Mind how

Can your mental state affect your susceptibility to disease? Anyone who has reddened through embarrassment or lust knows that the mind and body are inextricably linked, but in these days of target-obsessed and dehumanised medicine, we seem to be forgetting how to think ourselves better again.

The specialty of psychoneuroimmunology is gathering evidence of the important role the mind can play in manipulating the body's immune response, but this was common knowledge in the days when doctors observed and listened to patients (rather than stuck them through a body scanner).

As early as 1500BC, Hindus observed that a main cause of tuberculosis was sadness, and in the 17th century, TB was said to be triggered by "a long and grievous passion of the mind". The concept of the tuberculosis-prone personality, spes phthisica, was proposed to explain why it seemed particularly prevalent among artists.

In 1882, Robert Koch discovered the real cause of TB, Mycobacterium tuberculosis, but this failed to explain why some personality types seemed more prone to infection than others. There is evidence too of a "coronary prone personality".

For centuries, doctors proposed that hostility, impatience and naked ambition can take their toll on the heart. In 1910, the physician Sir William Osler wrote: "It is not the delicate neurotic person who is prone to angina, but the robust, the vigorous of mind and body, the keen and ambitious man, the indicator of whose engine is always at full speed ahead."

In 1930, high blood pressure was put down to "repressed hostility and anger" and in the 1950s, two American cardiologists called Friedman and Rosenman set about proving their observation that ambitious, competitive, impatient men were most at risk. Their research found that 28 per cent of these "Type A" men had heart disease compared to four per cent of relaxed "Type Bs".

Another study of Type A men took a random selection and gave them counselling aimed at reducing their hostility and sense of urgency. It halved their risk of a heart attack. And a study by the British Heart Foundation found that meek, gentle women who prefer to give in to others are less likely to have a heart attack than assertive women.

Eat your heart out, Germaine Greer. The evidence is clear. Neurosis, ambition, aggression and hostility are bad for both mind and body. So step back and remember: no one ever said on their deathbed, they wished they'd spent more time preparing for Ofsted

Dr Phil Hammond is a GP and chairman of governors at a primary school in Somerset

If you want to learn more about how the mind affects the body, read The Sickening Mind by Paul Martin (Flamingo) or Why Do People Get Ill? by Darian Leader and David Corfield (Hamish Hamilton)

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