How to Quit Worrying for Good—and the Power of the Placebo Effect
Stress, along with feeling anxious and/or overwhelmed, is an inevitable feeling we all experience. How we deal with it though, is not, according to Dr. Martin Rossman, board-certified physician, author, and founder of The Healing Mind. Rossman studies the ways our minds and bodies are intertwined, and how mastering the way we process stress can optimize both our mental and physical health. Here, he talks to us about becoming aware of what our bodies are trying to communicate to us, and explains how, by managing our thoughts—particularly stress-inducing thoughts—we can take control of our lives:
A Q&A with Martin Rossman, M.D.
Is there scientific evidence validating the mind-body connection, and is it related to the placebo effect?
People are often surprised when I say that there is actually more research done on mind/body healing than on any other medical intervention. Thousands of studies have been done in the last fifty years on the relaxation response, mindfulness, meditation, hypnosis, and guided imagery. Every drug study compares the effectiveness of the drug to the effect one’s positive expectation has on symptom relief and healing—we call this the placebo effect.
Many people think “placebo” means that nothing happened—that you were given a sugar pill, or just imagined that you were better. But the placebo effect is a real and very powerful healing effect that happens whenever a person feels something has been done that can help them, or make them feel better. The placebo effect is responsible for somewhere between thirty and seventy percent of all positive responses to treatment. The effect is so powerful that researchers try their best to eliminate the placebo effect, by either: A) making sure the person who is getting the treatment doesn’t know whether they’re getting the real or sham (placebo) treatment; or B) making sure the person administering the treatment doesn’t know whether they’re administering the real or fictitious (placebo) treatment.
“If we can be fooled into getting better, then why wouldn’t we learn to consciously turn on the body’s healing systems?”
Eliminating the placebo effect allows us to see the effects of the drug or intervention being studied. As doctors and patients, we should learn from this powerful mental effect in order to maximize our natural healing abilities. After all, if we can be fooled into getting better, then why wouldn’t we learn to consciously turn on the body’s healing systems? That’s what mind-body medicine and mind-body healing are all about: how to become skillful at working with the built-in healing systems of the body, mind, and spirit. A better name for the “placebo effect” would be the “mind-body healing effect,” and luckily, we have already learned a fair amount about how to teach people to take advantage of it.
A large part of your work focuses on how people handle stress—why is this so important?
It’s been estimated that that 60 to 90 percent of all visits to primary care doctors have a significant link to stress. Either the complaint is directly attributable to stress, or to a behavior that people adopt in order to manage stress, such as overeating, eating junk food, drinking too much alcohol, smoking, using uppers or downers, and even exercise addiction. The problem with managing stress in these ways is that over time, they become toxic. Not only do they fail to manage the stress, but they may lead to serious medical issues that make matters worse.
Because the majority of stress is self-generated—and as a society we’re not great at managing stress—I felt it was the most important topic to address in my recent work. Since worry is the mental aspect of stress, and the most accessible and easiest to manage, I picked it as the centerpiece of my work in stress reduction. Once you’ve learned to manage worry, and to use your imagination skillfully, many other benefits arise.
What typically goes wrong with our response to stress?
It’s not the physical response that’s the problem—our stress response is well designed to help us survive an immediate physical assault on our body. Blood is rushed to the major muscles, the heart rate and blood pressure go up, the blood clots faster, all in preparation to fight for your life, or to escape a life-threatening situation.
The problem is twofold: First, this life-saving response is triggered too frequently by events that do not immediately threaten life. These are mostly mental events (thoughts) about relationships, children, money, and the future. Second, we often mismanage our response to stress—we amplify it, become addicted to it (know any drama queens?), or attempt to shut it off with drugs, alcohol, cigarettes, or junk food. These “toxic coping” responses then create problems of their own.
“It’s not the physical response that’s the problem—our stress response is well designed to help us survive an immediate physical assault on our body.”
What are better ways to address stress?
First, we must learn to recognize the signs and symptoms of stress, such as body tension, headaches, anxiety, trouble sleeping, upset stomach, and indigestion, or harmful coping mechanisms. Then, we need to develop an effective way to mentally and physically relax, to reverse or calm the physiologic effects of the response.
I like what I call the “Three Keys to Calmness,” which include deep abdominal breathing, a simple body scan, and a brief guided imagery process. These steps unwind and reverse the immediate, biological stress response.
Finally, we must learn to become observant of ourselves, so we don’t unknowingly create stress where we don’t have to. It’s surprisingly easy to develop a “bad worry” habit—i.e., always thinking of the worst-case scenario, or projecting a negative outcome. If you have this habit, it’s good to know how to break it; otherwise, it will drive you into a lot of unhealthy stress.
What’s the science behind self-guided imagery and how does it work?
