Book Review

The Cure Within: A History of Mind–Body Medicine

N Engl J Med 2008; 359:440July 24, 2008

Article

The Cure Within: A History of Mind–Body Medicine
By Anne Harrington. 336 pp., illustrated. New York, W.W. Norton, 2008. $25.95. ISBN: 978-0-393-06563-3

Thirty years of practice have finally convinced me that the mind and body are indeed connected. As this fascinating book explains, the idea of these connections goes back a long way. The author, Anne Harrington, a historian of science, attempts to answer these questions: “Where do these stories of mind–body illness and mind–body healing come from? What is their relationship both to modern medicine on the one side and traditional religious and folk stories about illness on the other? What can their prominence in our culture today teach us about our own imperfectly secularized experiences of illness, the curious ways in which we navigate a path between science and sense-making in our own time?”

Harrington explains that there are three medicocultural approaches to the central question of why we fall ill. The first, termed the physicalist approach, reflects “a belief that physical symptoms of illness have physical causes.” But when people seek out the “meaning” of their illnesses, they look to the second approach, what Harrington calls the narrative of their malady, to help make some sense out of it. Her book, however, is not primarily about either of these two schools of thought but rather examines the history of how the third approach to understanding illness developed. This approach suggests “that there is more to physical illness than can be seen just in the body; and more to healing than can be found in just pills and shots.” Harrington goes on to explain, “Mind matters too: how one thinks, how one feels, what kind of personality or character one has or cultivates. `Why me? Why now? What next?' are not meaningless after all, but exactly the right questions — and for medical and scientific reasons, not just moral and existential ones.”

After discussions of Franz Anton Mesmer's idea of “animal magnetism,” a force that Mesmer claimed to have observed in his patients and that he believed could be recharged to help in the healing of physical illness, Harrington describes the work of Jean-Martin Charcot and Sigmund Freud and the concept of “shell-shock,” especially as defined in World War I. She then expands on the related concepts of “stress” and “psychosomatic” medicine formulated by Franz Alexander and Hans Selye in the 1950s.

I found the material discussed in chapter 6, “Eastward Journeys,” to be very interesting. The book's historical approach helped me make sense of where we find ourselves today. For example, Harrington's analysis of why so many physicians are attracted to traditional Chinese medicine is intriguing. There are many influences at work — both cultural and political — and they can affect our medical worldviews, often without our being aware of them. According to Harrington, the “Great Helmsman” Mao Tse-Tung had an explicit and significant role in stirring the interest of Western physicians in Chinese medicine. In the 1950s, he made a concerted effort to reduce his country's dependence on the Soviet Union, which up until then had trained most of China's physicians. Mao's support for the idea for the “barefoot doctor” was intended to reduce this reliance. From there it was but a short jump to the ancient tradition of acupuncture and some of the less impressive results of treatment with Chinese herbs and plants and the movement of an invisible life force called qi. And from there we have arrived at modern variants of complementary and alternative medicine.

This story, like history itself, is hardly over. We are still in its midst. As Harrington points out, like the mind and body, which so closely influence each other, “the stories of mind–body medicine do not merely describe experience and behaviors that are given in the world; they also help create behaviors and experiences that had not previously been there.”

A. Mark Clarfield, M.D.
Ben-Gurion University of the Negev, 84101 Beer-Sheva, Israel
markclar@bgu.ac.il