Professor Glenn Wilson, Gresham College, London

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MIND OVER MATTER

• Professor Glenn Wilson, Gresham College, London

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PSYCHOKINESIS

• Literally the capacity to influence the
  physical world by mind power alone (e.g., moving
  objects, influencing dice, bending spoons).
• No evidence for this that could not be explained
  by publication bias. Anyone with such powers
  would make a fortune in Las Vegas. Magician James
  Randi has offered 1million to anyone who can
  demonstrate it under properly controlled
  conditions so far no takers.

3
FIRE-WALKING

• Walking across hot embers is performed by
  Japanese priests as a purification and endurance
  ritual. Often regarded as a mystical
  mind-over-matter phenomenon but explanation is
  physical anyone can do it given the right
  conditions, without superpowers or incantations
  (often done on office motivational weekends).
• Dangerous though Embers must be in late stages
  of burning and not contain metal debris.
• Need to walk at a steady pace, not run (which
  causes the foot to plunge too deep).

4
HOMEOPATHY

• An alternative treatment based on theory that
  like cures like and the more dilute the better.
• Remedies often double diluted to point that no
  molecules of active substance are left - they
  are just water.
• Despite that, many feel better for various
  reasons (e.g., withdrawal of unpleasant medical
  treatments).

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THE PLACEBO EFFECT

• Placebo I shall please Belief one is being
  treated and expectation of improvement will
  alleviate distress, regardless of any medical
  mechanisms (c.f., Mummy kissing it better).
• Prescribed by many doctors but seldom blatantly.
  Usually as vitamin tablets or mild,
  over-the-counter analgesics that might give some
  general benefit (thus averting ethical dilemma).
• .

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PLACEBO COMPONENTS

• Many factors contribute to effect in clinical
  practice, including bedside manner, spontaneous
  recovery, regression to the mean (patients
  seeking treatment when at lowest point) and
  hello-goodbye effects.
• Drug trials try to minimise all but true
  placebo effect but usually unsuccessfully.

(Schematic pie-chart from Ernst, 2007)
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PERCEIVED POTENCY

• Trappings of medical authority help (e.g., white
  coat, stethoscope, diploma).
• Enhanced by expense (e.g. Bayer Aspirin beats
  generic form).
• Large pills better than small two better than
  one.
• Colour hot best for stimulants, green for
  anxiety, blue for insomnia.
• Capsules more effective than tablets injections
  beat both.

8
SHAM SURGERY

• Despite ethical issues, bogus surgery
  (anaesthesia, incisions, declaring the op a
  success) sometimes as effective as real surgery.
• Studies include ops for angina, arthritis of the
  knee, spinal infusion for osteoporosis and
  neuronal implantation for Parkinsons.
• Results show staggering placebo effects (c.f.,
  psychic surgeons of Indonesia).

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PLACEBO RESPONDERS

• Trait optimism predicts placebo response (Geers
  et al, 2010).
• Ego-resiliency, altruism, straightforwardness
  and low anger/hostility predicted placebo
  analgesic effect (together accounting for 25 of
  variance) along with higher endorphin release and
  reduced cortisol secretion (Pecina at al, 2012).
• (Placebo response thus not down to stupidity,
  gullibility or weakness of personality).
• Effects, when observed in the brain, generally
  mimic equivalent active medication, e.g., placebo
  analgesia similar to effects of opiates (hence
  they are real).
• PET scans from
• Petrovic et al,
• (Science, 2002).

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ACUPUNCTURE

• Inserting manipulating needles in various body
  areas reduce pain and stress in some sufferers.
• Difficult to find control procedures for true
  double-blind evaluation (hard not to notice
  youve been stuck with a needle).
• Differences between true and sham procedures are
  small evidence that either exceeds placebo is
  unconvincing.
• Release of endorphins a better explanation than
  traditional Chinese theory of meridians and
  energy balance.

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NOCEBO EFFECTS

• Negative (noxious) effects on health also occur.
• Voodoo curses, pointing the bone, being bitten
  by a non-venomous snake, etc. can cause death by
  shock or self-will (e.g., starvation).
• Chinese Japanese regard No.4 as unlucky.
  Cardiac mortality peaks on the 4th day of each
  month no such effect in White Americans
  (Phillips, 2001).
• Doctors have a moral dilemma about informing a
  patient their condition is terminal some give
  up hope and die more quickly.

