June 10, 2011
(last updated May 6, 2014) 
If you ever decide to work in book publishing, you’ll be asked in your very first job interview (and all the ones that follow) to write a “reader’s report” on a non-fiction proposal or a novel. What the editor you’re hoping to work for is trying to do is figure out what kind of reader you are. Are you sensitive? Astute? How are your analytical skills? Do you have good sense of structure and pace? Are you a careful reader, and do you catch mistakes easily? How good are you at summarizing the essence of something you’ve read? Reader’s reports, in which you sum up succinctly the book you’ve read and discuss its merits for a little while, are designed to test you on those fronts.
I’m glad that I’ll never ever have to write a reader’s report again. But when I quit publishing, I did promise to share more with you about my reading list and what rises to the top. Oddly, I don’t tend to talk much about books when I’m out in the world: I think this is because I know that my tastes are very particular, and that they were heavily shaped by exposure to the industry itself. But I have gone through a tear of books about medicine lately, for obvious reason, and I’m fairly sure that you all would take great interest in them. The first I’d like to mention is Anne Harrington’s THE CURE WITHIN: A History of Mind-Body Medicine, which I finished a few weeks ago.
One of the oddities of my new endeavor in life is that I’m coming into the world of medical education and training having already spent quite some time around people who were suffering from various ailments. In my counseling work and in the many emails I get because of my blog, I hear often about mysterious digestive ailments, autoimmune diseases, allergies, psychological conditions, and endocrine disorders. Clearly, I’m not a doctor (yet), and I’ve never had the training or capacity to work with those who are very sick. I have, though listened carefully to their stories, hoping that I might learn from them, and hoping that I’ll one day be able to do more for people who are suffering.
Anne Harrington is fascinated by stories, too; namely the stories of the many men and women whose symptoms and conditions defy a conventional medical explanation. She uses stories and narratives (the difference, she says, is that stories are individual, whereas narratives are templates) to illustrate the idea that, while we can’t simply make up our own bodies, “the body is a genuinely mindful entity,” and so our bodies “listen” not only to emotions and experiences, but also to social and cultural norms. The power of mind-body medicine is its acknowledgment of the fact that, while our bodies are susceptible to microbes and viruses and cell mutations, suffering and healing are also informed by feelings, anxieties, and the societies in which we live.
Harrington moves through the history of what we call mind-body medicine (an imperfect term, maybe, but useful for the purposes of this book) from its origins in Viennese psychoanalysis to its stronghold in post-WWII America, it’s collapse in the 1970s, and it’s rejuvenation in our own era. Today, it’s not at all unusual for a savvy and educated person to seek out acupuncture or hypnotherapy for a medical condition (such as PCOS, depression, or IBS), but this wasn’t always the case, and Harrington maps out quite skillfully the history of mind-body medicine’s ascension to mainstream acceptance.
One of the book’s strengths is Harrington’s background: she’s a chair of the history of science at Harvard and has done extensive work on placebo effects over the course of her careers. The placebo effect happens to be of great interest to me, because I think that one tends to see its effects writ large in the world of nutritional counseling. One can’t get interested in nutrition without realizing that changes in diet yield enormous and profound changes in overall health. The complicated thing here is that, once we see the effect that diet has on the way we feel, it’s easy for us to overemphasize or even imagine connections between what we’re eating and how we’re feeling.
I’ll use myself as a case in point: a year or two after I started eating raw, I wondered why my digestion wasn’t yet as strong as I wanted it to be. I read up on food combining, and it sounded so unbelievably intuitive to me: I tried it, and it seemed to work wonders. I was fanatical about it, until I started taking college level biology and nutrition classes, and realized that science simply isn’t in favor of food combining (namely, hydrochloric acid churns everything we eat into a giant bolus of digesting food; the idea that certain foods “wait” behind certain others, or that fruit can “ferment” in such a highly acidic environment, isn’t possible). Never one to cling to an idea simply out of habit, or to avoid admitting I’m wrong, I stopped combining to see what happened.
