What do we get wrong about...the connection between mind and body
An interview with New York Times bestselling author and science writer Jo Marchant, PhD.
In this series, ‘What do we get wrong about…?’ I speak to world-leading experts and/or those with unique insights on topics related to human thinking and behaviour.
Jo Marchant, PhD, is an award-winning journalist, speaker and author of the New York Times bestseller Cure: a journey into the science of mind over body (2016). Her writing explores the nature of humanity and our universe, from the science of the mind-body connection and the mysteries of past civilisations to the awesome power of the night sky.
Jo trained as a scientist: she has a PhD in genetics and medical microbiology from St Bartholomew’s Hospital Medical College in London, and an MSc in Science Communication from Imperial College London. She previously worked as a senior editor at New Scientist and at Nature, and her articles have appeared in publications including The New York Times, The Guardian and Smithsonian magazine.
You can find out more about Jo and her writing on her website.
Jo also has a lecture series available on Wondrium.
The moment I read Jo’s book Cure: a journey into the science of mind over body, I reached out to see if she would be interviewed as part of this series. Jo has a unique blend of the scientific credentials that allow her to talk with authority, combined with a curiosity and open-mindedness not always present in the scientific community, particularly on matters of mind and body (something we came on to discuss).
My top 3 takeaways
Rethinking stress - long-term chronic stress is highly damaging, but if we’re able to see short-term stress as a challenge rather than a threat, then our physiology will optimise for performance and this in turn will help build mental resilience.
The importance of social connection - there is a lot of research showing that our social connections are one of the biggest factors shaping our physiology and long-term health.
Don’t dismiss the unexplainable - I don’t mean become a conspiracy theorist! I just mean that as science is advancing we’re starting to better understand the links between mind and body. I admire Jo’s courage in asking the tough questions despite a lot of scrutiny from her scientific peers.
Jo and I met on a sunny September day in the entrance of the British Library and made our way up to the cafe. What follows is a distilled version of a highly enlightening conversation.
Seb: Why do you do what you do?
Jo: I think ultimately because I like to spend time doing things that I'm interested in and I like to learn new things. So my background is in science. I did a PhD in genetics working in the lab, but I realised that writing about science, communicating science, rather than spending my whole career working on one idea, gives me the chance to be learning and following my interests and writing about different things, every week, every month, or every year.
I also get to speak to some of the most interesting people in the world - nobel prize winners, astronauts, participants in clinical trials who've got incredible life stories. So it just gives me a very wide range of connections and ideas that I can bring together, and then at some point, when I'm investigating an idea, I get this feeling that there is something that isn't being said, that needs to be said. There's something that I really want to communicate and to get out into the world and I guess that is the starting point and the driving force that pushes me through the book.
And a big theme of what I've written about in my books has been the relationship between mind and body. No matter what I write about it seems to keep coming back, and I think it's because fundamentally we've got a lot of things wrong about that relationship.
Lots to unpack there. Where did that mind-body fascination start?
That's an interesting question. I think there were quite a few different threads coming together because every time I answer that question, I find myself giving a slightly different answer.
Part of it comes from my background in science and wanting to use a scientific approach to understanding how things work. But then feeling a little bit frustrated, that a lot of the research I was looking at didn't seem to have a place for the first person perspective - for our thoughts, emotions, beliefs. A lot of scientists would almost write that out of the picture and that's never made a lot of sense to me. It doesn't feel like a scientific approach to me, I think you should try and explain all of nature with science.
I also spent many years studying martial arts. I used to teach Jiu-Jitsu and that brings with it an eastern perspective and philosophy that I think definitely influenced me. I was doing a lot of martial arts at the same time as I was studying for my PhD, so those things came together.
And then, as I was working as a science journalist, I was writing news articles for New Scientist magazine for a few years and then the journal Nature, and I realised that a lot of the topics that I was really interested in - the placebo effect for example has always fascinated me - this idea that you take a fake medicine and yet it makes you feel better. Why would that be? I was really interested in hypnosis; what's going on there? I wrote a feature about mindfulness and it being used to help patients with major depression.
I realised that all of these things that I was interested in were all sort of different perspectives on the same theme, which was the relationship between mind and body.
