psychologyofhealing

Psychology of Healing

An extract from my research on "The Psychology of Healing."

This research was submitted as a post-doctoral research to Open International University, USA which was granted a D.Sc in 2004

The role of mind in causing & healing cancer

The Role of the mind in Causing Cancer

With respect to cancer, many physicians believe that the disease itself is caused by a breakdown in the immune system. Under this theory, anything that adversely affects the immune system -- including some kinds of brain activity -- can be carcinogenic. In Bernie Siegel's words:

One of the most widely accepted explanations of cancer, the "surveillance" theory, states that cancer cells are developing in our bodies all the time but are normally destroyed by white blood cells before they can develop into dangerous tumors. Cancer appears when the immune system becomes suppressed and can no longer deal with this routine threat. It follows that whatever upsets the brain's control of the immune system will foster malignancy

This theory could explain why so many substances have been linked to cancer. Anything that interferes with the functioning of the immune system can be carcinogenic. A study conducted at the Albert Einstein College of Medicine in the Bronx found that children with cancer had had twice as many recent crises as other children, who were similar except for their disease. Another study showed that 31 of 33 children with leukemia had suffered traumatic losses within two years of the onset of the disease.

Mental and emotional factors have been tied to cancer in several important ways. Like heart disease, cancer correlates positively with stress. Siegel cites two studies. In the 1970s, a study of mice bred to develop breast cancer, the cancer rate varied from 92 percent, for mice that were subject to stress, to 7 percent, for those that were not. In another experiment, in which rats injected with tumor cells and then given electric shock, 73 percent of the rats that could not escape the shock developed cancer. Of those that could, only 37 percent developed the disease, doing slightly better than the rats that received no shocks at all.

Although it might be argued that stress itself is not due to thinking and beliefs, but to external circumstances, Siegel argues otherwise. Referring to a 1961 study by L. E. Hinkle, he concludes that stress comes not from events but in the way in which we interpret them. Situations such as poverty, bereavement, and alcoholism in the family, which might seem to be incredibly stressful to the observer, were not associated with the illnesses by the patients who did not report them as stressful. Conversely, events one would ordinarily consider to be not very stressful can be experienced as traumatic, especially in the case of children, who have been known to commit suicide for having received a B on a report card.

Cousins cites a study by David M. Kissen indicating similar results. In this study of cancer patients, Kissen's research "suggested that an individual's emotional response to a life event was more critical than an event itself in the genesis of cancer." This evidence is consistent with that found in similar studies cited above, with respect to heart disease.

Dossey cites one example of a researcher who found that mental factors are heavily involved in cancer -- even though he was trying to prove otherwise.

Professor David Spiegel, a psychiatrist and researcher at Stanford University Medical School, set out to refute the idea that mental factors were important in the course of diseases. Like many clinicians, he felt that assigning a role to the mind in cancer was not only erroneous but potentially destructive as well. (Many believe this idea generates guilt on the part of the cancer patient because it suggests that he or she was somehow responsible for causing the disease.) Spiegel followed eighty-six women with breast cancer for a period of ten years. Those who received group therapy and lessons in self-hypnosis lived an average of twice as long as those who were given only traditional medical treatment. Spiegel described himself as "stunned" at this finding, which contradicted his expectations.

One of the more striking discoveries in the research of mental factors in causing cancer is that, "When combined with other psychological tests, mental imagery often is more useful than laboratory tests in assessing the patient's prospects." Siegel describes a study suggesting this:

Work done by the Simontons, Jeanne Achterberg and G. Frank Lawlis compared the predictive value of psychological factors and blood chemistry in 126 patients with extensive cancer. Virtually every psychological test showed a statistical relationship to one or more blood components. The patients who did most poorly were those who were very dependent on others -- such as the doctor -- for motivation and esteem, who used psychological defenses to deny their condition, and who visualized their bodies as having little power to fight the disease. Compared with patients who did well, those whose disease progressed fastest were more conformist to sex-role stereotypes and developed images that were more concrete and less creative or symbolic. The researchers concluded that "blood chemistries offer information only about the current state of the disease, whereas the psychological variables offer future insights" and that "the imagery was found to be the most important in predicting subsequent disease states." By analyzing drawings made by two hundred patients, Achterberg later achieved 95 percent accuracy in predicting who would die within two months and who would be in remission.

