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Unlocking the Secrets of Mind-Body Medicine: An Interview with Dr. Bernie Siegel

Bernie S. Siegel, M.D., helped to create a revolution in modern medicine. He is the author of Love, Medicine, and Miracles, the groundbreaking best-selling book that sold more than two million copies and went to number one on the New York Times bestseller list.

In his practice as a general and pediatric surgeon, Dr. Siegel began recognizing common personality characteristics in those patients who did well and those who didn’t. Studying these personality patterns helped Dr. Siegel to understand the important role that thoughts and emotions play in our health, and he began incorporating what he learned into how he treated his patients. In so doing, he helped to create a paradigm shift in  clinical medicine that paved the way for what is now commonly known as mind-body medicine.

Dr. Bernie Siegel

Dr. Siegel earned a medical doctorate from Cornell Medical College, and he received his surgical training at Yale University. In 1978, Dr. Siegel and his wife Bobbie founded the Exceptional Cancer Patients (ECaP) program in New Haven, Connecticut. This highly regarded and successful program—which incorporates a combination of group and individual therapy—is based upon what Dr. Siegel calls “carefrontation” or “a loving, safe, therapeutic confrontation that facilitates personal change, empowerment, and healing.”

Dr. Siegel’s book Love, Medicine, and Miracles was published in 1986. As a result of this book’s enormous popularity, Dr. Siegel appeared on numerous television shows, including Oprah, Donahue, and 20/20. Some of Dr. Siegel’s other books include Peace, Love and Healing, How to Live Between Office Visits, Prescriptions for Living, and 365 Prescriptions for the Soul. Dr. Siegel also produced a series of popular audio cassettes, including Meditations for Enhancing Your Immune System, and Humor and Healing.

Since retiring from clinical practice in 1989, Dr. Siegel has focused his energies on humanizing medical care and medical education. He is especially interested in teaching other health care professionals about how the mind-body connection affects health. Dr. Siegel travels extensively to speak and lead workshops. He recently completed a new children’s book, and is working on a book about how dreams and drawings can be used to reveal the somatic aspects of disease and treatment. To find out more about Dr. Siegel’s work visit his Web site: www.ecap-online.org

I found Dr. Siegel to be extremely warm and charismatic. He’s very funny and playful, curious and open-minded, and I immediately felt comfortable with him. We spoke about how beliefs and emotions affect our health, how dreams might offer insights and clues as to how to treat a particular illness, what he thinks needs to be done to help improve the Western medical profession, and he offered a few prescriptions for how to slow down or reverse the aging process.

Q: Can you talk a little about how you think our thoughts and beliefs effect the health of our bodies?

Dr. Siegel: You can’t separate thoughts and beliefs from your body. In other words, what you think, and what you believe, literally change your body chemistry. So if you have a pessimistic, hopeless outlook, yeah you’ll change your body, your immune function, and you can die a lot faster. I have literally seen this. I hear these stories from people, when someone’s hope is taken away. Let’s say they’re told they have a few months to live, but they can go home, climb into bed, and be dead in a week. So it’s really like turning off the “live switches”. When you study survivors you find that relationships, connections, hope and meaning all relate to people staying alive. For instance, just on simple terms, women live longer than men with the same cancers, and this has more to do with the men’s attitude. I can’t work, and what’s the point of living? And the women see all the connections in their family, and reasons for being here.

So, as I say, your thoughts, beliefs, all relate to the health of your body, and many doctors literally can kill people with their words, or in a sense, heal them and cure them with words and give them hope. This was something that I got into years ago, and everybody would yell at me, oh you’re giving false hope. But hope can’t be false (laughter). If you have hope, it’s real. So there’s no such thing as false hope. What they’re talking about is, you’re supposed to tell people what day they’re going to die. But who knows that? If the statistics say there’s six month survival that doesn’t mean there aren’t people walking around ten years later, you see, who had that disease, and some who died in a week. So you’re coming up with an average. But individuals are not effected by an average. Yes, I might use it to make therapeutic choices.

If something can improve your chances of surviving, you’d say, okay, let’s have an operation, let me have chemotherapy, whatever—but it doesn’t say where you’ll be next year or five years from now.

Q: What are some of the personality characteristics that exceptional cancer patients have?

