Wednesday, May 4, 2011

Botox for the Brain

Culture Culture & Society September-October 2009 Views Reviews and Interviews August 26, 2009

A Harvard psychologist argues that our mindless acceptance of stereotypes leads to premature aging.

Here’s an innovative way to lower health care costs: Set everyone’s biological clock back 20 years. Senior citizens of 75 will enjoy the strength and stamina they had at 55, meaning they will need far less medical attention. The energetic elderly will remain productive members of their community later into life, which could also ease the strain on Social Security.
Granted, this sounds like an unusually wonky episode of The Twilight Zone. But three decades ago, Harvard University psychologist Ellen Langer conducted a landmark experiment that suggested reverse aging needn’t be relegated to the realm of science fiction. Her revealing study, the many follow-ups it spawned and the implications of their findings are the subject of her fascinating new book Counterclockwise: Mindful Health and the Power of Possibility.

It’s a brightly written work — Langer has a knack for metaphors — that deftly challenges an array of assumptions we hold about health. She reminds readers that many definitive-sounding diagnoses are in fact best guesses, and that no study, however elegant and persuasive, can truly tell us the best course of treatment for any particular patient. Physicians, she counsels, should be thought of as “consultants.” Ultimately, we know our own bodies best.

In a sense, this is a book about the limits of empirical knowledge. But as Langer sees it, the ambiguity that inevitably accompanies medical research can be profoundly liberating. If we can’t be sure that a diagnosis — or a widely accepted truism such as “memory loss is inevitable with age” — truly applies in our case, we’re less likely to stick ourselves with a self-limiting label. “While many of our experienced disabilities may be a natural part of aging,” she writes, “many are instead a function of our mindsets about old age.”

The ingenious counterclockwise experiment was conducted in 1979. Langer and her students recruited two small groups of elderly men to spend a week living in a secluded New Hampshire monastery. Those in the control group spent the seven days reminiscing about the past, while those in the experimental group effectively re-entered the past. Their environment was designed to convey the impression they were living in 1959. They watched movies, listened to songs and read magazines from that era and discussed “current events” such as the first U.S. satellite launches.

“Both groups came out of the experience with their hearing and memory improved,” Langer reports. (It appears our bodies respond to being intellectually and emotionally engaged.) But members of the experimental group experienced more dramatic benefits. They were more likely to improve their scores on an intelligence test; more likely to show improvement in joint flexibility and dexterity; and more likely to look younger, as judged by a group of outside observers who compared before-and-after photos. Also, their fingers were longer. Since their arthritis declined in severity, they were able to extend their digits past the point they could a week earlier.

A fluke, perhaps? Well, Langer offers plenty of other data suggesting a strong link between self-perception and health. My favorite involves a group of hotel maids who reported their long hours and family responsibilities didn’t give them time to exercise. They were then told that their work, with all its bending and scrubbing, in fact involves quite a bit of exercise. So informed, they lost an average of 2 pounds over the next four weeks. Langer, who has spent several decades studying the effects of mindfulness, notes the women were paying renewed attention to activities that long ago became routine and mechanical. That, she suggests, is the key: If you’re noticing the precise condition of the carpet rather than daydreaming as you vacuum, chances are you’ll push the machine a little bit harder.
Langer defines mindfulness not in the sense of meditation and detachment popularly associated with Buddhism, but rather as being aware enough to notice subtle changes in ourselves and in our environment. The health implications of such alertness are obvious: If we notice small shifts in how we feel, we can address problems before they become acute. She argues we will also begin to realize that the distinction we make between being “sick” and “well” is often arbitrary and usually unhelpful, in that it prompts us to bounce back and forth between willful ignorance of our body’s workings and helpless dependence on a medical professional.

Langer wrote a best-selling book on mindfulness in 1990, and this latest volume may also climb the charts: A Hollywood movie focusing on the counterclockwise experiment, starring Jennifer Aniston as the research psychologist, is scheduled for release next year. No doubt the renewed interest in Langer’s research reflects a widespread fear of aging among baby boomers, many of whom will resonate to her ideas. How many have the discipline to follow through on her recommendations is another question. Living a fully engaged life in which we constantly question not only society’s assumptions about aging but also our own ingrained beliefs is a bit more involved than getting a Botox injection.

Nevertheless, policymakers and health educators need to be exposed to these concepts. (Her chapter about the consequences of language used by doctors should be taught in medical schools. Does anyone really feel better when told their cancer is “in remission”?) Langer persuasively suggests it is no coincidence that a society that worships youth and considers the elderly somewhat embarrassing is bankrupting itself with health care costs. If pop culture and the mass media equate being old with being weak, helpless and irrelevant, why wouldn’t the elderly feel feeble?

