NARRATOR: We're in the midst
of a chronic illness epidemic.
Sicknesses like cancer, heart disease and diabetes
are sweeping the world.
There's a one-in-two chance
you'll end up with a chronic illness.
It's likely you know someone or you are someone who is sick.
Diseases our grandparents have never heard of
are becoming common.
Mental illness.
Autoimmune disease.
Metabolic syndrome.
These are modern sicknesses.
They're not infectious, but they are spreading fast.
I think we've been seeing a stress epidemic in our society
for decades now,
and it seems to be only accelerating
as the pace of modern life is increasing.
It was always obvious to the ancient wisdom traditions
that mind and body were interconnected.
But somewhere along the line we sort of created a dichotomy
as if they were separate.
We came to believe
that everything could be cured
by drugs and surgeries,
whereas, to this day, they can't.
When we talk about much of mind-body phenomena,
we're talking about the non-physical mind
affecting the physical body.
That's not allowed for
in the Western scientific paradigm.
And we now understand these concepts
that were rejected by academic medicine.
So, this is something that actually has
enormous implications.
Modern science has shown us
that the mind has the power to heal.
We should use that capacity.
I was 24 when I got my first break in journalism.
My life became focused on deadlines
and chasing stories
that took me away from my family and friends.
Then everything changed.
I was diagnosed with an autoimmune disease.
One doctor warned I could end up in a wheelchair
or with organ failure.
Over the next six years I spent $30,000
on numerous specialist doctors, constant tests,
drugs and alternative therapies.
I was flat with fatigue and riddled with arthritis.
No-one could tell me why my immune system
was attacking my own body.
But there was one thing I did know.
The more I was stressed, the worse I felt.
I knew there had to be a connection.
On my journey to getting better
I travelled the world to find answers,
meeting some of the leading experts
at the frontier of science,
and tracking down people with remarkable stories of recovery.
This is the film I wanted to see when I got sick.
In the older days
there was no separation of mind and body.
In fact, throughout the world,
many cultures have never separated them -
in the East, for example.
But our scientific approaches
were so awesome
that they overwhelmed any mind-body approaches
or any mind-body potentials.
In Western science, unless you see it, it isn't real.
Unless you can measure it, it isn't real.
And that's what allowed the huge advances
in modern medicine and science -
the ability to do these amazing things
that we can do with cures today.
And we now understand these concepts
that were rejected by academic medicine
because we didn't understand them.
We understand them now in the language of science.
And now where we're at is we can take these principles
and apply them to clinical care, to the next phase,
the next new frontier, which is integrative medicine.
The body is always responding
to whatever the mind tells it to do.
So when the mind's tense, the body's tense.
When the mind's happy, the body's happy.
So the body is always responding,
not just in ways in terms of our physical tensions,
like the tensions of the muscles,
but even right down to the very core of our souls,
even what's happening in the level of our DNA.
And what's really been interesting
in the last five, 10 years is really understanding
that it really is a lot of two-way connections.
And there's a lot of molecules that we always have thought of
as just in the body, and we're recognising
that they actually also play roles in the brain,
and that the brain can also influence the body
at even a very cellular level.
All these terms, I think, are approaching the same idea,
that the mind is not separate from the body.
In fact, my belief is that the only way
you can really separate mind and body is verbally -
that they're two aspects of the same underlying reality,
or two poles of the same thing.
Here's what we know about the mind-body connection.
You may be familiar with the idea
that your brain is like a central message centre,
sending and receiving electrical and chemical signals
all over your body.
And now scientists are starting to understand
that the communication between your brain and body
is far more significant than they once realised.
For example,
over 60 neurotransmitter and hormonal receptors
have been found on the surface of immune cells
designed for fighting disease.
Your brain has a direct connection
to your body's first line of defence,
and those cells can talk back.
In another major breakthrough,
scientists have discovered around 80 million neurons
in your gut.
They're calling it the second brain
because while it talks to the brain
it can also act completely independently
and influence behaviour.
So rather than there being a mind in your head,
it's more like your mind is all through your body.
But the easiest way to understand
how your mind affects your health
is by looking at stress.
So if we think that we're...
Imagine ourselves walking through a jungle,
and out comes a tiger, and it's a very hungry tiger.
We activate the fight-or-flight response.
We've got to fight with the tiger or we've got to fly,
get out of danger really fast.
So if we think about this stress
or fight-or-flight response as an activation response,
like a turbo charge of energy,
the body going into a different gear, then it makes sense.
So the heart rate, the blood pressure,
the blood vessels to the muscles open up
to get all of this extra fuel,
sugars and fats are pumping into the bloodstream,
the respiratory drive kicks in in the brain.
We start to sweat to keep ourselves cool
while we're exerting ourselves.
Our blood gets thick and sticky
and will clot faster than normal,
and the body pumps out inflammatory chemicals
to activate our immune cells
and to start mobilising for tissue repair.
The attention centre in the brain
lights up like a Christmas tree.
This is a major physiological, neurological,
immunological, metabolic change in our system.
And it's designed to help us to adapt
to a clearly perceived present-moment threat
in the environment.
And it's the kind of thing that's there to save our life,
not to make us sick.
Unfortunately, 99% of the tigers we're running from
are the ones that are actually in our minds,
not the ones that are really there.
And when we do that over the long term,
it produces an effect that's called allostatic load.
It's a physiological wear and tear
that we place on our system.
It's like getting the car
and just absolutely flogging it like crazy.
And if you asked your mechanic,
are your repair bills going to go up?
He'd say, "If you drive your car like that,
"your repair bills will go up
"and your parts will wear out faster."
It's pretty much like that with our bodies.
My name's Craig Duncan. I'm from Sydney, Australia.
I'm a nonsmoker, nondrinker.
I'm active and exercise most days of the week,
and have for a long period of time.
