Pooh-poohing Mind-Body Interaction 😉

I surprise patients some times when I tell them that I do not believe in what is often called “mind-body interaction”. My explanation, though, convinces them not to run away and look for a different doctor. The idea that thoughts affect the body and physical disease alters emotions is right, but also very wrong. This concept falsely splits us apart.


The truth is that the brain is in the body. Every time I look at my books, there it is. The same was always true in anatomy lab, as well as looking at MRIs and CT scans. Despite this incontestable fact, there are those who view habits of thought as entirely divorced from biochemistry and physical health.

The problem starts on the medical side.  A doctor tells a patient that the tests are normal. Therefore, there is no problem or the problem is 100% emotional. Go away and fix yourself. This ignores the limitations of our testing and allows us to abdicate our response to provide help.  We fall into this trap out of ignorance at times, deluding ourselves into believing that thoughts are not biochemical, produced by and creating our physiology.  We know better.  MRIs show that the physical structure of our brains change after going through psychological counseling.  Proteins, hormones, immune factors, and alterations in the levels of a broad range of the compounds normally found in our blood, can all have subtle and lethally dramatic impacts on our brains’ ability to function, including thoughts and feelings.

On the patient side, recognizing the importance of right thinking tends to lead to blaming the victims of suffering, including themselves, for getting sick. Thoughts and feelings are supposed to be all powerful from this view point.

My experience is entirely at odds with both of these limited perspectives.

Regardless of whatever spiritual radiance/vitality we manifest, our bodies always break down.  The Law of Entropy applies to everything in the material world. You can do a lot to make your life healthier and better, but not forever.  Responding to an influenza infection, your body will work as hard as it can to create massive quantities of immune factors to save its/your life. Those immune factors make you feel tired and alter your brain and thinking.

Honestly, I can not figure out how to separate mind and brain enough to determine which is changing the other.  In reality they are one, influencing and influenced by everything.  Managing stress, thereby improving the quality of your life, is an excellent idea if you have cancer, heart trouble, depression, any other disease, or even if you are well.  Meditating increases telomere length, and then probably how long you will live.  Being angry cuts off the blood supply to your heart and kills far too many people every day.

This is not New Age, airy fairy, trivial or simply about living a beautiful life.  It is quite predictably a matter of life and death.  The only part that is unpredictable is the due date.

Building on that perspective –

Sudden cardiac death risk and emotion
Considering the effects of emotion on physical health, death is about as meaningful an outcome as one might imagine.

Swedish investigators recently determined to do something about what we know (BRAVO!). They took 362 patients who had been discharged from the hospital after a heart attack or a procedure to increase blood flow to the heart, and randomly assigned them to usual care with or without twenty sessions (2 hours) of small group cognitive therapy focusing on stress management. Patients in the counseling group were over 40% less likely to have any cardiovascular event (like a heart attack) and 28% less likely to die for any reason. It is notable that these effects were seen despite an absence of differences in the traditionally recognized risk factors (cholesterol levels, cigarettes, etc) between the groups.

Scientifically, this extremely impressive result should be confirmed but as far as those of us living in the real world, it is absolutely certain that if you do not want to die from heart disease or at least live as long as possible, you MUST become a master at stress management.

Preventing Sudden Cardiac Death

Women are less prone to heart attacks than men, but just barely.  Unfortunately, the symptoms they suffer are often not as easily recognizable as caused by their hearts, and often they have fewer symptoms.    We have much less research on women and heart disease than we have on men.

Sudden Cardiac Death (SCD) is much more common in men than in women.  You probably know of someone “who just dropped dead” one day unexpectedly.  Usually this is a surprise, coming out of the blue in the sense that most victims of SCD have not been diagnosed with coronary heart disease.  However, it turns out that a lack of diagnosis does not mean absence of disease.  At autopsy, the hearts of SCD victims usually show evidence of previously unrecognized coronary heart disease, suggesting that some of them ignored or did not recognize symptoms caused by their heart trouble.  Others, especially women and diabetics, are prone to unusual symptoms and might not even have any pain.

What are the usual symptoms?  Crushing left sided chest pain “like an elephant sitting on my chest”.  The pain can extend to the left arm or jaw.  Physical activity, emotional upset and eating can worsen the pain.  The heart will often beat rapidly or irregularly.  Shortness of breath, sweating and dizziness are also common symptoms.  Of course, each of these can have other causes, but you should not assume that the cause is minor.

Prevention is always the best idea, and studies of SCD are giving us useful ideas.  Fortunately, the major risk factors for SCD are the same in women as in men.  Harvard investigators dug into data  collected from 1984 – 2010 in the Nurse’s Health Study to learn what factors might lead to SCD.  What they found is really exciting, because it confirms that we are not so powerless against SCD as we had thought.

They found that following a healthy lifestyle dramatically reduced the risk of SCD.  The factors they considered were avoiding smoking, keeping weight down, averaging more than 30 minutes of exercise daily, and eating a Mediterranean type diet (lots of veggies, nuts, beans, fruit, fish, whole grains and moderate alcohol).  Women who did one of these right cut their risk of SCD in half.  Add another and the risk was down 60%.  Following three of these four wise health practices lowered risk by two thirds and a clean sweep of all four lowered risk of SCD by a dramatic 92%.  Looking at the data the other way around, they found that fully 81% of the Sudden Cardiac Deaths were attributable to lifestyle factors.

Written by 

Michael Carlston, MD is an internationally recognized authority in the integration of conventional and complementary medicine in clinical practice, as well as medical education, research and organizational consulting. Practicing in Santa Rosa, California, Dr. Carlston was voted “Best General Physician In Sonoma County, California” by readers of the Sonoma County Independent newspaper and also named one of the outstanding physicians in the Bay Area by San Francisco Focus Magazine. With 30+ years in private practice, his expertise is in nutrition, homeopathy and sports medicine.

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