they are more resilient. In these individuals, we can update the software program that runs the body.

Case Study: Jane and Carol

In my family practice many years ago, two unrelated patients, Jane and Carol, were diagnosed with breast cancer within a few weeks of each other. They were only a few years apart in age. Their biopsy results were coincidentally identical on the pathology report, so I referred them both to a well-known cancer specialist in the area. He ended up seeing them a few weeks apart.

Carol was a happy-go-lucky, charming, and no-nonsense woman who was very proactive about her health. I explained the report of cancer; she appeared surprised at the diagnosis. Yet Carol calmly asked a few questions and then responded, “Doctor, just do whatever you need to do to get this thing out of me. I have travel plans and grandchildren to care for.” On the way out, she asked if I could recommend some good reading resources.

When I called Jane in to inform her of the diagnosis, she reacted in a state of panic before I could give her all the information. She had lost an aunt to breast cancer many years earlier and watched her die. No amount of reassurance and education about new treatments would convince Jane that she would not necessarily have the same outcome as her aunt. It took a lot of time to calm her down so I could explain the next steps.

Shortly after the initial visit, both Carol and Jane required the same surgery, which the same surgeon performed. The same oncologist at the same hospital prescribed the same chemotherapy and radiation protocol. Since the pathology report was the same, they received the same course of medical treatment.

Due to her anxious mood, I referred Jane for counseling and a cancer support group. Counselors reported that Jane lived with the fear of pain and death and had little faith in herself or the medical system. Her anxiety became so severe, I also had to prescribe sleeping pills and anxiety medication. Occasionally, the anxiety escalated to debilitating panic attacks. She rarely left her house except to attend medical appointments. Jane cut herself off from friends and stopped going to church.

It’s important to recognize that having anxiety isn’t “wrong” or “bad.” Anxiety is energy, and it is up to us how we channel that energy. In Jane’s case, anxiety was a maladaptive emotion that made her body sick. Carol chose to channel her “anxious” energy into constructive behavior to keep herself motivated toward her goals of traveling and spending time with her grandchildren.

The oncologist and I had discussions about Jane’s lack of response to cancer treatment, the severe side effects, and the poor prognosis she faced. Carol also had side effects of chemo and many rough days, but her follow-up reports were excellent. The staggering difference perplexed me. Why were these two women responding so differently to the same treatment when surgery had confirmed identical pathology? Had I missed something? I second-guessed myself and reviewed both files after work one day, trying to find a reason why one patient was declining day by day and the other patient was improving.

Sadly, Jane continued to get sicker. Her cancer spread to other organs including her brain, and she lost her battle with cancer after eighteen months of treatment. For Jane, it had truly been a “battle.” She was angry and scared and saw her cancer as the enemy.

Carol had a fairly good recovery despite the awful side effects. When she lost all her hair, she went out and bought several wigs and called them funny names. Marilyn Monroe was her blond wig. A dark brown wig with a whitish streak she called “Roadkill.” Carol kept up a good front of humor and she remained grateful for each day; she saw her cancer as a “gift” to remind her to live each day to the fullest. Today, Carol is still alive and cancer-free, and I receive occasional cards and messages from her. She went on a cruise and has made countless memories with her grandchildren.

These two patient interactions forced me to consider the stark difference in their attitude and mindset. Jane had accepted defeat before she began the fight. She feared death far more than she trusted herself and the medical system. Jane truly believed the cancer would kill her, and it did. She had fixed beliefs of an illness mindset and no one had the power to change her beliefs. That is the profound power of the “nocebo” effect.

While the benefits of cultivating a health mindset are desirable, just thinking about it and “espousing” it are not enough. “Think healthy thoughts and you will be healthy,” many self-help books profess. It may be a step in the right direction, but positive thinking backed by a health mindset and applied ability—effort and practice—guarantee better outcomes. The positive knowledge and dialogue have to become a part of the subconscious narrative; we must have faith that we are a part of our healing and that healing begins inside. And we must act on that belief.