I'm a vegetarian as well.
I was working for a professional soccer team,
in charge of the sports science.
I was under enormous stress,
and I had been for a long, long time.
A lot of it's self-imposed -
just rushing around at a million miles an hour.
I was frustrated and unhappy in what I was doing,
and that was difficult.
I was struggling to sleep, or sleep well.
And I just...
Even though I might be healthy on the outside,
exercising and that, it all became too much.
I was at the gym and I was lifting weights,
and at the time I didn't know anything had really gone amiss.
It wasn't till that afternoon that I went for a run
and got chest pain.
And again, didn't think too much of it.
But in the next couple of days I continued to try and run,
and the chest pain got more and more,
and pain down my arm and in the jaw -
the classical heart attack symptoms.
And that's when I realised that I had a real problem.
When I went into emergency,
even though the emergency ward was packed,
they took me straight in.
And when they did some tests,
it was obvious that I'd had a heart attack.
I had a spontaneous coronary artery dissection,
and when I looked up the literature,
there had only been 150 cases reported,
and most people die.
And that's...that's frightening.
I had no risk factors.
My cholesterol was normal and my blood pressure was normal.
I'd recently had an ECG. That was OK.
Never had chest pain.
Didn't have any family history of heart disease.
But yeah, I was under a lot of stress,
and I think that contributed.
There's no doubt about that.
If I let my stress and my emotions get out of control
and am not in control of my life,
there's no doubt it could happen again.
And I really am not ready to not be here.
CRAIG HASSED: If you help a person to manage stress better
then you significantly reduce the risk
of a person having further cardiac events
in the progression of heart disease.
These are all reversible effects
if we learn how to recognise
the inappropriate activation of that response
and learn to switch it off when it's not actually required.
Then these effects
will start to reverse themselves right through the body,
and interestingly in the brain as well.
HERBERT BENSON: And I think the major breakthrough
was recognising that the body has a capacity
opposite to the stress response.
That's what we've called the relaxation response.
We did an experiment
in which we took people who meditated,
and we found there were dramatic physiologic changes.
And the essence of those changes
are a decreased metabolism in the body,
a quieting of the body.
There's decreased heart rate, decreased rate of breathing,
slower brain waves.
So here was a reaction
exactly opposite to the stress response.
This now was science.
Here was something measurable, predictable
and reproducible.
CRAIG DUNCAN: If you do not have your mind
in some sort of balance
it doesn't matter how healthy your body is.
I really had to use breathing techniques
and different forms of meditation that have helped me
to just stay calm.
That's it.
But I suppose the overriding thing
that's helped me to stay healthy and to decrease the stress,
I have to pray regularly.
If I'm praying, for me, it brings a calmness.
It centres me.
HERBERT BENSON: The two basic features
of evoking the relaxation response
are repetition
and the disregard of other thoughts when they come to mind.
And what those two things do
is break the train of everyday thinking.
And often that everyday thinking is what's stressful.
It's not a real sabre-tooth tiger in front of you.
It's your fear of losing your job,
it's your fear of illness or what have you.
Then we return to the literatures of the world
to see whether these two steps
that are breaking the train of everyday thinking
had been described before.
And every single culture of humankind
that had a history had these two steps.
There's a commonality.
So if a person argues, "My technique, my religion,
"is better for bringing this forth than another,"
it's foolish, because it's a bodily response.
Just as there are scores of techniques that are stressful -
same fight-or-flight response -
so there are scores of approaches
that evoke the relaxation response.
One way scientists teach people
to evoke the relaxation response
is to train people to meditate
by focusing their attention on just one thing.
With practice they become inwardly aware
and focused on the present moment.
And now, with the development
of modern brain imaging technology,
researchers are starting to understand
the biological mechanisms underpinning the practice.
While to an outsider
it looks like a person meditating isn't doing much,
it turns out there's a lot happening in their brain.
The really wonderful thing about MRI
is that it lets us look at the human brain
in a way that we couldn't before.
Most of the work that we've done centres on how meditation
can change the actual structure of the brain.
So the research shows that
a part of the brain called the amygdala gets turned down.
And the amygdala is important
for the fight-or-flight response.
So when you see something scary,
for instance, if you're walking in the woods
and you suddenly see a snake out of the corner of your eye,
your amygdala's going to alert you and say,
"Oh!" and make you jump.
And that part of the brain
seems to get quieter as you meditate.
And so this is consistent with a sense of decreased arousal
and greater feelings of peace.
Brain imaging technology is relatively new
in the context of scientific discovery,
and it's early days for mind-body research.
But Dr Sara Lazar's Harvard study on meditating people
has interesting parallels with studies recently done on mice
at the National Centre for Biological Sciences.
Researchers took normal mice
and stressed them out for two hours a day.
When they measured their brains
they found the amygdala got bigger.
After 10 days, they left the mice alone,
but two weeks later
they observed they were still acting anxiously.
They measured their brains again,
and although their stressors had been removed,
they found the mice's amygdala were still large.
This is the opposite of what we're seeing
with people who meditate.
Their life is exactly the same as it's always been.
So they still have a stressful job,
all the difficult people in life are still being difficult,
but their amygdala has gotten smaller
and they're reporting less stress.
So it shows in both cases
that it's not so much the environment
but your reaction to the environment,
and how you're relating to the events
and the people in your life.
And so it's not about changing your life,
it's about changing your relationship to your life.
My name is Jason Wachob.
I live here in Brooklyn, New York.
My back pain probably started
in 1996,
when I was playing basketball at Columbia.
After I paid off the mountain of college debt that I accrued,
I got into start-ups.
I love being an entrepreneur and I love start-ups,
but there's also the pressure
that you're constantly trying to grow,
and you're never growing fast enough.
And you're trying to raise capital
and you're trying to make money and you have investors
and you're trying to pick up business.