One of the best-known mental predictors of cancer is the "cancer personality type." Cousin cites the work of psychologist Lawrence LeShan, an early pioneer in this field:

LeShan..., research psychologist of the Institute of Applied Biology in New York, conducted extensive pioneering work regarding the cancer-prone personality that led him to identify several psychological characteristics that seemed to typify cancer patients (including such factors as the inability to express aggression and disruption of a parental relationship in early childhood). He concluded that personality factors have some bearing on the observed association between traumatic life events (most notably, the loss of a significant emotional relationship) and the development of cancer, and he speculated that specific psychological attributes could be linked to particular types and locations of cancer.

One of the more important traits of the cancer personality type is an inability to express emotions. Siegel, who calls it an inability to "be your own person," says:

As Elida Evans observed in her groundbreaking 1926 study of the cancer personality, "Development of individuality is a safeguard to life and health. It lifts a person out of the collective authority." I find in rural or rugged areas the percentage of exceptional patients is higher. They are independent, self-reliant people to begin with. Becoming your own person releases your creativity.

Cancer patients tend to be "nice" people possessing low self-esteem and an exaggerated desire to please others. Several studies have shown that cancer patients can often be identified by their psychological profile. Siegel cites several:

By using a simple psychological test on a large group of women, some of whom had cervical cancer, Arthur Schmale was able to pick out 36 of the 51 who had malignancies (already diagnosed but unknown to him), by looking for hopelessness and a recent emotional loss. Other research groups have since gotten even better results. Marjorie and Claus Bahnson have developed a questionnaire that is 88 percent accurate in identifying those who turn out to have a biopsy-confirmed cancer. Most of these psychological tests are now more accurate than physicians' physical exams....

Some of the most valuable work has been done by Dr. Caroline Bedell Thomas of Johns Hopkins University Medical School. Beginning in 1946, she took personality profiles of 1,337 medical students, then surveyed their mental and physical health every year for decades after graduation. Her goal was to find psychological antecedents of heart disease, high blood pressure, mental illness, and suicide. She included cancer in the study for the sake of comparison, because she originally thought it would have no psychological component. However, the data showed a "striking and unexpected" result: the traits of those who developed cancer were almost identical to those of the students who later committed suicide. Almost all the cancer patients had throughout their lives been restricted in expressing emotion, especially aggressive emotions related to their own needs. She also found that, using only the drawings they made as one of the tests, she could predict what parts of their bodies would develop cancer.

Dr. Fawzy Fawzy at the UCLA medical school conducted a study about the role of emotions in the levels of Leu-7 cells, one of the "natural-killer" T-cells. The study, which lasted over a year, compared levels of Leu-7 cells of an "experimental group" that had been able to "reduce anxiety about their illness and cope with life stresses more effectively" with a control group that had not. Cousins quotes Fawzy's account of the results:

The mean change scores showed that the control group's cells had actually decreased while the experimental group showed the desired increase in these cells at six weeks. By six months the control group had managed to return to close to baseline while the experimental group had continued to increase their Leu-seven cells. This trend continues in many of the other important cell categories.

Grief also can have a profound impact on the development of cancer-fighting immune cells. Dossey cites the following study:

Steven J. Schleifer and his colleagues at New York's Mount Sinai Hospital... studied the immune function of fifteen men whose wives had terminal breast cancer. Of interest were the T- and B-lymphocytes, the body's two main immune cells. Prior to the death of the wife, the researchers found that these cells functioned normally. But beginning shortly after the wife's death, and extending for many months in the period of grief, the cells, though normal in number, stopped working. They could not even be made to work when extracted from the blood of the men and exposed in test tubes to chemicals that ordinarily "turn them on."

Divorce has even worse effects, according to Siegel, because "...it's harder to accept that the relationship is really over."

Indeed, divorced people have higher rates of cancer, heart disease, pneumonia, high blood pressure, and accidental death than married, single, or widowed persons. Married men also have one-third the lung-cancer incidence of single men and can smoke three times as much with the same cancer incidence as single men.

