The Connection (2014)

NARRATOR:
We're in the midst
of a chronic illness epidemic.
Sicknesses like cancer,
heart disease and diabetes
are sweeping the world.
There's a one-in-two chance
you'll end up with
a chronic illness.
It's likely you know someone or
you are someone who is sick.
Diseases our grandparents
have never heard of
are becoming common.
Mental illness.
Autoimmune disease.
Metabolic syndrome.
These are modern sicknesses.
They're not infectious,
but they are spreading fast.
I think we've been seeing a
stress epidemic in our society
for decades now,
and it seems to be
only accelerating
as the pace of modern life
is increasing.
It was always obvious
to the ancient wisdom traditions
that mind and body
were interconnected.
But somewhere along the line
we sort of created a dichotomy
as if they were separate.
We came to believe
that everything could be cured
by drugs and surgeries,
whereas, to this day,
they can't.
When we talk about much of
mind-body phenomena,
we're talking about
the non-physical mind
affecting the physical body.
That's not allowed for
in the Western
scientific paradigm.
And we now understand
these concepts
that were rejected
by academic medicine.
So, this is something
that actually has
enormous implications.
Modern science has shown us
that the mind has the power
to heal.
We should use that capacity.
I was 24 when I got my first
break in journalism.
My life became focused
on deadlines
and chasing stories
that took me away from
my family and friends.
Then everything changed.
I was diagnosed with
an autoimmune disease.
One doctor warned
I could end up in a wheelchair
or with organ failure.
Over the next six years
I spent $30,000
on numerous specialist doctors,
constant tests,
drugs and alternative
therapies.
I was flat with fatigue
and riddled with arthritis.
No-one could tell me
why my immune system
was attacking my own body.
But there was one thing
I did know.
The more I was stressed,
the worse I felt.
I knew there had to be
a connection.
On my journey
to getting better
I travelled the world
to find answers,
meeting some of
the leading experts
at the frontier of science,
and tracking down people
with remarkable stories of
recovery.
This is the film I wanted
to see when I got sick.
In the older days
there was no separation
of mind and body.
In fact, throughout the world,
many cultures
have never separated them -
in the East, for example.
But our scientific approaches
were so awesome
that they overwhelmed
any mind-body approaches
or any mind-body potentials.
In Western science, unless
you see it, it isn't real.
Unless you can measure it,
it isn't real.
And that's what allowed
the huge advances
in modern medicine and science -
the ability to do
these amazing things
that we can do with cures today.
And we now understand
these concepts
that were rejected
by academic medicine
because we didn't
understand them.
We understand them now
in the language of science.
And now where we're at
is we can take these principles
and apply them to clinical care,
to the next phase,
the next new frontier,
which is integrative medicine.
The body is always responding
to whatever the mind
tells it to do.
So when the mind's tense,
the body's tense.
When the mind's happy,
the body's happy.
So the body
is always responding,
not just in ways in terms of
our physical tensions,
like the tensions
of the muscles,
but even right down to
the very core of our souls,
even what's happening
in the level of our DNA.
And what's really
been interesting
in the last five, 10 years
is really understanding
that it really is
a lot of two-way connections.
And there's a lot of molecules
that we always have thought of
as just in the body,
and we're recognising
that they actually also
play roles in the brain,
and that the brain
can also influence the body
at even a very cellular level.
All these terms, I think,
are approaching the same idea,
that the mind is not separate
from the body.
In fact, my belief
is that the only way
you can really separate
mind and body is verbally -
that they're two aspects of
the same underlying reality,
or two poles of the same thing.
Here's what we know about the
mind-body connection.
You may be familiar
with the idea
that your brain is like
a central message centre,
sending and receiving
electrical and chemical
signals
all over your body.
And now scientists
are starting to understand
that the communication
between your brain and body
is far more significant
than they once realised.
For example,
over 60 neurotransmitter
and hormonal receptors
have been found on the surface
of immune cells
designed for fighting disease.
Your brain
has a direct connection
to your body's first line
of defence,
and those cells can talk back.
In another major breakthrough,
scientists have discovered
around 80 million neurons
in your gut.
They're calling it
the second brain
because while it talks
to the brain
it can also act
completely independently
and influence behaviour.
So rather than there being
a mind in your head,
it's more like your mind
is all through your body.
But the easiest way
to understand
how your mind affects
your health
is by looking at stress.
So if we think that we're...
Imagine ourselves walking
through a jungle,
and out comes a tiger,
and it's a very hungry tiger.
We activate
the fight-or-flight response.
We've got to fight with
the tiger or we've got to fly,
get out of danger really fast.
So if we think about
this stress
or fight-or-flight response
as an activation response,
like a turbo charge of energy,
the body going into a different
gear, then it makes sense.
So the heart rate,
the blood pressure,
the blood vessels to the muscles
open up
to get all of this extra fuel,
sugars and fats are pumping
into the bloodstream,
the respiratory drive
kicks in in the brain.
We start to sweat to keep
ourselves cool
while we're exerting ourselves.
Our blood gets thick and sticky
and will clot faster
than normal,
and the body pumps out
inflammatory chemicals
to activate our immune cells
and to start mobilising
for tissue repair.
The attention centre
in the brain
lights up like a Christmas tree.
This is a major physiological,
neurological,
immunological,
metabolic change in our system.
And it's designed to help us
to adapt
to a clearly perceived
present-moment threat
in the environment.
And it's the kind of thing
that's there to save our life,
not to make us sick.
Unfortunately, 99% of the tigers
we're running from
are the ones that are actually
in our minds,
not the ones
that are really there.
And when we do that over
the long term,
it produces an effect that's
called allostatic load.
It's a physiological
wear and tear
that we place on our system.
It's like getting the car
and just absolutely
flogging it like crazy.
And if you asked your mechanic,
are your repair bills
going to go up?
He'd say, "If you drive
your car like that,
"your repair bills will go up
"and your parts
will wear out faster."
It's pretty much like that
with our bodies.
My name's Craig Duncan.
I'm from Sydney, Australia.
I'm a nonsmoker, nondrinker.