Dr. Siegel: In a broad perspective, I’d say that they express their emotion, including appropriate anger. They seek knowledge, and they combine the knowledge with their willingness to take action, so that the inspiration and the information go together. I’m always saying knowledge isn’t power if you don’t have inspiration. Let me put it simply, you don’t smoke because you’re stupid, okay. You know it isn’t good for you, but you do it anyway. So when the inspiration and the meaning come into your life, then you might put the cigarette out. And last but not least, they have a spiritual support basis. Now this is not about religion or theology as much as it is faith that a god, or a support, is out there. It’s not about being punished for breaking the rules of your religion, but rather a constant support.

In terms of specific questions to help determine who will be a long-term survivor, Dr. George Solomon, a psychiatrist, came up with the following questions when AIDS first broke out. Briefly, the questions he used are:
Do you have a sense of meaning in your life? Are you able to express anger appropriately? Can you ask for help from friends and family when you need it? Can you say no when someone asks you to do something you don’t want to do? Are you in charge of what is prescribed for you versus letting others tell you what to do? In other words, you make the decisions.

Do you have enough play in your life? I define play as things that make you lose track of time, that become very meaningful and healthy for you.
Do you use your emotions and feelings to help guide you and direct you?
Or do you become depressed about being depressed, and just have a downward spiral, and are you living a role in your life to the detriment of your own needs? See, because some people give up their lives to please everybody else, and then when they learn they have a life-threatening illness they stop doing what others wanted them to do, and start living their own life. And my way of saying it is, how would you introduce yourself to God? It isn’t about whether you have kids, a job, or whatever. It’s about identifying with that divine source, that you’re made of the same thing.

Q: What are some of the suggestions that you would make to help improve the Western medical profession?

Dr. Siegel: (laughter) One simple suggestion would be to put every doctor into a hospital bed for a week as a patient. Put them in a hospital where they are not known, and have them admitted with a life-threatening illness as their diagnosis. Then let them stay there. Another suggestion is to teach doctors how to communicate. If you take the word "words", as one of our children did in an art project, and repeat it, with no space between the words, you realize that words become "wordswordswordswords." Just today I got a phone call from somebody who was waking from surgery and being told how bad things were. From the minute that she woke up they started telling her how terrible her diagnosis was and what’s going to happen to her. That really destroys the patient. Most doctors aren’t aware of what they’re doing, because they haven’t been lying in that bed.

So many doctors think differently after they get sick, or after their loved ones get sick. Then they say, whoops, it’s not a diagnosis, it’s an experience. And, again, that’s what I try to teach doctors—people are living an experience. They’re not living a diagnosis. You have to deal with the person and their life, and what they’re going through.

Those are the things that I think we should work on in our training—how to deal with our emotions and how to express them—and not just have meetings about “what do you think?” and “how do we classify this death or complication?” Rather, we would discuss how it feels to have a patient that you’re taking care of die, or what it feels like to have someone come into your office that you can’t cure. I mean, we can’t even use the word death. You go to a hospital, and everybody talks about “failures”, “passing”, and “loss”, and nobody says so-and-so died, because that word just carries too much emotion for people.

See, what changed me was a patient saying, “I need to know how to live between office visits.” That’s what doctors have to do. The word “doctor” is derived from the word “teacher”, and we have stopped teaching people how to live. Doctors of the past did, because they didn’t have all this technology, and they had to care for people that they also knew. Today we don’t even know the patients we’re taking care of. That’s why there are all these mistakes in the operating room, and all these medical errors—because we’re taking care of diseases, room numbers, and diagnoses, and not people. So that’s important.

Q: How do you think dreams can offer insight into the symbolic meaning of one’s illness and help us to heal?

Dr. Siegel: I often ask the question, why do we sleep? I was just reading a magazine called Cerebrum, and I notice other scientists are beginning to ask that too. Why do we sleep? Why does our body have a rhythm? It’s called our circadian rhythm, so that we’re active and awake in the day, and then we quiet down and go to bed at night. You can throw away clocks and people still live that way.

To me dreams represent what I call the universal language, how creation or God speaks to us through universal symbols. My true sense is that one of the reasons we sleep is to allow ourselves to be in touch with this inner wisdom and knowledge that present themselves to us through dreams.

I use drawings literally to communicate with lots of people, and help them make decisions, because then they can put the symbols on a piece of paper which are largely coming from their unconscious. I say to people, draw yourself—like I mentioned I did with doctors, asking them to draw themselves at work. Those are simple instructions and a hundred people hear the same thing, but you get a hundred different images, because it’s coming from an intuitive place within them. Then we can interpret the drawings, and interpret the dreams, and help them be in touch with that.