Mental imagery is a natural way of thinking that involves your senses. It consists of thoughts that you see, hear, smell, or feel in your mind. Guided imagery is the use of that type of thinking for a particular purpose—it may be to help relax and relieve stress, fall asleep, relieve pain, create something, develop insight into an issue, or solve a problem.
Now that we have functional MRI, we can see what parts of the brain are active when we are doing various mental tasks. We learned that the occipital cortex—the part of your brain that processes visual information—becomes active not only when you are processing something visual in person, but also when you imagine seeing something. Similarly, when you imagine hearing a sound, the temporal cortex—which processes sound—becomes active. The same goes for imagining smells and sensations, which involve other parts of the brain.
“It’s whether our thoughts are carrying messages of ‘relax, take a break…’ or ‘battle stations!’ that makes all the difference.”
When we visualize going to a peaceful, safe place, and imagine going through all of our senses, the different areas of the cerebral cortex that process these senses send messages to the lower, more primitive parts of the brain that control our emotional and stress responses. In effect, they send the “all clear” signal, saying this looks, sounds, smells, and feels like a safe, peaceful place. The lower brain centers respond by sending the same message through the nerves, neurotransmitters, and hormonal chemicals to turn on the “relaxation response,” which is a deep, restorative state we naturally go into when we relax.
The opposite of the “relaxation response” is what happens when we are worrying about whether we can meet the mortgage, have kids, get a job, and do all the things on our to-do list. The fear and angst associated with those thoughts send nerve and chemical messengers down the same pathways in our bodies, stimulating an “alarm state.” It’s whether our thoughts are carrying messages of “relax, take a break…” or “battle stations!” that makes all the difference. That’s why it is so important to cultivate self-awareness, and develop the ability to both observe and use your mind on purpose, so that it doesn’t become taxing. As Einstein reportedly said, “The mind is a wonderful servant but a terrible taskmaster.”
Who do you recommend self-guided imagery for, and in what scenarios?
Everyone should learn to work thoughtfully with self-guided imagery. Everyone is already working with imagery—it’s just a question of who or what is “guiding” it. How much of your reality comes from television, movies, digital media, or gossip?
Are you a worrier? Worry is a form of imagery—a focus on possibilities that aren’t yet manifested. It’s useful to worry in some settings, because it helps you solve problems and avoid danger, but it very easily becomes a bad habit that can take over your life.
“Everyone is already working with imagery—it’s just a question of who or what is ‘guiding’ it.”
If we learn how to use it properly, imagination gives us the ability to envision future options and make choices. It’s when we let it run wild that it can destroy our lives.
Therefore, we all benefit from having basic education in the function and use of the imagination. Learn how your imagination can relax you and relieve stress—or how it can make you anxious. Learn how it can be used to solve problems rather than creating them. It’s an incredibly powerful mental ability that so many don’t utilize, or worse, let it work against them, creating a great deal of unnecessary suffering. The books, audios, and courses I have developed all aim to teach that, with a special emphasis on the imagination’s applications in health, healing, and well-being.
How do we incorporate self-guided imagery into our daily life? What’s a starter routine/session?
The simplest way I know to relax is to take yourself on a five-to-ten-minute “mini-vacation” in your mind. Find a safe, quiet place, and begin by taking a few deep relaxing breaths. Take yourself inside, to a place that’s beautiful to you and that you love to be in. Notice what you imagine seeing, hearing, what the temperature is, whether there’s an aroma or fragrance. Recognize how it feels to just relax and be there. Give yourself a few minutes where you have nothing to do; then, come back to the outer world feeling more relaxed and often a bit refreshed. Think of it as a “palate cleanser” for the mind, punctuation for the day. Many of us are constantly on the go and it is essential to take periodic breaks.
To develop a deeper practice, you can also listen to a wide variety of guided imagery audios that range anywhere from four to forty-five minutes long. They guide you through variations of the process described above, and are usually available as downloads, streaming audio, or CD’s. Find the ones you like best and that are most effective for you, and take a moment once or twice a day for about three weeks to really “groove” into the process.
“Think of it as a ‘palate cleanser’ for the mind, punctuation for the day. Many of us are constantly on the go and it is essential to take periodic breaks.”
Just as with anything else you learn, it’s a little awkward at first, but you will come to look forward to it. Your system gets used to having periodic breaks, and you’ll find that you have more energy, are in a better mood more often, and have more resiliency than you previously had.
Martin L. Rossman, M.D., is a physician, researcher, and speaker who founded The Healing Mind. He graduated from the University of Michigan Medical School, and maintains a practice based on holistic practices and healing through restoring the mind-body nexus. In addition to his various medical writings, he has published several audios and books, including The Worry Solution, Fighting Cancer from Within, and Guided Imagery for Self-Healing.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.