I'm always really interested in things that don't make sense, I suppose, that often get dismissed as a bit quirky or oddball, because I think hidden within those little mysteries that people dismiss because they don't really know what to make of them, can be really fundamental insights about how we need to shift our thinking, and approach things differently.
And what do we get wrong about the connection between mind and body?
Treating mind and body as separate entities
If you think of the mind and body as two different things - we've got the body as this physical mechanism and then we have this ephemeral floating mind, you have to go one of two ways: you can either say, well, that ephemeral mind isn’t really doing anything, which is what scientists have tended to do - I've spoken to some really sceptical scientists who've just called the whole idea of this mind-body connection as dangerous, deluded quackery. Your other option is to see the mind as some kind of magical, supernatural force that can do anything.
So, you end up with these two extremes of: the mind can do nothing, or the mind can do everything, and both of them I think stem from having lost this connection between the mind and the body.
Really I think the mind and body are just different sides of the same coin. They're two aspects of the same thing. An experience or belief is a physical state of the body and the lines of causation run in both directions. So, what I was doing with Cure and a lot of my work ever since has been to try and understand what that looks like. I want to take an evidence-based approach to see what research can tell us about that connection. What can the mind do? What can it not do?
Ignoring the first person experience
I think in Western medicine, what we get wrong is that we're essentially being treated as physical bodies or machines.
We base all of our treatments and the way people are treated on the results of clinical trials. And, for the most part, those clinical trials will focus on measurable outcomes, partly because it’s easier to do, and partly because of the philosophical bias against the mind being important. In a scientific study, if your outcome is subjective, like patients telling you how much pain they’re in, for example, that is seen as a less good study. That is not as rigorous as if you actually can have an objective outcome, something in the blood or seeing something in a brain scan.
And that approach is really powerful and can tell us a lot of things, and we can develop a lot of treatments that way; but we do miss a big part of the picture. If, say, pain is the thing that you're worried about, then to not include how much pain people say they are in is very unhelpful. But more generally, in medicine, to not include people's mental state is missing half the picture.
It's quite an exciting time in terms of the research, because, although I think it's going to be a slow process, we are starting to see a lot more studies now that are taking that seriously. Mindfulness is one example that has really been helped by advances in neuroscience. So it's not so much people taking the subjective experience seriously, but it's that because we have brain imaging now, we can start to see changes in the brain when people have done mindfulness courses. That has really helped for mindfulness to be taken seriously from a scientific point of view.
Our stress response - threat vs. challenge
The most important common theme in terms of how this affects us through life, I would say, is around the topic of stress, and whether we see stress and stressful situations as a threat or a challenge (positive opportunity). Is the body in a defensive, protective mode, in terms of physiology? Or is it enabling growth and performance?
And it's not just a psychological thing, it's actually changing the physiology of the stress response. When you're in a challenge, the body maximises performance - so your blood vessels dilate so your heart can pump blood around the body more efficiently. If you're in a threat situation, it's an evolutionary response that the blood vessels constrict, it's the body essentially trying to minimise future blood loss. That means that the blood can't be pumped around the body as efficiently. That puts more pressure on the heart. The heart has to work harder. So it's damaging your physical and mental performance. Because you're really just minimising damage at that point.
I looked at a few different ways of how we can shift ourselves away from threat and towards challenge. So one of them is just using different tools to try and shift the way that we look at things - a process called ‘reframing’ - and part of that is seeing stress as not necessarily a bad thing. Stress and challenge can actually be really good for us in the same way that when you do physical exercise, you are stressing your body in a controlled way that's within your ability to cope. Over time, those repeated stresses make you more resilient and make you stronger. And it's exactly the same for psychological stress as well. Putting ourselves into challenging situations that stretch us, but that we have the ability to cope with, is actually really good and will make you more resilient.
We build the habits for how we respond to stress throughout our life, so it's not as easy as it sounds to just go, ‘I'm going to think differently.’ You have to actually undo that work and retrain new ways of thinking, so that's where things like mindfulness come in because you've got that regular training to find new ways of thinking and new perspectives on the world, rather than just following all the automatic responses that have been built through your life. And that's particularly important for people who perhaps had early lives where they faced adversity. So you need to undo that. And just like with physical exercise, if you're very unfit, you can't go for one run and everything's fixed. It needs to be part of your daily routine.
