Show #1310, "Worried Sick"
will premiered June 3, 2003.
Primates' Stress Club
Angry at Heart
To Heal or Not to Heal
THE PRIMATES' STRESS CLUB
ALDA (NARRATION) This is the Masai Mara game reserve
in Kenya -- 700 square miles of rolling grassland,
filled with classic African scenes. When our cameras
came here a few years ago, we were looking for these.
Baboons are all over the Masai Mara. They're smart
and successful primates, with no real enemies -- except
perhaps themselves. In this respect, they're much
like humans. Baboon troops have a lot of rules, which
would have remained known only to baboons if it hadn't
been for a Stanford University biologist, Robert Sapolsky.
In thirty years of study, he's learned not only the
complex rules of baboon social life, but also how
those rules can place many members of the troop under
immense stress. He's now a leading expert in what
stress does -- to animals and humans. OK now don't
be fooled. We've jumped from Africa to the San Francisco
zoo, and these are blackbuck, antelope from India.
Recently I caught up with Robert Sapolsky here, to
find out some of the basics of stress.
ALDA How does an animal like that experience stress?
SAPOLSKY Well, it's your basic sort of crisis in the
savanna there. You're running for your life, something's
coming after you, this is no time to plan for next
winter's growth spurt, no time to reach puberty. It's
no time to repair last week's injury. You mobilize
energy to deliver at whichever muscles are going to
get you across the grasslands there. You increase
your blood pressure so you get the oxygen going there
in two seconds instead of three. So basically you
shut down all the long term projects and you just
divert all your physiology to getting away from that
ALDA When they're stressed because a predator's coming
after them, how long does that tend to last? Might
not they be always attacked by predators? Or is it
really just a few seconds?
SAPOLSKY No. I mean, that's the key difference between
them and us. They are not thinking about predators.
They are not thinking about any long term -- they're
probably not thinking about much of anything, but
that may be sort of my primate bias -- but they're
certainly not having long term psychological stress.
Something happens and it's over with in thirty seconds
or else they're over with. It's very short-term acute
stuff. They're not getting stressed, you know, worrying
about the ozone layer or the rain forests or whatever
is that is psychologically stressful to us. They're
not worrying about the long term stuff.
ALDA Every once in a while, one will pick up its head
and thinks it hears something. And then they'll all
get a little bit like that. And then maybe they'll
take off. Now, in those moments, aren't they going
through some beginning of this process even if there's
nothing really out there bothering them?
SAPOLSKY Oh yeah, absolutely. They're mobilizing...
there's a whole physiology of not yet using all that
energy but getting ready to do it and yeah, they're
probably doing that fifty times a day for five seconds
at a time.
ALDA But the thing is, when they're munching the grass,
before they hear a sound or smell something that alerts
them, they're not having this kind of anxiety thinking
about it, "Even though I'm eating grass, something's
liable to come along any minute now."
SAPOLSKY None of them are sitting there thinking,
"Oh my God, I'm gonna die someday." There's not that
anticipatory sort of angst stuff. They're not sophisticated
enough. They're not cognitively complex enough.
ALDA (NARRATION) All animals -- including us -- have
this "fight or flight" stress response as it's called,
whereby we shut down everything except what we need
to survive. The problem is that big-brained primates
get stressed constantly, by all kinds of things--
like the stock market, or for baboons like competing
for social position. Antelopes, on the other hand,
turn off their stress the moment the danger has passed,
and their physiology comes back into balance.
ALDA You know that they're not in that physiological
state of stress most of the time.
SAPOLSKY And the best way to get a sense of that is
the whole notion, stress-related diseases -- stuff
you get by just turning on the stress response all
the time, all the time. That's a primate invention.
That's an invention of species that are smart enough
to just get themselves sick with psychological nonsense.
They're not up to that level. That's our specialty.
ALDA Boy, are we lucky. We got it...
SAPOLSKY What a deal. What a deal we got there with
that cortex of ours.
ALDA (NARRATION) Here's an example of baboon psychological
nonsense, as Sapolsky calls it. The guy on the left
is very worried. He knows he'll lose a fight, but
it's a purely psychological clash, humiliating and
stressful for the loser. Sapolsky sees baboons play
out these kinds of mind games all the time. Sapolsky's
been able to match up his knowledge of individual
baboons' psychological stress with what's happening
in their bodies. In blood samples, analyzed in the
field, he measures the stress hormones that trigger
the fight or flight response. They should be present
only briefly, but in psychologically stressed baboons
they can be there over the long term, with serious
ALDA When a baboon is under stress and it's this kind
of this long term thing, similar to what we go through,
what's the baboon going through physiologically?
SAPOLSKY Bad news. I mean, you go back to the antelope
running away from the tiger. You mobilize energy to
power your leg muscles to get you across the savanna.
Instead, you're sitting there for hours each day thinking
about that scary guy on the other side the field,
or the mortgage payment due at the end of this month.
Chronically, you mobilize energy. You don't store
it. Your body wastes a lot of it. There's a bunch
of metabolic diseases you're more likely to get. You're
that antelope running for your life. You increase
your blood pressure and deliver the oxygen, glucose
in two seconds, blah, blah. Do that chronically and
what you're suffering from is high blood pressure.