Nothing happened. My digestion was every bit as strong as it was before. Gradually I stopped the practice, and I took information about it off my blog (even though I’m still 100% happy to discuss it with clients or those who are interested in doing it). Do I regret having experimented with combining for a while? No. The truth is that I had a long history of digestive suffering, and at the time I read up on food combining I needed to believe that there was something—anything—that I hadn’t yet tried that would really work. Food combining gave me that hope, and I think it also gave me relief from the stress that really was injuring my digestion. (Today, I credit stress management with helping me to heal.)
So you see, even treatments that aren’t grounded in biological fact can nevertheless work: food combining was most powerful to me as a placebo, I think, but that doesn’t mean that it didn’t actually yield great results. It just didn’t yield them exactly the way I thought it would.
(As an aside: I do think that there’s a basic logic to food combining: most people feel lousy after they eat really complicated combinations of food, and better with simple ones. And there are really strong reports of better health through combining, so my advice to you all is to experiment, read, research, and make up your own minds. I’m merely relaying the facts as I see them—which does, as you can see, leave quite a bit of room to acknowledge the value of food combining as a practice, if it happens to speak to you.)
It’s precisely these kinds of stories that Harrington unearths, except she selects cases that are more dramatic: the man whose tumors would shrink miraculously when a placebo drug was administered (even though it was mere water), for instance. Her goal is to talk about why and how such phenomena occur, all the while demonstrating the very real and very potent effect of the mind on the body. If you’re at all interested in medicine that reaches beyond the normal boundaries of allopathic treatment, and even if you’re not, I recommend this book. In the end, my only criticism is that Harrington’s many stories don’t always cohere into an argument. But that’s one small criticism for an otherwise worthy and illuminating read.
What do you guys think of placebos when it comes to food and medicine? Have you ever stopped eating something and felt better, only to realize later on that the food itself was less to blame for discomfort than you had thought? What are your thoughts on the mind-body connection? I’d love to know!
Happy Friday…
xo
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Wow, great post and so many great comments! I really must get back to studying now! 🙂
As an erstwhile historian of science and medicine, a vegan, and an individual interested in working in publishing, I was very interested to read this post. Thanks for sharing, and for interweaving your own experience with your thoughts on Harrington’s book. I’ll have to check the book for myself!
I feel as though I should leave something here. 🙂 Have you seen Kuriyama’s /The Expressiveness of the Body/? He compares the ancient Greek and Chinese medical views of the body side-by-side, and although his style gets a bit repetitive, the book itself is a really welcoming and readable treatment of the subject.
After reading this post, I’m selfishly happy that you left the publishing industry and are more willing to share your reviews with us. You may be interested in Mukherjee’s Emperor of all Maladies, although I’ve heard mixed reviews.
I read it, Kate, some time ago, but think I ought to refresh my memory to review it. I liked it very much, though it had moments of self-indulgence.
The mind is the most powerful predictor of our health. It’s reassuring knowing that there are and will be more people in medicine respecting the connection between our minds and our bodies and encouraging people to be more in-tune and intuitive about their health. I like the philosophy behind and movement toward functional medicine – have you read much on that to date? (the answer is probably “yes”!)
oh gosh this is us all the time…we read something, fall in love with the idea, try it out and then find something else to try. There are some things we know our bodies like and do not like, but like you said every one has to find out what works for them. We are big believers of how powerful the mind can be over how we feel, something we work on, but hope to be where you are in with food and mind connection.
I hope you know that one of the BEST researchers on placebo and nocebo effects and discussion about their ethical use in medicine is at Georgetown U? James Giordano.