And it's a frenetic pace, and that can be stressful.
I think I internalise stress.
At least, that's what my wife says.
So I'm not a yeller or a screamer.
People think I'm very even-keeled,
which I think I am, but I think I internalise it.
I think most...a lot of people internalise stress,
and stress manifests itself.
And I think one of the ways it manifested itself for me,
at this time of my life, was through my back.
I would wake up without pain,
and as soon as I got out of the bed, within five or ten minutes,
I would have shooting pain.
I could not walk more than a block
without keeling over in pain.
It started to wear me down, I think.
And then you're stressed about the pain,
so it's kind of a vicious cycle that you catch yourself in.
I went to see two different doctors, specialists,
and both of them told me I needed back surgery.
However, the second doctor said,
"You may want to practise yoga. That may help."
He said... It was like an afterthought.
So as a last-ditch effort, I started to practise yoga.
The work that I do
revolves around the clinic that I started 34 years ago now
called the Mindfulness-Based Stress Reduction Clinic,
or MBSR.
I was having lunch with a bunch of dermatologists,
and they were talking about some of their patients
giving up on their treatments in the dermatology clinic,
particularly patients with the skin disease psoriasis.
And the treatment for it
was a course of ultraviolet light therapy.
We did a small randomised trial
that compared people just getting the light treatment
with people meditating
while they were getting the light treatment
and it turned out the meditators' skin cleared
at about four times the rate of the non-meditators.
And I didn't believe it. It was such a powerful finding.
So we replicated it and tried to make
a little bit more rigorous study design,
and lo and behold, again the meditators were healing
four times as fast as the non-meditators.
And it is a beautiful example of the mind-body connection,
because you're doing something with your mind
and something is happening in the skin.
So it just doesn't get any better than that.
I think yoga is the perfect blend of mental and physical
if you're doing it right.
You're moving, and you're really paying attention to your breath.
And for me that's just magical because yoga turns into
meditation in motion, essentially.
I basically twice a day, every day,
for about 15 or 20 minutes in the morning and the evening
I would do these four or five poses religiously every day.
Like, I would just find a spot,
and maybe do a third time or a fourth time,
do what I needed to do.
And it just started to work.
After a week I started to feel better,
and after three or four weeks
I could literally start to feel my spine sort of move
and work itself out.
And then I started to take classes,
and, you know, there's a great instructor here, Tara Stiles,
who I started to go to her class,
and she helped me, like, take it to another level.
And the back pain's gone and it hasn't come back.
Through practising with them, everything went away,
and to me it's just... it's just magical.
Like, I am sold on yoga and its healing power.
JON KABAT-ZINN: I mean, that's one of the beauties of yoga.
You get down on the floor and start working with your body
in a kind of a way, systematically,
over a period of time,
and it's, like, you feel so good.
It's like you didn't even realise.
And it's not like callisthenics
and it's not like, you know, intense aerobic activity,
although it could be.
But there's just this sense of, again, integration,
that you are at one with your body,
and isn't it amazing what it actually does?
So a question I frequently get is,
"Well, you know, meditation or yoga, it's about attention.
"But what about other activities
"that require a lot of attention?"
So, for instance, like rock climbing
or playing a musical instrument.
When we look at brain activity during meditation,
we find that many parts of the brain
actually get turned off during meditation.
Some areas are more active,
but mostly there's a lot of turning off.
The focus is really inward.
So when you're running, people are wearing headphones,
you know, or they zone out.
Whereas with the yoga and the meditation
you're really paying attention very closely
to what's going on inside,
and you really get really in tune
with your body and with your mind.
You really notice things
that you didn't even notice were there before.
The deep structure of these meditative -
and I would include yogic - practices,
they've been around
for thousands and thousands of years.
It's not the next fad.
If they have value, they've had value for a very long time.
That's why they've survived.
And they really have to do with how we live our lives.
So it's not like, "Oh, something else should come along
"that will make this irrelevant."
This is about as relevant as you can get,
as long as the breath is moving in and out of your body.
I think it's vital that people understand
the power of the mind-body reaction.
And it's best understood by most
by recognising you have within yourself
a capacity that's opposite to the stress response.
And to the extent that stress is causing any disorder,
be it the brain, the body, the liver, what have you,
to that extent, by reversing stress's activity
through the relaxation response, you can treat that.
Does that mean you give up drugs or surgeries?
Of course not.
But you've got to bring this in
to that same level of respectability,
because now we're scientifically proven.
When you think about your emotions,
you may notice you don't feel them in your brain.
You feel them in your body.
Your face may flush. Your heart may race.
Your stomach may flutter.
These feelings are a result of chemicals and hormones released
when your brain is in a certain emotional state.
And now some researchers are starting to link these states
to health outcomes.
We know happy people
live up to 10 years longer
than unhappy people.
If you're optimistic,
You have about half the risk
of getting heart disease
than if you're more pessimistic.
In one landmark study of 2,000 middle-aged men
who worked at the Western Electric Company in the 1950s,
those who had been emotionally depressed
at the start of the study
were twice as likely to have died from cancer
20 years later.
While you might be thinking this is explained
by happier people being more inclined
to make healthier life choices,
this research made allowances for smoking habits,
alcohol intake, weight and cholesterol.
Even age, job status
and family history of cancer
were factored into the results.
Findings like this
are demonstrated in thousands of studies
published in peer-reviewed academic journals.
My name's Ann Salerno.
I'm a paediatric nephrologist, which is a physician
who takes care of children with kidney disease,
and I live in Hopkinton, Massachusetts.
I was married at 33 years old, and about a year later
we actively started trying to have children.
And after a year of trying,
really felt like there was some barrier
and that we should look into going to a fertility specialist.
All my testing was normal.
All the signals were happening at the right time,
and still nothing happened.