But it really is fascinating to me because most living things don’t sleep. I didn’t know that, but most animals don’t sleep. When you think about it, a fish can’t go to sleep, and I learned that horses sleep on their feet because they’re afraid of predators. When you think about it, sleeping is a dangerous thing. We lock ourselves in houses and have alarm systems now, so we’re safer, but why should we do it in the first place? I’d say yes, it lets our body rest. I think there are certain physical parts of our body that need to rest. As a matter of fact in some studies chemotherapy was far more effective, and the side effects markedly reduced, when given at night while the body rested but the cancer cells didn't. But I think also, while they’re quiet, there’s this other wisdom that comes forward.

Here’s the reason I call it a wisdom. There are people whose intellect tells them—don’t have an operation. Don’t have chemotherapy. Don’t this, don’t that, and they may make a decision that comes from their intellect. Then the drawing that they do will show them that the decision is wrong. Again, it’s their inner wisdom—intuitive wisdom, heart wisdom, whatever you want to call it—saying yes or no, this is good or not good for you. And believe me, that other wisdom knows more.

Drawings can answer all kinds of questions, like where should I live? Or what job should I take? It doesn’t have to be about medicine.

So I help them to either change their belief systems, their ways of thinking, or I help them make different decisions, and to try to help them put these two things together. At other times people will say no, I don’t want that, and the drawing will be beautiful. I say your inner wisdom knows it’s good for you and I suggest you go and do it, and don’t worry about it, and I show them how to reprogram themselves and their bodies. So it helps them find a harmony through that. But the trouble is most of us are busy thinking, and we forget how to use this inner wisdom, which comes from the body, from feelings, as well as this intuitive aspect.

Q: What do you mean when you say that a disease is more than “just a clinical entity; it is an experience and a metaphor, with a message that must be listened to”?

Dr. Siegel: It’s easiest just to give you examples, and these aren’t necessarily all about life-threatening illness. One is a lady with cancer who said that her disease is a failure after I asked her what it was like to experience the cancer? She had been yelling at her doctor for making her ugly with a scar—yet the incision was in her upper thigh, and nobody even knew it was there, unless she was wearing a bathing suit. So her physician said to me, “it’s something more, maybe you can talk to her and figure this out.”

When she came in I said, how would you describe what you’re experiencing? She said, it’s a failure. I said, how does failure fit your life? See, that’s my question then. And her first answer was, oh my body failed. I said no, you’re not answering my question. I said, how does failure fit your life? And she said, “oh, my parents committed suicide when I was a child, so I must have been a failure as a child.”

Then her life poured out. See, what she had decided was not to ever develop a relationship with anybody because it’s just going to hurt her again, like her parents did to her. So she’s living a life of pain because of that childhood experience, and then, because of the cancer, and that word, she changed totally. She set out to change herself and her entire life, and stop being afraid of the world, relationships, and everything else.

Another was a lady with a severe migraine headache that was being sent to the hospital because she was vomiting and in pain. I was in another doctor’s office while she was there, so I walked over to talk to her for a minute. She was lying in a room with all the lights out. I walked over and said, “How would you describe your headache?” She said, “It’s a burden.” And I thought, that’s a weird word for pain. So I worked with her on burdens. She wasn’t my patient, so I didn’t plunge into her life, but we talked about burdens, and how you can deal with them and live with them. After about fifteen minutes I left her. Then the nurse walked in a few minutes later to tell me that her pain was gone and she’s going home. And by the way—the burden’s her marriage. (laughter)

When I asked a woman with a urinary tract infection how she would describe it, she laughed and said, “Oh, it’s very draining.” Then she looked at me and said, “Okay, thank you,” and walked away. See, she knew that she’s has to deal with all the things that are draining her.
So for some people it becomes very obvious, and they look at me and say, thank you. For others, yes, you can help them a little bit to define what that word means in their life and why. As a matter of fact, I just received an e-mail from a friend of mine who’s having problems, and one of the things that he said to describe the situation was that he felt like he was hitting his head against the wall. So I said, okay, let’s look at the barriers in your life that you’re banging your head against.

People send me pictures, and these descriptions, and they say, okay, What does it mean? How can you help me? Then I ask them to think about why they use these expressions, and how it applies to their life. I also use this process in my own life.