So the fountain of youth may in fact be the flood of chemicals in our brain that processes both internal and external messages about old age and dutifully passes them on to our joints, blood vessels and vital organs. Perhaps it’s time to start noticing these cerebral downloads and disregard the disempowering ones. Personally, I’m planning to pop in a tape of When Harry Met Sally into the VCR and celebrate the fall of the Berlin Wall. It turns out 1989 was quite a year.

Just Say No to Aging?

Newsweek Article

A provocative new book from a Harvard psychologist suggests that changing how we think about our age and health can have dramatic physical benefits.

Imagine that you could rewind the clock 20 years. It's 1989. Madonna is topping the pop charts, and TV sets are tuned to "Cheers" and "Murphy Brown." Widespread Internet use is just a pipe dream, and Sugar Ray Leonard and Joe Montana are on recent covers of Sports Illustrated.

But most important, you're 20 years younger. How do you feel? Well, if you're at all like the subjects in a provocative experiment by Harvard psychologist Ellen Langer, you actually feel as if your body clock has been turned back two decades. Langer did a study like this with a group of elderly men some years ago, retrofitting an isolated old New England hotel so that every visible sign said it was 20 years earlier. The men—in their late 70s and early 80s—were told not to reminisce about the past, but to actually act as if they had traveled back in time. The idea was to see if changing the men's mindset about their own age might lead to actual changes in health and fitness.

Langer's findings were stunning: After just one week, the men in the experimental group (compared with controls of the same age) had more joint flexibility, increased dexterity and less arthritis in their hands. Their mental acuity had risen measurably, and they had improved gait and posture. Outsiders who were shown the men's photographs judged them to be significantly younger than the controls. In other words, the aging process had in some measure been reversed.

I know this sounds a bit woo-wooey, but stay with me. Langer and her Harvard colleagues have been running similarly inventive experiments for decades, and the accumulated weight of the evidence is convincing. Her theory, argued in her new book, "Counterclockwise," is that we are all victims of our own stereotypes about aging and health. We mindlessly accept negative cultural cues about disease and old age, and these cues shape our self-concepts and our behavior. If we can shake loose from the negative clich├ęs that dominate our thinking about health, we can "mindfully" open ourselves to possibilities for more productive lives even into old age.

Consider another of Langer's mindfulness studies, this one using an ordinary optometrist's eye chart. That's the chart with the huge E on top, and descending lines of smaller and smaller letters that eventually become unreadable. Langer and her colleagues wondered: what if we reversed it? The regular chart creates the expectation that at some point you will be unable to read. Would turning the chart upside down reverse that expectation, so that people would expect the letters to become readable? That's exactly what they found. The subjects still couldn't read the tiniest letters, but when they were expecting the letters to get more legible, they were able to read smaller letters than they could have normally. Their expectation—their mindset—improved their actual vision.

That means that some people may be able to change prescriptions if they change the way they think about seeing. But other health consequences might be more important than that. Here's another study, this one using clothing as a trigger for aging stereotypes. Most people try to dress appropriately for their age, so clothing in effect becomes a cue for ingrained attitudes about age. But what if this cue disappeared? Langer decided to study people who routinely wear uniforms as part of their work life, and compare them with people who dress in street clothes. She found that people who wear uniforms missed fewer days owing to illness or injury, had fewer doctors' visits and hospitalizations, and had fewer chronic diseases—even though they all had the same socioeconomic status. That's because they were not constantly reminded of their own aging by their fashion choices. The health differences were even more exaggerated when Langer looked at affluent people: presumably the means to buy even more clothes provides a steady stream of new aging cues, which wealthy people internalize as unhealthy attitudes and expectations.

Langer is not advocating that we all don uniforms. Her point is that we are surrounded every day by subtle signals that aging is an undesirable period of decline. These signals make it difficult to age gracefully. Similar signals also lock all of us—regardless of age—into pigeonholes for disease. We are too quick to accept diagnostic categories like cancer and depression, and let them define us. Doing so preempts the possibility of a healthful future.

That's not to say that we won't encounter illness, bad moods or a stiff back—or that dressing like a teenager will eliminate those things. But with a little mindfulness, we can try to embrace uncertainty and understand that the way we feel today may or may not connect to the way we will feel tomorrow. Who knows, if we're open to the idea that things can improve, we just might wake up feeling 20 years younger