The mindful body Thinking our way to chronic health

Review by Publisher's Weekly Review

Social psychologist Langer (Mindfulness) provides a fascinating glimpse into her lab at Harvard, where for more than 40 years she's been exploring the mind-body unity concept, which suggests "psychology may be the most important determinant of our health" and that reworking thought patterns can impact physical well-being. According to Langer, patients given grim diagnoses often adopt defeatist attitudes and other "stereotypical responses and behaviors" associated with the illnesses, but when one recognizes that diagnosis criteria, cut-off points, and labels "are made by people... we gain a newfound sense of freedom" and "can learn to heal ourselves." Langer notes that even chronic diseases such as multiple sclerosis and Parkinson's can improve with psychological interventions, making decisions mindfully, and realizing that every choice offers opportunities for growth and education. While the author's assertion that "health may be only a thought away" might strike some as overly optimistic, and despite a few less-convincing anecdotes, including one about an 89-year-old patient whose chronic pain disappeared after she disclosed her childhood trauma to a doctor, readers will appreciate Langer's insightful takes on the close relationship between psychological and physical wellness and attempts to revise a rigid medical paradigm of healing. Those seeking a novel approach to recovery should check it out. (Sept.)

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Review by Library Journal Review

This book by the award-winning Langer (psychology, Harvard; Mindfulness) builds on the 40+ years of research she's conducted about mindfulness and creativity. Her findings suggest there's a nearly linear relationship between mindfulness and long-term positive health outcomes. The book outlines ways in which socially constructed rules about behavior fail to acknowledge or affirm actual ways in which risk-taking and fictions of control shape people. That ultimately builds a case for approaches to health that bring together what the author terms "mindful medicine," applying the healing power of mindfulness to broader systemic changes, such as mindful hospitals. These concepts will be familiar to readers of Robin Berzin's State Change and other recent books focused on holistic, patient-centered approaches to wellness. Like Berzin, Langer draws together a well-balanced combination of evidence-based research with less empirical explorations of perception in ways that will inspire readers to look for spaces for a positive mindset within systems that often focus on symptoms rather than complete individuals. VERDICT This is not a wellness book with checklists. Instead, it serves as an exploration of what change looks like and how people can incrementally move away from learned rules toward more nuanced approaches to their own health.--Emily Bowles

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Review by Kirkus Book Review

Thought-provoking exploration of the mind-body connection and its relationship to health. Langer, a professor of psychology who was the first women to be tenured at Harvard, opens with mention of an experiment in which several elderly men roomed together in housing "that was retrofitted to suggest that time had gone backward twenty years." The men quickly began to behave as if they were 20 years younger: "Their vision, hearing, strength, and even objective appearance improved." Received medical wisdom has no room for such "miracles," relying instead on hard measures that are, Langer holds, sometimes arbitrary and probabilistic. For example, there's not much difference between A1C counts of 5.7 and 5.8, but one is held to be normal and the other prediabetic. Furthermore, telling someone they are prediabetic often leads to diabetes owing to the way people are inclined to read medical judgments as infallible and fixed. "Labels aren't just labels," Langer writes. "They also can change how we behave." That behavior involves decision-making, a fraught venture: Will we decide correctly in making a medical decision such as whether and when to get that hip replaced? The thing to do, the author suggests, is to allow the possibility of uncertainty and become mindful about how we "take these probabilities and convert them into absolutes, making it hard for us to question basic assumptions." Devotees and practitioners of integrative medicine will be on top of some of Langer's thinking already, though more traditional doctors may not be quick to endorse her view that "in some sense, health may be only a thought away." Regardless, a reminder to keep tabs on how we feel and what cues we respond to isn't out of place, and Langer is both lucid and encouraging. A readable primer on how to navigate emotions and, in the bargain, become a more discerning medical consumer. Copyright (c) Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.