About a year into my journey,
one of our chickens was killed by a coyote in the backyard,
and the other four chickens stopped laying eggs.
It was really just a wake-up call that...
Look at this simple animal model of a chicken,
and how them feeling that there was danger and feeling stressed
had affected their fertility and their ability to ovulate.
The doctors that I had been to had not really attended to
how this infertility treatment and journey
had been affecting me emotionally.
I didn't realise it was happening,
but I started feeling more and more depressed.
WOMAN: Women with infertility
become very depressed and very anxious.
And we actually published a paper
that showed that women with infertility
were twice as depressed as women who were fertile.
So depression is really common in the infertile population.
You know, you throw away the birth control,
you try for a few months, you don't get pregnant,
you start to get anxious and depressed about it.
So even if the physical problem
that caused the infertility at the beginning
goes away or gets treated,
the angst about not getting pregnant can then kick in
and independently contribute to the infertility.
CRAIG HASSED: Emotions have a profound effect on the body,
for better or for worse.
We shouldn't be one-dimensional about emotion,
thinking there's only one positive emotion,
and that's smiling and laughing,
and if we're doing anything else, like feeling sad,
then that's a negative emotion.
We do have, like a piano, if you like...
We've got a whole lot of octaves.
We've got a whole range of emotions.
And so there might be times
when it's quite appropriate to feel sad,
and if we express that sadness
in a way that we feel comfortable with
then that's not a negative emotion,
that's a natural human emotion.
It's really when the emotions, what's on the inside,
gets out of step with what's on the outside,
and then we start to wrestle with emotions,
we start to wallow in emotions.
We get caught up in negativity, caught up in self-criticism,
caught up in anger,
so that it lasts and lasts way after its use-by date.
And that has a long-term and cumulative effect on the body
that's not particularly healthy.
MAN: It's a sobering thought, but it's true.
Depressed people don't live as long.
That's true with heart disease as well.
If you're depressed and you have heart disease,
you're not going to live as long
as if you're not depressed and have heart disease.
So it's a major risk factor
with the major medical illnesses that kill us.
People who are depressed feel hopeless,
helpless and worthless,
they may not exercise as well, they don't sleep as well.
CRAIG HASSED: So the mind has its direct effects on the body
by what we think - that mind-body relationship -
but we also should consider
how the mind affects our health via indirect means.
So that is, the mind decides what we eat,
whether we exercise, how we live.
And so the state of the mind has profound effects on the body,
both in the short term and the long term.
DAVID SPIEGEL: And depression is something
we can do something about.
So it's a predictor of cancer outcome
that we can have an effect on,
and potentially affect disease outcome as well.
We published an article
in the 'Journal of Clinical Oncology'
showing that the course of depression
over a period of a year for women with breast cancer
predicts survival time.
So the women whose depression was getting better
lived substantially longer
than the ones whose depression was getting worse.
And it wasn't just two months
after we studied their depression,
it was seven years later.
And this prediction was independent
of all the standard risk factors -
oestrogen receptor status, progesterone receptor status,
time from initial diagnosis to relapse,
all of which are powerful predictors of outcome.
This depression prediction was independent of that.
Study after study has shown
that people who are lonely and depressed and isolated
and three to ten times more likely
to get sick and die prematurely
than those who have a sense of love and connection and support.
And I don't know any single factor in medicine -
not smoking, not cholesterol, not blood pressure -
that affects our lives and our survival to that degree.
ALICE DOMAR: If you look at the data
that I've clocked in in my career
on the impact of the mind-body program on fertility rates
in infertility patients,
and the fact the program costs a few hundred dollars
and pretty much doubles pregnancy rates,
yes, if you had a pill that did that,
every infertility patient in the country would take it.
ANN SALERNO: I learned about
Ali Domar's mind-body program for infertility,
and it sounded like exactly what I needed.
Just going to the first meeting
and seeing all these women in the room
that looked like they were normal,
and just looking around the room and saying, like,
"I'm not alone. I'm not a freak.
"I'm just, you know,
"another woman that has a struggle like the rest of them."
And that was just extremely powerful
in terms of just turning my mood around
and helping me to feel more optimistic about my life
regardless of whether I got pregnant or not.
After a period of using the mind-body techniques
that I had learned,
I felt that I would proceed to the IVF treatment.
We ended up getting just one embryo,
and that embryo took on the first try.
And I did conceive, I got pregnant,
and ultimately delivered my first child,
my baby boy, Luke, who's now almost two years old.
ALICE DOMAR: Most of my research
is actually looking at the impact of the mind-body program
on infertility patients.
And we found the women who did the mind-body program,
in addition to having
much fewer physical or psychological symptoms,
had a 55% take-home baby rate
compared to a 20% take-home baby rate in the control group.
So 55%, 20%.
The research shows that if a woman feels stressed
she continues to meet the demands of her family,
her home and her job, and she lets go of her friends,
which is the thing you need the most when you're stressed.
And I think there's an expression
that a crisis shared is half the burden.
And so I think that's why social support is so important.
In the 1960s
a US town called Roseto
was an anomaly in America.
No-one under 55 had died of a heart attack
or showed any signs of heart disease.
The local death rate for men over 65
was half the national average.
A team of researchers led by Dr Stewart Wolf
considered whether this was because of their diet,
location, family history or exercise habits,
but on the surface
nothing was different from the rest of America.
In fact, the town was made up of Italian immigrants
who worked in quarries and factories,
smoked unfiltered cigars
and had dinner tables laden with rich Italian food.
Rosetans of the 1960s still held onto their old-world ways.
It was normal to find three generations
under the same roof.
80% of men in the town
were members of at least one community group.
They would gather in each other's kitchens,
play cards and simply talk.
The conclusion?
Rosetans were nourished by each other.
Over the next decade
the multi-generational homes broke up.