You're that antelope short term. You shut down, digestion,
growth, reproduction, immunity, tissue repair, all
of that -- no problem, do all that stuff 30 minutes
from now when it's all over with; do it chronically
like a psychologically stressed primate, you get ulcers,
you get colitis, you get reproductive problems, your
immune system doesn't work as well, you get more infectious
diseases. And those same stress hormones which, short-term,
can make you think more clearly, alertly, a very good
thing for that ten-second sprint -- do it chronically
and they can be, in fact, very damaging to the nervous
ALDA (NARRATION) In the rest of the program we're
going to look more closely at some of the ways stress
can undermine health, and we'll also see if there's
anything we can do about it.
ALDA (NARRATION) We're at Wake Forest medical school
in North Carolina, in the lab of Jay Kaplan.
KAPLAN Who do you think is dominant in that pen?
Oh, I'd say--.
ALDA (NARRATION) Kaplan has conducted a series of
experiments that shed some light on the interactions
among personality, stress and heart disease. His subjects
are macaque monkeys. In the wild macaques, like baboons,
live in large groups filled with competition and contention.
Social hierarchies are established, with dominant
and subordinate animals.
KAPLAN If I look in this pen now, I see the two monkeys
on the right who look to be sitting exactly where
they want to be sitting. One of them is now threatening
three monkeys who are huddled off on the upper left
hanging off the bars which is a less preferred position.
So I would say that these two guys are the dominant
monkeys in this group and the other three are more
subordinate, just by the nature of the way they are
using the space in here.
ALDA (NARRATION) The relationships the monkeys establish
are not an accident. They are determined by interactions
of their personalities. Some are just naturally more
aggressive, and they come to dominate. Primate personalities
are stable over the long term, as Robert Sapolsky
discovered with his baboons. Personality is the key
to understanding their lives, he says.
ALDA Does a difference in personality have something
to do with how well they're able to handle stress
or how much stress they experience?
SAPOLSKY Yeah. Absolutely. Sort of my initial assumption
that I sort of squandered my first 15 years on with
them was dominance rank. That's the thing. If you're
a low-ranking baboon you're gonna have the stress-related
diseases. And what I've learned since then is, yeah,
rank's important. Far more important is what sort
of society you have that rank in. Is it a troop that
treats its low-ranking animals miserably? Is it a
troop whose hierarchy is unstable? Those are both
much more stressful situations. And then even more
important than your rank in the sort of society in
which it occurs is your personality. Which is basically
saying, What's your filters with which you see the
world around you? And that's the single-biggest predictor.
You look at a single question, How often -- if you're
a male baboon -- How often do you sit there, in contact
with another baboon, grooming another baboon, being
groomed back? Get sort of an aggregate measure of
that, a sociality score, and that's the single strongest
predictor I have ever found of stress hormone levels
in these animals.
ALDA (NARRATION) In the macaque monkey experiments,
the kind of social complexity which macaques and baboons
show in the wild has been stripped away.
Go on, go on.
ALDA (NARRATION) Here a group of five males, all strangers
to each other, are placed together. They immediately
set about establishing who's dominant, and who's subordinate.
Macaques do exactly this in the wild, but here everything's
exaggerated. Groups are unnaturally small, and their
members are switched often, so here complex social
relationships aren't as important as just the relative
aggressiveness of the personalities. This is a stressful
time, but the question is, Who's under most stress
-- the top monkeys, or the subordinates? Some groups
are remotely monitored for vital signs -- heart rate,
ALDA (NARRATION) The dominance hierarchies within
the groups are constantly reinforced, with the leaders
confirming their leadership. And as they do so, a
surprising fact emerges. It's not subordinate, but
dominant monkeys that are most stressed -- with higher
heart rates, blood pressure, and stress hormone levels.
Maybe in the wild it wouldn't be so simple, but here
dominance equals aggression equals stress. Food is
the next ingredient in the macaque experiments. The
monkeys get a nutritious diet, but with about 30 percent
fat. That's high fat for monkeys, and about average
for Americans. So the dominant males lead the same
kinds of lives that many humans do --plenty of stress,
with plenty of fat to eat. During the course of the
experiments the monkeys get regular checkups of their
cardiovascular systems. This is an angiogram procedure,
to look at the coronary arteries, exactly like a human
patient would receive. Some of the experiments run
for two years, and over that time the dominant, stressed
monkeys develop twice the artery clogging atherosclerosis
as the subordinate animals.
KAPLAN Animals who maintain their dominance under
these conditions experience arousal of the fight-flight
response. Whereas animals who immediately become subordinate
under these conditions don't experience those same
cardiovascular changes. And its the cardiovascular
response that accompanies the behavior of maintaining
dominance under these provocative conditions that
we think is damaging when combined with a high fat
ALDA (NARRATION) Males whose aggressive personalities
compel them to keep a cage-full of subordinates in
their place experience constant surges in heart rate
and blood pressure -- enough to damage their blood
vessels and provide sites where artery-clogging deposits
can build up.
HANEY Good morning.
AND CARLTON Morning.
HANEY I'd like for you please to fill out some questionnaires
for us. These are some standard psychological questions.
