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• What is the connection between the mind and illnesses like heart disease?
• Can a person's attitude and emotional state affect his or her chances of recovery from a serious disease?
• Can we teach our minds to heal our bodies?

PARTICIPANTS William Bergman, MD Hahnemann Health Associates Warren Berland, Ph.D. Author, "Out of the Box for Life"

We have two doctors joining our discussion. They both focus their practices on exploring the power of the mind over the body. We hope the mind does have some power over the body. Dr. William Bergman, a physician and educator with many years of study and experience in behavioral and holistic approaches to disease prevention. He currently practices at Hahnemann Health Associates in New York City, a holistic medical facility he established in 1980. He specializes in homeopathic medicine, nutrition, and stress management.

Also joining us is Warren Berland, PhD. He is a practicing psychotherapist in New York City for nearly 20 years. He is also the author of "Out of the Box for Life - Being Free is Just a Choice," a book which details a mind-body process that he has developed dealing with many problems including illness.

Now this line of thinking is not entirely new. People blame a bad boss for ulcers or their teenage son's driving habits for their insomnia but the focus has shifted from external forces to internal ones. It is not your boss or your kids but how you react to them and the other stresses in your life. How significant is that power of your mind over your body's reactions?

WILLIAM BERGMAN, MD: I think it is very significant. I think as time goes on, more and more we will appreciate the degree to which the mind is influencing to a very great degree the health of the body. For example, conventional medicine has recognized for years the placebo effect. The placebo effect is something that every pharmaceutical company has to exclude as being the reason why their new drug is exerting its effect. Is it from the drug or is it because of the power of belief of that particular patient? So they set up double-blind placebo controlled research to actually eliminate the placebo effect recognizing that the power of belief is so strong that you may get a change in the body that is equivalent to a drug effect. So I think as time goes on, we are going to realize that both in constructive ways and destructive ways, this connection is very significant when we talk about health and healing.

LISA CLARK: Definitely so. Dr. Berland, you have a book, "Out of the Box for Life." Tell us a little bit about how you developed this theory and how it relates to your experience in treating people who may have some dissonance with their mind and their body experience.

WARREN BERLAND, PHD: I first created the process about 15 years ago. I realized that we really can look at life from a perspective where we are back in charge. We don't need to spend years in therapy focusing on what went wrong with us and how we got to be the way we are. In one session with a client I realized that I said to him, "Oh, it sounds like you are stuck in a box. What if you were free right now, what would do then?". And he realized he could take steps that could make a profound difference in his life. He didn't have to wait and he really could take action. So the process is one where I teach people a four-step process where they first recognize that they are stuck in a box, which means we are stuck in our feelings, our doubts, our insecurities, what's wrong, and then to recognize that. The second step is to put whatever the issue is, whatever we are upset about on a shelf. Let's say we are angry at our spouse. We sort of put it on a shelf for a moment until we can get out of the box. The third step is to say to ourselves, "What if I were out of the box right now, what if I were free, what if I were in my heart, what if I were in touch with my strength, what would I do then, what actions would I take?" Once we ask ourselves that question and we get to that perspective where we are free of what is wrong, and free of our doubts and our history, then we can make changes. We can take steps that really are much more powerful for us rather than these autonomic reactions that we have in our life.

LISA CLARK: Let's talk a little bit about how, as you put it, being in the box and having a dissonance in your mind-body connection, can trigger things like heart problems. I know that you have done a lot of work with patients who have heart disease. How does that relate to problems with the mind-body connection?

WILLIAM BERGMAN, MD: For example, we recognize clinically a syndrome known as autonomic nervous dysfunction. This means that the autonomic nervous system which normally needs to control many other aspects of our physiology is out of balance. The sympathetic nervous system which gears us up for dealing with danger and the parasympathetic nervous system which tends to quiet us and relax us, these are meant to be in balance so that we can respond appropriately to whatever we are confronted with in life. But as a result of dysfunction in the autonomic nervous system, there is imbalance between the sympathetic and parasympathetic branches of the autonomic nervous system and as a result, there can be elevated blood pressure, heart rhythm abnormalities, and spasm of the coronary arteries. All of these things can predispose to a coronary event, like a heart attack. So we can see that autonomic dysfunction which tends to respond to a psychological mind-body approach is a powerful way to help intervene in cardiovascular illness, which is, of course, one of the major illnesses that we face. It is probably the number one killer in terms of our own society.

