PDF Summary:Mind Over Medicine, by Lissa Rankin

If you want to heal your body, you have to cultivate a healthy mind. In Mind Over Medicine, Lissa Rankin explores the mind-body connection and reveals our innate ability to promote self-healing. By proliferating positive beliefs and designing a fulfilling lifestyle, she says you can create conditions for healing relaxation and whole-body health.

Rankin is a physician, author, and speaker. Using her own chronic illnesses as a catalyst, she expanded her modern, Western healing repertoire to include holistic medicine after researching mindset and lifestyle factors on spontaneous remissions. She now teaches that optimal health involves more than just prescription medicine and physical treatments—it also depends on the quality of our beliefs, our relationships, and our jobs.

In this guide, we examine Rankin’s principles for healing and compare them to similar books like When the Body Says No and The Upside of Stress.

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Modern humans tend to think we’re more connected than ever because of our online networks and constant interactions, but despite this, levels of anxiety, depression, and loneliness are higher than ever. This clearly indicates that we need to actually get out and talk to people, face to face, as our evolutionary urge to be in connection with others depends on that physical presence.

On the other hand, Rankin says if you surround yourself with people that make you feel accepted, loved, and uplifted, you’ll feel relaxed and promote healing. To demonstrate the healing power of positive support, Rankin references a study that observed the influence of relationships on the recovery of 3,000 nurses with breast cancer. Those who had 10 or more friends supporting their recovery were four times less likely to die from their diagnosis. In the second half of this guide, we’ll share tips on how to surround yourself with the right people to help you relax and heal.

Healthy Relationships Contribute to Healing

In the study Rankin references, the type of relationship that was most predictive of a patient’s cancer survival was having 6 or more children, then having 10 or more friends, and then having 10 or more relatives. Interestingly, being married and having ties to your community or a religious group were not related to increased cancer survival.

The type of support patients received from these relationships was not measured (emotional, financial, informational, and so on), but a similar study showed that cancer patients with a lot of emotional support are half as likely to die from their disease as those with low emotional support. This emotional support was measured according to how comfortable patients felt talking to their social networks about their disease or other personal problems.

Purposeful Work Can Heal, but Work Stress Is Toxic

You probably know intuitively that work stress isn’t good for you, but did you know your job can be so impactful on your mind that it can either heal you or kill you? Rankin explains that in Japan, it’s estimated that roughly 10,000 people die from overwork each year. They call this karoshi, which translates to “death by overwork.” It’s so common that Japan offers workers compensation benefits to families who survive their worked-to-death loved ones. Karoshi typically manifests as spontaneous cardiac failure. Rankin argues that even though the US doesn’t have a word for this phenomenon, US citizens suffer from overwork too. One study she cites found that people who didn’t take annual vacations were 21% more likely to die of any cause. Further, their cancer risk increased by 32%.

Rankin notes that even when we clock out of work, the world of technology keeps us connected. Emails, texts, and calls travel right to your pocket and wait for you on your laptop at home. This makes it difficult to get away from work stress and relax.

Make the Most of Your Vacations

Even though we’re suffering from overwork in the modern age, we always count on vacation to reduce stress, right? One study that surveyed 1,500 people before and after their vacations found that most of the participants didn’t feel any less stressed after their vacations ended and they actually had less energy when they returned to work. The common causes of stressful vacations are travel-related complications such as unfamiliarity with the area you’re visiting, sorting out unplanned details while on vacation, and feeling unsafe.

On the other hand, vacations that are well planned can reduce your stress and help you feel rejuvenated when returning to work. To avoid a Clark Griswold-esque vacation, here are some tips to dial in your travel details and optimize your time away from work:

• Seek help from a travel agent. A travel agent can help you sort out the logistical issues that are responsible for stressful vacations so you can focus on relaxing.

• Make your plan at least one month in advance. Another study found that 90% of people that planned a good trip had their plans sorted out a month beforehand. 27% of stressful trips were still being sorted out at the last minute or during the trip.

• Meet with a local expert. Most positive vacations recorded in the same study were guided by a local host or a knowledgeable friend that lived in the area.

When Work Helps You Relax

In some cases, work can help you relax rather than stress out, and when this happens, it can improve your health and even save your life. Rankin shares the story of a man plagued with a terminal heart problem who decided to follow his dream of spreading music to the world. The man was suffering so much from the side effects of over a dozen medications that he decided to opt out of his treatments and live out his final days doing something he loved—donating harmonicas to children and teaching them music lessons. Although he wasn’t expected to live more than a year off of his medication, his passion has sustained him for over 13 years. In the next section, we’ll share tips on how to follow your passion or mitigate the stress you experience at your current job in order to relax and heal.