Nocebo effects are also really strong in alternative medicine- you got a headache after eating nuts with avocado, right? Or living near an electric plant? After coincidentally eating a certain food before getting the flu, many people exhibit an automatic response of nausea to that food in the future, even if they are aware it was not the cause. So it’s not hard at all to see how negative psychological experiences or beliefs paired with suspect foods can create strong nocebo responses and reinforce false beliefs. In addition, food sensitivities and allergies usually become stronger when that food is not eaten regularly. Thus if I believe I have a dairy sensitivity and refrain from eating dairy for a year, I am much much more likely to become sensitive to dairy. Combined with the nocebo effect, it’s a self-fulfilling prophecy. Fascinating stuff. A lot of my lab’s research falls into the “mind-body” category. Our internal experience is very much constructed as a model of the world based on information from all our sense, memory, beliefs, etc. Imagination X engages much the same neural systems as actually experiencing X. In fact, I should return to writing my qualifying review paper now, which is on this very topic of embodied cognition. Your blog is enabling my procrastination, Gena! 🙂
Well I was thinking directly of you when I wrote this, my dear, so while I’m sorry to enable procrastination, I’m also grateful for your feedback!
What a fascinating post. I really enjoyed it!
What I find most interesting about the mind-body connection is the third axis: the cultural translation of an illness. Psychological illnesses, for instance, can manifest physically along cultural lines or within encapsulated populations in strikingly different manners and with strikingly difference frequencies (Conversion Disorder immediately comes to mind).
As for a personal story, since the age of seven I thought I was allergic to pomegranates due to a rash that once developed following ingestion. I have been avoiding them my whole life (even through the superfruit pom craze!). Just recently however, I discovered that I am not allergic to them at all. Delicious.
Again, wonderful post!
It’s interesting you talk about this today—I’m at a Food as Medicine course by the Center for Mind-Body Medicine right outside of DC. The amazing things I’ve learned are such a blend of the science (which always intrigues me) and the mind-body aspect of it all.
The speakers here include Mark Hyman and Neal Barnard…two of my go-to references for sound nutritional advice for clients.
I love the aspects of mind-body that can be brought into real life practice! This conference is amazing, and I highly respect the CMBM for all of their trainings and work they do (even though I know most of the nutrition science “facts” presented, I’ve met so many like minded health professionals and see the connections between mind-body-food even better).
Even if you just check out Dr. Jim Gordon’s story…I think you’ll like it!
cmbm dot org
Great post, Gena! It brings up a lot of fascinating points about mental health and physical health. I think mental health plays a huge role in our overall physical health, I can eats perfectly clean and healthy – but it I’m depressed, stress, anxious, etc., it won’t be as beneficial. Cherie Soria talked a lot about that too at a raw health fest I went to last year, eating healthy is only part of the equation for good health and mental health was another huge part. She’s definitely living proof of that to me.
Definitely a mind-body connection here. I physicalize my stress, usually as GI distress or sleep disruption. For instance: the past three months, about half an hour after I lie down I wake up with a crazy accelerated heart rate/breathing, sometimes screaming, sometimes half out of bed. In the beginning, I wouldn’t wake up all the way at first and would hallucinate (giant spiders, sharks) until I was fully awake, which just panicked me more. I have no idea what to do about it, either, because I don’t *consciously* feel stressed out. I’m just so used to physicalizing *all* my stress I constantly feel keyed up physically, even if *mentally* I’m not anxious. (Though I can usually find something to be anxious about.) I’m hoping to start exercising again and see if that helps.
I think stress is one of the biggest factors in our health, maybe even more than diet. After three years of depression anxiety I developed a dairy allergy, wore out my adrenal glands and messed up my blood sugar. I think it’s because thoughts and feelings occur in the body as chemical reactions, which involve various body parts like my poor shriveled up adrenals. It’s fascinating. I haven’t been very good about sticking to the diet or taking all the supplements my doctor recommended, but I feel a million times better now that I’ve moved to a better situation and I’ve developed some cognitive tools for dealing with stress.
Great post, Gena! I am a firm believer in the mind-body connection. It’s very powerful and a fascinating subject. It just so happened that I bought ” The Cure Within” a few days ago; I can’t wait to start reading it now!
Sounds like an interesting book, Gena. I really must start reading more real “book-books”. I seem to just read blogs 🙂
That’s really interesting to read about your take on food combining. I don’t really worry about it myself, either. Compared to the way I used to eat–junk-food vegetarian–and the way I eat now–100% raw vegan for 2 years–I figure I am doing sooo much better than the old me.