ALDA (NARRATION) So does aggressiveness damage arteries
in people, too? Aggressiveness, along with mistrust
and anger, define what psychologists call a hostile
personality. The qualities are assessed with this
No one cares much what happens to you. True or false?
I have at times had to be rough with people who were
rude or annoying. True or false? When people do me
wrong I feel I should pay them back if I can. True
ALDA (NARRATION) 30 year ago it was thought that "Type
A" personalities -- dynamic, always in a hurry --
got heart problems. But that wasn't always reliable.
A few researchers thought hostility was a better match,
so they went back through old personality test records,
and tracked down the people who'd taken them. Redford
Williams takes up the story.
REDFORD WILLIAMS What we found was that those people
who had high hostility scores back in the 1950s were
two to three times more likely to develop heart disease.
And in one study, those with high hostility scores
were about seven times more likely to die.
THOM HANEY The first time it inflates it might be
a little tight.
ALDA (NARRATION) In Redford Williams' lab they've
been studying how hostile and non-hostile personalities
react to stress. NURSE I'm just gonna put a syringe
on here because we're gonna be drawing bloods periodically...
ALDA (NARRATION) Blood stress hormone levels, blood
pressure and pulse rates will be tracked while subjects
remember, and re-live, a stressful event. First un-stressed,
resting levels are measured. Terry's blood pressure
is normal -- 136 over 72. The blood sample, analyzed
later, will show low stress hormone levels.
HANEY Now I want you to recall a time, sometime in
the past when you felt very angry towards another
person. This should be a situation or incident that
still makes you angry right now when you think about
MILLER I was an assistant teacher…
ALDA (NARRATION) Terry's blood pressure increases
a little as her anger rises -- about 10 percent.
MILLER ...and we had a small girl and she had been
abused by her mother. But she had gotten to the point
where she couldn't even speak any more. So they put
her in our autistic classroom...
ALDA (NARRATION) Blood pressure is up another 5 percent.
MILLER ...she would come into class with bruises on
her body. We called the social services and...
ALDA (NARRATION) Although Terry's now clearly upset,
her blood pressure and stress hormone reactions are
MILLER ...and we couldn't get anybody to do anything
about it. That made me angry.
ALDA (NARRATION) Now a different kind of stress, and
a new subject, Theresa.
HANEY Your start number is 13,485.
ALDA (NARRATION) Theresa has to keep on subtracting,
in steps of nine, as quickly as possible.
LEWIS OK that would be thirteen thousand four hundred
and... did you say eighty five? Um, seventy six?
HANEY That's correct.
ALDA (NARRATION) The experimenter signals for Teresa
to speed up. Now she's getting really flustered, but
her blood pressure's hardly up at all.
HANEY Last correct number, thirteen thousand four
hundred and seventy six, minus nine.
LEWIS ...seventy six minus nine, Theresa, is...
HANEY OK now, remember, accuracy counts.
LEWIS Sixty four, no it's not...
CARLTON GUDD I got a phone call at work. My co-worker
ALDA (NARRATION) Now here's Carlton, doing the anger
GUDD ...and it was the alarm company at my house.
And my burglar alarm was going off, and police were
called. Well, instant panic set in. I was scared to
death. That's about the time my kids come home, my
little girl and my little boy get home from school.
ALDA (NARRATION) Already Carlton's blood pressure
has shot up, his pulse is racing.
GUDD I yelled at my boss, "I'm leaving." Made the
fastest ride home that I've ever made in my life.
I got to the house and the police officers were leaving.
So I grabbed a great big Maglite flashlight that I
have in my truck, opened the door, stormed into my
house, yelling the whole time, "I've got a gun. If
you're in my house, come out." I jump through the
doorways, intending to crack the skull of anybody
that was in there. I was so mad…"
ALDA (NARRATION) Unlike the others, Carlton scored
high on the hostility questionnaire.
WILLIAMS Even low hostile people do get angry. I mean,
everybody gets angry if provoked enough. And the fascinating
thing is that when high hostile people get angry,
they have this very large fight-flight response. But
when low hostile people get angry, their response,
their biological response is much smaller. It's as
though they are wired in a different way. The connection
between anger and that arousal, that biological arousal
for fight or flight is not so tight in low hostile
people as it is in high hostile people.
ALDA (NARRATION) The lesson of the lab stress tests
is that personality really matters. Just as with Sapolsky's
baboons and Jay Kaplan's macaques, hostile, aggressive
personalities experience more stress over the long
term -- and that's bad for their health.
GUDD ...I was so mad, thinking about my kids and what
could have happened...
WILLIAMS The one person that we had today who had
a higher level of hostility on the hostility questionnaire
showed a much higher level of blood pressure, both
systolic and diastolic during the test, during the
anger, than the other three who had lower levels.
And this is probably what's happening with us -- and
I include myself in this group -- us high hostile
people. Day in and day out we're getting angry at
little things. Our blood pressure is going up more
than people like Thom here who don't have a high hostility
level. And that's probably what's clipping off our
arteries, and damaging our arteries and causing the
increased atherosclerosis. Now it's not the only thing,
obviously. We have our cholesterol levels, our health
habits, our exercise habits, and Lord knows, a multiplicity
of genes that feed into this. But this is one thing
that does feed in. And you know, it doesn't mean you're
for sure going to have a heart attack. It means that
you have a slightly but reliably increased risk.