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Chapter 1 Whose Rules? Any fool can make a rule. And any fool will mind it. --Henry David Thoreau Rules are important but, in my view, they should guide not govern our behavior. We need to take a closer look at the creation and adherence to "rules" in general before we can more fully understand the problem mindless compliance to rules has on our health. Consider a simple, low-stakes example. I've been painting for decades, though I've never been formally trained. When I started to paint, I had no idea what the rules were. I didn't even know there were rules. Had I known, I think my own technique would have taken a different form. I am still amused when I go into an art supply store and see the labels indicating which brush to use for which effect, as if there were no other way to achieve it--as if there were a right way and a wrong way. On occasion, I cut the hairs of my brushes to get a novel look. I'd like to think it is this originality--the desire to create something different, a work of art that doesn't resemble anything else--that makes my paintings interesting, at least to me. The novelty might not have been possible if I had rigidly followed the rules. This attitude has defined my artistic style. One of my first paintings featured a boy holding groceries at the top of a distant hill. In the foreground, a woman sits on a bench. When I was done with the painting, I showed it to a few friends. One person commented on my "mistake," how the perspective was all wrong, since the boy in the distance was too big. I dutifully tried to "fix" things, shrinking the boy to make him look more realistic. But then I realized that the flaw is what made the painting worth looking at. In life as in art, although we tend to praise rule followers, I believe that breaking the rules is often necessary. Too often, we follow rules mindlessly. We buy the "right" brushes and wear the "right" clothes and ask the "appropriate" questions. When we approach the rules mindfully, however, we realize they are often arbitrary and don't make sense. You don't need to use that brush or obey the rules of perspective. It's your painting. It's your life. That's okay with paintbrushes, you might say, but not so with health. Indeed, when it comes to our health, some people are loath to question rules created by doctors or researchers--who are we to question their authority, we ask? But it's important to remember that many health rules were created with people in mind who were different from who we are today, at earlier times before certain medical advances, and without attention to how much we differ from one another and how we ourselves keep changing. For example, years ago medicines were primarily tested on young men. This testing produced good data on how the medicine affected young men, but often proved problematic for older women since their physiology is different; medicine stays in the mature female body longer. Now, appropriately, prescribing doctors take differences in age, weight, and gender into account when they set doses. In most hospitals, visitors are supposed to leave the hospital at seven p.m. On what data, if any, was this rule based? I told my mother's nurses that I intended to stay as long as my mother wanted me to stay. She was more important to me than their rule. They had three choices: change the rule, look the other way when I was there, or deal with the commotion I would create each time they asked me to leave. They chose to look the other way. When they created the seven p.m. rule, perhaps they thought it best for the patients, perhaps best for the staff. But now there is ample research evidence that social support is important for people's health, so perhaps the rule needs to be questioned. Why, then, do we follow rules, even when they are arbitrary and hold us back? One reason is that much of our behavior is shaped by the labels that we impose on ourselves. In one telling study, social psychologist Russell Fazio and his colleagues asked people questions that led them either to consider ways they were introverted (for example, "When do you find social gatherings stressful?") or extroverted ("At what party you attended did you have the most fun?") Then, they were given a short test known as the introversion-extroversion personality scale. Those who had been asked extroversion-eliciting questions saw themselves as more extroverted while those asked introverted-eliciting questions saw themselves as more introverted. Other research has shown that priming older adults with negative stereotypes about aging led to worse performance on a test of memory. Subtly reminding women of their gender elicited more stereotypical opinions from them about the math abilities of other women. The good news is that it doesn't have to be this way. Consider research I conducted with one of my past graduate students, Christelle Ngnoumen. We were interested in whether mindfulness--essentially, the process of noticing--can reduce the limiting effects of rules and labeling. To do this, we used the Implicit Association Test (IAT), which is based on work led by my colleagues Anthony Greenwald and Mahzarin Banaji. The IAT assesses whether people make subconscious associations between concepts. In the test, people are asked to sort images and concepts, and the time it takes them to do so is measured. Their research showed that, for example, if someone associated "white" with "good" and "Black" with "bad," they were slower when asked to sort images suggesting the opposite, that is, that "white" was bad and "Black" was good. These varying reaction times reveal implicit bias. In our study, people were asked to sort photos into piles, and they were directed to choose the categories for those piles themselves. But we gave some participants a chance to mindfully engage with photos of "out-group" members (people with whom they didn't share obvious characteristics) before taking the IAT. If someone sorts the images mindlessly, they are likely to default to the obvious categories of race, gender, and ethnicity, since these are the easiest labels to apply. African Americans in this pile, white people over here. Men in this pile, women in this one. In our "high-mindful" condition, however, we asked people to sort by novel psychological categories, such as how social each person seemed, or whether he or she was smiling. We also asked these participants to generate two new categories on their own. This brief intervention made a big difference. When people used mindful labels--when they broke the usual rules of sorting--their implicit racial bias on the IAT decreased by half. In another experiment, white participants displayed increased empathy when primed to be mindful; after the intervention, they spent much more time listening to the stories of people who were not like them. This mindfulness intervention works because it forces us to notice our surprising differences, which cut across the usual stereotypes. As a result, we begin to see people as individuals, and not as easily categorized members of a group. We ignore our self-imposed labels and the constraints they suggest. Not only can we reduce prejudice by increasing mindful noticing of out-group members, but I believe we can also reduce out-group prejudice by increasing in-group discrimination. In other words, by having people notice the differences among people like them, they come to see how different we all are one from the other, and out-group differences appear not so different after all. Just as noticing similarities among things that seem different is the essence of mindfulness, so too is noticing differences among things thought to be similar. Excerpted from The Mindful Body: Thinking Our Way to Chronic Health by Ellen J. Langer All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

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