I'm active and exercise
most days of the week,
and have for a long period
of time.
I'm a vegetarian as well.
I was working for a professional
soccer team,
in charge of the sports science.
I was under enormous stress,
and I had been for
a long, long time.
A lot of it's self-imposed -
just rushing around
at a million miles an hour.
I was frustrated and unhappy
in what I was doing,
and that was difficult.
I was struggling to sleep,
or sleep well.
And I just...
Even though I might be
healthy on the outside,
exercising and that,
it all became too much.
I was at the gym
and I was lifting weights,
and at the time I didn't know
anything had really gone amiss.
It wasn't till that afternoon
that I went for a run
and got chest pain.
And again, didn't think
too much of it.
But in the next couple of days
I continued to try and run,
and the chest pain
got more and more,
and pain down my arm
and in the jaw -
the classical
heart attack symptoms.
And that's when I realised
that I had a real problem.
When I went into emergency,
even though the emergency ward
was packed,
they took me straight in.
And when they did some tests,
it was obvious that I'd had
a heart attack.
I had a spontaneous coronary
artery dissection,
and when I looked up
the literature,
there had only been
150 cases reported,
and most people die.
And that's...that's frightening.
I had no risk factors.
My cholesterol was normal and
my blood pressure was normal.
I'd recently had an ECG.
That was OK.
Never had chest pain.
Didn't have any family history
of heart disease.
But yeah,
I was under a lot of stress,
and I think that contributed.
There's no doubt about that.
If I let my stress and my
emotions get out of control
and am not in control
of my life,
there's no doubt
it could happen again.
And I really am not ready
to not be here.
CRAIG HASSED: If you help a
person to manage stress better
then you significantly
reduce the risk
of a person having further
cardiac events
in the progression
of heart disease.
These are all
reversible effects
if we learn how to recognise
the inappropriate activation
of that response
and learn to switch it off
when it's not actually required.
Then these effects
will start to reverse themselves
right through the body,
and interestingly
in the brain as well.
HERBERT BENSON: And I think
the major breakthrough
was recognising
that the body has a capacity
opposite to the stress response.
That's what we've called
the relaxation response.
We did an experiment
in which we took people
who meditated,
and we found there were dramatic
physiologic changes.
And the essence
of those changes
are a decreased metabolism
in the body,
a quieting of the body.
There's decreased heart rate,
decreased rate of breathing,
slower brain waves.
So here was a reaction
exactly opposite
to the stress response.
This now was science.
Here was something
measurable, predictable
and reproducible.
CRAIG DUNCAN: If you do not
have your mind
in some sort of balance
it doesn't matter
how healthy your body is.
I really had to use
breathing techniques
and different forms of
meditation that have helped me
to just stay calm.
That's it.
But I suppose
the overriding thing
that's helped me to stay healthy
and to decrease the stress,
I have to pray regularly.
If I'm praying, for me,
it brings a calmness.
It centres me.
HERBERT BENSON:
The two basic features
of evoking
the relaxation response
are repetition
and the disregard of other
thoughts when they come to mind.
And what those two things do
is break the train
of everyday thinking.
And often that everyday thinking
is what's stressful.
It's not a real sabre-tooth
tiger in front of you.
It's your fear
of losing your job,
it's your fear of illness
or what have you.
Then we return to
the literatures of the world
to see whether these two steps
that are breaking the train
of everyday thinking
had been described before.
And every single culture
of humankind
that had a history
had these two steps.
There's a commonality.
So if a person argues,
"My technique, my religion,
"is better for bringing
this forth than another,"
it's foolish, because
it's a bodily response.
Just as there are scores of
techniques that are stressful -
same fight-or-flight response -
so there are scores
of approaches
that evoke
the relaxation response.
One way scientists teach people
to evoke
the relaxation response
is to train people to meditate
by focusing their attention
on just one thing.
With practice
they become inwardly aware
and focused on
the present moment.
And now, with the development
of modern brain imaging
technology,
researchers are starting
to understand
the biological mechanisms
underpinning the practice.
While to an outsider
it looks like a person
meditating isn't doing much,
it turns out there's a lot
happening in their brain.
The really wonderful thing
about MRI
is that it lets us look
at the human brain
in a way
that we couldn't before.
Most of the work that we've done
centres on how meditation
can change the actual structure
of the brain.
So the research shows that
a part of the brain called
the amygdala gets turned down.
And the amygdala is important
for the fight-or-flight
response.
So when you see
something scary,
for instance, if you're walking
in the woods
and you suddenly see a snake
out of the corner of your eye,
your amygdala's going to alert
you and say,
"Oh!" and make you jump.
And that part of the brain
seems to get quieter
as you meditate.
And so this is consistent with
a sense of decreased arousal
and greater feelings of peace.
Brain imaging technology
is relatively new
in the context
of scientific discovery,
and it's early days
for mind-body research.
But Dr Sara Lazar's Harvard
study on meditating people
has interesting parallels with
studies recently done on mice
at the National Centre
for Biological Sciences.
Researchers took normal mice
and stressed them out
for two hours a day.
When they measured their brains
they found the amygdala
got bigger.
After 10 days,
they left the mice alone,
but two weeks later
they observed they were still
acting anxiously.
They measured
their brains again,
and although their stressors
had been removed,
they found the mice's amygdala
were still large.
This is the opposite
of what we're seeing
with people who meditate.
Their life is exactly the same
as it's always been.
So they still have
a stressful job,
all the difficult people in life
are still being difficult,
but their amygdala
has gotten smaller
and they're reporting
less stress.
So it shows in both cases
that it's not so much
the environment
but your reaction
to the environment,
and how you're relating
to the events
and the people in your life.
And so it's not about
changing your life,
it's about changing your
relationship to your life.
My name is Jason Wachob.
I live here in Brooklyn,
New York.
My back pain probably started
in 1996,
when I was playing basketball
at Columbia.
After I paid off the mountain of
college debt that I accrued,
I got into start-ups.
I love being an entrepreneur
and I love start-ups,
but there's also the pressure
that you're constantly
trying to grow,
and you're never growing
fast enough.