(Shortform note: Research shows that, on average, the least stressful jobs are in forestry and agriculture. Not only do lumberjacks and farmers feel the least stressed, they also report feeling the most happiness and meaning while working. Researchers conclude that this is because they spend their work days in nature doing physical activity—two things known to ease stress and promote happiness. Their work gives them a sense of meaning because it has a positive impact on other people and the natural world. Granted, these careers aren’t all sunshine and rainbows (although you would be enjoying more of these things too)—they lead to more self-reported physical pain than any other career.)

Happiness Releases Healing Hormones

When you’re feeling satisfied and appreciative of your life, your physical health reflects these positive feelings by relaxing and healing. Rankin says a happy mind boosts your general health, lowering your risk and severity of heart disease, lung disease, diabetes, and colds. She adds that happy people produce 50% more antibodies than unhappy people in response to flu shots. Happiness is also linked to greater longevity.

Rankin says that happiness reduces the number of stress responses you have, which keeps your immune system in better condition to repair cellular damage and fight off disease. In this way, happiness is preventative medicine. Although happiness has been shown to be an effective disease preventative, Rankin says the data showing its effectiveness for the treatment of already existing diseases is limited.

Happiness also boosts your physical health by increasing the release of neurotransmitters, such as dopamine and oxytocin:

• Dopamine drives our anticipation of happiness, such as when you’re looking forward to reuniting with an old friend or on the cusp of achieving a meaningful goal.
• Oxytocin is nicknamed the “cuddle hormone” because it’s the feel-good hormone that’s released when you’re snuggling with a loved one or playing with a child. One notable benefit of oxytocin is reduced inflammation in the body.

How Does Happiness Reduce Stress?

In addition to the hormone response, another way happiness limits stress is by motivating you to develop healthy coping strategies. As we discussed, anxiety and depression are negative emotional states that can overwhelm your thoughts and demotivate you, which leads to a downward spiral of more stress and illness. The broaden-and-build theory suggests that the mood-boosting neurotransmitters released when you’re happy counter these negative emotions and help you view stress in a more balanced way.

Positive emotions also help you feel motivated to build resources that promote more happiness and resilience toward stress in the future (such as supportive friendships and a job you love). In this way, happiness induces an upward spiral of positive thoughts and actions that are known to make you more resilient to stress. For instance, if you make an effort to connect more deeply with the people in your life, you’ll not only benefit from the immediate stress-resistant effects of oxytocin (as Rankin mentions), you’ll also elevate your mood in a way that motivates you to engage more with other people and build supportive relationships.

Part 2: Embrace a Relaxing Lifestyle That Promotes Healing

In Part 1 of this guide, we learned how beliefs, lifestyle, and stress affect our physical health. In this section, we’ll explain how to reprogram your beliefs and design a lifestyle to promote relaxation and healing. We’ve organized Rankin’s advice under two categories: mastering your inner world and designing your outer world.

Master Your Inner World

To get your mind healthy and promote physical healing, Rankin says it’s crucial to master your inner world. To do this, she says you should embrace and reflect upon negative emotions, meditate, and develop your spirituality.

Normalize Negative Emotions, Shift Negative Beliefs

If you believe you shouldn’t experience negative emotions at all, when these emotions inevitably occur, you’ll worry about your worries, which will cause you to spiral into chronic stress. Rankin says because we’re not in total control of our thoughts and feelings, we should embrace sadness, anger, and fear. Acknowledging these negative emotions help us process them more effectively and allow them to pass. To embrace your negative emotions in a healthy manner, appreciate the purpose they serve you. For example, fear helps you survive by making you apprehensive and alert around danger.

(Shortform note: In When the Body Says No, Gabor Maté explains that it’s also important not to practice “toxic positivity”—where you focus so much on positive thinking that you repress your negative feelings. By forcing insincere positive feelings, you’ll mask the negative feelings that you need to pay attention to in order to heal. This is often caused by our attempts to avoid the pain our negative emotions cause us or our desire to meet other people's expectations of us. Instead, accepting your negative emotions and paying attention to what they’re telling you can help you discover their root cause, which will ultimately help you correct your lifestyle and live healthier.)

While it’s healthy to acknowledge and embrace negative emotions, which are temporary, negative beliefs are more insidious because they induce chronic threat responses. To change a negative or self-limiting belief, Rankin says to argue against it by asking yourself the following questions:

• Is the belief true? If so, what evidence is there to support that it’s true?
• How does this belief make you feel?
• How would your life be different if you didn’t have this belief?