ALDA (NARRATION) This is New York City -- urban living
at its most hectic, and its most stressful. You may
be surprised to learn that walking around, hidden
inside the chests of hundreds of New Yorkers are tiny
stress measuring devices. Charles Harmon has one.
He's an office worker, and also a heart patient who
carries an automatic, implanted defibrillator. When
clogged arteries reduce blood flow to the heart, heart
muscle can be damaged. Damaged hearts can lose their
steady rhythm. Extreme arrhythmia is called fibrillation,
and the defibrillator shocks the heart back into action.
STEINBERG Have you had any racing heartbeats?
HARMON A little bit. I could feel it.
STEINBERG Enough to set off the defibrillator?
HARMON Not quite. No, it never did that.
STEINBERG Did it make you feel dizzy or pass out?
HARMON I didn't pass out but I got a little dizzy.
STEINBERG So let's interrogate the device. We'll talk
ALDA (NARRATION) Implanted defibrillators are pretty
smart. Not only do they constantly monitor heart rhythm
and deliver shocks when appropriate, they also record
everything they do.
JONATHAN STEINBERG Nothing's happened since we last
saw you a few weeks ago.
ALDA (NARRATION) Stress, with its surging blood pressure
and pulse rate, can overload a damaged heart and disrupt
STEINBERG Everybody is susceptible to stress. And
everyone can have a physiological response to stress.
It's the interaction of that response and a damaged,
diseased heart that leads to dangerous arrhythmias.
ALDA (NARRATION) September 11, 2001 was the beginning
of a time of extreme stress for New Yorkers. All over
the city, implanted defibrillators were sitting in
the chests of heart patients, monitoring hearts, firing
off when they detected dangerous arrhythmias, and
recording their actions. Charles Harmon's cardiologist
collected together records downloaded from 200 implanted
STEINBERG We found the results were quite striking.
There was about a two and a half fold increase in
the number of patients who experience these arrhythmias
in the period, the 30-day period after the attack,
compared to the 30-day period before the attack.
ALDA (NARRATION) Stress can be the final trigger for
a heart attack. 40,000 heart attacks a year are triggered
by stress, it's estimated -- as many as strenuous
exercise. And as we've seen, chronic stress clogs
up arteries as well, damaging the heart and making
it more vulnerable to an attack. So stress is a major
risk to cardiovascular health. Next we're going to
see how stress undermines another of the body's essential
HEAL OR NOT TO HEAL
ALDA (NARRATION) We're in Columbus, Ohio at the Ohio
State University's Clinical Research Center. The couple
on the left, Eve and Bud, are going to let the researchers
probe into the most private areas of their marriage.
LOIS GRINSTON Now I usually just start like right
here in the middle.
ALDA (NARRATION) The researchers are trying to see
if the psychological health of the marriage has any
effect on the physical health of the couple. LOIS
GRINSTON OK, great.
ALDA (NARRATION) It's a gruesome but ingenious technique.
The couple's given superficial skin wounds on the
arm -- eight small blisters, produced using a suction
GRINSTON OK, now I'm going to turn this on. EVE OK.
GRINSTON Now, do you feel that? EVE Yeah, I feel it.
GRINSTON OK, OK.
ALDA (NARRATION) It's an uncomfortable process, but
not painful. Bud'll get his blisters next.
LOVING You're just got to do the best you can to fill
out the bubbles. It's not a big deal.
OK. BUD She cheats on all tests, you know that don't
ALDA (NARRATION) Psychologist Tim Loving asks Eve
and Bud to assess how much they disagree in typical
sensitive areas, like money or in-laws. A zero score
means no disagreement, so it seems Eve and Bud, who've
been married 13 years, get along pretty well. After
ten minutes, nurse Lois Grinston checks her handiwork.
GRINSTON Oh those are lovely. Just lovely.
ALDA (NARRATION) The idea is to follow how well Eve
and Bud's lovely blisters heal over the course of
the next month, and to see if the stress levels in
their marriage have any effect. Ninety couples are
in the study. The healing process will be monitored
visually, and by measuring the rate the blisters dry
out. Also during the first 24 hours, fluid placed
in little chambers above the wounds will be drawn
off. The fluid will be assayed for the chemicals which
the body's immune system sends to wound sites, to
get healing started.
GRINSTON OK guys we're getting ready to get started
now. And I'm gonna close the curtain.
ALDA (NARRATION) With the blisters in place, and Lois
Grinston ready to draw blood samples, Eve and Bud
are supposed to start arguing. Likely hot topics have
been suggested by the researchers, after exploring
with the couples the questionnaires they had filled
out. For Eve and Bud, they've zeroed in on Bud's hearing
aid -- or rather his lack of a hearing aid.
When they put me in the casket you can go ahead and
put the hearing aid in my ear.
The bad thing is, we even have a hearing aid at home
that you could wear so that you won't have to keep
saying, "What? What? What?" even when we're watching
ALDA (NARRATION) As with the hostility study we saw
earlier, blood samples will show what levels of stress
hormones the argument stimulates.