And by 1971, when opulent houses,
expensive cars and swimming pools appeared,
the first person under the age of 55 died of a heart attack.
By the 1980s
the rate of fatal heart attacks in Roseto
was the same as the rest of the country.
DEAN ORNISH: Many people don't have an extended family
that they see regularly.
They don't have two or three generations of people
who live in the neighbourhood together.
They don't have a church or synagogue they go to regularly,
a job they've been at for many years.
We all know that these things affect the quality of our lives,
but they actually affect our survival
and to a much larger degree than we had once realised.
And so what we've learned
is that it's not enough to focus on the behaviour,
it's not enough just to give people information,
we have to work at this deeper level.
The number one most commonly prescribed prescription drugs
in the US and probably most of the world
have been antidepressants for the last 10 years,
because there are a lot of depressed people out there.
Now, a sceptic might say, "Oh, come on, give me a break.
"You mean sitting around talking about my feelings will
"somehow help me live longer if I've got cancer? Please."
It's so easy to make fun of these ideas,
how we're just so touchy-feely, you know.
But we are touchy-feely creatures,
we are creatures of community.
That's how we've survived as a species,
is by learning how to care and love and nurture each other.
And we ignore those ideas at our own peril.
ANN: I just felt a contentment
that I had never felt before in my life.
It was a feeling like if I never accomplished anything
or never did anything special for the rest of my life,
that it was OK.
And...um, about five months ago
I found out that I was naturally pregnant,
which was very much a surprise,
and that, uh, you know, it happened
the way it was, you know...
..I always thought it was supposed to happen.
But I think a lot of that has to do with, you know...
..sort of that you no longer have that inner stress,
that inner angst.
It's definitely another miracle in our lives.
I think that as a physician
I never was taught to appreciate
sort of, um, how a patient is coping with an illness
or coping with an ailment
and how that interplays with their therapy
or their success in their therapy.
It just wasn't even mentioned.
There are now
more than 10,000 peer-reviewed academic papers
looking at the science of mind-body medicine,
with more research being published daily,
and with it comes the molecular underpinnings
of emotions and disease
proving a mind-body connection.
And yet in most conventional medical centres
the mind is not a component in a treatment plan.
Millions of people are being turned away from doctors' rooms
with potentially curable chronic illnesses.
Hi. My name's Scott.
I was diagnosed with melanoma in 2000.
I think, looking back,
I was a bit of a worrying sort of person -
not so much worried about myself
or where I'm gonna be in 10 years...
..but I think I just worried about stuff.
You know, a bit of a perfectionist by nature and...
I don't know, I just probably obsessed a bit
about my life, and how this worked and how that worked
and whether that was a good way to do things
and things like that.
My doctor never gave me a prognosis.
But I did ask him.
You know, I said, "How unwell am I?"
And... I think I said, "How serious is this?"
And my doctor said, "It doesn't get any more serious."
My doctor was happy to call me a terminal patient.
You know, I was unwell.
I had stage IV melanoma,
and people with stage IV melanoma didn't get better.
And my doctor said,
"Well, look, you can have chemotherapy if you like,
"but it's only got a 5-10% success rate."
He said, "But that's all I've got for you."
They offered me chemotherapy as a palliative treatment
and that's all they had for me.
I never looked to myself.
You know, I just...looked to the medical system
and whacked a drip in my arm
and sat there and said, "She'll be right, mate."
Like, that's the mentality that I had.
But I wasn't right, because it kept coming back.
I think there's an art in how you approach a patient.
The words that a doctor uses have great power.
I've written also about what I call 'medical hexing',
which is the negative side of this,
that many patients have been
told by doctors in one way or another
that they're not gonna get better.
Often, doctors haven't, you know, meant to do that,
and they may even be unconscious of the things that they've said,
but I think this is an area that needs correction,
that doctors need to be aware of how powerful their words are
and to use them, you know, to promote healing
rather than hinder it.
DAVID SPIEGEL: Medicine used to be a trade.
It used to be that you would apprentice yourself to a doctor
and roam around with - mostly then - him, not her
and learn the craft.
At the beginning of the last century
there was a report called the Flexner Report
in the United States
that said, you know, medicine should be a science,
and so people started
going to formal medical schools after university.
But, I think, in an odd way,
we solved one problem and created another
because the old general practitioners,
they understood the importance of emotional support
as well as whatever medication or surgery you gave.
So the oldest adage of medicine is that our job is
to cure rarely, relieve suffering, and comfort always,
and in the Flexner era we rewrote that job description
to be that our job was to cure always,
relieve suffering if you had the time,
and let someone else do the comforting.
MAN: We've started to look at the doctor-patient interaction
and then, even more broadly,
this ritual or theatre, even, of healing.
What is it that we do when we prescribe a medicine,
or see a patient about a surgery or even conduct surgery?
What is in that environment
and how does it affect a patient's brain?
There's a couple of trials which have been done
by a colleague of mine in Italy, Professor Benedetti,
in the early 2000s,
and they were able to look at
post-operative pain with the drug morphine,
and were able to show
that morphine was almost half as effective
when you didn't know you'd received it.
In other words, the effect of a drug
is a combination of the pharmacology of the drug
and the effect of your brain
knowing that you're having the drug
and the therapeutic ritual of the drug administration.
That component is the placebo effect,
and that's what we're studying.
ESTHER STERNBERG: What we're really talking about here
is what has been almost misnamed 'the placebo effect' -
the brain's own healing mechanism.
And the reason it's misnamed
is it's usually the placebo effect...
The word 'placebo' is usually preceded
by a four-letter word - 'just'.
"Oh, it's 'just' the placebo effect'."
Well, it's not 'just' the placebo effect.
It's a very powerful effect that contributes
about 30% to 50% of the effect of any biological cure.
