October 22, 2011

Mind Over Body Treatment

24 years old female presents with several week history of progressive stomach pains, substernal chest discomfort, heart palpitations, loss of appetite, headache, insomnia, and growing lump sensation in her throat. Physical exam was essentially normal.

Can this previously healthy female have suddenly developed reflux, globus, paroxysmal supraventricular tachycardia, brain tumor, and throat cancer with possible overlying thyroid disorder? Or perhaps has she contracted some other horrific mystery disease?


But maybe none of the above...

What if I told you she will be giving a doctoral dissertation for her Master's next week for which she is ill-prepared for given a recent breakup with her boyfriend of 5 years and has a growing distaste of her school classmates who have been less than supportive.

In other words anxiety.

The point is that the mind has tremendous influence over the body and numerous physical maladies can be attributable to a patient's mental state. People can die of a broken heart or out of extreme fear. Stress can age the body dramatically (look at a picture of a presidential candidate and than another after having served 2 terms as President of the United States).

A mind under stress CAN affect the body. Reassurance helps. Elimination of the stressor is even better. If the stresses can't just go away, development of strong coping mechanisms will do much to help. After that, there are prescription drugs that help, but have addictive potential as the anxious patient will tend to take a pill rather than dealing with and learning coping skills.

But here's where the power of the mind can be "manipulated" into helping rather than hurting the body.

In my last blog, I did ridicule therapeutic hands to manipulate human body energy as total bunk (or rather a 9 year old girl did)... BUT... if a person truly believes that it does help, it probably can help some individuals just from the idea/belief/faith that it can.

Faith, trust, and sharing with another human being who lends a sympathetic ear is where questionable "medical" practices and homeopathy may provide benefit... not because such quackery directly helps the individual, but more because the individual BELIEVES it can help.

I can totally make up a quack treatment like placing an ice cube over the heart and stating that this practice can "calm" the heart palpitation down by "cooling" it to a more natural state... and if the patient believes it to be true... than the mind can potentially make it so in a significant number of people. In fact, I can state with some confidence that it will help in as many as 20-40% of patients.

How can I state such a statistic knowing my treatment is total hogwash?

It's because of the placebo affect.

Although I don't support (and perhaps even discourage) such quack medicine, as long as it doesn't harm the patient and there's no danger if a patient decides to forgo more traditional and evidence-based medical treatment, than I don't see any long-lasting harm in it.

Because as scientists and doctors know... the placebo effect is real and DOES lend improvement nearly 40% of the time! Who cares if the activation mechanism of the placebo effect is via "therapeutic hands" or "local honey" or some other "un-accepted" treatment.

After all... the patient is feeling better and that's what really counts in the end.

AND... if it doesn't work, than traditional medical treatments can be pursued.

What is evidence-based, scientifically proven medical treatment?

It's when the treatment helps people way more than the placebo (or in other words, way more than 40%).
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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