Depression can also suppress immune cell activity, as well as the production of antibodies, which can both aid in the suppression of cancer. What is equally important is that some of these deleterious effects can be mitigated with relaxation and creative imagination exercises. Cousins cites a series of studies:

Drs. Sandra M. Levy and Ronald B. Herberman of the University of Pittsburgh and the Pittsburgh Cancer Institute observed that depressive behavior (fatigue, listlessness, apathy) was associated with diminished natural-killer (NK) cell activity and accelerated tumor spread in breast cancer patients. [Cousins then cites the Schlieffer study mentioned above.] To confirm the relationship between severity of depression and suppressed immunity, the investigators conducted a series of studies comparing individuals hospitalized for depression with those not hospitalized and those hospitalized for other reasons. They concluded that the severity of depression was associated with reduction of T and B cells and their activity. This conclusion was strengthened by their observation that relief from depression is paralleled by changes in the immune system.

Drs. Janice Kiecolt-Glaser and Ronald Glaser, of Ohio State University, found that highly depressed nonpsychotic psychiatric in-patients had significantly poorer DNA (genetic) repair in immune cells exposed to irradiation than did less depressed patients; and that both depressed groups fared significantly worse with regard to DNA repair than the psychologically healthy, nonpsychotic group. All group differences were sustained through the final measurement point, five hours after irradiations time period in which DNA repair is expected to recover to pre-irradiation levels. This finding suggests... that emotional stress may contribute to the incidence of cancer by directly causing abnormal cell development or by indirectly diminishing immune surveillance or competence.

By the same mental processes, however, the immune response can be strengthened or restored. Use of relaxation exercises and creative imagination were found to be helpful in a study of cancer patients by Dr. Barry L. Gruber of the Medical Illness Counseling Center in Chevy Chase, Maryland, in collaboration with Dr. Nicholas R. Hall of George Washington University and later of the University of South Florida. For one year, the patients were asked to imagine the forces in their immune systems being fully engaged in a war against the cancer cells.

The investigators found that these exercises had the effect of stimulating lymphocytes and increasing the production of antibodies and interleukin-2 cells, enhancing NK-cell activity and augmenting the effectiveness of the cytotoxic T cells. The pattern of immune changes corresponded to the level of relaxation and imagery. Equally interesting was the fact that the patients clearly showed intense determination to overcome their disease.

With respect to the same study, Siegel adds the following comments:

[The exercises also affected] the levels of thymosin-alpha-1, a hormone especially important to the auxiliary white cells called T helper cells. Thymosin-alpha-I also helps produce feelings of well-being, showing that the immune system can directly affect one's state of mind, as well as vice versa.

Cousins elaborates on these studies, with respect to the problem of emotional inhibitions:

Both Dr. Temoshok's and Dr. Levy's studies linked emotional inhibitions to impairment in immune activity. This may explain the link between emotional suppression, such as passivity or stoicism, and the progression of cancer.

Evidently, the adverse effects on the immune system brought about by depression are worse when the depression is coupled with the lack of an emotional outlet. LeShan drew the distinction between the psychological condition of "depression" and that of "despair."

LeShan conducted personality studies of 455 cancer patients and in-depth therapy of 71 "terminal" cases. He found that this condition of "despair" (so named to distinguish it from the more commonly recognized form of depression) was reported as predating the disease by 68 of his 71 cancer patients in therapy, but by only 3 of 88 other clients who did not have cancer.

While both depression and despair are unhappy emotional states, despair entails the sense of helplessness that we found was so important in the link between stress and heart disease. That sense of helplessness may in fact be mitigated for those who can express emotions. Siegel cites two more studies:

[O]ver thirty years ago... internist D. M. Kissen studied a group of smokers, comparing those who had lung cancer with those having other diseases. Based on personality tests, Kissen found the cancer patients had poorer "outlets for emotional discharge," and concluded that, the more repressed a person was, the fewer cigarettes were needed to cause cancer.

Working with breast-cancer patients, Mogens Jensen of the Yale psychology department showed that "defensive-repressors " die faster than patients with a more realistic outlook. These are the smiling ones who don't acknowledge their desperation, who say, "I'm fine," even though you know they have cancer, their spouses have run off, their children are drug addicts, and the house just burned down. Jensen feels this behavior "disregulates" and exhausts the immune system because it is confused by the mixed messages.

