What Role Does Mindset Play? November 9, 2014

I always keep a lookout for good, interesting journalism on end-of-life caregiving and I have to say that the New York Times has really delivered some great articles over the last several years. A few weeks ago another article caught my attention, not about caregiving per se, but about a subject that I believe needs to be part of the caregiving conversation; mindset and health.

The NYT article “What if Age is Nothing But a Mindset?” highlights the work of psychologist Dr. Ellen Langer, a Harvard psychology professor.  Back in the early 1980’s Langer ran a psychology experiment with a group of men, in their seventies, who were in good health but manifesting typical old age deterioration; walking with a cane, arthritis, stooped over, weakness, etc.  At the conclusion of the experiment, five days later, the men had gone through a transformation. “They were suppler, showed greater manual dexterity and sat taller… Perhaps most improbable, their sight improved. Independent judges said they looked younger.”  Today Langer is involved in bringing her work to even more challenging areas such as using her brand of psychology to try and shrink tumors in stage 4 metastatic cancer patients. It was at this point in the article that I started to think about her work in the context of my own caregiving experience.

What Langer did

In her original experiment Langer took this group of aged men, had them live together surrounded with nothing but items and culture from the heyday of their past. For five days they were immersed in the 1950’s, watching and reading the news from that time, TV programs from that period, magazines, music and so on – all from that period of time. Even their conversations remained in this period. The outcome? Reliving that time period impacted the mindset in which they viewed themselves – i.e. they were able to get in touch with their more vibrant and youthful selves.

The physical impact of that change in mindset appeared to have a direct effect as noted above. In a similar fashion Langer is attempting to bring a positive mindset to breast cancer patients by once again creating an environment that will have them think differently about themselves and their condition. As Langer describes it, even the very diagnosis of the illness appears to cause a mindset that brings on the symptoms the patient expects to feel. “You change a word here or there, and you get vastly different results”.

Now, even though I believe there is some truth is all this, I also know that in the long run, no matter what we do, we will not overcome death and disease. Still, the question it brings up for me is twofold: can our mindset actually prevent us from dying prematurely and during that extended period can we maintain a good quality of life? There are a lot of books out there about the power of our words and how those words affect how we view ourselves, resulting in habits, actions and quality (or lack of) of life. But how much of this is anecdotal and how much is scientifically proven? Nonetheless, I like the sound of it. It resonates with my own life experiences and I was consequently happy to learn about Langer’s work.

So what about us caregivers? 

Most of us who end up caregiving are not psychologists, doctors or professionals in the caregiving industry, yet we become involved in a dynamic with another individual that can be highly complex and overwhelming. At times it’s very simple because the love and care we feel comes easily and genuinely. That love guides many of our actions. But there are so many variables caring for someone that it’s easy to feel way out of our depth.  To do the smallest thing like roll someone over on the bed, can be terrifying when you don’t know what you are doing. But here is a whole other aspect, namely the psychological side of what’s going on. Add on top of that times when your loved one is delirious or unable to think straight and you’ve got some serious challenges in being assured you are responding in the best way.

But it’s not only us, what about those professionals who interact with our loved ones such as doctors, hospice and hospital nurses and aids?  I really loved the hospice nurses who came over to care for Kris but I noticed that their psychology varied. Some were more sensitive to what was said around Kris, others weren’t. Some brought up language in her presence that assumed death, others refrained. Those conversations that assumed death made me very uncomfortable. Not because I couldn’t handle it, but I was worried about how it was affecting Kris.

On one hand I see there is value in being realistic, but on the other hand I wonder how our “realism” affects the recipient?  I have met people who have overcome amazing odds. A friend in Florida was diagnosed with cancer and was told she didn’t have long. She mostly ignored it and went on living happily for another 15 years. Yes, this may be an anomaly, but it also makes me wonder about the toll our mindset has on our health and well being.

When Kris found out that the targeted chemo didn’t work on her secondary liver cancer and that the lesions had doubled in size, it felt like a death sentence was issued. Even the doctors said it wasn’t worth doing anything at that point. We both cried. It was like entering a world where hope was no longer valid.  I find it chilling that from that day onward her deterioration seemed to really kick in and escalate. Sure maybe it would have been the same even if she hadn’t received the results of her test, but I’ll never know.

Does caregiving only encompass making the person comfortable?  Or is there another aspect to this in which our words and mindsets play a bigger role than we think? I don’t profess to know the definitive answer to this, but I will certainly keep my eye on the work of Dr. Ellen Langer.

What are your thoughts on this subject? I’d love to know.

Here are a couple of Dr. Langer’s books:

Counterclockwise: Mindful Health and the Power of Possibility

Mindfulness