LISA CLARK: Definitely so. Dr. Berland, another significant killer in the U.S. and abroad is cancer. You have done a lot of work with cancer patients. How does the mind-body connection sync up with that illness, which understandably is a host of different illnesses and may manifest in different ways? Just an overview.

WARREN BERLAND, PHD: Stress, lifestyle, and how we lived our lives plays a profound role in people getting cancer. I think it is one of the most important things to look at besides genetics, possibly. I think that what I have found over the last 15 years is that people know what it is that has got them sick. Often when I sit down with people, they know I am going to be talking about these questions. I say, "What do you think has been going on? What do you think the issue is?". People often say I know exactly why I got sick. I know what my thoughts were. I know how I felt a sense of being trapped in my life. I know how I have even thought that I am going to get sick from this. So they know that is something that has played a role in their getting sick and they know that can begin to make changes to turn that around.

LISA CLARK: Even something that may not be on the surface be life-threatening but is an epidemic problem, overeating. It can lead to more serious problems. But that is often described as being a stress event and again there is a definite mind-body connection there, wouldn't you say?

WILLIAM BERGMAN, MD: Oh absolutely. I think more and more we are seeing compulsive eating. We are seeing anorexia and bulimia. We see that these are connected to psychological inner life phenomena. The more that we can be empowered emotionally and psychologically, the more we will have the ability to be able to transform our experience and deal with the problems of eating too much or whatever it might be. Most people recognize that there is possibly a hormonal component to overeating, but there is also a very important emotional component. The more we can manage our emotions effectively through mind-body techniques, the more we will be able to actually change our behavioral patterns and our habits of daily life. It doesn't just have to be a struggle to eat less or to eat more healthy food but it is something we are empowered from inside ourselves to be able to accomplish.

LISA CLARK: Turning on the internal motivation.

Let's talk about a primary care situation. Let's say a patient has just gotten a serious diagnosis. For most people, a traditional Western approach would include medication, possibly surgery, and other treatments. Where does mind-body fit into that equation? When do you seek that as a support or a compliment?

WILLIAM BERGMAN, MD: That would depend on the individual and would also depend on the specific diagnosis. In primary care, for example, we have patients coming to see us who might have elevated blood pressure. There is a potential for a stroke or some cardiac event as a result of uncontrolled blood pressure. But it would depend on how high the blood pressure is. How much the patient would be willing to consider either a natural medical approach and/or a mind-body approach? Now what I would say is that normally we expect that someone with elevated blood pressure would be under the care of a cardiologist or an internist who can make sure that the blood pressure isn't way out of control. Perhaps they would have to be on regular anti-hypertensive medication.

So many times, in my office we will see patients coming in who are hypertensive but they have been brought under good control by their internist or cardiologist with medication. But then they will say to me, "Is it possible that I can get off the medication? Or is it possible I can be on less medicine because I am concerned about the side effects of the medicines?" That is where again depending on their motivation and the particular circumstances of that patient, we could interface a stress management program. I could be teaching them some simple exercises that they could do. Certainly, although it goes outside the sphere of mind-body medicine, we could be looking at their nutritional situation and what we could do to help them nutritionally. There is a reasonable chance that the blood pressure could begin to come down so that their regular conventional doctor might be able to put them on less of the conventional drug or, even at some point, get off of it.

LISA CLARK: What sorts of illness are we talking about that could be approached from this stand point, where you might try a complimentary, alternative therapy rather than a traditional, Western drug or surgery?

WILLIAM BERGMAN, MD: I would say virtually in most of the problems in primary care people are candidates for an alternative, complimentary program in many, many cases.

LISA CLARK: Can we name some things, like insomnia?