And you're trying
to raise capital
and you're trying to make money
and you have investors
and you're trying to
pick up business.
And it's a frenetic pace,
and that can be stressful.
I think I internalise stress.
At least, that's what
my wife says.
So I'm not a yeller
or a screamer.
People think I'm very
even-keeled,
which I think I am,
but I think I internalise it.
I think most...a lot of people
internalise stress,
and stress manifests itself.
And I think one of the ways
it manifested itself for me,
at this time of my life,
was through my back.
I would wake up without pain,
and as soon as I got out of the
bed, within five or ten minutes,
I would have shooting pain.
I could not walk
more than a block
without keeling over in pain.
It started to wear me down,
I think.
And then you're stressed
about the pain,
so it's kind of a vicious cycle
that you catch yourself in.
I went to see two different
doctors, specialists,
and both of them told me
I needed back surgery.
However,
the second doctor said,
"You may want to practise yoga.
That may help."
He said...
It was like an afterthought.
So as a last-ditch effort,
I started to practise yoga.
The work that I do
revolves around the clinic that
I started 34 years ago now
called the Mindfulness-Based
Stress Reduction Clinic,
or MBSR.
I was having lunch with a bunch
of dermatologists,
and they were talking about
some of their patients
giving up on their treatments
in the dermatology clinic,
particularly patients
with the skin disease psoriasis.
And the treatment for it
was a course of ultraviolet
light therapy.
We did a small randomised trial
that compared people just
getting the light treatment
with people meditating
while they were getting
the light treatment
and it turned out the
meditators' skin cleared
at about four times the rate
of the non-meditators.
And I didn't believe it.
It was such a powerful finding.
So we replicated it
and tried to make
a little bit more
rigorous study design,
and lo and behold, again
the meditators were healing
four times as fast
as the non-meditators.
And it is a beautiful example
of the mind-body connection,
because you're doing something
with your mind
and something is happening
in the skin.
So it just doesn't get
any better than that.
I think yoga is the perfect
blend of mental and physical
if you're doing it right.
You're moving, and you're really
paying attention to your breath.
And for me that's just magical
because yoga turns into
meditation in motion,
essentially.
I basically twice a day,
every day,
for about 15 or 20 minutes
in the morning and the evening
I would do these four or five
poses religiously every day.
Like, I would just find a spot,
and maybe do a third time
or a fourth time,
do what I needed to do.
And it just started to work.
After a week
I started to feel better,
and after three or four weeks
I could literally start to feel
my spine sort of move
and work itself out.
And then I started to
take classes,
and, you know, there's a great
instructor here, Tara Stiles,
who I started to go
to her class,
and she helped me, like,
take it to another level.
And the back pain's gone
and it hasn't come back.
Through practising with them,
everything went away,
and to me it's just...
it's just magical.
Like, I am sold on yoga
and its healing power.
JON KABAT-ZINN: I mean, that's
one of the beauties of yoga.
You get down on the floor
and start working with your body
in a kind of a way,
systematically,
over a period of time,
and it's, like,
you feel so good.
It's like
you didn't even realise.
And it's not like callisthenics
and it's not like, you know,
intense aerobic activity,
although it could be.
But there's just this sense of,
again, integration,
that you are at one
with your body,
and isn't it amazing
what it actually does?
So a question
I frequently get is,
"Well, you know, meditation or
yoga, it's about attention.
"But what about other activities
"that require
a lot of attention?"
So, for instance,
like rock climbing
or playing
a musical instrument.
When we look at brain activity
during meditation,
we find that many parts
of the brain
actually get turned off
during meditation.
Some areas are more active,
but mostly there's a lot of
turning off.
The focus is really inward.
So when you're running,
people are wearing headphones,
you know, or they zone out.
Whereas with the yoga
and the meditation
you're really paying attention
very closely
to what's going on inside,
and you really get
really in tune
with your body
and with your mind.
You really notice things
that you didn't even notice
were there before.
The deep structure
of these meditative -
and I would include yogic -
practices,
they've been around
for thousands and thousands
of years.
It's not the next fad.
If they have value, they've had
value for a very long time.
That's why they've survived.
And they really have to do with
how we live our lives.
So it's not like, "Oh, something
else should come along
"that will make this
irrelevant."
This is about as relevant
as you can get,
as long as the breath is moving
in and out of your body.
I think it's vital
that people understand
the power
of the mind-body reaction.
And it's best understood by most
by recognising
you have within yourself
a capacity that's opposite
to the stress response.
And to the extent that stress
is causing any disorder,
be it the brain, the body,
the liver, what have you,
to that extent, by reversing
stress's activity
through the relaxation response,
you can treat that.
Does that mean you give up drugs
or surgeries?
Of course not.
But you've got to bring this in
to that same level
of respectability,
because now
we're scientifically proven.
When you think about
your emotions,
you may notice you don't
feel them in your brain.
You feel them in your body.
Your face may flush.
Your heart may race.
Your stomach may flutter.
These feelings are a result of
chemicals and hormones
released
when your brain is in a certain
emotional state.
And now some researchers are
starting to link these states
to health outcomes.
We know happy people
live up to 10 years longer
than unhappy people.
If you're optimistic,
You have about half the risk
of getting heart disease
than if you're
more pessimistic.
In one landmark study
of 2,000 middle-aged men
who worked at the Western
Electric Company in the 1950s,
those who had been
emotionally depressed
at the start of the study
were twice as likely
to have died from cancer
20 years later.
While you might be thinking
this is explained
by happier people
being more inclined
to make healthier life choices,
this research made allowances
for smoking habits,
alcohol intake,
weight and cholesterol.
Even age, job status
and family history of cancer
were factored into the results.
Findings like this
are demonstrated
in thousands of studies
published in peer-reviewed
academic journals.
My name's Ann Salerno.
I'm a paediatric nephrologist,
which is a physician
who takes care of children
with kidney disease,
and I live in Hopkinton,
Massachusetts.
I was married at 33 years old,
and about a year later
we actively started trying
to have children.
And after a year of trying,
really felt like there
was some barrier
and that we should look into
going to a fertility specialist.
All my testing was normal.
All the signals were happening
at the right time,
and still nothing happened.
