What's love got to do with it?

(Dean Ornish, heart specialist, finds
that heart disease is reversible
without the use of drugs)(Interview)

By Suzanne Gerber
Vegetarian Times
March, 1998

Twenty years ago, when Dean Ornish,
M.D., first began to research the
effects of a vegetarian diet, yog
and meditation on heart disease, many
of his peers thought he was a little
crazy. "For at least 10 years, I took
a lot of flack for even thinking
these things were worth
investigating," he recalls. Back
then, in the late 1970s, the U.S.
government and the major medical
institutions that funded most
clinical studies firmly held the
position that it was impossible to
reverse heart disease. Even if it
were possible, they argued, you could
not motivate people enough to change
their diet and lifestyle to the
necessary degree. "It was a Catch-
22," says Ornish. "Without the
funding, we couldn't do the studies
to see if it was possible, and
without showing that it was feasible,
they didn't want to fund it. But I
believed it was worth trying and had
blind faith that we'd raise the
money." Eventually Ornish not only
found the money, he proved for the
first time that heart disease is, in
fact, often reversible, without drugs
or surgery.

Today Ornish has gone from fringe to
mainstream: The federal government's
National Institutes of Health has
funded his work; most cardiologists
are familiar with and supportive of
his work; some 40 health insurance
companies reimburse patients on his
program; and even ultraconservative
Medicare is analyzing his program for
possible future coverage. In 1984, he
founded the nonprofit Preventive
Medicine Research Institute in
Sausalito, Calif., where he holds the
Bucksbaum Chair in Preventive
Medicine. A vegetarian for 25 years,
he also is a clinical professor of
medicine at the University of
California, San Francisco's medical
school, where he is a founder of the
Center for Integrative Medicine.
Ornish is a physician consultant to
President Clinton, the recipient of
numerous national and inter national
awards and, according to Life
magazine, one of the 50 most
influential people of his generation.

Up until now, Ornish's published
works (scores of medical journal
article and four books, including Dr.
Dean Ornish's Program for Reversing
Heart Disease and Everyday Cooking
with Dr. Dean Ornish) have focused on
reversing and preventing heart
disease. But this month he publishes
his fifth book, Love & Survival The
Scientific Basis for the Healing
Power Intimacy (HarperCollins, 1998),
which looks at the factors that
Ornish believes to be the most
important in premature death and
disease. In conjunction with the
book's release, he also has taped two
hour-long specials for PBS, which
will air later this month. And, to
help people make the transition to
more healthful vegetarian eating,
this month he's launching a new line
of natural food products, called
Advantage\10[TM], which will be
available in most natural food store
and supermarkets.

Vegetarian Times: In your previous
four books, you've established the
role die and lifestyle play in heart
health. How is your new book, Love &
Survival, different

Dean Ornish: The real epidemic isn't
just physical heart disease--it's
what I call emotional or spiritual
heart disease. In our culture,
there's a pervasive sense of
isolation and loneliness and
alienation. The point of Love &
Survival is that isolation is at the
too of behavior patterns that often
lead to a significantly increased
risk of premature death and disease.
Heart health is not just about
getting our cholesterol down or
preventing something bad from
happening. It's about finding love
and intimacy, which give our lives a
sense of joy and meaning.

The premise of this book, and my work
in general, is that whatever promotes
a sense of loneliness and isolation--
from oneself or other people or
something spiritual--predisposes us
to disease and premature death.
Whatever promotes a sense of intimacy
is healing.

VT: What first tipped you off that
love and intimacy might be as
important as diet, stress and
lifestyle?

DO: Throughout my 20 years of
research, support groups have always
been important, but they were
originally designed to help people
stay on the other parts of the
programs--the diet, for example. But
over time, what became clear was that
we ended up creating, almost
unwittingly, an intentional
community, a place where people felt
safe enough to let down their
defenses and talk about what they
were of really feeling and what was
really happening in their lives
without fear of being judged or made
fun of or being given advice on how
to fix it.