First on the food combining: so glad you’ve come 180 on this! Ive always rolled my eyes over the whole thing but some people swear it works for them so I say, go with what works. But I never want to feel guilty over miscombining or whatever. Probably thinking about combining foods might also get one to eat less or more thoughtfully or slower which also helps with bloating and digestion.
I have to say having been suffering from chronic health issues, I find the whole placebo stuff hard to stomach. It can easily lead into a slippery slope of saying its all in one’s head and that’s not true for me. It can lead to people being less serious. Also, there have been times where I have really really believed something would work for me, and it didn’t, and other times where I really really believed it wouldn’t and it did. I don’t doubt that mood and stress has an impact on health but to suggest that a large portion of it is caused by one’s mind or can be controlled by one’s mind just doesn’t sit right with me.
sorry meant to say “taking people less seriously”. I should refrain from typing comments past midnight. 🙂
great post.
I think it’s also important to remember that whether illness is caused by stress (“all in one’s head”) or not, the illness is still *there* and you still *suffer* and feel it. I was told that a lot with my GI issues, oh, you’re just stressing, it’s in your head. All my tests came back normal. Okay, fine… but… It’s irrelevant because I _still feel like I’m going to barf if I eat anything._ You still have to deal with it.
I encourage you to get more testing from someone who is not mainstream. My mainstream tests often are deemed “normal” but someone who looks at other things not often tested and more outside the box can find a true medical cause for things.
I think when doctors tell you it’s in your head, unless they mean you are suffering from a true mental disorder (which can be legitimate), they are being lazy and have given up. It’s been the case for me so many times.
B,
I think that’s actually one of the things Harrington handles well; she doesn’t veer into any dialog that suggests that illness is imagined, but I do think she takes a really heavy interest in how illnesses/symptoms change along with shifting culture and societal norms. It’s a balanced and respectful approach, and she has little patience for the short-sightedness of doctors.
I do certainly believe that situations like mine are good for examining the effect of placebos, but there are factors to keep in mind: I wasn’t terribly sick, and I knew already that my digestive problems had a very heavy stress/mood component. I simply didn’t know how it could be managed. It’s no surprise that I experienced what I did from food combining, but I would never want to say that this little example illustrates a bigger norm that applies to people with graver illnesses.
G
I don’t completely disagree that the placebo factor exists, but I think some people take it WAY too far (louise hay for example). Good to know this book is more balanced. I also think I am somewhat atypical probably.
bitt, it’s definitely a hard pill to swallow that very real physical problems/illnesses are “simply” results of stress. And, many doctors can seem so dismissive in the way they tell you that your issues are caused by stress, especially when not combined with any testing. I think it’s best to be as careful as possible. I suffered for years with so many issues I jokingly referred to as my “old lady ailments”—I was in my mid 20s. Anyway, I finally documented all my doctor’s visits and wrote a letter explaining that it made no sense for someone my age to constantly need medical attention and I’d appreciate some further investigation. It sure worked. It actually spooked the doc and she thought I might have lymphoma! I was tested for it and other things, and found out it was all “normal”. However, I was a very stressed person. Eventually, I took major steps to make my life better including moving 2000 miles to a warmer climate, changing jobs, and one by one my old lady ailments vanished. It’s still hard to believe that stress wreaked such havoc on my body but it did. In the same way I felt the 15+ doctors I saw were dismissive of me, I realized I was overly dismissive of those who’d told me I had too much stress. Anyway, based on my experience, I’d recommend do everything you can to reduce stress and when you go to the doctor, go prepared with everything you want to convey in writing so that it can’t be so easily glossed over! Good luck to anyone who is struggling!
I’m currently reading The Next Ten Minutes, which sort of relates to this post. Basically, the author (Andrew Peterson) talks about how little changes (even absurd things like sleeping on the other side of the bed!) that we implement in our lives can have a “butterfly” effect and result in huge changes in our lifestyle. It’s a super interesting, eye opening book, but also makes me think of the placebo effect.