About a year into my journey,
one of our chickens was killed
by a coyote in the backyard,
and the other four chickens
stopped laying eggs.
It was really
just a wake-up call that...
Look at this simple animal model
of a chicken,
and how them feeling that there
was danger and feeling stressed
had affected their fertility
and their ability to ovulate.
The doctors that I had been to
had not really attended to
how this infertility treatment
and journey
had been affecting me
emotionally.
I didn't realise
it was happening,
but I started feeling more
and more depressed.
WOMAN:
Women with infertility
become very depressed
and very anxious.
And we actually
published a paper
that showed that women
with infertility
were twice as depressed as
women who were fertile.
So depression is really common
in the infertile population.
You know, you throw away
the birth control,
you try for a few months,
you don't get pregnant,
you start to get anxious
and depressed about it.
So even if the physical problem
that caused the infertility
at the beginning
goes away or gets treated,
the angst about not getting
pregnant can then kick in
and independently contribute
to the infertility.
CRAIG HASSED: Emotions have
a profound effect on the body,
for better or for worse.
We shouldn't be one-dimensional
about emotion,
thinking there's only one
positive emotion,
and that's smiling and laughing,
and if we're doing anything
else, like feeling sad,
then that's a negative emotion.
We do have, like a piano,
if you like...
We've got a whole lot
of octaves.
We've got a whole range
of emotions.
And so there might be times
when it's quite appropriate
to feel sad,
and if we express that sadness
in a way that we feel
comfortable with
then that's not
a negative emotion,
that's a natural human emotion.
It's really when the emotions,
what's on the inside,
gets out of step
with what's on the outside,
and then we start to
wrestle with emotions,
we start to wallow in emotions.
We get caught up in negativity,
caught up in self-criticism,
caught up in anger,
so that it lasts and lasts
way after its use-by date.
And that has a long-term and
cumulative effect on the body
that's not particularly healthy.
MAN: It's a sobering thought,
but it's true.
Depressed people don't
live as long.
That's true with
heart disease as well.
If you're depressed
and you have heart disease,
you're not going to live as long
as if you're not depressed
and have heart disease.
So it's a major risk factor
with the major medical illnesses
that kill us.
People who are depressed
feel hopeless,
helpless and worthless,
they may not exercise as well,
they don't sleep as well.
CRAIG HASSED: So the mind has
its direct effects on the body
by what we think -
that mind-body relationship -
but we also should consider
how the mind affects our health
via indirect means.
So that is, the mind decides
what we eat,
whether we exercise,
how we live.
And so the state of the mind has
profound effects on the body,
both in the short term
and the long term.
DAVID SPIEGEL: And depression
is something
we can do something about.
So it's a predictor
of cancer outcome
that we can have an effect on,
and potentially affect
disease outcome as well.
We published an article
in the 'Journal
of Clinical Oncology'
showing that the course
of depression
over a period of a year
for women with breast cancer
predicts survival time.
So the women whose depression
was getting better
lived substantially longer
than the ones whose depression
was getting worse.
And it wasn't just two months
after we studied their
depression,
it was seven years later.
And this prediction
was independent
of all the standard
risk factors -
oestrogen receptor status,
progesterone receptor status,
time from initial diagnosis
to relapse,
all of which are powerful
predictors of outcome.
This depression prediction
was independent of that.
Study after study has shown
that people who are lonely
and depressed and isolated
and three to ten times
more likely
to get sick and die prematurely
than those who have a sense of
love and connection and support.
And I don't know any single
factor in medicine -
not smoking, not cholesterol,
not blood pressure -
that affects our lives
and our survival to that degree.
ALICE DOMAR: If you look at
the data
that I've clocked in
in my career
on the impact of the mind-body
program on fertility rates
in infertility patients,
and the fact the program costs
a few hundred dollars
and pretty much doubles
pregnancy rates,
yes, if you had a pill
that did that,
every infertility patient
in the country would take it.
ANN SALERNO: I learned about
Ali Domar's mind-body program
for infertility,
and it sounded like
exactly what I needed.
Just going to the first meeting
and seeing all these women
in the room
that looked like
they were normal,
and just looking around the room
and saying, like,
"I'm not alone. I'm not a freak.
"I'm just, you know,
"another woman that has a
struggle like the rest of them."
And that was just
extremely powerful
in terms of just turning
my mood around
and helping me to feel more
optimistic about my life
regardless of whether
I got pregnant or not.
After a period of using
the mind-body techniques
that I had learned,
I felt that I would proceed to
the IVF treatment.
We ended up getting
just one embryo,
and that embryo took
on the first try.
And I did conceive,
I got pregnant,
and ultimately delivered
my first child,
my baby boy, Luke,
who's now almost two years old.
ALICE DOMAR: Most of my research
is actually looking at the
impact of the mind-body program
on infertility patients.
And we found the women
who did the mind-body program,
in addition to having
much fewer physical
or psychological symptoms,
had a 55% take-home baby rate
compared to a 20% take-home baby
rate in the control group.
So 55%, 20%.
The research shows that
if a woman feels stressed
she continues to meet
the demands of her family,
her home and her job,
and she lets go of her friends,
which is the thing you need
the most when you're stressed.
And I think there's
an expression
that a crisis shared
is half the burden.
And so I think that's why social
support is so important.
In the 1960s
a US town called Roseto
was an anomaly in America.
No-one under 55 had died
of a heart attack
or showed any signs
of heart disease.
The local death rate
for men over 65
was half the national average.
A team of researchers
led by Dr Stewart Wolf
considered whether this
was because of their diet,
location, family history
or exercise habits,
but on the surface
nothing was different
from the rest of America.
In fact, the town was made up
of Italian immigrants
who worked in quarries
and factories,
smoked unfiltered cigars
and had dinner tables
laden with rich Italian food.
Rosetans of the 1960s still
held onto their old-world
ways.
It was normal to find
three generations
under the same roof.
80% of men in the town
were members of at least
one community group.
They would gather in each
other's kitchens,
play cards and simply talk.
The conclusion?
Rosetans were nourished
by each other.