In his conversations with Bill Moyers, Michael Lerner, co-founder of the Commonweal Cancer Help Program, cites a study by Lydia Temoshek, whose work was also cited by Cousins earlier, of patients with malignant melanoma:

Temoshek looked at the difference between patients who expressed their feelings and those who didn't, and discovered that the ones who expressed their feelings had more immune activity at the site of their lesions. They also had thinner lesions than the people who did not express their feelings.

As with heart disease, denial can also have a healing influence on cancer. According to Dossey, there are definitely times when deluding one's self can in fact heal, because it can help maintain a more positive mental attitude. Tactics such as denial, making excuses, and comparing one's self to only the worst off among other victims, in order to look good by comparison, all tend to promote healing:

Researcher Keith W. Pettingale and his colleagues at King's College School of Medicine and Dentistry in London studied the psychological response of women three months after mastectomy. At a five-year follow-up, they found that the rate of recurrence-free survival was significantly higher among patients who had reacted to their cancer either with a fighting spirit or with denial than among those who had reacted with stoic acceptance or feelings of hopelessness and helplessness.... After a follow-up period of ten years, the outcome was the same: those patients demonstrating a fighting spirit or denial did better and had higher rates of survival....

Another strategy used by most cancer patients, [psychologist Shelley E.] Taylor found, is to make selective comparisons with other persons with the same disease. Women with breast cancer tended to compare themselves with other women with cancer who were doing poorly, which enhanced their estimation of their own strengths.... Summing up, Taylor states, "The effective individual in the face of threat... seems to be one who permits the development of illusions, nurtures those illusions, and is ultimately restored by those illusions."

Another device used by the secret helper is excuses.... Research by psychologists C. R. Snyder and Raymond Higgins at the University of Kansas has shown that persons who offer themselves plausible excuses have greater self-esteem, better health, and perform better on all sorts of cognitive, social, and physical tasks than people who put the blame on themselves when things go wrong.... They help preserve a sense of self-worth and personal integrity -- as when we say that we flunked a test because we didn't study hard enough, not because we weren't intelligent enough.... Excuses give them time to marshal additional psychological resources for the next challenge.... Snyder and Higgins conclude that excuses are far from the "simple, silly and ineffective ploys" most people consider them to be and are, in fact, necessary illusions.'

Dossey may well have exposed a conflict between moral and physical health here.

If intellectual dishonesty is sometimes helpful, emotional dishonesty is not. People who express their negative emotions tend to do better. Being ornery and cantankerous pays more often than not. Siegel, who calls this expression "fighting spirit," says:

Psychologist Leonard Derogatis, in a study of thirty-five women with metastatic breast cancer, found that the long-term survivors had poor relationships with their physicians -- as judged by the physicians. They asked a lot of questions and expressed their emotions freely. Likewise, National Cancer Institute psychologist Sandra Levy has shown that seriously ill breast-cancer patients who expressed high levels of depression, anxiety, and hostility survived longer than those who showed little distress. Levy and other researchers have also found that aggressive "bad" patients tend to have more killer T cells, white cells that seek and destroy cancer cells, than docile "good" patients. A group of London researchers under Keith Pettingale recently reported a ten-year survival rate of 75 percent among cancer patients who reacted to the diagnosis with a "fighting spirit," compared with a 22-percent survival rate among those who responded with "stoic acceptance" or feelings of helplessness or hopelessness.

Siegel elaborates on fighting spirit, with respect to the Derogatis study:

His work stands as excellent scientific support for a group of researchers nearly three decades earlier, who were "impressed by the polite, apologetic, almost painful acquiescence of patients with rapidly progressive disease as contrasted to the more expressive and sometimes bizarre personalities" of those who lived longer.

Cousins cites another study that supports Siegel's contention:

Dr. G. Nicholas Rogentine, Jr., and colleagues of the National Cancer Institute recruited patients who had been successfully treated for malignant melanoma. The patients were asked to rate the amount of "adjustment" they required in order to cope with their illness. Participants who reported that they reconciled themselves to their illness were more prone to recurrence than those who resisted the idea of adapting to cancer.

Anything seems to work better than resignation. Cousins, citing the Temoshok study mentioned earlier, argues that "passive" emotional states are the most dangerous:

[Lydia Temoshok's] structured interview with patients measured emotional, behavioral, physical, and mental reactions to events. These measurements revealed that malignant melanoma patients whose attitudes and emotions were active instead of passive exhibited better immune function and slower tumor growth.