Also, I, like Averie (above), remember your food combining post(s?) and how it all seemed to make a lot of sense…but I’ve never really had problems eating fruit with cooked food, so I haven’t really been food combining anyhow… My dad doesn’t prescribe to a strict food combining regimen, but he waits 30+ minutes after he eats fruit to eat anything cooked (and vice versa). It works for his stomach, but I’ve found I don’t generally need to do so. Do you think food combining is more like 90 percent placebo, or is there any legitimate science behind it that you can see?
I really admire that you wrote this post. And I find the psychological aspects of nutrition and food fascinating. I think in addition to belief being enough to heal us, I think that belief is enough to make us sick. Not to say that all food allergies and intolerances aren’t legitimate, but I think widespread self-diagnosis is running rampant.
That’s for sure. I don’t mind that we’re more empowered nowadays to explore our own best health, but I don’t like it when exploration turns directly into constant self-experimentation.
I don’t know, Gena. I am thinking of your post on kitchen intuition, which I liked a lot. Unless I’m baking, I don’t measure anything. And I don’t need to consult an expert to know whether or not something in my fridge is edible or not. Similarly, I don’t run to a doctor or medical “expert” over every physical ailment. People are shocked (no, horrified) to hear that in 14 years I’ve made only TWO sick visits to doctors with my son (one for contact dermatitis, so no medicine was prescribed). Of course, there are legitimate reasons to consult trained professionals, but I think we’ve lost a lot of our intuition and ability to provide adequate self-care (to say nothing of child-care) with the professionalization of medicine. Maybe the “experimentation” and “self-diagnosis” so many of us are guilty of (especially around diet) is simply finding our way back to what was once second nature. At least for women.
I followed the blood type diet for a few years, and was convinced I was an “O” blood type. O blood types are not meant to eat peanut butter. So every time I did, I would get a horrible stomach ache. Then I gave blood, and discovered I was an “A” blood type, and peanut butter is supposed to be good for them! I ate peanut butter to my hearts content after that and was free from pain. Totally in my mind the whole time. Weird!
Oh Gena, you speak straight to me and rock my world! I know I scratched the surface of placebo/nocebo recently and you intimated that you have lots to say on it: I love this encapsulation of that ‘lots,’ contained within a very intriguing book review too.
I love your discussion of food combining: can hardly agree more, both about the scientific negation of it and about the fact that following the practice often helps people to sort some things out just through the simplification.
I’ve only worked as a freelance editor, but those ‘reader reports’ sound so much up my alley. And the mind-body connection–well, I could go on and on.
On the feelings affecting response to a food, I have a good one from years ago. So, as you know, I have celiac and am very allergic to gluten–an accidentally ingested crumb will make me sick for two days. So, I’d been eating a little soy sauce in stir fries and happened to read the ingredients and see ‘wheat flour.’ That day, I couldn’t eat the soy sauced stir fry, because I knew I’d be sick. But after a while, I was puzzled, because I _hadn’t_ been sick before. I did a little research and found that when the gluten, which is a protein, is fermented, significantly less than one percent of it was seen to survive the process. So it’s a matter of how cautious you want to be. And I also suspect that the amount varies. Nowadays, I tend not to chance it: back in my college days, I drank beer sometimes on the same logic (and risked occasionally being violently ill, presumably gluten, not alcohol ;0 )
Woof–that’s gotten long! I’ll leave it there, but thanks again
love
Ela
I think the placebo effect is fascinating. Just last week I heard a really interesting interview with Dr Amir Raz, who studies the placebo effect:
http://www.cbc.ca/thecurrent/episode/2011/06/08/placebo-medication/
Take a few minutes to listen to it!
Don’t have any food stories 🙂
But there are several interesting tangents to this discussion that I can see, even though there is very little I personally know about them. But perhaps, other readers here know more and could contribute links or books?
1. One of the most interesting biological mechanisms I have recently became aware of is epigenetics: the study of gene expression throughout our lives. And while there are many very reasonable cautions about the newborn behavioural epigenetics, I can’t help but wonder if this might turn out to be one of several possible explanations we could find for the mind-body connection.