...keep rewinding the movie so you can hear what they
said, which is aggravating.
Well, you should put the hearing aid in your ear and
listen to the news...
Listen to the movies…
...for a while and see what the hearing aid sounds
You've never had it in, how do you know? You've never
tried to watch a movie with it.
I watch a movie with it once in a while.
ALDA (NARRATION) I think we can tell their hearts
aren't really in this argument.
EVE When sometime?
BUD Next time we watch a movie.
Okay, I'll go rent one tonight.
I didn't say that...
ALDA (NARRATION) In fact Bud and Eve are pretty good
friends. Their argument provoked no stress hormones
in the blood, their immune systems responded strongly
to the blisters, and healing was close to complete
by around Day 12. They're a typical unstressed couple,
with healthy immune systems. Now let's follow Deb
and Mike through the same procedure. They've been
married ten years, they don't regard their relationship
as terrible, but neither has any difficulty coming
up with multiple areas of disagreement. The researchers
have several topics to suggest for discussion. For
Mike and Deb, how to divide time between chores and
relaxation is a contentious area. Observing this session
is Janice Kiecolt-Glaser, the psychology professor
who developed these tests.
Alright, well I... MIKE Now wait, number one...
We can start talking... MIKE Number one. Two hours.
You know, I put my workout schedule together for you
on the fridge so you could see what days I'm gonna
run. Number one, you need a healthy heart. And number
ALDA (NARRATION) As before, blood samples are taken
to measure stress hormone levels.
...talk about excessiveness. I talk about, in our
lives right now...
That's how you accomplish things.
...we are so busy from the minute we wake up 'til
the minute we go to sleep. Take for instance the morning.
When I wake up, you wake up, you get yourself ready,
and you go to work.
Yup. DEB I get myself up. I get myself ready. I do
a load of laundry. Check the emails. Pack the kids'
lunches. Put the dishes away... If you guys get together
once in a while, whether it be in the evenings...
How long is once in a while?
ALDA (NARRATION) Obviously Deb and Mike don't have
a perfect relationship, but as with almost all the
couples in the study, it's still a marriage that works.
In fact, Deb and Mike don't regard this argument as
especially stressful. MIKE ...you got to do it the
way I like it.
KIECOLT-GLASER The couples who tended to be nastier
or more hostile toward each other had higher elevations
in stress hormones, particularly the women. And they
had greater changes 24 hours later, in terms of a
whole battery of different immunological assays. We
were surprised because the conflicts, the discussions
of disagreement, weren't what you'd call heated or
nasty, by and large -- it's only a relative kind of
thing. These were very happy couples. They only represented,
among the sample we had only 3% would be what we would
call distressed couples based on the way they described
their marriages. And yet we could find these reliable
relationships between physiology and behavior.
ALDA (NARRATION) Here are the blisters, unhealed at
Day 6, in one of those mildly stressed marriages.
And here they are -- nearly healed -- at the same
day in an unstressed marriage. It's a dramatic contrast,
given the relatively low stress levels involved.
POOLES Hey guys, how you doing?
DR. POOLES Dr. Pooles. Nice to meet ya. So what are
we supposed to be doing today?
TAYLOR Today is head and neck.
POOLES Head and neck exams.
ALDA (NARRATION) These are medical students in the
last few weeks before important exams. It's the kind
of high stress situation we all find ourselves in
from time to time.
TAYLOR You could look through the scalp, see if there's...
ALDA (NARRATION) This is another Ohio State study,
this time to see if it's possible to deliberately
counteract the effects of stress. John Stauffer and
Ben Taylor are second year students just coming up
for their first clinical exams. A total of 57 students
receive the same blister wounds the married couples
got, with the progress of healing to be tracked in
the same way.
NURSE We place it just on top like that...
ALDA (NARRATION) Soraya Rofagha is just completing
her neurology specialty, and has a big final exam
in two weeks.
ROFAGHA Well she's a 21 year old white female with
a 15-month history of weakness in her lower extremities
which began in July 2001, when she noticed increased
difficulty when she was walking to and from work.
She has had increased weakness…
ALDA (NARRATION) The students continue with their
routines as the blisters on their arms heal.
ROFAGHA ...so functionally, she's really decreased,
and they're thinking of putting her in a wheelchair.
ALDA (NARRATION) The students were randomly assigned
to two groups. John Stauffer was in the group that
was simply left to cope with the stress in their own
ways. But Ben Taylor's group got something extra.
ATKINSON Breathe slowly and deeply. You let tension
go. And you let yourself go deeper. Begin by relaxing
your right foot. Just letting the tension flow out…
ALDA (NARRATION) Throughout the pre-exam period, all
of Ben's group attended frequent sessions in which
they received standard relaxation therapies.
ATKINSON ...down into your fingertips. Every muscle
fiber just letting go.
ALDA (NARRATION) All the students were tested again
to compare healing during a relaxed, exam-free period.