Over the next decade
the multi-generational homes
broke up.
And by 1971,
when opulent houses,
expensive cars
and swimming pools appeared,
the first person under the age
of 55 died of a heart attack.
By the 1980s
the rate of fatal heart attacks
in Roseto
was the same
as the rest of the country.
DEAN ORNISH: Many people
don't have an extended family
that they see regularly.
They don't have two or three
generations of people
who live in
the neighbourhood together.
They don't have a church or
synagogue they go to regularly,
a job they've been at
for many years.
We all know that these things
affect the quality of our lives,
but they actually affect
our survival
and to a much larger degree
than we had once realised.
And so what we've learned
is that it's not enough
to focus on the behaviour,
it's not enough
just to give people information,
we have to work at
this deeper level.
The number one most commonly
prescribed prescription drugs
in the US
and probably most of the world
have been antidepressants
for the last 10 years,
because there are a lot of
depressed people out there.
Now, a sceptic might say,
"Oh, come on, give me a break.
"You mean sitting around
talking about my feelings will
"somehow help me live longer
if I've got cancer? Please."
It's so easy to make fun
of these ideas,
how we're just so touchy-feely,
you know.
But we are
touchy-feely creatures,
we are creatures of community.
That's how we've survived
as a species,
is by learning how to care
and love and nurture each other.
And we ignore those ideas
at our own peril.
ANN: I just felt a contentment
that I had never felt before
in my life.
It was a feeling like
if I never accomplished anything
or never did anything special
for the rest of my life,
that it was OK.
And...um, about five months ago
I found out that I was
naturally pregnant,
which was very much a surprise,
and that, uh, you know,
it happened
the way it was, you know...
..I always thought
it was supposed to happen.
But I think a lot of that
has to do with, you know...
..sort of that you no longer
have that inner stress,
that inner angst.
It's definitely another miracle
in our lives.
I think that as a physician
I never was taught to appreciate
sort of, um, how a patient
is coping with an illness
or coping with an ailment
and how that interplays
with their therapy
or their success
in their therapy.
It just wasn't even mentioned.
There are now
more than 10,000
peer-reviewed academic papers
looking at the science
of mind-body medicine,
with more research
being published daily,
and with it comes
the molecular underpinnings
of emotions and disease
proving a mind-body connection.
And yet in most conventional
medical centres
the mind is not a component
in a treatment plan.
Millions of people are being
turned away from doctors'
rooms
with potentially curable
chronic illnesses.
Hi. My name's Scott.
I was diagnosed with melanoma
in 2000.
I think, looking back,
I was a bit of a worrying
sort of person -
not so much worried about myself
or where I'm gonna be
in 10 years...
..but I think I just worried
about stuff.
You know, a bit of
a perfectionist by nature and...
I don't know,
I just probably obsessed a bit
about my life, and how this
worked and how that worked
and whether that was
a good way to do things
and things like that.
My doctor never gave me
a prognosis.
But I did ask him.
You know, I said,
"How unwell am I?"
And... I think I said,
"How serious is this?"
And my doctor said, "It doesn't
get any more serious."
My doctor was happy
to call me a terminal patient.
You know, I was unwell.
I had stage IV melanoma,
and people with stage IV
melanoma didn't get better.
And my doctor said,
"Well, look, you can have
chemotherapy if you like,
"but it's only got
a 5-10% success rate."
He said, "But that's all
I've got for you."
They offered me chemotherapy
as a palliative treatment
and that's all they had for me.
I never looked to myself.
You know, I just...looked
to the medical system
and whacked a drip in my arm
and sat there and said,
"She'll be right, mate."
Like, that's the mentality
that I had.
But I wasn't right,
because it kept coming back.
I think there's an art
in how you approach a patient.
The words that a doctor uses
have great power.
I've written also about
what I call 'medical hexing',
which is the negative side
of this,
that many patients have been
told by doctors
in one way or another
that they're not gonna
get better.
Often, doctors haven't,
you know, meant to do that,
and they may even be unconscious
of the things that they've said,
but I think this is an area
that needs correction,
that doctors need to be aware
of how powerful their words are
and to use them, you know,
to promote healing
rather than hinder it.
DAVID SPIEGEL:
Medicine used to be a trade.
It used to be that you would
apprentice yourself to a doctor
and roam around with -
mostly then - him, not her
and learn the craft.
At the beginning
of the last century
there was a report called
the Flexner Report
in the United States
that said, you know,
medicine should be a science,
and so people started
going to formal medical schools
after university.
But, I think, in an odd way,
we solved one problem
and created another
because
the old general practitioners,
they understood the importance
of emotional support
as well as whatever medication
or surgery you gave.
So the oldest adage of medicine
is that our job is
to cure rarely, relieve
suffering, and comfort always,
and in the Flexner era
we rewrote that job description
to be that our job was
to cure always,
relieve suffering
if you had the time,
and let someone else
do the comforting.
MAN: We've started to look at
the doctor-patient interaction
and then, even more broadly,
this ritual or theatre, even,
of healing.
What is it that we do
when we prescribe a medicine,
or see a patient about a surgery
or even conduct surgery?
What is in that environment
and how does it affect
a patient's brain?
There's a couple of trials
which have been done
by a colleague of mine in Italy,
Professor Benedetti,
in the early 2000s,
and they were able to look at
post-operative pain
with the drug morphine,
and were able to show
that morphine was
almost half as effective
when you didn't know
you'd received it.
In other words,
the effect of a drug
is a combination
of the pharmacology of the drug
and the effect of your brain
knowing
that you're having the drug
and the therapeutic ritual
of the drug administration.
That component
is the placebo effect,
and that's what we're studying.
ESTHER STERNBERG: What we're
really talking about here
is what has been almost misnamed
'the placebo effect' -
the brain's own
healing mechanism.
And the reason it's misnamed
is it's usually
the placebo effect...
The word 'placebo'
is usually preceded
by a four-letter word - 'just'.
"Oh, it's 'just'
the placebo effect'."
Well, it's not 'just'
the placebo effect.
It's a very powerful effect
that contributes
about 30% to 50% of the effect
of any biological cure.
