Mind control

Hoje foi dia de consultório!
Entre os pensamentos que me vieram à cabeça durante a jornada, veio a lembrança de um editorial do New England de 1985 que me chamou atenção na época.
Qualidade de vida e de morte não eram preocupações médicas.
A acupuntura ainda não tinha sido motivo de estudos assim como tambám a ioga e a meditação transcendental.
Depressão era uma doença desconcertante e dor crônica nem sonhava em ser uma especialidade médica.
Ninguém nunca tinha conseguido evidenciar o poder de mentalizações sobre a evolução de tumores...
Dona Canô, Niemeyer e Caymmi eram septuagenários
Neste editorial, procurando ser científica e racional, a autora transforma "ausência de evidência" em "evidência de ausência" perdendo uma enorme chance de ficar calada, como os anos a seguir vieram a provar.
Sob a bandeira de quem defende a desculpabilização do doente pela sua evolução a autora nos oferece uma visão do pensar médico da época.
Esta visão era "oficial" no 1º mundo médico de então e ainda perdura na cabeça de muita gente que parou de pensar sobre o tema por volta dos "eighties".
O texto completo está nos arquivos da revista.
Leia-o para evitar tanto aquele médico que queima incensos em pleno consultório como aquele que atribui influência zero do mental sobre o orgânico.
Felizmente as coisas mudaram e à medida em que técnicas comecem a ser padronizadas começaremos a utilizar cada vez mais a nossa mente como instrumento de cura e bem-estar.
Sem emoções, a nossa vida mental não passaria de um filminho enjoado e com sérios problemas de roteiro e argumento!
A menos que vc se chame Spinoza, Darwin, Churchill, Sabin etc
É o caso?

Disease as a Reflection of the Psyche


Marcia Angell, M.D.

N Engl J Med 1985; 312:1570-1572 Is cancer more likely in unhappy people? Can people who have cancer improve their chances of survival by learning to enjoy life and to think optimistically? What about heart attacks, peptic ulcers, asthma, rheumatoid arthritis, and inflammatory bowel disease? Are they caused by stress in certain personality types, and will changing the personality change the course of the disease? A stranger in this country would not have to be here very long to guess that most Americans think the answer to these questions is yes. The evidence for mental state as a cause and cure of today's scourges is not much better than it was for the afflictions of earlier centuries. Most reports of such a connection are anecdotal. They usually deal with patients whose disease remitted after some form of positive thinking, and there is no attempt to determine the frequency of this occurrence and compare it with the frequency of remission without positive thinking. Other, more ambitious studies suffer from such serious flaws in design or analysis that bias is nearly inevitable.4 In some instances, the bias lies in the interpretation. One frequently cited study, for example, reports that the death rate among people who have recently lost their spouses is higher than that among married people.5 Although the authors were cautious in their interpretation, others have been quick to ascribe the finding to grief rather than to, say, a change in diet or other habits. Similarly, the known physiologic effects of stress on the adrenal glands are often over-interpreted so that it is a short leap to a view of stress as a cause of one disease or another. In short, the literature contains very few scientifically sound studies of the relation, if there is one, between mental state and disease.


Is there any harm in this belief, apart from its lack of scientific substantiation? It might be argued that it is not only harmless but beneficial, in that it allows patients some sense of control over their disease. If, for example, patients believe that imagery can help arrest cancer, then they feel less helpless; there is something they can do. On the other hand, if cancer spreads, despite every attempt to think positively, is the patient at fault? It might seem so. According to Robert Mack, a surgeon who has cancer and is an adherent of the methods of the Simontons, "The patients who survive with cancer or with another catastrophic illness, perhaps even in the face of almost insurmountable odds, seem to be those who have developed a very strong will to live and who value each day, one at a time."8 What about the patients who don't survive? Are they lacking the will to live, or perhaps self-discipline or some other personal attribute necessary to hold cancer at bay? After all, a view that attaches credit to patients for controlling their disease also implies blame for the progression of the disease. Katherine Mansfield described the resulting sense of personal inadequacy in an entry in her journal a year before her death from tuberculosis: "A bad day... horrible pains and so on, and weakness. I could do nothing. The weakness was not only physical. I must heal my Self before I will be well.... This must be done alone and at once. It is at the root of my not getting better. My mind is not controlled."3 In addition to the anguish of personal failure, a further harm to such patients is that they may come to see medical care as largely irrelevant, as Cassileth et al. point out, and give themselves over completely to some method of thought control. I do not wish to argue that people have no responsibility for their health. On the contrary, there is over-whelming evidence that certain personal habits, such as smoking cigarettes, drinking alcohol, and eating a diet rich in cholesterol and saturated fats, can have great impact on health, and changing our thinking affects these habits. However, it is time to acknowledge that our belief in disease as a direct reflection of mental state is largely folklore. Furthermore, the corollary view of sickness and death as a personal failure is a particularly unfortunate form of blaming the victim. At a time when patients are already burdened by disease, they should not be further burdened by having to accept responsibility for the outcome.