That ensures it was really the stress of exams being
assessed, not simply the stress of receiving the blister
wounds. The study showed that students under a pretty
common kind of stress suffered the same effects as
the stressed married couples -- increased stress hormones
in the blood, reduced immune system function and delayed
wound healing. But it also showed that the simple
relaxation therapies that Ben's group received were
remarkably effective. Their blister wounds healed
up as rapidly as everyone's did during the relaxed,
non-exam period. The conclusion that our immune systems
don't work so well when we're under psychological
stress is completely consistent with what we know
about the fight or flight stress response. After all,
the whole point of the stress response is to briefly
shut down non-essentials, while we make a quick getaway.
You can afford to put off fighting infections for
30 seconds. But that means long-lasting stress makes
us more vulnerable to disease. Exactly which diseases,
or how severe they might become, is still controversial,
but the basic conclusion that chronic stress and disease
go together is beyond doubt. Next we're going to explore
further what we can do about stress.
ALDA So that's picking up what?
This is the photo-plathismagraph, and this is picking
up your skin conductance, which is another way of
saying your skin sweating.
ALDA You sweat enough to indicate a change in, I mean
a subtle change in...
Oh yes. Every time you experience any kind of emotional
change, your circulation changes.
ALDA (NARRATION) I always seem to be the guinea pig
on Frontiers. This time they want to see if I can
RESEARCHER What I'm going to do now is just wipe off
your forehead, just to get any extra oil off, and
put the muscle tension monitor on you.
ALDA How do you measure muscle tension on my forehead?
I'm not known for the muscles in my forehead.
Well, there's not a lot of fatty tissue on the forehead,
and it's considered to be a good indicator of the
muscle tension in the rest of your body.
ALDA What happens? What are you measuring?
Well, it actually measures the electrical impulses
put out by the muscle.
ALDA Oh, I see.
I'm just gonna put the lead up. It's not going to
be the most comfortable thing, but, er...
BENSON How many years have you been doing this?
ALDA This show, we've done, er... I've been doing
it about seven or eight years now.
ALDA (NARRATION) Now I'm supposed to get into a normal,
even state of mind as I make small talk with Herbert
Benson. For 35 years he's been a leading advocate
of relaxation as a useful medical therapy. He even
coined the phrase "relaxation response" to describe
what I'm about to do. But first, just to make a nice
contrast, I get to be totally frantic while everyone
watches my numbers go off the charts.
THIBEAULT If I give you the number 113, I'd like you
to subtract 13 so that you have 100, and then you
subtract 13 again to have 87.
ALDA I see.
THIBEAULT I'm going to be testing you for speed and
accuracy, so it's very important that you're accurate,
but also very quick.
THIBEAULT OK? Do you have any questions?
ALDA No, but I know my needle is jumping right now.
THIBEAULT OK. OK. I would like you to say the numbers
aloud and as fast as you can. OK? So I'm gonna have
to start from the number six thousand forty six.
ALDA And subtract thirteen.
THIBEAULT That's right.
ALDA Six thousand forty six minus thirteen. Six thousand
THIBEAULT Right. Faster. Keep going.
ALDA Oh, I keep going. Oh, I'm sorry.
THIBEAULT Yes, keep going.
ALDA Six thousand thirty three. Six thousand twenty.
Six thousand three. Six thousand six. No.
ALDA Six thousand seven.
THIBEAULT Could you just start over from the beginning.
Six thousand forty six.
ALDA OK, start over.
THIBEAULT Six thousand forty six subtract...
ALDA Six thousand forty six minus thirteen. Six thousand...
I'm sorry. Six thousand forty six minus thirteen.
ALDA (NARRATION) As I'm flailing around, it's not
just these measures that are jumping. The stress hormones
in my blood must be surging, too. Mercifully Herbert
Benson comes to the rescue.
ALDA Six thousand twenty. Six thousand seven.
ALDA Five thousand seven...
THIBEAULT Faster if you can.
BENSON Okay, that's enough. Let me show you how to
evoke the relaxation response, so if you will, just
close your eyes. And relax all your muscles, starting
with your feet, your calves, your thighs. Shrug your
shoulders around. Lower your head and neck around.
Great. Wonderful. Now sit without movement and just
focus on your breathing, but breathe oh, so slowly.
Each time your breath is coming out, say silently
to yourself, the word, "Calm." You're going to find
all sorts of other thoughts coming to mind. Those
thoughts are natural. They should be expected. But
when they occur, don't be upset, but simply say, "Oh,
well," and passively come back to the word, "Calm."
On each out breath, "Calm," and as the other thoughts
come to mind just, "Oh, well," and back to, "Calm."
ALDA (NARRATION) This is a simple, basic form of meditation.
The sensors confirmed what I was beginning to feel
-- that I was more relaxed.
BENSON Now just slowly, slowly open your eyes. How
ALDA It was nice.
BENSON You got into it nicely. What did the physiologic
RESEARCHER I think the most dramatic one was your
muscle tension, measured right here. Before it was
so high it was off the screen. And after about a minute
and a half it came down quite nicely.
BENSON This is how you can use the mind to effect
the stresses of the body. And to the extent that any
disorder is caused or made worse by stress, to that
extent we can use this as a therapy.
ALDA Is there a difference between what you might
call chronic stress and momentary stress? I mean is
it good for you to have short bursts of stress that
you can handle?
BENSON The more the stress, the more efficient you
are, the more productive you are, but to a point.
