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When hope heals

How a positive sense of calm and control can help combat disease.

Illustration: Mark Kolle

Ten years after he was diagnosed HIV-positive, Paul was still alive. This was long before tri-therapy—the remarkably effective treatment that keeps AIDS patients alive—and everyone asked what he was doing to stave off the illness. He replied that he was taking natural supplements, watching his diet carefully and exercising regularly. One day at a press conference, a professor of medicine told him, "I'm sorry to say I've had a lot of patients who were doing the same thing and they all died. Unfortunately, I expect that within a year, or at most two, your disease will have gotten the upper hand."

Indeed, Paul died within two years, his hopes struck down by that terrible omen. It takes 24 hours for certain voodoo priests to bring about the death of a person on whom they've cast an "evil spell." The grand priests of modern medicine aren't so quick but can sometimes be as deadly.

An experiment: Two groups of rats receive transplants of malignant tumors and are given electric shocks. One of them can avoid the shocks by pushing on a lever; the other can't. In the group that can avoid the shocks, the immune system does its job, counterattacks and eliminates the cancer cells in 64 percent of the animals. In the other group, animals soon get discouraged, the immune cells are paralyzed and the cancer spreads in a few weeks. Only 23 percent of the rats reject the tumor.

Is that why Paul died—because he suddenly felt powerless to escape the "shocks" he got from his disease? Cancer seems to develop faster and more aggressively in patients who have less control over the inevitable stress of existence, which seems to be one of the reasons support groups prolong survival. Now what could be more stressful than being told there's no hope of a cure? At the University of California, Los Angeles, Assistant Professor Steve Cole demonstrated that among AIDS patients on tri-therapy, the treatment benefits those who remain calm facing life's difficulties far more than those who have trouble controlling their stress. In the latter group, the virus spreads four times as fast.

But who will explain that to patients? Almost every week I hear patients tell me how they've received "death sentences" from their oncologists. These pronouncements are made with the greatest confidence, as if statistics were certainties. Studies like Cole's are almost never mentioned. Yet patients really need them. Because I've already made this mistake myself, I suspect doctors are more afraid of giving false hope than of talking about the worst that can happen. To guard against this Western-style voodoo, patients often need to know more than their doctors about what they can do to help themselves—beginning by placing more hope in their bodies than medicine is prepared to give them.

David Servan-Schreiber is a French psychiatry professor and the author of Healing without Freud or Prozac: Natural Approaches to Curing Stress, Anxiety and Depression without Drugs and without Psychoanalysis and Anticancer: A New Way of Life .