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Depression, isolation and loneliness cause the most suffering in our culture because they spur behaviors that trigger our most deadly diseases, argued heart-health and lifestyle guru Dean Ornish, MD, director of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., in a 2002 APA Annual Convention presentation.

"There are lots of ways we have of bypassing and killing pain, both physical and emotional," said Ornish, a prolific author and researcher who served as physician consultant to President Bill Clinton. "You ask people, 'Why do you smoke? Work too hard? Abuse drugs? Drink? Watch TV?' They say, 'To get through the day.' To many people, getting through the day is more important than their health."

In the end, he said, their unhealthy behaviors cause them to contract more illnesses and die younger than their happier, more socially connected counterparts.

But that needn't be the case, Ornish believes, if people learn ways to ease loneliness and depression. They can do that, he said, by moving from the "I" of illness to the "we" of wellness through intimacy with others and spiritual growth. Tools for such personal transformation include psychotherapy, support groups, meditation, communication training and the like.

"I'm hoping," said Ornish, "that we [in the medical community] can address the emotional and spiritual emptiness that is the real epidemic in this culture, and that we do more of the type of treatment provided by psychologists."

In particular, Ornish pointed to the effectiveness of a holistic "Multicenter Lifestyle Demonstration Project" he created to curb heart disease. The program incorporates stress management--including meditation, relaxation and spirituality--and psychosocial support--such as support groups and psychotherapy--with the more traditional medical tools of diet and exercise. It has produced powerful results: In a recent study (see www. pmri.org/Research_Medicare.html), 80 percent of program participants successfully avoided bypass surgery or angioplasty, for a Medicare savings of more than $30,000 per patient. Medicare is now paying for select patients to participate in the program at hospitals nationwide.

In Ornish's studies, and a number of others, key healing and preventive elements appear to be interpersonal and spiritual support. For example, said Ornish, recent research suggests that people who were close to their parents growing up have fewer midlife illnesses. Other research suggests that men who undergo open-heart surgery have a sevenfold decrease in mortality if they draw strength from religious faith and regularly get together with a group of people, such as a bowling league.

Why do intimacy and spirituality produce such powerful health benefits? Because they help bring down the emotional defenses that foster health-sapping depression and isolation, Ornish believes. "The irony is that the very thing we're doing that we feel is protective may be the very thing that causes us to get sick and die early," he noted. "Many people have nowhere they feel safe enough to trust. [Something like a] support group creates a community where they begin to see how good it feels to do that--to talk about what's really going on in their lives."

Along with social support, meditation also helps patients manage stress and unhappiness and cultivate their spirits, said Ornish. As another speaker--Harvard University mind/body health expert Herbert Benson, MD--noted at the same session, "People feel that it's unAmerican to meditate, that they're wasting time if they're not using every minute."

But, in truth, meditation maximizes our time use, said Ornish, "because it shows us what it's like to be at peace. When you quiet down the mind and body, you can hear your own inner voice...and if you take it far enough into direct experience, there's not only transformation but a transcendence, that on one level you're you and I'm me...but on another level we're all part of something larger that connects us. When we can see the 'I' and the 'we'--that double vision--then I think we can be healed, and often cured, as well."