I was once training for a marathon. I was really doing a lot of running in hot weather, and I began to have dizzy spells, particularly in the morning. It became just so hard to get out of bed. So I said, “Hey, what would I ask a patient? How would I describe this?” And I said, “The world is spinning around.” Then I said, “Yep, right. Slow down (laughter). It was very obvious to me that my body was trying to keep me in bed and get me to rest, and I’m out there pushing, pushing, pushing. So yeah, I listen to those words myself.

Q: What do you think are currently the best ways for a healthy person to slow down, or reverse the aging process and extend their life span?

Dr. Siegel: I think if you want to reverse the aging process, the number one thing that every doctor agrees upon is to exercise. Keep moving and keep active. Also, have some meaning in your life. What I find particularly helpful is to not think of yourself as an age. Don’t let the child in you die. See things through the child’s eyes, and it just makes life interesting and humorous.

I mean, I’m a real character. What I mean by that is, if I see a contract that says “sign here”, I write “here” on it (laughter). See, that’s the kid in me. Every time I see a sign that says “Depressed Drains”, I say let’s stop and try to cheer up the drain. (laughter) It’s this little kid inside that keeps me laughing and seeing the world differently. I think when you do that you don’t age. Studies have shown that if you live in an environment that you lived in twenty years ago you feel younger. In other words, if I took and secluded you, and only gave you newspapers, movies and media from twenty years ago, you’d come out feeling younger, and healthier if I examined you.

So those are things people need to do. To keep the child alive, and not say I’m a certain age, I’m getting older. No, do what you feel like doing. Keep yourself active and moving, and again, have meaning, connections, and relationships. You’ll stay alive a lot longer. Studies have shown this. I can give you a plant to take care of, and you’ll live longer than somebody across the hall from you in a nursing home to whom I say, I’m putting a plant in your room to decorate it, and then I’ll take care of it. But if I go in and say, here’s a plant, you’re to see it gets sunshine and water it regularly, you end up living longer and being healthier than the person across the hall.

A study in Australia that was written up a few months ago in the paper showed that if you went home to a dog after your heart attack you had a six percent mortality rate that year . If you went home without a dog it would be closer to thirty percent. You say, what has a dog got to do with it? Again, it’s the relationship. The connection may be taking the dog for a walk, or whatever, but it means something to you. So those are the things I would say. Find meaning. Keep the child in you alive. Keep moving. Keep thinking. Be creative. Experiment. Do different things. It just goes on and on, and I could give you pages and pages, but I think it’s just those basic things that get you started.

Q: How do you envision the future of medicine?

Dr. Siegel: I think that it needs to be a combination of things. The technology is important, I would never deny that. There are people alive today because of science and what we are able to do, like transplanting organs. But at the same time, you have the awe and the wonder of somebody awakening with a transplanted organ, and then having memories of the other person’s life. So it’s combining the practical and the technological with the mysterious and the meaningful. Quantum physicists and astronomers, I think, understand this better than doctors, because they are living with uncertainty, and the wonder and the awe of creation. So they’re in a very different place, and I always enjoy speaking to them. Doctors also need to find that place, so that they are contributing to each person’s life that they see in some practical way, as well as in some spiritual way. They need to be open minded and in awe of the human body.

I also think that doctors need to allow their patients to heal them, and give them something back. One woman used the term “mutual investment society,” and maybe this is the best description of the future of medicine. She said, “It ought to be a mutual investment society, so you are invested in the doctor and the doctor’s invested in you.”

When people ask me how to find a good doctor I often say to them, find one who is criticized by family, patients, and nurses—because they’re listening and learning from the criticism. See, because what I’ve learned is, if somebody doesn’t listen you stop criticizing them. You just get somebody else or stop talking to them because it’s pointless.

They’re always making excuses and never saying, I'm sorry. So when we become a mutual investment society, and each of us is teaching the other, then the natives and the tourists help teach each other. Patients are the natives, doctors are the tourists. We have to understand each other’s land, as well as what we’re living and going through.

David Jay Brown is the author of four volumes of interviews with leading-edge thinkers, Mavericks of the Mind, Voices from the Edge, Conversations on the Edge of the Apocalypse, and Mavericks of Medicine. (Mavericks of Medicine will be published by Smart Publications as a book in late 2006.) He is also the author of two science fiction novels, Brainchild and Virus. David holds a master’s degree in psychobiology from New York University, and was responsible for the California-based research in two of British biologist Rupert Sheldrake’s bestselling books on unexplained phenomena in science: Dogs That Know When Their Owners Are Coming Home and The Sense of Being Stared At. To find out more about David’s work visit his award-winning web site: www.mavericksofthemind.com.