Belief is critical
because belief has the ability
to trigger part of the overall
healing response, if you like.
In simple terms, belief is
part of why we get better.
It's not the complete answer,
but it's one part of any medical
treatment, which is important.
And that's both at a
patient level - having belief -
and at a doctor level -
realising that belief
is important.
And the communication
about some of these things
with the patient
is important as well.
My name's Ian Gawler.
I started off my working life
as a veterinarian,
but after just a couple of years
of being in practice
I got a swelling
in my right thigh
which turned out to be a very
aggressive form of bone cancer.
And so in the beginning of 1975
I had my leg amputated
through the hip,
and it got worse
because less than a year later,
the cancer reoccurred.
Nobody on record had lived
more than six months
with that particular type
of secondary cancer,
and most people seemed to die
within about three months.
Being a veterinarian, I'd seen
animals healing through their
own natural agency, if you like,
and so that set me off on
this sort of quest for healing.
And I was very fortunate
because I was around in the
early days of mind-body medicine
when meditation
was just starting
to be used therapeutically,
where nutrition was starting
to be taken,
by some people, seriously
for its therapeutic value,
and that whole role of the mind
and emotions and health
was being considered.
As I was putting all this effort
into getting well,
I reached a point where I...
..it was very apparent that
my mind was the limiting factor,
because up to that point
I'd been doing all these things
that had the possibility
of helping me to recover,
but it became apparent
at that time
that I had some level of doubt
about it.
I was told about this
Indian holy man named Sai Baba,
who was revered in India
at the time
as a...as a divine incarnation.
I must say, of all the people
I met through my healing journey
in terms of presence
and in terms of fulfilling
the expectation
of what one would have
of a really extraordinary
holy man,
he really fitted the bill.
And he said to me very clearly,
very directly,
"You're already healed.
Don't worry."
And he'd sort of
picked up on the fact
that there was this doubt
sort of there.
And with doubt,
you hang back a bit.
And although from the outside
I would have looked like I was
very committed, very engaged
with this whole healing process,
I know - it was a fact -
that there was this
level of doubt there
that was sort of
holding things back.
And through the agency
of meeting him
and the catalytic effect
that he had
and the sort of power
of his presence,
which is, like, what made him
for me a true healer,
I was able to actually
switch that
and I came away from there
with conviction.
And it didn't actually change
what I was doing,
but it changed
how I was doing it
in this quite deep
and profound way.
And so everything from then on
I thought...
You know, I came away, you know,
thinking I'd really get well.
In recent years
the scientific line of inquiry
has moved from being
not if, but how,
belief effects your health.
And while the study
of placebo responses
still has a long way to go
to influence the practices
of conventional medicine,
scientists are starting
to uncover
a physiological basis
for placebo.
Neuroscientists can see
placebo treatments
prompt chemical responses
in the area of the brain
that modulates things like
mood, sleep and pain reception
in a similar way to drugs.
Research on the brains of
people with Parkinson's
disease
has shown that placebos
increase dopamine,
a chemical
that affects emotions
and sensations of pleasure
and reward.
In a study of patients with
irritable bowel syndrome,
people got better
even when they knew
pills given to them were fake.
These people were told
their doctors felt the pills
would help,
and they did.
This is
a really important reminder
that the therapeutic interaction
between the therapist -
any healthcare professional -
and the patient,
is important,
and I think people have
known that for years.
And now we can,
through placebo research,
demonstrate that it's important
because there's a clear
biological manipulation
or altering of...of symptoms.
I think 'healing response'
is a better term
than 'placebo response',
because in most doctors' minds,
placebo responses...
People only think of
giving sugar pills
and saline injections,
so this is fooling patients,
duping them in some way.
And doctors don't like to see
themselves as duping patients,
and patients certainly don't
want to see themselves as dupes.
So I think to avoid all that
I would tend to
talk about these
as mind-mediated
healing responses.
Now, it doesn't mean, you know,
"I think I'm gonna
get rid of my cancer
"or my, you know,
other major illness
"and it's just gonna go away,"
but it does mean
that the body's response
to the insult of an infection
or a tumour or something else
may be modulated by
central nervous system effects,
including expectation
and placebo.
There's no way you can ever
draw a line and say,
"On this side are the
intrinsic effects of treatment
"and on this side are
the mind-mediated effects."
And not only is it impossible
to do that,
it's foolish to do that,
because to me
the placebo response
is the meat of medicine -
that's what you're trying
to make happen.
IAN GAWLER:
It wasn't like I found
some magic medical thing
that fixed me
or some alternative treatment
that fixed me.
I think if there's a magic
bullet involved in my case,
it was actually that sort of
inner capacity for healing
and activating that.
After I recovered,
a lot of people
heard about my story
and wondered what I'd done
and whether it could
be of help to them.
And really, my story's got
less and less significant
in that sense
because the real body
of the work
is the testament
of all the people
who've done these things
over many years.
A friend had mentioned
the Gawler Foundation to me.
Straightaway in this program,
things started to make sense
to me.
You know, like,
full light bulb moments.
You know, I was motivated
and I was keen to stay alive.
I'd just got married.
I was...I was 27.
Like, I didn't want to die.
And I made a lot of changes.
IAN GAWLER: And I have
no trouble in saying,
"I don't care what the odds are.
You're an individual.
"You've got a body,
you've got emotions,
"you've got a mind,
you've got a spirit.
"It's possible that
you're gonna recover."
A lot of the people
that I've helped
that have managed to recover
sort of in spectacular ways
against difficult odds
have found
that point of conviction
at some point
in their own healing journey.
SCOTT: They teach you about
the effects of emotions
on your body,
your immune system,
the importance of meditation,
nutrition,
having some sort of
spiritual connection
to whatever it is
you believe in,
all these things.
And they're all things
that you can do for yourself.
So some people say that my...
..my healing
is this miraculous recovery.
But to me, it was...
..it was just hard work
and perseverance.
And belief.
I believed these things,
you know, were good for me.
The easiest way
to sum it up for someone is
would I have got well
without all these approaches
like meditation
and, essentially,
looking after yourself?
No.