For many people, that sense of being
heard and seen and understood was a
new experience. In an early group,
only one man refused to participate
in the group sessions--while everyone
else was talking about what was
happening in their lives, he'd go to
the gym and work out--and he was the
only person in that study to die.
While one person does not prove
anything, his death really got our
attention and made it clear that
group support might be as important
as anything else we were doing--if
not more so. Many people had the
greatest resistance to this part of
the program, and yet once they began
the process, they invariably said it
was the most meaningful because it
filled a basic human need that wasn't
being met in other parts of their
lives.

VT: In the book, you write rather
confessionally about your own
struggles with intimacy. Was that
part of the original plan?

DO: I don't think of it as confession
so much as sharing. It was the most
difficult chapter to write, and I
wasn't sure until the very end that I
was going to include it. It's so
personal, and yet I'm trying to model
in the book what I'm suggesting that
others do.

In my own case, I didn't want to be
completely alone, because that felt
like nonexistence, yet being too
intimate felt overwhelming. My
dilemma wasn't unique; many people
believe they're the only lonely or
depressed ones because it looks like
everyone else has it all together. If
you don't have anybody to talk to
about these issues, it may seem that
way. An integral part of intimacy is
the ability--the willingness--to make
oneself vulnerable. And the more
vulnerable we can make ourselves, the
more intimate we can become.

In our culture, it's often considered
dangerous to be vulnerable because
you can get hurt. I've struggled with
these very issues in learning to open
my own heart and be more intimate. By
"open my heart," I mean letting down
our emotional defenses. It's not that
we shouldn't have emotional defenses-
-you don't want to go into a job
interview and talk about your deepest
secrets--but if you have no one with
whom you feel close enough to do
that, in effect, those walls will
always remain up. And the same walls
that protect you can also isolate
you.

VT: But how can someone who's spent a
lifetime building up those walls
begin to let them down?

DO: The first step in healing is
awareness. So if we understand how
much love, intimacy and a feeling of
connectedness matter, not only in the
quality of our lives but in the
quantity, or the length, of them,
then we can begin saying, "Well, gee,
it may be scary to let down my
emotional defenses, but it's worth
it." And it's important to remember
that this doesn't happen overnight;
it's part of a lifelong process. In
the book, I go into detail about ways
to begin this process: meditation,
compassion, altruism, group support,
commitment, communication skills,
psychotherapy. But the way one goes
about doing this is less important
than understanding what an important
difference love and intimacy make in
our lives. When people really get
that, they begin to find their own
way of incorporating it into their
lives. It's funny how the universe
works in that way. If you're really
hungry, you tend to notice all the
restaurants. If you decide you want
more love and intimacy in your life,
then often spiritual teachers or
emotional resources appear, as does a
willingness to take risks with your
beloved.

Forgiveness is another important
pathway to learning to open our
hearts. It's part of virtually every
religious tradition. Forgiveness
doesn't wipe the slate clean or mean
that all actions are condoned. But it
does free us from the anger, guilt,
stress and fear that separate us from
others and get in the way of true
intimacy. When we can confess our
darkest secrets to another person and
be forgiven, then we can learn to
trust them more and begin the
difficult process of forgiving
ourselves.

VT: How many studies on love and
intimacy do you cite in the book?

DO: Around 200, but there are
thousands out there. There's a vast
and extensive literature that
demonstrates to me beyond question
that people who feel lonely and
isolated and depressed and hostile
have three to five to 10 times the
risk of premature death and disease
from virtually all causes when
compared to those who have love and
connection and community in their
lives. I don't know anything in
medicine--not drugs, not surgery, not
diet, not lifestyle, not genetics--
that has a greater across-the-board
powerful effect. Cholesterol has a
powerful effect on heart disease, for
example, but not on premature-birth
complications.

One of the first studies to really
impress me involved Harvard
undergraduates in the early 1950s who
were simply asked how close they felt
to their mothers and fathers. Then,
35 years later, their medical files
were checked and detailed histories
taken. Those who had said they
weren't close to either parent were
found to have substantially higher
rates of disease--in fact, in this
study, 100 percent had major
illnesses in midlife compared with
only 47 percent of those who felt
close to both parents.