The role of social connection
The other big one that I look at is social connection which is just so important. There's a lot of research showing that our social connections are one of the biggest factors of shaping our physiology. In lonely people, you see very similar physical changes - in patterns of gene expression, immune responses, blood pressure. Lonely people look very similar - in terms of their physiology - to chronically stressed people.
But if you have a lot of social connections and you feel part of a group, and you feel supported, then you don't see those effects of chronic stress.
So you'll see longer telomeres, you’ll see less inflammation, you’ll see healthier immune responses, you'll see lower blood pressure. You’ll see lower rates of all of the prevalent diseases associated with stress, from depression and dementia, to heart disease and cancer.
So if you take a common theme from all of that, it comes back to - do we see ourselves as isolated, under threat, in danger? Or do we see our world as safe, supportive, connected? And when we reach out, we just seem to do better physically as well as mentally. I really love that finding because I think it says something about who we are as human beings, and our natural state.
As you- someone with the scientific credentials - have mounted more evidence and more structure around that narrative, have you seen any changes in attitudes?
I have actually. I was a bit nervous before the book came out because my background is in science. I'm a science journalist, so if everyone in science starts thinking I’m a total quack that's the end of my career.
And before the book came out, I wrote an opinion piece in Nature about Reiki. With something like Reiki, where you're not physically touching the patient, scientists would say, well there's no scientific mechanism that this could work through, and if we compare Reiki against fake reiki where you've got someone pretending to do Reiki, there’s generally no difference between those two groups so the idea is that doesn't work. But actually the placebo effects with things like Reiki, if compared to no treatment, can be huge. Patients with conditions such as chronic pain can actually do better with either real or fake alternative medicine compared to patients, who get drugs for example. So I was arguing that actually, there is something happening here and it might not be necessarily working through the same mechanism that the therapists are claiming, but patients are sometimes getting better.
So I wrote this opinion piece saying that we should be looking and trying to work out what are the active ingredients of these therapies. Why did they have such big effects? So that we can then incorporate those ingredients into conventional medicine. And there was this huge response to that - letters to Nature, Tweets, lots of people saying that I was a complete idiot and this was going to be the nail in Nature’s coffin. How could they publish such quackery?
There was one particular online publication that wrote many thousands of words about how awful I was, and they were just horrified that the word Reiki had appeared in the pages of Nature. They then reviewed the book when it came out. And actually gave it a really positive review. The reviewer said that she was surprised and actually found it really interesting and really enjoyed it. So I think when they actually read what I had to say, that fear and defensiveness kind of melted away a bit and they realized that it's okay. I am basing this on research.
And it was really my aim to write a book that the hard-nosed scientists could read, and the alternative practitioners could read and find a place in the middle where everyone could agree. And I don't think they're going to agree on everything, but I have had lovely conversations with people on both sides that makes me think at least I’ve done something.
I'm curious, through the process of writing Cure and then subsequent work on related topics, how has that influenced your own life?
It's definitely changed how I approach my own health and life and then also as a parent, it's informed how I parent as well.
It’s made me feel a bit more in control. This idea that we don't have to be ruled by our experience. One of the things that I talk about in the book, is that we often think that when we experience pain, for example, that it is somehow a direct reflection of the physical state of our body, and actually research from lots of different areas is telling us at that is not actually the case, that we bring a huge amount to what we experience.
So a big realisation for me has been that we don't just passively experience what happens to us. We're very much projecting out into the world and creating that experience and we have got a role to play in deciding which way that goes.
I could have spoken to Jo all day. It was one of the most thought-provoking conversations I’ve had in a long time, but I wanted to be respectful of her time and not to keep her from her current writing so we wrapped things up there. This conversation certainly inspired me to read more of her work.
As I get this ‘What do we get wrong about…?’ series off the ground, I’d love to hear your feedback.
What did you like?
What could have improved this for you?
Any suggestions on future topics or guests?
You can reach out to me via comments here, my website, or Linkedin.
I look forward to hearing your thoughts.
Seb