Then, replace your negative belief with a positive alternative. Consider using whatever the positive opposite of your negative belief is. For example, if your negative belief is that your sickness is the only valid excuse for canceling events you don’t want to attend, you could counter this belief by realizing that you can cancel plans by being honest with the people at those events.

Why Your Beliefs About Stress Matter

In The Upside of Stress, Kelly McGonigal argues that stressful events aren’t what damage your health; it’s your beliefs that make the difference. She supports this by citing a study that found that high levels of stress increased the risk of death by 43%—except for those who didn’t believe stress was harmful. In fact, the lowest risk of death occurred in those who experienced high stress but didn’t believe it was harmful. This risk was even lower than those who reported low levels of stress. Although the researchers didn’t manipulate the participants’ mindsets—and thus, couldn’t say for certain that a difference in mindset was the cause—participants’ negative mindset was the strongest predictor for mortality.

McGonigal explains that your mindset—that is, a set of beliefs that determine your worldview—makes a difference in whether stress harms you because it determines the type of stress response you have. A negative mindset on stress tends to trigger a harmful fight-or-flight response while a positive mindset induces a challenge or tend-and-befriend response (which we covered earlier).

One way to develop a more positive mindset about stress is to embrace it as an opportunity to grow. For example, if you go through a difficult breakup, realize that the pain of this situation can also provide you with more freedom and an opportunity for personal development.

Meditate to Become the Master of Your Mind

Among other benefits, Ranking recommends meditation as one tool for accepting your negative emotions. She defines meditation as a strategy for relaxation where you increase your awareness of your inner thoughts and the world around you and accept these things passively. Meditating helps you become more accepting of your negative thoughts and feelings, which allows you to relax and heal.

Rankin explains that meditation has been shown to have significant effects on physical health such as reducing blood pressure and strengthening your immune system. She also says that meditation activates several areas of the brain (the hippocampus and corpus callosum, to name two) that are connected to creativity, empathy, intuition, and happiness. In addition, the amygdala, the part of the brain responsible for fight-or-flight, settles down during meditation. All of these brain responses activate positive hormonal responses that aid the physical healing of your body.

While there are several ways to meditate, here are some of Rankin’s steps to help you meditate effectively:

• Get into a comfortable position.
• Close your eyes.
• Focus on your breath. Alternatively, Rankin says you can repeat and focus on a mental device—a prayer, mantra, or noise.
• Tense and relax each muscle from head to toe. As you do this, visualize your breath as a relaxing force that relieves tension wherever you find it in your body.
• Adopt an open, accepting attitude. If your mind wanders and begins planning or worrying about something you have to do, don’t suppress or get frustrated with these thoughts. Acknowledge them with love and then try to return your focus to your breath.

Which Meditation Techniques Are Best for Healing?

Two of the most studied forms of meditation are transcendental meditation and mindfulness meditation. They differ in that transcendental meditation involves focusing on a mantra, while mindfulness meditation involves focusing on the present moment, often by paying attention to physical sensations in your body and your breath. Both techniques maintain a passive, non-judgmental attitude toward internal thoughts and emotions. Rankin’s general meditation steps outlined above seem to combine elements of both these techniques, focusing on breath (or a mental device) but also paying attention to your body in the present moment.

A meta-analysis of the treatment efficacy of these two meditation techniques concluded they both have the following benefits:

• Increased grey matter in the brain (a type of brain matter associated with improved cognitive function)

• Reduced symptoms of anxiety and depression

• Reduced fatigue

• Increased positive personal beliefs such as self-acceptance and a sense of purpose

Mindfulness shows additional benefits, such as improving insomnia, increasing cell longevity in breast cancer patients, increasing immune function in people with weak immune systems, and decreasing inflammatory responses. A recent study even found that mindfulness meditation was as effective as the most common anxiety medicine in reducing anxiety symptoms. Mindfulness has more extensive and trusted research behind it, while the quality of many studies on transcendental meditation are questionable because of selection bias (participants who are particularly favorable toward transcendental meditation have been chosen for studies).

To optimize the effects of meditation, experts recommend replicating the manner that these techniques have been performed in studies (and thus, scientifically validated). For example, transcendental meditation was typically performed twice per day for 15-20 minutes. Mindfulness meditation was typically practiced in a standardized 8-week program called mindfulness-based stress-reduction (MBSR). Experts recommend that both these techniques are learned by certified instructors. However, Rankin and other experts also encourage you to learn and practice these techniques from books, videos, or by whatever means you’re able to because any amount of meditation can be beneficial and poses no risk.