Would I have got well
with just that
and no chemical intervention?
Maybe.
But if you wanted to
break it down,
the drugs weren't gonna cure me,
not by themselves.
I was a terminal patient.
I had stage IV melanoma.
And here I am,
cancer-free, 6.5 years later.
Despite
the overwhelming evidence
that your mind plays
a major role
in both determining
your sickness and wellness,
there remains a major line
of inquiry to explore -
the role of genetics.
Genes are stretches of DNA
that sit in almost every cell
in your body.
They contain instructions
for producing proteins that
run every bodily function.
We inherit half our DNA
from each of our parents.
And if your parents,
grandparents or other
relatives
have an illness,
you have a greater risk
of getting sick too.
I'm George Jelenik.
I'm a medical doctor
who is in academic medicine,
and emergency medicine is the
specialty I've been trained in.
Mum was diagnosed with MS.
So MS is multiple sclerosis,
which is...
..which means that you've got
multiple lesions,
or little areas of damage,
through your nervous system.
Generally it's thought to be
an autoimmune disease,
so the immune system essentially
attacks your own nervous system.
And she deteriorated
quite quickly.
Within perhaps five years
of diagnosis,
she could no longer walk.
And I remember her
then coming to my
medical school graduation
in a wheelchair
and having to be sort of
lifted up the ramp to get inside
to...to see me graduate
from medicine.
I'd done three years
of residency as a doctor
and I thought I would just
take off and see the world
and go for a few years.
And in fact
it was at my going-away party
that I was rung to say that
my mother had been found dead.
She was intent
on finishing her life perfectly
rationally and...and reasonably
because of
what her life had become.
And so she took an overdose
and was found in the morning.
There's a very strong
genetic predisposition to MS,
so if you have a first-degree
relative who had MS,
like my mother,
then your chance is
about 20 to 40 times
the average chance
of the rest of the population.
And it was 1999, 18 years later,
when I was 45,
that I first developed
symptoms of MS.
We used to think that
the genes you were born with
are what you're stuck with
and that's it,
that it's set in stone.
And it turns out
that's not the case.
You're born with the genes.
The genes aren't gonna change.
But the way they are expressed
is very profoundly affected
by the experiences
that you go through.
So often I hear people say,
"Oh, I've just got bad genes.
"It's all in my genes.
What can I do?"
Well, actually you can do a lot.
For the last 36 years,
I've directed a series
of research studies
showing what
a powerful difference
changes in diet and lifestyle
can make
not only in preventing disease,
but actually in treating
and often reversing it.
We were able to show
for the first time
that we could slow, stop,
or even reverse
the progression
of early-stage prostate cancer.
We looked into some of the
mechanisms to help explain that,
and we found that over 500 genes
were favourably changed
in just three months.
And, in fact,
turning on the good genes
that prevent these conditions
and turning off
particularly the oncogenes
that promote prostate cancer
in men, breast cancer in women,
colon cancer and so on.
And I think these findings are
giving many people new hope
and new choices
that they didn't have before.
So the bedrock principle
of biology,
that genes are fixed
and unchangeable,
has now been shaken
to the core.
Through the study
of gene expression,
scientists now know
that your genes can be
switched on and switched off.
And while for the most part
every cell in your body
contains exactly
the same genes,
and that won't change,
being exposed
to external forces
can flip the switch
one way or another.
By studying epigenetics,
researchers also know
that gene expression can be
passed to the next generation.
The way
your great-grandmother lived
could be affecting your health.
And here,
at the front line of science,
there are major implications
for mind-body medicine.
Recently, research
on the relaxation response
was taken to a whole new level.
Scientists at
the Benson Henry Institute
for Mind Body Medicine
looked at
the genetic expression
of people who meditated.
And the results revealed
that meditation can
flip the switch
on genes affecting disease.
But it's even,
from my point of view,
more remarkable than that,
because the first time you evoke
the relaxation response,
these genomic gene expression
changes occur.
Now, what happens,
the more times you do it daily,
the more intense
is the response,
the more anchored it is,
but it happens
the very first time
when you go through
these instructions.
That's incredible.
That's absolutely remarkable.
So what you're saying is
that within minutes
of doing a technique
that evokes
the relaxation response,
we can change the way
our genes are expressed?
Yes. Yes. And that's...
Now, there is
a very important point here,
namely, the more you do it,
the more intense the response.
That means the daily practice
of these techniques is vital.
Sure, you can get a benefit,
but you can get
so much more benefit
if you do it on a daily basis.
GEORGE JELENIK:
To be diagnosed with MS
was just an enormous...
an enormous blow.
I mean, it's impossible
to really adequately convey
how life-changing that is.
At a stage when you've got
a really young family
and you've just been appointed
to a really important new job,
and things seem, apparently,
to be going really well
in your life,
it's like an enormous hand
just reaches in
and takes your life away
from you.
In an instant it's just gone.
I started thinking,
"Why have I gotten sick?
"Why did I get sick right now?
"What is this illness
doing for me?
"What does it mean
in the context of my life?"
And so I...I had a path
suddenly to explore.
I'm no stranger to medical
research in the job I do,
so it was relatively easy for me
to look through
the medical literature
and see what had been written
about this illness before.
And really the literature
had so many clues
about what causes MS
and what makes it worse
that it wasn't that difficult
to put that together.
I think I got sick,
in hindsight,
because everything in my life
was really out of whack.
It was really out of balance.
And it was the exploration
of that path, really,
that led me to be well
and keeps me well.
For a long time, I wouldn't use
the word 'recovery'
because I thought...
That doesn't even get discussed
in medical circles,
that it's possible
to recover from MS.
And I thought it was
really sticking my neck out
to say I'd recovered.
But in fact, from what I've seen
in my own personal experience
now,
I think
it's perfectly reasonable
to start a conversation
about recovery from MS.
Why not?
It's just
another chronic illness
like many of the others we see
in the West.
Why couldn't you recover
from that?
If you looked at my life now,
it is unrecognisable
from my previous life.
I live
a pretty healthy lifestyle.
So I exercise every day
of the week,
plus walking to work and back.