Another study that fascinated me was
done by Dr. David Speigel at Stanford
Medical School and published in 1989.
Originally he had set out to disprove
the notion that psychosocial
interventions, like support groups,
could prolong the lives of women with
breast cancer. In the study, women
with metastatic breast cancer were
randomly divided into two groups:
Both received conventional treatment
(surgery, radiation, chemotherapy),
but one group also took part in a
support group that met for 90
minutes, once a week for a year. Led
by a psychiatrist or social worker
with breast cancer in remission, the
group was encouraged to share their
feelings. Five years later, the women
who'd been in the support group lived
twice as long, on average, as the
women who hadn't been. In fact, none
of those women were alive after five
years.

VT: You write that loneliness is the
leading cause of death in this
country. That's quite a claim.

DO: Yes. That these things matter is
beyond question. Why they matter is a
bit of a mystery. We know they matter
to some degree because on a
behavioral level, people who feel
lonely and depressed and unhappy and
isolated are more prone to smoke and
overeat, drink too much, work too
hard and abuse drugs--such behaviors
help them just get through the day.
Yet even when these factors are
controlled for in studies, people who
feel lonely and isolated have much
higher rates of premature death and
disease from virtually all causes. In
the book, I interview a number of
eminent scientists, healers,
theologians, psychologists and
therapists, each of whom provides a
fascinating perspective on why love
and intimacy matter so much.

VT: How do negative emotions "get
into" the body?

DO: We are constantly learning new
pathways through which chronic
emotional stress leads to illness. In
the case of heart disease, stress can
cause your arteries to constrict, it
can cause your blood to clot faster,
it can make the blockages in your
arteries build up more quickly--all
of which can lead to chest pain or
heart attacks. And yet it's not only
through stress that loneliness and
isolation affect our health and well-
being. A common denominator is
energy. Einstein showed that energy
and matter are interconvertible. The
idea that we are energy systems and
that energy affects our bodies in the
form of matter is a fundamental
concept of most forms of healing yet
not in Western medicine. When you
wall yourself off emotionally, you
may be literally walling yourself off
from the source of energy that other
people are continually exchanging
with each other. It's the life force-
-known as qi (pronounced chee) in
Chinese medicine; kundalini, Prana or
Shakti in yog. There are many things
that even in conventional medicine we
understand play an important role in
disease, even if we don't yet
understand the mechanisms underlying
them. But it's not necessary to
understand them to begin integrating
them into our lives.

VT: What was your goal in writing
this book?

DO: I'm hoping that this book will
raise awareness to the extent that
people will become willing to take
risks and make themselves vulnerable
in order to become more intimate.
Social change happens one person at a
time--it's not something you can
legislate. Any kind of change is
stressful at first. But once you
understand the power of love and
intimacy, then the idea of change
becomes more appealing. Ultimately,
it's not about a fear of dying but
the joy of living. It's easy to make
fun of these ideas and call them
"touchy-feely" or "soft," but in many
ways they are the most powerful and
most healing. And if the book
accomplishes that, even in a small
way, then it will have been worth
doing.

Suzanne Gerber is the senior health
editor of Vegetarian Times.

VT: What was your goal in writing
this book?

DO: I'm hoping that this book will
raise awareness to the extent that
people will become willing to take
risks and make themselves vulnerable
in order to become more intimate.
Social change happens one person at a
time--it's not something you can
legislate. Any kind of change is
stressful at first. But once you
understand the power of love and
intimacy, then the idea of change
becomes more appealing. Ultimately,
it's not about a fear of dying but
the joy of living. It's easy to make
fun of these ideas and call them
"touchy-feely" or "soft," but in many
ways they are the most powerful and
most healing. And if the book
accomplishes that, even in a small
way, then it will have been worth
doing.

Suzanne Gerber is the senior health
editor of Vegetarian Times.

More at:
http://www.findarticles.com/cf_dls/m0820/n247/20380033/p1/article.jhtml

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