Biology 202
2004 First Web Paper
On Serendip

A positive outlook during a time of suffering particularly during an illness can help one heal faster. It is often believed that a person can fight disease with their mind. The thought that we can combat sickness with our attitude is not an idea that has much scientific proof. Until recently little scientific research was available on the effects of hope in the healing process. However recent studies show significant evidence is available which suggests that hope may have an effect on the body during illness.

On the surface there is practical evidence that a hopeful outlook can help a person heal. Someone who believes that he or she might eventually get better when afflicted with a life threatening disease is more likely to take care of his or her body. This approach of taking care of ones body with the hope that it might heal can keep a person alive until better methods of treating her specific disease come along. This type of hope is believed to have helped some HIV patients who were first diagnoses with the virus. As these individuals took various steps to stay as healthy as possible, scientific advances made living for a longer period of time with the virus viable (2). While this observation is interesting this type of hope does not actually help a person heal.

As Abraham Verghese writes in his article "The Way We Live Now: Hope and Clarity" there is a belief in our society that with hope and a positive outlook one can fight off a disease such as cancer. He writes "If you accept the war metaphor... then a diagnosis of cancer becomes a call to arms, an induction into an army and it goes without saying that in such a war optimism is essential. Memoirs of Cancer Centers state this as a creed: a 'positive attitude' influences survival" (2) . He goes on to argue that this belief is not backed by substantial scientific research and therefore adds pressure to patients to always appear positive when the realities of their situations warrant some realistic grief. Verghese cites a study from Australia, which suggests a positive attitude or hope did not have a substantial effect on the survival rate or health of lung cancer patients participating (2). He uses this study to show that hope cannot make a sick person magically better.

Despite Verghese's points many scientists, patients, and medical doctors believe that a hopeful outlook can help a sick person overcome a serious illness. These proponents of the power of hope argue that a person who believes he will get better produces endorphins and enkephalins released by the pituitary gland, which can intercept the feelings of pain in the body from reaching the brain (Groopman, p.170). The research of Jerome Groopman M.D. is some of the most conclusive about the effects hope has on sick people. His research attempts to show the way the brain aids the body's healing and coping ability in sick peoples' bodies. Manipulations of the nervous system sparked by the emotions associated with hope begin a chain of events, which may help sick people recover.

Groopman uses the placebo effect to help explaining how the nervous system, with the help of hope, combats pain (Groopman, p.175-190). The placebo effect is widely accepted by medical doctors and scientists. It shows that in some cases a placebo or fake cure can satisfy patients and make them believe they are cured when in reality no medicine, surgery, or treatment has been given. For example a doctor who prescribes a sugar pill or pill containing no medicine to a group of patients suffering from an illness, without telling them that the drug is a placebo, will have some patients who report their symptoms have faded. It may seem that theses particular patients were not really that sick to begin with, but the placebo effect is actually thought to be a result of "belief and expectancy"(Groopman, p.176). The patient believes and expects the medication to cure her ailments. Belief is encouraged as the patient trusts that a doctor will be able to identify an illness and then find the appropriate medication to treat the problem. The patient then expects the treatment to work. This combination of belief and expectation can sometimes be enough to help a person recover form their symptoms.

Groopman argues that the same type of belief that is present with the placebo effect is similar to that created by a hopeful outlook. Within the body the theory that hope can heal is based within the nervous system. When a person is hopeful their body produces endorphins and enkephalins. These endorphins and enkephalins are chemicals, which alter the messages sent to the brain through the nervous system. The types of endorphins believed to be produced in a hopeful person's pituitary gland include the beta-endorphin, which is thought to improve ones mood by blocking pain (6) . According to Groopman's study in a hopeful patient's body the endorphins prevent the brain from recognizing the message of pain sent through the nervous system. Without the message of pain the body is able to exert the energy necessary to recuperate from an illness. The endorphins and enkephalins are also thought to help improve the immune system. If the body is not preoccupied with the pain of an illness it might be able to fight off a life threatening disease.

The production of endorphins and enkephalins alone cannot explain the positive effects of hope on ill people. A hopeful person benefits from a positive outlook because his body is less likely to produce the chemicals, which can prolong an illness and are associated with a negative outlook. To explain how hopelessness can prolong an illness Groopman looks to the effects of Substance P and cholecystokinin also know as CKK(Groopman, p176). These chemicals, when released in the central nervous system have the opposite effect of endorphins and enkephalins. CKK helps send the messages of pain to the brain thus increasing ones hopelessness and suffering. Groopman argues that these two chemicals are produced when a person is constantly reminded of an illness and the grave circumstances of their infirmity. This is common in patients who have serious illness with low survival rates. The pain creates a cycle, which is hard to escape (Groopman). Groopman argues that this cycle can be broken with hope.

If we accept the theory that hope sends on endorphins and enkephalins that act in a fashion similar to pain killers blocking pain from the brain we are left with the fact that some very hopeful patients never heal and that some very negative thinkers survive the worst of illnesses. The answer to this problem is that while hope may help a person survive or at least feel better it is not a cure for disease. It is simply another tool that can help on the way to recovery. Hopefully more research will come along to redefine and improve on Groopman's observations but for the time being Verghese's belief that hope is not a cure remains. Positive thinking and the mind do not have to power to completely overcome pain. However thanks to Groopman we now know that our minds and bodies together have the ability to protect us from certain pains, which could eventually help seriously ill people heal.

Sources

1) Groopman, Jerome. The Anatomy of Hope. New York: Random House Press, 2004.
2.) Verghese, Abraham. "Hope and Clarity." The New York Times Magazine February 22, 2004. Available on the web at the following web site: 5)New York Times Web Site,
3.) web site dealing with the issues faced by those with serious illness, a rich resource from Bryn Mawr College
4.) Acumen Journal Web Page, a life science journal
5.) Acumen Journal Web Page, a life science journal
6.) beta-Endorphin, a beta endorphine


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