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How can the placebo effect be explained? Some will dismiss it by saying the patient's illness was "psychosomatic." It was "all in his head," a figment of his "imagination," and therefore not "real."

But this is a distortion of the meaning of the word psychosomatic, which simply means that an illness originated as a result of, or is aggravated by, an individual's psychological processes. It does not mean that the illness is any less real because it is not solely physical in origin—if any illness ever is. An ulcer may have originated as a result of, and he aggravated by, anxiety and tension. This does not make the ulcer any less real.

While almost everyone acknowledges that there are psychosomatic factors in high blood pressure, heart attacks, headaches, and certain skin disorders, the psychosomatic connection with cancer is not generally accepted even though the idea that such connections may exist is not a new or revolutionary one. As early as 1959, Dr. Eugene P. Pendergrass, president of the American Cancer Society, emphasized the necessity of treating the whole patient, not just the physical manifestations of cancer.

Anyone who has had an extensive experience in the treatment of cancer is aware that there are great differences among patients. ... I personally have observed cancer patients who have undergone successful treatment and were living and well for years. Then an emotional stress such as the death of a son in World War II, the infidelity of a daughter-in-law, or the burden of long unemployment seems to have been precipitating factors in the reactivation of their disease which resulted in death. . . . There is solid evidence that the course of the disease in general is affected by emotional distress. . . . Thus, we as doctors may begin to emphasize treatment of the patient as a whole as well as the disease from which the patient is suffering. We may learn how to influence general body systems and through them modify the neoplasm which resides within the body.

As we go forward . . . searching for new means of controlling growth both within the cell and through systemic influences it is my sincere hope that we can widen the quest to include the distinct possibility that within one's mind is a power capable of exerting forces which can either enhance or inhibit the progress of this disease. [Emphasis added.]

The importance of Dr. Pendergrass's view is not just that it underscores the role that psychological factors play in aggravating a disease, it also emphasizes the possibility that psychological factors, including the patient's beliefs, may be mobilized to move toward health. Not only can mental and emotional conditions originate or aggravate physical conditions, they can also contribute to health. Just as one can become psycho-somatically ill, so one who is ill can move in the other direction and become psychosomatically healthy.

Although at times we may say that someone "wanted" to make himself or herself sick, psychosomatic illness is generally attributed to unconscious processes. Basically our belief has been that the unconscious aspect of psychosomatic illness made it something that was beyond our control, and therefore something that simply "happened" to us. Although the mind might make the body sick, we did not think about the degree to which we might consciously influence the mind to make the body well again.

One of the greatest advances in modern medicine, however, is the new vision that doctors and others are gaining in regard to the amount of control a person may learn to exert over the mental processes that influence a wide variety of physical processes.



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