Belief is critical because belief has the ability
to trigger part of the overall healing response, if you like.
In simple terms, belief is part of why we get better.
It's not the complete answer,
but it's one part of any medical treatment, which is important.
And that's both at a patient level - having belief -
and at a doctor level -
realising that belief is important.
And the communication about some of these things
with the patient is important as well.
My name's Ian Gawler.
I started off my working life as a veterinarian,
but after just a couple of years of being in practice
I got a swelling in my right thigh
which turned out to be a very aggressive form of bone cancer.
And so in the beginning of 1975
I had my leg amputated through the hip,
and it got worse
because less than a year later, the cancer reoccurred.
Nobody on record had lived more than six months
with that particular type of secondary cancer,
and most people seemed to die within about three months.
Being a veterinarian, I'd seen
animals healing through their own natural agency, if you like,
and so that set me off on this sort of quest for healing.
And I was very fortunate
because I was around in the early days of mind-body medicine
when meditation was just starting
to be used therapeutically,
where nutrition was starting
to be taken, by some people, seriously
for its therapeutic value,
and that whole role of the mind and emotions and health
was being considered.
As I was putting all this effort into getting well,
I reached a point where I...
..it was very apparent that my mind was the limiting factor,
because up to that point I'd been doing all these things
that had the possibility of helping me to recover,
but it became apparent at that time
that I had some level of doubt about it.
I was told about this Indian holy man named Sai Baba,
who was revered in India at the time
as a...as a divine incarnation.
I must say, of all the people I met through my healing journey
in terms of presence
and in terms of fulfilling the expectation
of what one would have
of a really extraordinary holy man,
he really fitted the bill.
And he said to me very clearly, very directly,
"You're already healed. Don't worry."
And he'd sort of picked up on the fact
that there was this doubt sort of there.
And with doubt, you hang back a bit.
And although from the outside
I would have looked like I was very committed, very engaged
with this whole healing process,
I know - it was a fact -
that there was this level of doubt there
that was sort of holding things back.
And through the agency of meeting him
and the catalytic effect that he had
and the sort of power of his presence,
which is, like, what made him for me a true healer,
I was able to actually switch that
and I came away from there with conviction.
And it didn't actually change what I was doing,
but it changed how I was doing it
in this quite deep and profound way.
And so everything from then on I thought...
You know, I came away, you know, thinking I'd really get well.
In recent years the scientific line of inquiry
has moved from being not if, but how,
belief effects your health.
And while the study of placebo responses
still has a long way to go
to influence the practices of conventional medicine,
scientists are starting to uncover
a physiological basis for placebo.
Neuroscientists can see placebo treatments
prompt chemical responses in the area of the brain
that modulates things like mood, sleep and pain reception
in a similar way to drugs.
Research on the brains of people with Parkinson's disease
has shown that placebos increase dopamine,
a chemical that affects emotions
and sensations of pleasure and reward.
In a study of patients with irritable bowel syndrome,
people got better
even when they knew pills given to them were fake.
These people were told
their doctors felt the pills would help,
and they did.
This is a really important reminder
that the therapeutic interaction
between the therapist - any healthcare professional -
and the patient, is important,
and I think people have known that for years.
And now we can, through placebo research,
demonstrate that it's important
because there's a clear biological manipulation
or altering of...of symptoms.
I think 'healing response'
is a better term than 'placebo response',
because in most doctors' minds, placebo responses...
People only think of
giving sugar pills and saline injections,
so this is fooling patients, duping them in some way.
And doctors don't like to see themselves as duping patients,
and patients certainly don't want to see themselves as dupes.
So I think to avoid all that
I would tend to talk about these
as mind-mediated healing responses.
Now, it doesn't mean, you know,
"I think I'm gonna get rid of my cancer
"or my, you know, other major illness
"and it's just gonna go away,"
but it does mean that the body's response
to the insult of an infection or a tumour or something else
may be modulated by central nervous system effects,
including expectation and placebo.
There's no way you can ever draw a line and say,
"On this side are the intrinsic effects of treatment
"and on this side are the mind-mediated effects."
And not only is it impossible to do that,
it's foolish to do that,
because to me the placebo response
is the meat of medicine -
that's what you're trying to make happen.
IAN GAWLER: It wasn't like I found
some magic medical thing that fixed me
or some alternative treatment that fixed me.
I think if there's a magic bullet involved in my case,
it was actually that sort of inner capacity for healing
and activating that.
After I recovered,
a lot of people heard about my story
and wondered what I'd done
and whether it could be of help to them.
And really, my story's got less and less significant
in that sense
because the real body of the work
is the testament of all the people
who've done these things over many years.
A friend had mentioned the Gawler Foundation to me.
Straightaway in this program,
things started to make sense to me.
You know, like, full light bulb moments.
You know, I was motivated and I was keen to stay alive.
I'd just got married. I was...I was 27.
Like, I didn't want to die.
And I made a lot of changes.
IAN GAWLER: And I have no trouble in saying,
"I don't care what the odds are. You're an individual.
"You've got a body, you've got emotions,
"you've got a mind, you've got a spirit.
"It's possible that you're gonna recover."
A lot of the people that I've helped
that have managed to recover
sort of in spectacular ways against difficult odds
have found that point of conviction
at some point in their own healing journey.
SCOTT: They teach you about the effects of emotions
on your body, your immune system,
the importance of meditation, nutrition,
having some sort of spiritual connection
to whatever it is you believe in,
all these things.
And they're all things that you can do for yourself.
So some people say that my...
..my healing is this miraculous recovery.
But to me, it was...
..it was just hard work and perseverance.
And belief.
I believed these things, you know, were good for me.
The easiest way to sum it up for someone is
would I have got well
without all these approaches like meditation
and, essentially, looking after yourself?
No.
Would I have got well
with just that and no chemical intervention?