2. As well, I am currently pursuing counselling as a career field. Yet as I reentered school for a psychology after-degree, I am now drawn to courses in neuroscience. I don’t yet know enough to even begin to speculate, but this is another field where I, personally, would dig for explanations.
3. In my own country of origin, Russia, there is a branch of counselling practice that deals specifically with psychosomatic problems and attempts to improve mental well-being through working with the body. Once again, I don’t yet know enough, but I am contemplating returning there for 6 months to study this, once I got my Masters degree and can fit it withing the theoretical framework I am exposed to here.
So interesting! I, too, am a complete believer in the mind-body connection. I just listened to an online class yesterday on digestion and absorption and how digestion is affected by our emotions; that when we’re sad or scared, our digestion slows down, and when we’re aggressive and angry, it speeds up. So interesting to hear that from a MS/RD/CDN. And from personal experience I know that stress can wreak havoc on the body in a gazillion different ways. Back in the day I used to grind my teeth, my skin would break out in a strange rash, I’d have breathing problems, etc., all from just plain old stress. It took me a while to realize the answer was so simple and easy to fix!
I totally, 100% agree with you on this. I am also one of those people who manifest mental distress as physical symptoms. They say the gut is the “second brain” – for me, it’s the first! I struggled for years with digestive problems and, not coincidentally, anorexia. For me, the two are intertwined and hopelessly entangled. The key was, as with you Gena, learning to manage my anxiety; the practice of “watching” my thoughts, rather than letting myself become them, has been an invaluable skill.
I want to get my hands on this book now! Thanks for the report :).
One day, Vanessa, I would love to write a book on the relationship between IBS (and other digestive problems) and anorexia survival. It would be a tome.
I think other eating disorders are connected in the same way! And with my long history of a binge eating disorder and ongoing digestive problems to follow, I’d be ready to read your book in a heartbeat. 🙂
That would be amazing and quite a feat! There are so many people I know who have IBS since ED. The mind and body is so complex. I don’t know whether I should just stop trying to figure it out!
I, without a smidgen of doubt, believe wholeheartedly in the mind-body connection. I’m a very mental person. I know it, my mom knows it, my boyfriend knows it. I’ve always been one to manifest my emotional problems into physical ones. I get nauseous and shaky when I’m stressed or panicky. If I have a bad meal experience, I’ll make myself sick by thinking about it, when in reality there was nothing physically wrong with the food (aside from how it tasted.)
I’ve read about a lot of studies involving placebos, and I’ve always found the results to be very convincing. Our minds are more powerful than we give them credit for. I truly believe that. Thank you for recommending this book! I’ve been doing a lot of pleasure reading lately, but nothing too educational. This sounds like a really intriguing read. I love learning about the human mind and what it’s capable of. We human beings are fascinating creatures!
“Gradually I stopped the practice, and I took information about it off my blog”–
I knew in the past year or so you moved away from food combining and were not “militant” about it or rigid the way that some people who get into it can become, but I didn’t know you took the info down. I will NEVER forget your post on food combining from maybe 18-24 mos ago…it was an eye opener for me at the time and definitely food for thought.
As far as the mind-body connection…YES I strongly believe in it and basically everything from “fake it til you make it”, telling yourself things are good or will work out, to positive affirmations to believing in a certain treatment or practice whole-heatedly…yes, there is tons of value and merit in that for me.
All of my undergraduate and graduate work was in psychology with a bio minor in undergrad so this is all fascinating to me and I always say if something gives someone hope or works for them, even if it’s not proven or is not necessarily rooted in total science,and even if the person knows this but still wants to believe in the item or treatment, and that it will help them, then who am I to say but there’s no science behind it. To each her own and do whatever works!
The mind is extremely powerful, as is the power of suggestion, so really, nothing surprises me 🙂
Yup, took it down. Not because I don’t still offer the info to people who ask, or because I think its entirely without value, but because its not something I can talk about without a million disclaimers, and a static post in the archives can’t do that. I like the blog to evolve with me, so that means fluid content 🙂
Both of you say it best 🙂