The Science of How What We Believe Becomes Our Reality – Part I

thoughts become things"Mind is the Master Power that molds and makes, and we are mind. And ever more we take the tool of thought, and shaping what we will, bring forth a thousand joys, or a thousand ills. We think in secret, and it comes to pass, environment, is but our looking glass."    James Allen

At some point we have all heard the adage "Thoughts are things," which serves as the central tenet of such popular New Age philosophies like the Law of Attraction, featured in best-selling books like The Secret by Rhonda Byrne. And while many skeptics have been quick to dismiss the idea of "As a man thinketh, so is he" (Proverbs 23:7) as nothing more than a pop psychology platitude, the ongoing findings of medical science are telling a different story.

In an article from the January – February 2013 edition of Harvard Magazine Cara Feinberg profiles the pioneering work of Dr. Ted Kaptchuk, Director of the Program in Placebo Studies at Beth Israel Deaconess Medical Center in Boston, a Harvard Medical School teaching hospital. In the article, Feinberg chronicles the exciting findings made by Dr. Kaptchuck and his team in conducting a "clinical drug trial" charting the effects of prescription medication vs. acupuncture in relieving the pain of the trial participants:

"Two weeks into Ted Kaptchuk's first randomized clinical drug trial, nearly a third of his 270 subjects complained of awful side effects. All the patients had joined the study hoping to alleviate severe arm pain: carpal tunnel, tendinitis, chronic pain in the elbow, shoulder, wrist.

In one part of the study, half the subjects received pain-reducing pills; the others were offered acupuncture treatments. And in both cases, people began to call in, saying they couldn't get out of bed. The pills were making them sluggish, the needles caused swelling and redness; some patients' pain ballooned to nightmarish levels.

"The side effects were simply amazing," Kaptchuk explains; curiously, they were exactly what patients had been warned their treatment might produce (emphasis added)." Even more startling, "…most of the other patients reported real relief, and those who received acupuncture felt even better than those on the anti-pain pill. These were exceptional findings: no one had ever proven that acupuncture worked better than painkillers.

But Kaptchuk's study didn't prove it, either – the pills his team had given patients were actually made of cornstarch; the "acupuncture" needles were retractable shams that never pierced the skin. The study wasn't aimed at comparing two treatments. It was designed to compare two fakes (emphasis added)."

Although Dr. Kaptchuk doesn't contend that patients can simply "think themselves better" his study – along with many others conducted on the placebo effect – does prove a very important, and critically under looked, fact in health care: "patients' perceptions matter, and the ways physicians frame perceptions can have significant effects on their patients' health."

Beliefs are powerful things and what we tell ourselves and others tell us can make us better or worse. We all have "our narrative" and we tell it over and over again both to ourselves and to others. We believe it, we expect it and we project it. When we change our beliefs and our story, we change the outcomes.

One of the better known studies which demonstrates how changing our narratives can change our outcomes (and our lives) is the 1980s breast cancer support group study that was written up in the journal Advances. All of the women had breast cancer that had metastasize before the study began.

Their prognosis was poor but they became a group who listened to each other's stories, supported each other, cared about one another and helped each other manage their symptoms and disease. They also helped each other change their story. It is not surprising that the women in this support group lived on average 18 months longer than breast cancer patients with the same degree of metastasis.

This article has previously appeared on Huffington Post

Doctor-Patient Communication is the #1 Problem in Medicine

At the 2015 National Health Policy Conference held in Washington, D.C., members of the Agency for Healthcare Research and Policy agreed that the need for research focusing on the doctor-patient relationship was urgent in order to address the current crisis of patient dissatisfaction, medical-error, malpractice claims and physician burnout.

Patients are not happy, doctors and medical teams are not happy, and the health care system is struggling to adapt measures to turn the tide of this growing problem. The 2012 Institute for HealthCare Communication (IHC) report regarding research on the impact of poor communication revealed the following:

  • Research conducted during the 10 year period of 1995-2005 has demonstrated that ineffective team communication is the root cause for nearly 66 percent of all medical errorsduring that period.
  • This means that when healthcare team members do not communicate effectively, patient care often suffers.
  • Further, medical error vulnerability is increased when healthcare team members are under stress, are in high-task situations, and when they are not communicating clearly or effectively.

The research from the IHC reports cites that 50% of all malpractice is the result of poor communication between doctor and patient.

The IHC report states: "Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care."

IHC goes on to make an alarming statement that “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

And, while the addition of nurse health coaches to the medical team has been viewed by some as a solution to the communication problem, the relationship between the physician or primary care provider and the patient cannot be corrected by these additional team members. In fact, not addressing the underlying cause of doctor-patient discomfort may even increase the distrust and discomfort the patient experiences with their doctor or primary care provider.

As physicians, physician assistants and nurse practitioners are the diagnostic experts in our medical care system, ensuring the communication between these providers and their patients is critical, as research data demonstrates.

A recent pilot study, conducted through Central Michigan University (CMU), on the effects of a communication model, Behavior Engagement with Pure Presence, on patient and physician satisfaction has just concluded, and will be published shortly. The study was funded by Blue Cross and Blue Shield Foundation of Michigan.

The Primary Investigator (P.I.) of this study, Dr. Christine Clipper, wanted to thoroughly test the Behavioral Engagement model by including renowned endocrinologist, Dr. Opada Alzohaili, who was trained in the model's communication skills and had previously earned high patient satisfaction survey ratings. Dr. Alzohaili's post-pilot patient satisfaction scores were significant, revealing 100% improvement on all measures of patient perception of relational empathy during their encounter with the doctor, in contrast to his pre-pilot patient satisfaction scores.

Dr. Clipper's research data demonstrated that Behavioral Engagement with Pure Presence has "…a psychological effect on the patient's perception of the patient-provider relationship. The patient perception of relational empathy with their doctor increased through improved provider communication skills through applying the Behavioral Engagement model."

Further research on the application of the model includes a pilot study on the Behavioral Engagement model in Electronic Medical Record Communication, funded by the U.S. Department of Health and Human Services/ MI Dept. of Community Health;
and a randomized controlled clinical trial study with funding from major national health care organizations.
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Dr. Georgianna Donadio is the Director of the National Institute of Whole Health and author of the multi-award winning, Amazon bestselling book, Changing Behavior.