Maybe.
But if you wanted to break it down,
the drugs weren't gonna cure me, not by themselves.
I was a terminal patient.
I had stage IV melanoma.
And here I am, cancer-free, 6.5 years later.
Despite the overwhelming evidence
that your mind plays a major role
in both determining your sickness and wellness,
there remains a major line of inquiry to explore -
the role of genetics.
Genes are stretches of DNA
that sit in almost every cell in your body.
They contain instructions
for producing proteins that run every bodily function.
We inherit half our DNA from each of our parents.
And if your parents, grandparents or other relatives
have an illness,
you have a greater risk of getting sick too.
I'm George Jelenik.
I'm a medical doctor who is in academic medicine,
and emergency medicine is the specialty I've been trained in.
Mum was diagnosed with MS.
So MS is multiple sclerosis, which is...
..which means that you've got
multiple lesions, or little areas of damage,
through your nervous system.
Generally it's thought to be an autoimmune disease,
so the immune system essentially attacks your own nervous system.
And she deteriorated quite quickly.
Within perhaps five years of diagnosis,
she could no longer walk.
And I remember her
then coming to my medical school graduation
in a wheelchair
and having to be sort of lifted up the ramp to get inside
to...to see me graduate from medicine.
I'd done three years of residency as a doctor
and I thought I would just take off and see the world
and go for a few years.
And in fact it was at my going-away party
that I was rung to say that my mother had been found dead.
She was intent
on finishing her life perfectly rationally and...and reasonably
because of what her life had become.
And so she took an overdose and was found in the morning.
There's a very strong genetic predisposition to MS,
so if you have a first-degree relative who had MS,
like my mother,
then your chance is about 20 to 40 times
the average chance of the rest of the population.
And it was 1999, 18 years later, when I was 45,
that I first developed symptoms of MS.
We used to think that the genes you were born with
are what you're stuck with
and that's it, that it's set in stone.
And it turns out that's not the case.
You're born with the genes. The genes aren't gonna change.
But the way they are expressed is very profoundly affected
by the experiences that you go through.
So often I hear people say, "Oh, I've just got bad genes.
"It's all in my genes. What can I do?"
Well, actually you can do a lot.
For the last 36 years,
I've directed a series of research studies
showing what a powerful difference
changes in diet and lifestyle can make
not only in preventing disease,
but actually in treating and often reversing it.
We were able to show for the first time
that we could slow, stop, or even reverse
the progression of early-stage prostate cancer.
We looked into some of the mechanisms to help explain that,
and we found that over 500 genes were favourably changed
in just three months.
And, in fact, turning on the good genes
that prevent these conditions
and turning off particularly the oncogenes
that promote prostate cancer in men, breast cancer in women,
colon cancer and so on.
And I think these findings are giving many people new hope
and new choices that they didn't have before.
So the bedrock principle of biology,
that genes are fixed and unchangeable,
has now been shaken to the core.
Through the study of gene expression,
scientists now know
that your genes can be switched on and switched off.
And while for the most part every cell in your body
contains exactly the same genes,
and that won't change,
being exposed to external forces
can flip the switch one way or another.
By studying epigenetics, researchers also know
that gene expression can be passed to the next generation.
The way your great-grandmother lived
could be affecting your health.
And here, at the front line of science,
there are major implications for mind-body medicine.
Recently, research on the relaxation response
was taken to a whole new level.
Scientists at the Benson Henry Institute
for Mind Body Medicine
looked at the genetic expression
of people who meditated.
And the results revealed
that meditation can flip the switch
on genes affecting disease.
But it's even, from my point of view,
more remarkable than that,
because the first time you evoke the relaxation response,
these genomic gene expression changes occur.
Now, what happens, the more times you do it daily,
the more intense is the response,
the more anchored it is,
but it happens the very first time
when you go through these instructions.
That's incredible.
That's absolutely remarkable.
So what you're saying is
that within minutes of doing a technique
that evokes the relaxation response,
we can change the way our genes are expressed?
Yes. Yes. And that's...
Now, there is a very important point here,
namely, the more you do it, the more intense the response.
That means the daily practice of these techniques is vital.
Sure, you can get a benefit,
but you can get so much more benefit
if you do it on a daily basis.
GEORGE JELENIK: To be diagnosed with MS
was just an enormous... an enormous blow.
I mean, it's impossible to really adequately convey
how life-changing that is.
At a stage when you've got a really young family
and you've just been appointed to a really important new job,
and things seem, apparently,
to be going really well in your life,
it's like an enormous hand just reaches in
and takes your life away from you.
In an instant it's just gone.
I started thinking, "Why have I gotten sick?
"Why did I get sick right now?
"What is this illness doing for me?
"What does it mean in the context of my life?"
And so I...I had a path suddenly to explore.
I'm no stranger to medical research in the job I do,
so it was relatively easy for me
to look through the medical literature
and see what had been written about this illness before.
And really the literature had so many clues
about what causes MS and what makes it worse
that it wasn't that difficult to put that together.
I think I got sick, in hindsight,
because everything in my life was really out of whack.
It was really out of balance.
And it was the exploration of that path, really,
that led me to be well and keeps me well.
For a long time, I wouldn't use the word 'recovery'
because I thought...
That doesn't even get discussed in medical circles,
that it's possible to recover from MS.
And I thought it was really sticking my neck out
to say I'd recovered.
But in fact, from what I've seen
in my own personal experience now,
I think it's perfectly reasonable
to start a conversation about recovery from MS.
Why not?
It's just another chronic illness
like many of the others we see in the West.
Why couldn't you recover from that?
If you looked at my life now,
it is unrecognisable from my previous life.
I live a pretty healthy lifestyle.
So I exercise every day of the week,
plus walking to work and back.