Dossey is more specific. According to his interpretation, the following studies indicate some specific thoughts that are associated with both defeatism and suppressed immune system activity:

When people learn... to be genuinely helpless, they tend chronically to react to their problems with the classic triad of "I caused it," "It'll always be this way," and "This is going to spoil everything else I do." This point of view seems actually to be channeled into the body. It creates physiological changes that set the stage for bad health. When Seligman and his colleagues rated 172 undergraduates for the presence or absence of this explanatory style, they accurately predicted which students would be sick the most; the predictions held both one month and one year later. In another study involving 13 patients who had malignant melanoma, absence of this style of explanation was a better predictor of survival than even the level of activity of natural killer cells, a type of white blood cell crucial in the immune response.

In sum, the studies indicate that despair, a profound feeling of sadness coupled with a sense of resignation to conditions, is the attitude that is least healthy when attempting to recover from cancer. Secondly, the social style of not expressing one's negative emotions, especially if it stems from an exaggerated fear of others' disapproval, seems to describe the personality profile of those most likely to get cancer in the first place.

The Role of the Mind in Curing Cancer

Having seen how thinking patterns can exacerbate or lead to cancer, we can now turn to the various forms of mental therapy that seem to work. Without advocating specific techniques, Siegel cites five characteristics, outlined by Dr. Kenneth Pelletier, that are typical of cancer patients who survive against the odds;

1. Profound intrapsychic change through meditation, prayer, or other spiritual practice.

2. Profound interpersonal changes, as a result: Their relations with other people had been placed on a more solid footing.

3. Alterations in diet: These people no longer took their food for granted. They chose their food carefully for optimum nutrition.

4. A deep sense of the spiritual as well as material aspects of life.

5. A feeling that their recovery was not a gift nor spontaneous remission, but rather a long, hard struggle that they had won for themselves.

Then, Siegel adds:

In 1977 a research group led by Dr. Edward Gilbert of Denver's Presbyterian Medical Center completed one of the first controlled tests of psychological treatment of cancer patients. Gilbert and his co-workers asked independent physicians to examine a group of forty-eight patients and predict how long they could expect to live using standard medical treatments. The patients entered an eight-week program of individual and group therapy, biofeedback, and training in meditation and visualization. Then the patients were tested by independent psychiatrists to see which ones had made the most positive changes in their lives. Five patients were graded as having changed most significantly and four of these far exceeded medical expectations. Of the other twenty-five then remaining in the group, only one outlived the initial prognosis by a similar margin.

Siegel cites the techniques of "individual and group therapy, biofeedback, and training in meditation and visualization," but he also notes that these methods are most effective when, coupled with the experience of the disease itself, they result in profound transformation in the afflicted individual's character.

For me, the diagnosis of cancer was a terrifying experience -- and mine was one of the more readily "curable" varieties. Moreover, the primary weapons modern medicine uses to fight cancer, surgery, radiation and chemotherapy (or as some have put it, "slash, burn, and poison") often cause more discomfort than the actual disease itself. It is, therefore, understandable, why a protracted battle with cancer can in itself bring about depression, the very mental condition that tends to bring on cancer or make it worse. Recognizing this, Cousins decided to look for ways to combat the depression, with the aim of improving the physical condition as a result. He organized and led a group of cancer patients called the "Society of Challengers," who met weekly for a six-week period. During that time they received "education information about their cancer and about nutrition" and were "taught various relaxation techniques as well as positive coping strategies and problem-solving techniques." As one might expect from Cousins, the therapy also included healthy doses of humor.There was, of course, a control group that received nothing but standard medical therapy.

To measure the potential effectiveness of his techniques, Cousins used two standard psychological tests to measure levels of depression: the Profile of Mood States (POMS) and the psychosocial adjustment to illness (PAIS) test. Standard medical tests (LEU 7 and LEU II) were used to measure the immune system. When comparing the scores of both kinds of tests, in both the Challengers and control groups, Cousins found that not only did the Challengers group fare better than the control, but also that the measures of mental well-being correlated positively with the levels of immune system activity.