When it gets too chronic, then performance and efficiency
start dropping off. And that's what most people are
ALDA (NARRATION) John Goddard is one of the beneficiaries
of Benson's relaxation therapy. Once a victim of panic
attacks, depression and high blood pressure, he's
now mentally stable and off his blood pressure medication.
He says his daily meditation is responsible.
JOHN GODDARD It's given me my life back. I was hiding
in my house for twelve years, I was so frightened.
And now I'm out in the world, I'm actually working
again. It's just so fantastic.
ALDA (NARRATION) Gina Francis failed for years to
get pregnant. After learning relaxation techniques,
she now has one child, and there's another on the
way. Elisa Toledo had a stress-induced heart attack.
Her cardiologist recommended yoga-based relaxation
for stress management.
TOLEDO When I used to feel stressed I would do very
shallow breathing. And that really is a sign of stress.
And by telling yourself the same word all the time
or focusing on the same sound, you can de-stress yourself
very quickly. I mean, it doesn't happen like within
seconds, but you can, over a period of a few minutes
de-stress yourself, where before I didn't know to
do that. You know, I would be stressed, and I would
just probably stay stressed for the day.
ALDA (NARRATION) It makes sense that reducing stress
lowers blood pressure, or increases the chance of
pregnancy, because the fight or flight stress response
does the opposite -- increases blood pressure and
shuts down reproduction. But exactly how meditation
and yoga function to reduce stress is still something
of a mystery. This is northern India, the foothills
of the Himalayas, and the year is 1981. These scenes
were filmed on visits led by Herbert Benson to track
down experts in Tum-mo yoga. It's practiced by Tibetan
monks who had followed the Dalai Lama here when he
was exiled. Benson, knowing of the Dalai Lama's reputation
for openness, got permission to investigate.
BENSON For years the practice of Tum-mo has been a
secret within Tibetan Buddhist practice, and you allowed
the West to have studies of this for the first time.
Why is that?
LAMA Yes, as you mentioned, this is a practice usually
regarded as a secret doctrine and also as a private
thing. But I feel, as usually I believe and also explain
to people, that we are believing or -- emphasis on
reasons and facts. If this is something true, something
fact, then the investigation taken through meditation,
and investigation taken through instrument, may reach
the same point.
ALDA (NARRATION) The Tum-mo meditation experts live
alone in unheated stone huts at high altitude. Benson
was able to bring some into town for tests. He was
astonished to learn what they are capable of.
BENSON What their monks can do in Tum-mo yoga is essentially
naked in mid-winter in 40 degree Fahrenheit temperatures,
take a sheet measuring six by three feet, dip it in
icy water, wrap themselves in that sheet -- you and
I will go into uncontrollable shivering and perhaps
even die. They can get that sheet steaming within
three to five minutes.
BENSON We've been studying that for 20 years.
ALDA (NARRATION) Benson brought back now famous film
of the Tum-mo monks drying their ice-cold sheets.
For them it's of course an essential religious ritual,
designed to create a fire which burns away all traces
of improper thinking. For Benson it was simply astonishing,
and in fact he found with his tests that monks could,
at will, raise the temperature of their extremities
-- fingers and toes -- by as much as 15 degrees. At
the same time they don't increase their heart rates,
he found. So somehow they must be deliberately opening
up their blood vessels, increasing the flow. I'm no
Tibetan monk, but after my relaxation session the
idea of warming yourself up didn't sound out of the
question to me.
ALDA Three quarters of the way through trying to repeat
the word "calm", I felt warmer.
BENSON Exactly. That's a common response. You see,
the stress hormones lead to vasoconstriction. That's
just what we were measuring -- muscle tension. When
you evoke the relaxation response that way, what then
occurred, that hormone was counteracted, and that
led to .a warming of the skin.
ALDA (NARRATION) But how exactly are the stress hormones
counteracted? Usually the fight or flight stress response
is beyond our conscious control. It just starts and
stops automatically. Somehow meditators tap into the
part of the brain that controls the switches. And
you don't have to be a Tibetan monk to do it.
GROUP Hah, hah, hah, hah...
ALDA (NARRATION) We're in a community just outside
Boston which follows the Sikh religion, and practices
a kind of yoga called Kundalini -- which literally
means coiled like a snake. Kundalini yoga aims to
uncoil the snake, unleashing the energy of body and
mind. Harimandir Kur Khalsa has practiced Kundalini
for about ten years. She's come here to the Mass.
General Hospital so researchers can look into her
brain while she meditates. The study's being run by
Sara Lazar, a psychologist, assisted by Katie Killilea.
KILLILEA So this should be just a little snug. It
should definitely not restrict your breathing, but
you should feel it move upon inhalation and exhalation.
ALDA (NARRATION) Harimandir's going to be wearing
uncomfortable wires and tubes, and she'll be inside
a noisy MRI machine, so she needs to be an expert
meditator to avoid distraction.
LAZAR Would you like something underneath your legs?
KUR KHALSA Yes.
ALDA (NARRATION) There's a frame to hold a mirror
so she can read an instruction screen. The operators
line up the thirty thin slices in which the machine
will picture brain activity. TECHNICIAN OK we're going
to get started. This one's going to be a little bit
loud, and it's going to last 32 minutes. Go.