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HEADED FOR AN EARLY GRAVE?

• Feelings of well-being lower mortality in both
  healthy and diseased groups (Chida Steptoe,
  2008).
• People more likely to die just after a major
  birthday or holiday than before.
• People with ve initials (A.C.E., V.I.P. etc)
  live longer that those with ve initials (P.I.G.,
  D.I.E. etc). Due to self-esteem? (Christenfeld et
  al, 1999).
• Catastrophes such as earthquakes and military
  conflict have cardiac consequences.
• When England lost a penalty shoot-out to
  Argentina in the 1998 World Cup hospital
  admissions for coronaries increased 25 (Carroll
  et al, 2002).

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PERSONALITY ILLNESS

• Little evidence that personality is prognostic
  with respect to cancer proneness or survival, at
  least not extraversion, neuroticism, or
  suppression of emotion (De Vries et al, 2012).
• Hostility (one component of so-called Type A
  personality) predicts coronary proneness but
  effect size small and cause and effect unclear.
  Irascibility could be early sign of disease
  process.
• Better evidence for Type D Distressed)
  personality. Negative affect (anxiety,
  depression, anger) is associated with poor
  cardiovascular outcomes.

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IMMUNE FUNCTION
Stressful childhood current stress reduce
ability of immune system to fight certain
diseases. Fagundes et al (2012) found that child
neglect combined with recent life stress led to
increased vulnerability to basal cell carcinoma.
BCC is common non-malignant skin cancer, but same
may apply to lethal cancers normally kept at bay
by the immune system (e.g., melanoma and ovarian
cancer). Cohen et al (2012) stressed individuals
more likely to catch a cold when exposed to the
virus (due to immune suppression).

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GUIDED IMAGERY

• Guided imagery is a kind of meditation in which
  patients thoughts are turned toward places that
  are safe, happy and relaxing. One approach is to
  picture the immune system gobbling up cancer
  cells and the tumour shrinking.
• Supportive in reducing stress, anxiety pain
  but little impact on physical symptoms and no
  evidence that it cures cancer (Roffe et al,
  2005).

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FORGET THE PAIN

• Mindfulness is an approach to therapy derived
  from Buddhist meditation. Argues that people are
  happier when their thoughts are focused on the
  present. (A wandering mind is an unhappy mind).
• However, depends on circumstances. In prison, or
  dentists chair, preferable to fantasize?
• Evidence that distraction, e.g., performing a
  difficult mental task, can be harnessed as
  analgesic in the treatment of chronic pain
  (Sprenger 2012).

Marquis of Anglesey to Wellington at Waterloo
By God Sir, Ive lost my leg.
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ELECTRIC ZEN

• Knowledge of results is a major principle in
  learning. Biofeedback works on theory that if
  person can observe their own physiological
  processes they are better able to exert control
  over them.
• Devices include EEG, ECG, skin conductance and
  skin temperature.
• Clear evidence that biofeedback is a useful
  adjunct to treatment of many conditions such as
  stress, hypertension, headaches, urinary
  incontinence (Yucca Montgomery, 2008).

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CONVERSION DISORDER

• Psychogenic (hysterical) symptoms such as
  blindness, paralysis amnesia are well
  documented.
• Famous case studies of Breuer Freud but still
  occur today.
• May be difficult to distinguish from deliberate
  malingering and somatic causes.
• Signs include (1) precipitated by extreme
  stress, (2) belle indifference, (3) secondary
  gain (4) retention of normal reflexes.

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A HELPING HAND

• Since hysteria (wandering womb) is more common
  in women, many psychiatrists considered sexual
  frustration to be the primary cause. Since
  masturbation was considered dangerous to health,
  mid-body massage became a favoured treatment
  approach - popular with patients and doctors
  alike.
• May have given some relief at a time when female
  orgasm was little recognised but today the doctor
  would be struck off.