After six weeks, Cousins found that the experimental group showed a significant decrease in depression (as measured by the POMS), while the control group showed only a slight decline. The trend continued. After six months, the decline in depression accelerated for the Challengers group and actually increased for the control. Moreover, a dramatic difference in PAIS scores between the two groups had appeared, with the control group showing a slight decrease in distress and the experimental group showing a more marked decrease. Says Cousins:

The reeducation of the patients, apparently, was having its effects. The growth in confidence; the increasing knowledge by patients about the nature of their own resources; the enhancement of life-style; the decline in feelings of helplessness -- all these were reflected in the POMS and PAIS measurements of the research group.

Most exciting of all, however, was that the decline in depression was accompanied by an increase in certain immune cells, or activating forces, within the immune system. The conclusion was inescapable: If you can reduce the depression that almost invariably affects cancer patients, you can increase the body's own capacity for combating malignancies. This becomes especially important in view of the fact that chemotherapy, which is often used in the treatment of cancer, can have deleterious effects on the immune system.

The results of Cousins's own study would seem to indicate that the psychotherapeutic techniques used produced statistically significant differences in both the patients' emotional sense of well-being and their immune system responses.

Cousins cites another study, conducted by Dr. Herbert Benson of the Harvard Medical School, whose work was also previously cited by Dossey, in which "relaxation response" training had a positive effect on cancer patients. Benson found that patients undergoing meditation, relaxation, and guided imagery therapy reported significant improvements in quality of life, including increased vigor and fighting spirit, along with a decrease in hopelessness, tension, depression, anxiety, and somatization. Dr. Benson also found relaxation response training effective in moderating the adverse physical effects of chemotherapy.

Preliminary results have shown that the gains made as a result of participation in the relaxation response group endure over time and that patients with more advanced cancer who rated highly on "fighting spirit" survived significantly longer.

Cousins's concludes that intelligence and free will can both combat existing diseases and help prevent future ones.

Other studies support his view. Two of the early pioneers among mainstream physicians in applying mental healing techniques with cancer patients were physician O. Carl Simonton and psychologist Stephanie Matthews (Simonton's wife at the time). Siegel describes their initial studies on the effectiveness of imaging techniques on "terminal" cancer patients as follows:

Of their first 159 patients, none of whom was expected to live more than a year, 19 percent had gotten rid of their cancer completely, and the disease was regressing in another 22 percent. Those who eventually did succumb had, on the average, doubled their predicted survival time.

Dossey makes a similar point in citing two other studies, including the Achterberg and Lawlis studies cited earlier.

[T]here is ample solid scientific evidence that directed, highly specific imagery can bring about changes in the body. For instance, Dr. Howard Hall of Pennsylvania State University has shown that subjects, using hypnosis, can generate a more active immune response when they imagine their white blood cells as "strong and powerful sharks." Working with 126 cancer patients, psychophysiologist Jeanne Achterberg and psychologist G. Frank Lawlis demonstrated that the patients' clinical response -- future tumor growth or remission -- was directly related to the specificity, vividness, strength, and clarity of their mental imagery. The work of Achterberg and Lawlis, pioneers in the clinical use of imagery, thus offers another side to the debate over whether directed or nondirected imagery and prayer strategies work best.

Hypnosis too has been beneficial in treating cancer patients, especially in the area of relieving pain. Murphy cites two studies:

In a series of articles published during the 1950s, physician Byron Butler reported the successful reduction of pain in cancer patients and gave a history of cancer treatment by hypnosis going back to 1980. More recently, V. W. Cangello gave posthypnotic suggestions for pain reduction to 73 cancer patients and found that 30 of them reported excellent to good results. His deeply hypnotizable patients generally experienced more relief than the others, though about half of his less susceptible subjects were also helped. The results of these studies, wrote Ernest and Josephine Hilgard, "show a relationship between hypnotic responsiveness and success in pain reduction. The figure that commonly emerges -- about 50 percent of the cases showing substantial improvement -- is close to that reported by other clinicians.

Though Murphy cites no similar studies with respect to hypnosis curing cancer, Siegel makes a qualified argument that cancer can be cured by mental activities. Apparently the tabloid The Midnight Globe ran a headline quoting him as saying the mind can cure cancer. Siegel describes his reaction as follows:

I thought it [the headline] was simplistic and misleading. The more I worked with patients, however, the more I came to see that the statement was correct. Now I consider those omnipresent supermarket newspapers to be important medical journals. (I say this tongue mostly in cheek.) The mind can cure cancer, but that doesn't mean it's easy.