ALDA (NARRATION) First, in this control period, Harimandir's
screen tells her to think randomly -- to run through
an arbitrary list of animals, for example -- to show
what a brain that's not meditating looks like. Right
now her breathing's about as expected.
LAZAR At this point, she's breathing at a fairly fast
rate. This is about 12 breaths per minute.
ALDA (NARRATION) When she starts to meditate, Harimandir's
breathing should change. Now her instruction screen
LAZAR Begin meditation. Begin meditation.
ALDA (NARRATION) A common type of Kundalini meditation
involves coordination of breathing with repetition
of mantras. Breathing rate drops dramatically, without
the meditator forcing it to.
LAZAR So you can see, now it's getting much wider,
so she's beginning to meditate. Before she was going
about 12 breaths per minute, and now, she's going...
these are much longer, slower breaths, slower exhalations.
KUR KHALSA As I inhaled, I thought "sat-nam" and as
I exhaled I thought "wahe-guru". So it involved a
focus, and also... with the breath. And I just kept
focused on that and then allowed whatever changes
would come about to happen.
LAZAR This is one particular slice to the brain, and
here we see a bit of the lymbic system called the
amygdala circled in blue. And this time course is
the average activity of that bit of brain during the
experiment. This bit of brain becomes more active
during meditation than during the control period.
So there's something going on during meditation which
is not happening during just sitting there repeating
the words of animals.
ALDA Do you know other stuff about that part of the
brain that throws light on what functions are otherwise
performed by it?
LAZAR M-hmm, it's involved in vigilance, so paying
attention to things. And so certainly, events which
provoke fear, i.e. lions and tigers and snakes, would
activate the amygdala. But also other things, and
so since, when you're meditating, you're being vigilant
on yourself, on your mantra, and on your body, and
on your subjective state, that's why we think we see
the amygdala during meditation.
ALDA What other kind of vigilance are you talking
LAZAR If you're hungry and you're driving down the
street and you want to pay attention to which restaurants
are there, that might be something similar. So it's
vigilance to things which are biologically relevant,
I guess that's a better...
ALDA Ah, I see.
LAZAR ...more precise. But probably not vigilance
of say, you're reading a book, or watching a movie.
It's not the same attention. It's more-- it's got
to be biologically relevant, they think.
ALDA Isn't that interesting, that meditation which
is supposed to be so spiritual, lights up the part
of your brain that a sirloin steak does.
ALDA (NARRATION) People once thought meditation was
a bit like dozing off, so the detection of vigilance
in Harimandir's brain is especially interesting, and
it matches what she feels.
KUR KHALSA There's a complete awareness, and in a
way even a more heightened awareness of everything.
And then with the particular sounds, "sat-nam" felt
like it was very focusing for me. And then "wahe-guru"
had a very kind of expanding feeling of awareness.
So I felt more unified in my experience of the MRI
and of myself.
ALDA (NARRATION) I did think of a very straightforward
way to explain the brain activity, but Sara Lazar,
in her latest tests, got there first.
ALDA Let me ask you a kind of a dumb question.
ALDA How do you know they were meditating, if they
can just bring their breath down...
LAZAR ...to four breaths per minute.
ALDA ...to four breaths a minute, mechanically, then
maybe you get this kind of... maybe these part of
the brain light up any time you bring your breath
down to four times a minute.
LAZAR Very good question. That's another experiment
we're doing this time, is we're having them go down
to four breaths per minute, we're showing them arrows
and telling them when to breathe. And so far, what
we've seen is that, no, this is not the pattern you
ALDA Oh, really?
LAZAR ...when you just change your breathing rate...
Right. So there's something more to it. So, no.
ALDA (NARRATION) Sara Lazar's experiments have shed
some light on how meditation and relaxation reduce
stress -- the part of the brain that was active in
the meditators is also involved in sending signals
that control the fight or flight stress response.
But we still don't know how meditators change those
signals more or less at will. Regardless of how it
works, meditation does help people deal with the stress
of life. This is how Harimandir puts it.
KUR KHALSA Life presents situations and most of these
situations, I'm not going to know what they're going
to be, and so by encountering my own self, my own
mind, through meditation in meditation practice, then
when I'm out in the world, whatever confronts me I've
already confronted my own self and my own reactions,
so then I can confront it squarely.
ALDA Let's say you're worried about your health, or
you're worried because your boss is stressing you
all the time. Can simply meditating relieve you of
that stress, or do you have to go through an involved
BENSON It's very important to try and change the situation
itself. In other words, if it's a social situation,
recognize it for what it is and try and rectify it.
But if you can't, as many of us can't, change a situation,
then you can protect against the harmful effects of
stress, or at least lessen them by regularly evoking
the relaxation response. And people should do that
regularly. Just think of the numbers of people who
have told you, without my yoga, without my daily exercises,
many will say without my prayer, I don't feel as calm
as I do otherwise. And although this isn't speaking
to the inherent value of the beliefs in these various
things, it certainly shows their effects.
ALDA (NARRATION) So can we be worried sick? No doubt.
Can we be less stressed, and less sick? Yes. Can we
reduce stress? Yes -- and don't forget what Robert
Sapolsky found. His least stressed baboons were the
guys who just got along with others the best.