I eat a plant-based wholefood diet,
I eat a lot of fish, take omega-3 supplements, vitamin D.
I'm perfectly happy to meditate with my colleagues at work.
And, interestingly enough,
the whole organisation at St Vincent's Hospital
is starting to embrace meditation.
When things go wrong, I seek counselling,
I keep my diary,
I've got some really good friends I can sit and talk to
and really close family who really understand me.
So, all in all, it's a whole lot easier
for me to stay emotionally healthy now
than it was in other parts of my life.
If you looked at the kind of cards I was dealt,
then I think the average person would have said that
that's a recipe for... for a disastrous life.
And yet I don't remotely feel like
I'm living the kind of prescription that was delivered.
It's real hope that you can end up perfectly well
after 10 or 15 years with this illness.
I mean, I have.
Through the story of George Jelenik,
a professor of emergency medicine,
we have living proof
that your wellness is determined
by far more than your genes,
that you can apply the latest science
to change the way your chronic illness affects your life.
But here at the frontier of mind-body medicine,
it doesn't stop at gene expression.
Thanks to the work
of a Nobel Prize-winning team of researchers
from the University of California,
we know that high levels of stress
affect the rate your DNA ages.
They found, for example,
that women with the highest levels of stress in their lives
had about 10 years of accelerated ageing
compared to low-stress women.
They measured this by looking at telomeres.
These are little caps
that sit on the ends of your DNA strands,
like the ends of shoelaces,
and guard your genetic information.
As you age, your telomeres get shorter,
and the shorter your telomeres, the greater the risk
of illnesses associated with ageing.
Shortened telomeres have been linked
to increased risk of cancers, heart disease and dementia.
But it's not too late.
A pilot study by Dr Dean Ornish
has shown that even this is reversible.
DEAN ORNISH: When people went through our lifestyle program,
which included stress management,
exercise, a healthier diet and more love and intimacy,
their telomeres actually got longer,
so their lives get longer.
It's still the only intervention, including drugs,
that's been shown to actually make your telomeres longer.
And I think these findings are giving many people new hope
and new choices that they didn't have before.
CRAIG HASSED: I just think it's fascinating
to be thinking you're sitting in a chair
practising a mind-body technique like meditation
and you're doing genetic engineering at the same time.
I find that extraordinary.
So how we feel and how we relate to ourselves in the world
has an effect on our ageing
through a whole lot of different mechanisms
from genetics to physiology,
for better or for worse,
and things accelerate ageing
and there are things that slow it down,
and it's not surprising.
Having good emotional health,
coping well with demands of day-to-day life,
leading a healthy lifestyle, slow it down,
and the things that we associate with
poor mental health and an unhealthy lifestyle
speed it up.
It just depends on how fast we want to burn the wick.
But if there was a patentable product
that had those kinds of effects
we'd be all over it.
We'd be spending billions of dollars on research
and rolling it out in no time at all.
It's been nearly 10 years
since I was diagnosed with an autoimmune disease,
a 3-year journey to make this film.
I am not in a wheelchair.
I am not on medication.
I now see that when it comes to my health,
balancing my mind and body
is as essential as the air I breathe.
And in a strange way I'm grateful for the illness
because, like so many other people I've met along the way,
it wasn't until I got sick
that I realised I needed to get better.
DEAN ORNISH: I can't tell you
how many patients have said things to me
like, "Having a heart attack
"was the best thing that ever happened to me,"
or, "Being diagnosed with prostate cancer..."
You want to go, "What? Are you nuts?"
And they say, "No, that's what it took to get my attention
"to begin making these changes in my life
"that have made it so much more meaningful and beautiful
"that I might not have ever done it otherwise."
They're spending more time with their loved ones,
they're eating and exercising more, so they feel better.
And so for me that's what...
I mean, we're all gonna die, so...
More important than how long we live is how well we live.
HERBERT BENSON: For health and wellbeing
and to treat illnesses,
of course we need drugs, of course we need surgeries,
but we also need the power of the mind.
Now we have the evidence-based proof
that the mind can heal,
and it should be added appropriately
to drugs and surgeries.
DEAN ORNISH: I've spent my whole life professionally documenting
what a powerful difference these simple changes can make.
You know, we think it has to be a new laser
or something really high-tech and expensive -
a new drug, a new surgical technique.
We are trying to show that these very simple choices
that we make in our lives each day
have a powerful impact on our lives,
much more and much more quickly than we had once realised,
for better and for worse.
JON KABAT-ZINN: Absolutely.
We have much more to say over how healthy we'll be
than our doctors, and how we do that
whether it's though yoga, whether it's through meditation,
whether it's through exercise,
whether it's through changing our diets,
whether it's through giving more...
..airtime to our relationships
and appreciating that our relationships
aren't, like, off to the side someplace.
They're absolutely critical to how well we will feel.
DAVID SPIEGEL: I believe in the power of group support.
I have no doubt at all that it helps people live better.
And we are not just splendid individuals.
We define ourselves in part by the people around us
and how they interact with us.
And so I have no doubt at all
that it helps people live better,
and I think the evidence is accumulating
that it helps them live longer as well.
ALICE DOMAR: I know our mind and body are connected.
I've had thousands of patients get pregnant.
I know there's a mind-body connection.
I've seen it, I've done research on it.
It's a given.
ANDREW WEIL: I think mind-body medicine
is central to good medicine.
In fact, you know, one thing I often say
is that one day we'll be able to drop the word 'integrative' -
this will just be good medicine.
There is no doubt that the mind and the body are connected.
There is no doubt that the brain and the immune system
and the rest of the body are connected,
and that when those connections are intact and in balance
you have health
and when they're broken you have disease.
You can't always overcome your genes.
You can't always overcome your environment.
But with help,
with an experienced practitioner who can help guide you,
you can find the best formula
to help your body and your brain to help you heal.