One of you forwarded me a link to a Krista Tippett interview with Dr. Esther Sternberg, a prominent immunologist who has written a book about the importance of place — as in our physical surroundings — in the healing process. I discovered this interview earlier this year, and might have blogged about it, I dunno. I interviewed Dr. Sternberg this spring about her book on the topic, and discussed with her how my sister Ruthie’s having a serene place to which she could retreat (our father’s pond) likely helped build her resistance to cancer, and gave her more time. To be clear, Dr. Sternberg is a medical scientist, not a New Ager, and she builds her argument on scientific studies about the interaction of mind, body, and environment with regard to the immune system and healing.
From the public radio interview with Dr. Sternberg:
Ms. Tippett: So one of the big interesting places this points out is at what we have traditionally called “the placebo effect.” And there’s been a lot of interesting thinking and revisiting of that term recently, and your work is, you know, very much speaking to that. How would you describe what you’re learning what you know that, I don’t know, would not only make us rethink, but perhaps rename this thing we call the placebo effect?
Ms. Sternberg: Well, the placebo effect really is the brain’s own healing process, and that’s a long word, so it’s probably easier to say the placebo effect. But the problem with the word placebo is it carries with it a lot of baggage.
Ms. Tippett: Yeah. It feels like a trick or there’s nothing to it somehow.
Ms. Sternberg: Right. The word placebo is usually preceded by a four-letter word: “just.”
Ms. Tippett: Right.
Ms. Sternberg: Oh, it’s just the placebo effect. Well, you know, when you look, there’s controversy about this too, the exact numbers, but when you look at placebo-controlled trials, the reason we have to do placebo-controlled trials to determine the “true biological effect of a drug or intervention” is we have to subtract out the placebo effect where people have an expectation that just taking a pill or having an injection or whatever the intervention is, they have an expectation that that will heal and, in fact, it does. It reduces pain, it can reduce inflammation to a certain degree, and it’s hard to estimate and it differs with different conditions.
But the percent of effect of the placebo effect in any given intervention has been estimated to be somewhere between 30 and 90 percent. Ninety is probably a little high and 30 may be a little low, so let’s say 50 percent. A drug that has the ability to help reduce pain by 50 percent is a very powerful drug. So, you know, it’s not a trick; it is your brain activating anti-pain pathways releasing those endorphin molecules, releasing those desire molecules, dopamine, to shift and reducing the stress response.
Ms. Tippett: It’s in fact the drug that is a trick, right? Because what we do with the drug is trick our brains into doing that.
Ms. Sternberg: Absolutely, that’s it. You know, so why not use this in a sort of a carefully titrated way and say, OK, why not put the individual who needs to heal into the most healing environment where the stress response is not activated and, to the extent that we can, it’s reduced where you have positive emotional memories that flood you. Put them into a situation where they’re likely to release these positive, these anti-pain molecules and these, you know, dopamine molecules of reward, and that will allow their body to heal or to receive the drugs that you are then giving them.
So I’m not saying, you know, don’t go to a desert island and don’t take your cancer chemotherapy, but I’m saying don’t fight against it by putting yourself in a stressful situation. Do the maximum that you can with things like meditation and yoga and prayer to help amplify these pathways in the brain that we know ultimately can help the immune system do its job to heal.
Ms. Tippett: There is a phrase that especially occurs in Celtic spirituality: thin places. I don’t know if you’ve ever heard that.
Ms. Sternberg: Yes.
Ms. Tippett: The idea is, well, a lot of people would think of cathedrals as thin places or, you know, green pastures, still waters. Um, being in a place where — and this is the way some people will say it — it feels like the veil between heaven and earth has worn thin, where there’s a sense of being, you know, planted in the earth and yet also having some kind of almost physical sense of transcendence. I just wonder how you react to that, knowing what you know.
Ms. Sternberg: Well, I react to that. I have heard of that notion and I am actually very interested in exploring what is it about such places, about beautiful vistas of mountains, about the infinite horizon of the ocean. What is it that makes you feel that way about a cathedral? There are certainly physiological and neuroscientific bases to that feeling, that sense of awe. And I am convinced — I know — that these things can be measured and that’s the exciting new frontier for me, to ask exactly that question: What is it that makes one feel transcendent and is the environment something that we can consciously manipulate to find those feelings of transcendence? You know, if we’re so grounded in clay is there a way to at times, by simply going to a different place, achieve that sense of awe and transcendence?
Do you have a “thin place”? For me, the thinnest places are Gothic churches, and the Luxembourg Gardens in Paris. I am using my prayer rope to find the inner garden … and to learn how to build one of my own.