Later, he describes some of the hurdles involved:

I have collected 57 extremely well documented so-called cancer miracles. A cancer miracle is when a person didn't die when they absolutely, positively were supposed to. At a certain particular moment in time they decided that the anger and the depression were probably not the best way to go, since they had such a little bit of time left, and so they went from that to being loving, caring, no longer angry, no longer depressed, and able to talk to the people they loved. These 57 people had the same pattern. They gave up, totally, their anger, and they gave up, totally, their depression, by specifically a decision to do so. And at that point the tumors started to shrink.

The "cancer miracles" mentioned by Siegel here are called "spontaneous regression of cancer" or SRC in medical jargon. SRC does occur, but according to Dossey it is "uncommon, to say the least." Opinions as to how rare vary, but he cites one study in which the researchers simply concluded that when it did occur, it was a fluke:

Researchers T. C. Everson and W. H. Cole collected 176 case reports from various countries around the world on spontaneous regression of cancer (SRC), and concluded that SRC occurs in one out of 100,000 cases of cancer. Other authorities believe the incidence may be higher, perhaps one in 80,000 cases.

These researchers concluded that, since almost any treatment seemed to work occasionally but not consistently, all these measures were equally worthless and that SRC is purely a random event entirely beyond the control of an individual patient. According to this point of view, the disappearance of St. Peregrine's cancer had nothing to do with prayer; it would have happened anyway for reasons that are essentially obscure and unpredictable. The saint was simply one of the lucky ones. And in any case, these events are too rare to hold out as hope to people suffering from cancer, especially since they cannot control them.

Dossey, however, does not concur with this conclusion. Citing five carefully controlled case studies conducted in 1975 by physician Yujiro Ikemi at Kyushu University's medical school in Fukuoka, Japan, Dossey maintains that that attitudes such as "prayerfulness" can make a significant difference:

Ikemi and his co-workers did not "skim off the top," picking only cases that conformed to their expectations and preconceived ideas. The reports are scientifically precise and include biopsy confirmation of all the cancers in question. On balance these remarkable cases seem to contradict the idea that SRC is accidental, random, and beyond the effects of a patient's thoughts, attitudes, and feelings. They strongly suggest that there is a profound effect of prayerfulness and an indwelling spiritual sense on the cancer process.

Dossey believes, evidently, that "spontaneous" regression of cancer, although rare and apparently random, may be less "spontaneous" than it might seem. However, he is somewhat more cautious than Siegel in his position on whether we can call prayer an outright "cure" for cancer. Citing a study by Michael Lerner, special consultant to the U. S. Office of Technology Assessment, in preparing a report on unconventional cancer treatments, Dossey expresses the following reservation:

So far no one has been able to demonstrate that cancer or any other disease will predictably disappear by using prayer, meditation, or any psychological or spiritual method whatever. Lerner has concluded that although there is plenty of anecdotal evidence that many such therapies improve the quality of life, he has not found any cure for cancer among the many unconventional methods he examined, and little scientific evidence that such methods extend life beyond what could be achieved with conventional treatments.

The exact extent to which prayer or mental therapy can work with cancer is not yet known. Cousins unexpectedly found himself under attack by people in the news media, when physician Barrie Cassileth published a paper, "Psychosocial Correlates of Survival in Advanced Malignant Disease," in the New England Journal of Medicine, in June 1985. In spite of the controversy in the news media that ensued, Cassileth had no intention of discrediting Cousins's work. Her intent was to prevent people from misinterpreting it to mean that anybody could simply laugh their cancer away. Cousins's and Cassileth's subsequent discussion of the matter resulted in the following joint statement:

Some of the reports and comments incorrectly interpreted the [Cassileth] study's results to mean that positive attitudes have no value in a strategy for effective treatment of illness.

These reseasrch findings of mine will soon be released in a book " The Psychology of Healing"

Most of the supervised research was carried out in a clinical setting at the Government University Teaching hospital, Kalubowila,Colombo South, Sri Lanka during 2001-2004 period.