Develop Your Spirituality

In addition to embracing negative emotions and meditating, Rankin says that investing in your spirituality will help you feel more grateful, find meaning in hardship, and live a peaceful life. All of these things help you relax and heal. People who consider themselves spiritual are happier, have better mental health, abuse fewer substances, and live longer. Rankin views spirituality as a perspective that finds sacred value in the things of life.

Here are a few of Rankin’s tips for embracing spirituality:

• Acknowledge what is sacred in your life. By assigning extraordinary qualities to everyday things, Rankin says you expand your awareness and transcend superficial aspects of reality, which makes you more open, grateful, and forgiving. This can help you overcome temporary troubles or grudges that cause negative emotions.
• Trust a higher power to guide you on your healing journey. Rankin defines a higher power as any loving force that has your best interest in mind. This could be a religious deity or your own body’s natural healing force. Belief in a higher power can help us find meaning in loss and suffering, mitigating the stress of grief and sorrow. Trusting that a loving force is guiding your healing can also relieve the stress that results from our efforts to control every step of the healing process.
• Follow a spiritual path that is true to you and helps you relax. Rankin explains that your spirituality can stress you out if it doesn’t align with your values and truth. For instance, a religious group you belong to might make you feel guilty or shameful of your lifestyle, which has been shown to cause you stress and potentially lead to illness. On the other hand, belonging to a spiritual group that makes you feel welcome, loved, and supported may help you relax and heal. Spiritual communities that gather based on shared beliefs have been shown to induce positive health effects such as better mental health, lower rates of cancer, and greater longevity.

What Element of Spirituality Most Contributes to Healing?

The most comprehensive study on spirituality and health concluded that the most influential aspect of spirituality on positive health outcomes is engagement with a spiritual community.

Does your community have to be spiritual in order to benefit your health? Another meta-analysis concluded that the social support gleaned from attending religious services appears to be more advantageous for health than any other type of social support, including marriage, number of close friends, and hours spent in social groups. Although these other forms of support are associated with health, the analysis concluded that religious service has the strongest effects on health over the widest variety of outcomes.

Although the benefits of regularly attending a religious service are strong, spirituality doesn’t have to be religious and it doesn’t need to involve a community. To expand on Rankin’s suggestion that nature can be a source for spirituality, science writer Chet Raymo, in his book When God Is Gone, Everything Is Holy, describes his religious naturalist approach to the world. He claims that when you abandon a supernatural explanation for the natural world, it becomes even more awe-inspiring. If you don’t have a spiritual belief system or practice, try connecting with nature and contemplating the interconnectedness of it, to feel yourself as part of a larger whole.

Design Your Outer World

Along with mastering your inner world (your beliefs, mindset, and connection to a higher power), designing an outer world that helps you relax and experience joy will promote self-healing. According to Rankin, some of the most important parts of outer life that are under your control are your relationships, your career, and how you spend your free time. Improve these, and your body will thank you.

Improve Your Relationships

Earlier in this guide, we established that loneliness is detrimental to your health. But Rankin emphasizes that being around people isn’t enough to spare you from the negative effects of loneliness—you have to be around the right people. In fact, the quality of your relationships can be more influential to your health than your diet, exercise, and even whether or not you smoke. According to Rankin, healthy relationships trigger those positive hormones oxytocin and dopamine, which induce relaxation and healing.

Here are five of Rankin’s tips for forming good relationships:

1) Stay true to yourself. Other people’s expectations are constantly moving targets. So instead of trying to meet them, open yourself up to people who accept and love you as you are. As a result, you’ll form quality relationships.

2) Seek people you relate to. To find people who accept you as you are, find a group of people in your community who share interests with you.

(Shortform note: In The Upside of Stress, Kelly McGonigal says you can cultivate meaningful relationships by being honest and open about the things you personally struggle with. For example, if you struggle with anxiety, admit when you’re feeling anxious to people you trust, or start a social media group that discusses anxiety. Doing this will help like-minded people feel heard and comforted, which will ultimately inspire them to be open and supportive toward you. In this way, you can attract the right people toward yourself.)

3) Fix your sex life. Engaging in a healthy sex life offers innumerable benefits—from lower risk of cancer, stroke, and heart disease to having more youthful skin. Sex alone doesn’t offer these benefits, however—to reap the rewards, sex should serve as a deep connection between two partners who trust each other. Rankin says if anything about the sex causes you stress, such as dishonesty, distrust, cheating, or physical pain, then that sexual relationship can actually cause health problems. If this is the case, consider finding a different sexual partner or seek therapy to help with the issues.