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MESMERISM

• Origins of hypnosis are in animal magnetism.
  Mesmer initially thought effect was physical
  (c.f., electrical brain stimulation). Since it
  worked especially on hysterical conditions,
  soon recognised that the mechanism was
  suggestion. Patients were responding to his
  personal magnetism and persuasion.
• Freud favoured psychoanalysis because not all
  patients could be hypnotised. Amazed at how often
  female patients recalled sexual episodes with
  their fathers, he attributed hysteria to child
  sex abuse (later revised this as fantasy/desire
  on part of patient).

Anton Mesmer (1734-1815) found that waving
magnets across hysterical patients could
alleviate their symptoms.
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MODERN HYPNOSIS

• Suggestions of sleep/relaxation, attention focus
  and compliance are used to induce a trance state.
  
• Suggestibility is a stable trait, not a mental
  weakness. Good subjects engage with the
  hypnotist and use imagination but seldom behave
  in ways grossly out of character.
• Used as therapeutic tool in dealing with common
  problems such as pain, anxiety, phobias and habit
  control (e.g., smoking).
• Effects go beyond simple role-play (more like
  total absorption in a movie) but little evidence
  for super feats of strength or memory.
• False recollections may be elicited (e.g. of
  past lives, alien abductions, child sex abuse).

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FAITH-HEALING

• Works best on conversion symptoms. Some
  miraculous cures have apparently occurred,
  dating from Biblical days. Still popular within
  Catholicism and charismatic (e.g., Pentecostal)
  churches.
• Pilgrimages to Lourdes are popular, where
  praying or drinking the waters are believed to
  heal the sick. Miracle cures are rare (Vatican
  has validated 67 out of 7000 claims) but many
  more might benefit from stress reduction and
  placebo.

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STIGMATA

• Crucifixion-style wounds have appeared in devout
  Catholics, since Francis of Assisi, 1224.
• Generally poorly documented. Some are fraud,
  some self-inflicted in trances during fasting.
• A few may be psychogenic purpura purple
  blotches resulting from powerful self-suggestion
  (c.f., markings of alien medical exams appearing
  under hypnosis).
• Appearance on palms rather than wrists owes more
  to mediaeval paintings than Roman execution
  procedures.

Padre Pio, a celebrated stigmatic, canonised in
2002, was accused of using carbolic acid to
create his wounds (Lazzatto, 2007)
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HYSTERICAL CONTAGION

• Mysterious illnesses strike throughout the
  world. After environmental toxins are excluded,
  are put down to hysterical anxiety.
• Symptoms include fainting, swooning, tics
  paralysis.
• Victims typically socially cohesive teenage
  girls.
• Theatrical, attention-seeking (histrionic)
  individuals most susceptible.
• Social stress often implicated (c.f., Medieval
  dancing plagues possessed nuns).

Outbreak of fainting in a Kenyan school
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THE TOWN THAT CAUGHT TOURETTES

• A recent episode in the town of Le Roy, NY
  (2011) was subject of a Ch.4 documentary.
• Several teenage girls from the same school
  showed violent tics convulsions.
• No plausible organic basis found but those
  affected seemed to have difficult life
  circumstances and feelings of neglect.
• Treatment with antibiotics helped some to
  recover but probably a placebo effect.

LeRoy students present symptoms on TV chat show.
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THE INCREDIBLE SHRINKING MANHOOD

• Not only women affected. Outbreaks of koro
  (belief that ones genitals are shrinking) occur
  sporadically in S.E. Asia, usually in times of
  social stress. Men may apply pegs or clamps to
  prevent total retraction (thought fatal).
• In W. Africa, outbreaks of penis shrinking and
  theft are attributed to evil magic. Those accused
  are likely to beaten to death (at least 14
  penis-thieves were put to death in Nigeria in
  2001).

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MIND MATTERS

• Mind and body closely intertwined. Few disorders
  purely physical or mental.
• Peptic ulcers were once attributed to stress
  alone. Then discovered that 80 involved
  helicobacter pylori. However, most people
  colonised by h.pylori are asymptomatic, so not
  just an infectious disease.
• Warts are due to viruses but often disappear
  mysteriously, so the wart-charmers remain in
  business. Seems that stress impairs immune
  resources that normally keep these disorders at
  bay.
• Psychosomatic effects are real, not imaginary
  their action can be observed in the brain. Need
  to study interactions between mind and body in
  order to optimise treatments and benefit health.