WILLIAM BERGMAN, MD: Well sure. Insomnia, gastrointestinal problems. Headaches, allergies. Again, this can be approached with both natural medicine like homeopathic medicine or herbs, but it can also be approached with a mind-body stress management kind of program that would also facilitate it. The whole gamut of primary care problems, if people are open, there is a place for a mind-body approach to be able to facilitate their recovery, to strengthen their immune system, and to balance their hormonal system. It can be a part of a comprehensive program to get that patient well.

LISA CLARK: Would it be in your experience that this approach is more effective in preventive medicine rather than curative medicine?

WARREN BERLAND, PHD: I think it is really important. I have seen a number of clients who have gotten well from serious cancers. I had a woman just last week who had a very serious diagnosis. There is still some question whether it was ovarian cancer or pancreatic cancer but it was a very serious cancer. She came in last week and her CT scan is absolutely clear. She is a woman who took profound charge of her life. She quit a very demanding job that she never could have seen herself leave. She went to an alternative physician. She didn't have traditional chemotherapy but she made the most profound changes in her life. She actually quit this work and has begun a spiritual practice. She has been exercising, running, and completely changed her life. I know that has played a profound role in her healing. It had to have. So I think that even in the most serious illnesses like cancer or heart disease, people can take charge, make these changes. It can lead to a cure.

LISA CLARK: I have to offer something personal here. It can kind of be a two-edged sword. I had thyroid cancer a couple of years ago and, although I would like to think that my mental outlook helped in my recovery, it is daunting and even a little guilt inspiring to think what did I do to cause this. Am I still doing things that could make it come back?

WARREN BERLAND, PHD: Right. So one way is to be daunted by it. The other way is to say what can I do. Are there things in my life that if I look at them, I can change? So yes it takes responsibility and in some ways it puts that responsibility on our shoulders but we have to make the choice not to then blame ourselves. What use is that? Would it be useful to say I'm bad or it's my fault? It's just not a useful thing in terms of our healing but it is much more useful to say, "Let me look at my life". Why not look at everything in my life, my work, and my feelings about myself. Why not look at everything single thing to support my healing and make an agreement with myself that no matter what I'm not blaming myself. I am going to make whatever changes that I need to make and I am going to take charge and know that part of the healing is on my shoulders, part is on my treatment and my doctor but to feel good about wanting to have the control back in my hands so that every aspect of your life can be covered to support you in staying healthy.

LISA CLARK: Well, the good news is that for both of you in both of your practices, you have seen some dramatic instances where a person's mental outlook has dramatically changed their recovery outlook. Can you give us any examples?

WILLIAM BERGMAN, MD: Yes, for example, a patient with severe eczema who had been to countless dermatologists and was prescribed various kinds of corticosteroids, topical ointments, and creams which would tend to work as long as she would use the ointment. But if she would stop the ointment, the eczema would come back. Of course, in seeing her in the office, we not only looked at the eczema but we looked at her as a person with the eczema, her lifestyle, her eating habits. We also looked at the issue of stress and how that might have been impacting her. I have to say that it was challenging to really help her but over a period of time, the combination of a natural medical approach and the stress management program seems to really have made for her a very dramatic difference although it took time. Indeed, this wasn't something that just happened overnight. But to hear from her point of view, she felt that really being able to handle her stress was the biggest change that she felt was responsible for the benefit. So that is one example I can think of. There are many.

LISA CLARK: And you mentioned a patient with a diagnosis of either pancreatic or ovarian cancer. You have done extensive work with cancer patients. How do you convey to your patients how important activating this mind-body connection can be for them to help take control of their own recovery?

WILLIAM BERLAND, PHD: People realize right away. It certainly is my bias. I believe strongly in helping people to really look deeply at the changes that they need to make. I will talk to people about my doctoral work where I interviewed 33 people who had very serious cancers and recovered from them. I talked to people about the changes that these people made and it is very impactful for these people to know that people can turn around the most serious cancers by making really profound changes in their life. That is something that I talk to people about and really help them to take charge again so that they do get well.

LISA CLARK: A very empowering thing indeed. Thank you again, Dr. Berland and Dr. Bergman. And thank you for joining us for this webcast. I'm Lisa Clark.