Don’t Go It Alone: Illness and Connectedness

I’m the only one in my family with a green thumb. I’ve got foster plants from almost every relative, which I’ve nursed back from the vegetative graveyard, and they’ve taken over my house. My husband is quite tolerant of it, given that they infringe on every reading space he tries to carve out for myself. My daughter is somewhat less so, as she calls one of them Audrey II and occasionally, when I’m least expecting it, speaks in its voice, calling out, “Feed me, Seymour!” It’s a bit startling each time.

I always intuitively thought tending to plants was good for people, although I’ve had little success in getting my cancer patients to adopt my Where The Wild Things Are-like menagerie. Seems I should have pushed harder.

Doctor’s Ellen Langer and Judith Rodin, two social psychologists now at Harvard and Yale, arranged a study in a nursing home where some residents were encouraged to make more decisions for themselves. As a part of that self-determination, the more decisive group and the control group were each given a plant, but the first group was put in charge of it–they decided where it should go, when it should be watered–and then followed up on those decisions. The second group was also given a plant, but told it was just for their pleasure; the staff took charge of it.  A touch of green–and increased oxygen–couldn’t hurt anyone.

In their paper, “The effects of choice and enhanced personal responsibility for the aged: A field experiment in an institutional setting,” published in the August 1976 volume of the Journal of Personality and Social Psychology, Rodin and Langer found that after a year and a half, the two groups differed dramatically in how many people had died.

The decision-makers and plant-provisioners died at about half the usual rate of those in the nursing home, and of the control group.

Of course the issue of the locus control was paramount, but as a secondary point it seems clear that those who cared for their plant felt needed by the plant and bonded with it–in fact, they felt connected to the plant, and that connectedness was enough to, as a group, change their mortality patterns.

Let’s step up to connection with more communicative creatures. Note a study published by Friedmann and Thomas in the December 1995 issue of the American Journal of Cardiology entitled “Pet ownership, social support, and one-year survival after acute myocardial infarction in the Cardiac Arrythmia Suppression Trial (CAST).”

They studied a group of heart attack patients, comparing those who owned dogs with those who did not, and found that the pet-owners did significantly better than their non-dog-owning counterparts. In fact, it seemed, dog owners were six times more likely to survive an additional year than patients who didn’t have dogs.

Now, not to be the world’s biggest critic, but I can think of a couple reasons right off the bat that would explain the difference by other causes. There’s the fact that dog-owners may very likely have walked more, as required by their pet–or that, knowing the physical requirements of owning a dog, healthier patients self-selected ownership to begin with.

But every research study has its quirks, and its hard to argue with results: Dog? Check. More likely to live an additional year.

Jon Kabat-Zinn, Professor of Medicine Emeritus and founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School, notes in his book Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, “When you feel connected to something, that connection immediately gives you a purpose for living. Relationship itself gives meaning to life.”

Now here’s no great leap of imagination: If owning a mongrel or tending to a potted plant increases health–just think what interpersonal connection can do for you.

The statistics on the life span of marrieds vs. unmarrieds is just one surprising example. Although father-in-law claimed his wife would drive him to his grave (she did survive him by over a decade), turns out that, according to David Roelfs, assistant professor of sociology at the University of Louisville, Ky, and his research team, published in last year’s American Journal of Epidemiology, singles kick off about 10 years earlier than their married counterparts. [Although, of course, they spend considerably less time fighting over who gets the shower in the morning, so maybe they make up a few months that way.]

And psychologist Julianne Holt-Lunstad, from Bringham Young University, led a study with shocking results.  Her team conducted a meta-analysis [didn’t I say no blog was complete without that term? It makes me feel so erudite.] of studies that examine social relationships and their effects on health. They looked at 148 studies that covered more than 308,000 people for their analysis, published as “Social Relationships and Mortality Risk: A Meta-analytic Review.”  And what did they find? Sit down for this:

People with strong social relationships marriage, contacts with extended family, church membership, other group involvement) were 50 percent less likely to die early than people without such support.

Holt-Lunstad claimed a lack of social relationships was “equivalent to smoking up to 15 cigarettes a day” or being an alcoholic, and was twice as harmful as obesity.

Specific to cancer patients,  an article in the June 2008 edition of Psycho-Oncology entitled “Improving the health and well-being of cancer survivors: past as prologue,” takes the beneficial effects of social connectedness on the illness as a given. The author concludes, “We have learned about how the health, well-being, and ultimate survival of cancer patients is improved by social support and social networks. . .  These resources at the individual level, such as one’s perception of social and emotional support, at the level of one’s social ties with family and friends, and at the community level appear to improve survival across disease conditions including cancer.”

And here’s one, perhaps most astonishing of all. In an absolutely fascinating study led by Suzanne D. Conzen, MD, associate professor of medicine at the University of Chicago,  published in September, 2009, in Cancer Prevention Research, Conzen and her team found, using mice as models to study human breast cancer, that isolation is actually connected to altered gene expression in mouse mammary glands, and this changes lead to increased tumor growth.

Before I make my pitch, I want to say that I know. I know that cancer patients already tend to feel isolated, isolated by how their illness makes them difference, by the withdrawal of friends, by changes in their sex lives, by feeling less attractive, by soreness, swelling, nausea, headaches–the list goes on and on.

But what we know for sure is that connectedness makes a difference. If you can continue to resist withdrawing into isolation, you will have made a significant move not just for your mental, but for your physical well-being as well.

What’s the proper dose?  How much connectedness do we need to make a difference? Well, Dr. James Lynch from the University of Maryland found in his studies that even the mere presence of another person can calm cardiac physiology and reactivity in an intensive care unit.

If, when you feel so ill, you don’t have the energy for actively engaging in social interaction, can you snuggle with your pets? Take care of your plants? Or even just let someone sit with you, quietly, while you recuperate? It just might make all the difference.

Addenda:
Check out http://alternativecancerresources.com/page27.html about the importance of establishing and maintaining your social network. This quote leapt out at me: “There is overwhelming evidence that people who have few social contacts are more likely to get sick and less likely to recover from an illness,” says Erik Peper, Ph.D., Associate Director of the Institute of Holistic Healing Studies at San Francisco State University. People with the fewest social ties are two to three times more likely to die of all causes than those with the most social connectedness.

Take a look at “Sometimes Four Paws and a Tail Are the Best Medicine” on how pets can make a radical difference, particularly for senior citizens.

Read 4 Reasons Twitter Is a Great Health Resource by Jackie Fox, which addresses how the e-media serve as forms of connectedness now thought possible only a couple decades ago. She makes excellent points for Twitter-usage in her piece–they should pay her for advertising!