I eat a plant-based
wholefood diet,
I eat a lot of fish, take
omega-3 supplements, vitamin D.
I'm perfectly happy to meditate
with my colleagues at work.
And, interestingly enough,
the whole organisation
at St Vincent's Hospital
is starting to embrace
meditation.
When things go wrong,
I seek counselling,
I keep my diary,
I've got some really good
friends I can sit and talk to
and really close family
who really understand me.
So, all in all,
it's a whole lot easier
for me to stay
emotionally healthy now
than it was in other parts
of my life.
If you looked at the kind
of cards I was dealt,
then I think the average person
would have said that
that's a recipe for...
for a disastrous life.
And yet I don't
remotely feel like
I'm living the kind of
prescription that was delivered.
It's real hope that you can
end up perfectly well
after 10 or 15 years
with this illness.
I mean, I have.
Through the story
of George Jelenik,
a professor
of emergency medicine,
we have living proof
that your wellness
is determined
by far more than your genes,
that you can apply
the latest science
to change the way your chronic
illness affects your life.
But here at the frontier
of mind-body medicine,
it doesn't stop
at gene expression.
Thanks to the work
of a Nobel Prize-winning team
of researchers
from the University
of California,
we know that high levels
of stress
affect the rate your DNA ages.
They found, for example,
that women with the
highest levels of stress
in their lives
had about 10 years
of accelerated ageing
compared to low-stress women.
They measured this
by looking at telomeres.
These are little caps
that sit on the ends
of your DNA strands,
like the ends of shoelaces,
and guard
your genetic information.
As you age,
your telomeres get shorter,
and the shorter your telomeres,
the greater the risk
of illnesses
associated with ageing.
Shortened telomeres
have been linked
to increased risk of cancers,
heart disease and dementia.
But it's not too late.
A pilot study by Dr Dean Ornish
has shown that even this
is reversible.
DEAN ORNISH: When people went
through our lifestyle program,
which included
stress management,
exercise, a healthier diet
and more love and intimacy,
their telomeres
actually got longer,
so their lives get longer.
It's still the only
intervention, including drugs,
that's been shown to actually
make your telomeres longer.
And I think these findings are
giving many people new hope
and new choices
that they didn't have before.
CRAIG HASSED: I just think
it's fascinating
to be thinking
you're sitting in a chair
practising a mind-body technique
like meditation
and you're doing genetic
engineering at the same time.
I find that extraordinary.
So how we feel and how we relate
to ourselves in the world
has an effect on our ageing
through a whole lot
of different mechanisms
from genetics to physiology,
for better or for worse,
and things accelerate ageing
and there are things
that slow it down,
and it's not surprising.
Having good emotional health,
coping well with demands
of day-to-day life,
leading a healthy lifestyle,
slow it down,
and the things
that we associate with
poor mental health
and an unhealthy lifestyle
speed it up.
It just depends on how fast
we want to burn the wick.
But if there was
a patentable product
that had those kinds of effects
we'd be all over it.
We'd be spending
billions of dollars on research
and rolling it out
in no time at all.
It's been nearly 10 years
since I was diagnosed
with an autoimmune disease,
a 3-year journey
to make this film.
I am not in a wheelchair.
I am not on medication.
I now see that
when it comes to my health,
balancing my mind and body
is as essential
as the air I breathe.
And in a strange way
I'm grateful for the illness
because, like so many other
people I've met along the way,
it wasn't until I got sick
that I realised
I needed to get better.
DEAN ORNISH: I can't tell you
how many patients
have said things to me
like, "Having a heart attack
"was the best thing
that ever happened to me,"
or, "Being diagnosed
with prostate cancer..."
You want to go,
"What? Are you nuts?"
And they say, "No, that's what
it took to get my attention
"to begin making these changes
in my life
"that have made it so much more
meaningful and beautiful
"that I might not have ever
done it otherwise."
They're spending more time
with their loved ones,
they're eating and exercising
more, so they feel better.
And so for me that's what...
I mean, we're all gonna die,
so...
More important than how long
we live is how well we live.
HERBERT BENSON:
For health and wellbeing
and to treat illnesses,
of course we need drugs,
of course we need surgeries,
but we also need
the power of the mind.
Now we have
the evidence-based proof
that the mind can heal,
and it should be added
appropriately
to drugs and surgeries.
DEAN ORNISH: I've spent my whole
life professionally documenting
what a powerful difference
these simple changes can make.
You know, we think
it has to be a new laser
or something really high-tech
and expensive -
a new drug,
a new surgical technique.
We are trying to show
that these very simple choices
that we make in our lives
each day
have a powerful impact
on our lives,
much more and much more quickly
than we had once realised,
for better and for worse.
JON KABAT-ZINN: Absolutely.
We have much more to say
over how healthy we'll be
than our doctors,
and how we do that
whether it's though yoga,
whether it's through meditation,
whether it's through exercise,
whether it's through
changing our diets,
whether it's through
giving more...
..airtime to our relationships
and appreciating
that our relationships
aren't, like, off to the side
someplace.
They're absolutely critical
to how well we will feel.
DAVID SPIEGEL: I believe
in the power of group support.
I have no doubt at all that
it helps people live better.
And we are not just
splendid individuals.
We define ourselves in part
by the people around us
and how they interact with us.
And so I have no doubt at all
that it helps people
live better,
and I think the evidence
is accumulating
that it helps them live longer
as well.
ALICE DOMAR: I know our mind
and body are connected.
I've had thousands of patients
get pregnant.
I know there's
a mind-body connection.
I've seen it,
I've done research on it.
It's a given.
ANDREW WEIL: I think
mind-body medicine
is central to good medicine.
In fact, you know,
one thing I often say
is that one day we'll be able
to drop the word 'integrative' -
this will just be good medicine.
There is no doubt that the mind
and the body are connected.
There is no doubt that
the brain and the immune system
and the rest of the body
are connected,
and that when those connections
are intact and in balance
you have health
and when they're broken
you have disease.
You can't always overcome
your genes.
You can't always overcome
your environment.
But with help,
with an experienced practitioner
who can help guide you,
you can find the best formula
to help your body and your brain
to help you heal.