(Shortform note: Some experts say that issues with your sex life can potentially be remedied by designing a consensual open relationship with your partner. Because monogamous relationships tend to demand that each partner fill so many of the other's needs (social, emotional, financial, and sexual, to name a few), this traditional type of relationship can be overwhelming to some. When your partner is unwilling or unable to meet your sexual needs, consensual non-monogamous sex can sometimes lead to healthier relationships too. However, open relationships—like any sexual relationship—have the potential to bring you connection and satisfaction or stress, and this arrangement isn’t right for everyone.)

4) Find doctors who care. Consult with doctors until you find “the one.” This doctor should take time to answer your questions and believe that you can get better. If you ask about “alternative” forms of treatment (for example, doing acupuncture in conjunction with physical therapy), a good doctor will give you advice but not dismiss anything outright or disparage other treatments that may help.

(Shortform note: One tip is to prepare for your consultations by writing down everything you’d like to talk to your doctor about—your symptoms, how they’re affecting you, your goals, and so on. This can help you avoid feeling overwhelmed or forgetting anything important to your health journey when you meet with a physician for the first time.)

5) Be honest about your needs. If any important person in your life isn’t meeting your needs, tell them. Rankin says all relationships strengthen with honest communication about what is and isn’t working. (Shortform note: In Attached, Psychiatrist Amir Levine and psychologist Rachel Heller emphasize that communicating directly and honestly about your own needs has the added benefit of setting a good example for your partner and encouraging honesty in return.)

Find an Occupation You Love

Along with your relationships, Rankin says your occupation has a massive influence on your stress levels. For this reason, it’s important to work in a way that fulfills you and helps you relax. According to Rankin, your work doesn’t have to be a job you get paid for, but instead, it’s whatever you spend most of your time doing. This could be raising children or caring for your elderly parents.

As we touched on earlier in the guide, fulfilling work is beneficial to health but stressful work can be toxic. Work stress comes in many forms, but your body perceives them all as threats. Thus, it can trigger chronic stress responses that degrade your health over time.

Here are the different types of work stress to look out for:

• Overwork. As mentioned previously, working too hard can kill you.
• Conflicts with others. Abuse from superiors or colleagues can wreck your mindset and body.
• Moral dilemmas. Moral dilemmas occur when your job demands something of you that conflicts with your values. For example, if you’re a strict vegetarian, your mental health is likely to suffer if you work for a butcher.
• Feeling unheard. If you frequently voice your needs at work and your feelings are dismissed or go unmet, this isn’t a healthy environment.
• Chaos. Working in an environment where systems frequently fail or expectations aren’t clear is likely to put your brain into fight-or-flight mode.

If you recognize these sources of stress in your own workplace, set boundaries to avoid or mitigate them. For example, limit your work hours and respect your time off. In more drastic cases, don’t be afraid to leave your job for another. When this sounds implausible considering your responsibilities and debts, Rankin urges you to consider how the work stress is wearing on your body and shaving years off your life. It’s not worth it.

Finding Fulfilling Work

In Okinawa, Japan, discovering and living in accordance with your ikigai, or “life purpose” is a central focus. Researchers say Okinawa’s focus on life purpose is a significant reason why Japan has the world’s longest-living people.

Finding your life purpose isn’t something you force, but there are some relaxed strategies you can use to help the process along:

• Logotherapy. This is a form of psychotherapy created by psychologist and Auschwitz survivor, Victor Frankl, which focuses on helping people find meaning. Logotherapists guide their patients to meaning by helping them realize their negative feelings about life are actually a desire for meaning. In this view, the forms of work stress that Rankin outlines could be viewed as indicators of your desire for meaning and that your stressful work isn’t fulfilling you.

• Morita Therapy. This is a Japanese therapy that involves spending a week resting in silence and observing your emotions. Once you’ve done this, your true feelings, and perhaps your life purpose, will become more clear to you.

• Follow your flow. Flow is an intense state of focus where you become deeply immersed in something you enjoy doing and forget about everything else. By paying attention to activities that seem to activate your flow state, you can find your ikigai.

Express Yourself Creatively

Finally, Rankin says that expressing yourself creatively makes you feel happier and more relaxed, which soothes your stress response and promotes healing. Additional health benefits include better sleep, a lower risk for Alzheimer’s disease, and an increase in self-esteem.

The positive effects of creativity aren’t just limited to you. Creativity can enhance your work life, sex life, and so on. So, express yourself in whatever way brings pleasure to your life. This might be carpentry, cooking, knitting, painting or writing.

(Shortform note: If you struggle to find time for creativity, take advantage of “between times”: your commute to school or work, your lunch break, or the time you have before going to bed or just after waking up in the morning.)