The way I see it…

As a psychologist I am fascinated by people’s behaviour. Their thoughts, feelings and behaviour. The way in which they experience the world, or respond to it. Being diagnosed with MS I found myself playing a central role in a play I had been reading about for many years. I am learning all the time and piecing together the puzzle. Remembering things I knew. Rediscovering information I once learned. Really understanding information I thought I understood…but viewing it from a new position gives it a different depth and urgency.  A new clarity. It is proving helpful to me in my recovery and in my work and I want to share it with you.

Having researched the psychology of health in the past the concept of individual’s Illness Perceptions is not new to me. Nor is the concept new to social scientists. In many ways it is the science to explain common-sense processes that many of us are aware of. The idiosyncratic way we respond to health ‘threats’. In general, our illness perceptions emerge out of our beliefs about illness and what illness means for us in the context of our lives. So that’s no surprise, right? What is significant though is how they seem to play a role in health outcomes and recovery.

In Current Directions in Psychological Science (Feb 2012) Petrie (University of Auckland) and Weinman (Institute of Psychiatry, King’s College London) reviewed the extensive evidence regarding this and demonstrated that people’s illness perceptions bear a direct relationship  to important health outcomes, including the individual’s level of functioning and ability, health care use, treatment adherence and even *gulp* overall mortality (http://cdp.sagepub.com/content/21/1/60.short).

How this occurs is what is interesting. What seems to happen is that when faced with ‘illness’ we develop a set of beliefs or ‘ideas’ about it. Of course, these are influenced by many things such as our previous experience of that illness, personality variables such as optimism/pessimism, social support and many other factors. All of these things as you can imagine, affect how we respond to the illness or diagnosis. Research has consistently shown there is a pattern to the way we do this which includes our ideas about the illness identity, ideas about what caused it, ideas about control or cure and the consequences it will have on our life.

There are a growing number of studies that show that if individuals hold a generally negative view of their illness –for example, attribute a large number of symptoms to it and predict more severe consequences, then their health outcomes tend to be worse. It is associated with increased risk of disability. And slower recovery. And what makes this evidence so convincing is that it seems to occur independent of the severity of the condition.  (Botha et al, 2006; Scharloo et al, 2000; Scharloo et al, 1999).

So as a patient looking for a way forward, and as a psychologist looking for ways to improve health outcomes this represents a massive opportunity. By influencing peoples’ perceptions or ‘ideas’ about their illness early on, there really could be an opportunity to improve their health.  This has already been demonstrated to be effective in conditions such as heart attack (Petrie et al, 2002) and fatigue management in MS (Skerrett & Moss-Morris, 2006).

This is not the same as saying ‘Mind over Matter’. I do not suggest we can think ourselves better. I would not patronise you so. The process is more complex than that. What this highlights is that there is an opportunity, perhaps during and after diagnosis (which is a scary process often handled by medicine in a clumsy way). An opportunity to influence how people regard the illness. In doing so, it may well impact their future.

 

Advertisements

2 thoughts on “The way I see it…

  1. Interesting. I don’t know if you remember but I had an aunt who had cancer. She was told based on how the cancer had spread she should by rights be dead. She was a deeply religious woman and had faith that she would recover. She went on to go into full remission and the cancer never returned.
    Do you think that doctors giving the worst case scenario is a bad thing? I doubt it’s Ethical to tell patients that they aren’t as ill as they are but is it about the way they present it? Maybe this is why children with illness or disability surprise us, a limited awareness of consequences can be helpful.

  2. its certainly an interesting area for discussion. there is a huge amount of research that looks at the way in which we respond to illness impacts health outcomes. Which I guess, makes sense on a ‘common sense’ level… Its the mechanisms by which this occurs that are more difficult to understand.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s