Love and Survival

Dr. Dean Ornish proved that symptoms of heart disease can be reversed with a regimen of a low-fat diet, exercise, and stress reduction. In Love & Survival, he concentrates on the less tangible aspects of a healthy life. His view is that personal intimacy and other aspects of emotional well-being--all the elements that make up what we call "love"--are as important to our physical condition as to our mental health. These positive emotions have a powerful direct effect on our bodies, giving us stronger immune systems, better cardiovascular functioning, and longer life spans. Ornish conceives of love in a broad sense - including the love of God, of mate, family, and friends. He notes that commitment is vital to loving relationships, especially marriage. He further states "I am not aware of any other factor in medicine that has a greater impact on our survival than the healing power of love and intimacy - not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery."

Ornish suggests the most serious epidemic in modern culture is not physical heart disease but what he terms “spiritual heart disease,” the states of loneliness, isolation, alienation, and depression. Our survival depends on the healing power of love, intimacy, and relationships to overcome these painful states. The powers of love and intimacy deal with our emotions, our personal relationships and our spiritual relationships. Intimacy must exist in all the domains - individuals, families, communities, the country, the culture.

In the chapter on pathways, eight areas that are conducive to the practice of love and intimacy are listed. These include: conversations (ordinary communication skills), group support (applied in his heart health program), the practices of confession, forgiveness and redemption (part of most spiritual and religious traditions), the practices of compassion, altruism, and service (caring for and helping others), therapy (particularly insight oriented therapies), touching (rare in our culture - common in others) commitment (creates safety and makes openness possible) and meditation (as applied in his heart health program).

The second part of the book contains Ornish's conversations with a wide spectrum of thoughtful men and women with different perspectives on the role of love and intimacy in health and disease. They include a yogi, an intuitive healer, a theologian, a sociologist, a psychologist, and many scientists and physicians.

Ornish notes the changes in recent decades in our culture. We don't have continuous relationships at work and church anymore, so at home it's even more important that we share who we are in stable, trusting relationships. Yet divorce rates remain at record highs and each year the breadwinners, now almost always both husband and wife, must spend an increasing number of hours away from the home.

Ornish highlights the critical importance of social factors (relationships, community, friendship, support groups, lines of communication, love) in both avoiding and recovering from life-threatening illness. The greatest influence on healing is being connected to others in a loving, intimate way.  Such relationships increase our caring and love for others and generate resistance to many types of medical problems. He cites numerous scientific studies which support his claims. One of the studies he cites is the now well known study by Dr. David Spiegal that showed that the enhanced love and intimacy provided by weekly group support sessions double the length of survival in women with metastatic breast cancer.

He recommends that we find a place where we can feel a connection to our community. This could be a community center, a church or synagogue or any place where people meet on a regular basis, e.g. clubs, leagues, games. People who don't draw strength from their religious faith or who are not a member of a group of people who meet on a regular basis have a much higher the death rate, when compared to those that do.

The biggest disease of modern culture is our estrangement from each other. The real epidemic of our times is the emotional and spiritual malaise stemming from feelings of loneliness, isolation, alienation, and depression. For the greater part of recorded history, we lived with others in small, intimate groups. Now the population is much larger and we live in large groups with no close relationships. Even our families are losing that intimacy. And now, when people need more connection and community as an antidote to the pressures of stress and overwork, membership in clubs, local organizations and volunteer organizations is decreasing.  The social structures that used to provide us with a sense of connection and community have broken down.

A key part of the Ornish heart disease reversal program is group support. He offers specific detailed examples of conversations in those groups in his book. The purpose for the group participants is to learn to improve communication skills for themselves, and communications with family and colleagues. The group sessions help people to be more comfortable with intimate conversations, particular about emotions and feelings. Members learn to better express their feelings and concerns, and, most importantly, to improve their ability to listen to others empathetically and compassionately. This promotes connection and relation as opposed to isolation and alienation. The ability to be intimate has long been seen as a key to emotional health and physical health. And socially isolated people are more likely to die than those who are not socially isolated.

The book contains several references to specific scientific studies. A study was initiated which compared mortality rates of heart attacks in a town called Roseto, Pennsylvania with towns nearby. The towns were similar with the same hospital facilities and similar doctors. The study title is "The Power of the Clan, The Influence of Human Relationships on Heart Disease." The towns had a death rate from cardiac disease one-third that of the neighboring towns. Until the 1960s Roseto was a family-centered community, founded and populated in the 1890s by Italians from the same small area in Italy and was characterized by a very high level of social integration. In the 1960s, the town became more "Americanized" and the patterns of relationships shifted in the direction of competition, achievement orientation, and self-centeredness. With this change Roseto became indistinguishable from its neighbors in cardiac mortality. As family relationships and traditional values declined, there was a substantial increase in deaths due to heart attacks.

We have a cultural bias in the U.S. toward individualism and against interdependence. The individual is important while the idea of mutual dependence with other people is often perceived negatively. We are competitive and striving.  Psychologist researchers, as well as therapists, view the individual as the unit of study, not the context or social system within which people live. The social system itself is something added to a person. Ornish’s view, similar to that of Arthur Morgan, is that the social system is not something that is added to us. Rather it is something that is part of us.

The fundamental requirement is for interpersonal relationship. And the relationship needs to be based on the characteristics of community, which have been listed elsewhere on this site. Our relationships must be intimate, communicative, loving and supportive. Without such relationships, the stress produced by isolation separates us from the healing environment that is typical in other societies.

This valuable work is written to a great extent in professional language, particularly the language of the therapist. This is unfortunate in that it may make it more difficult to establish rapport with those who use a different terminology. Smaller, older, more established communities deeply understand the concepts of caring and concern, of mutual support. Whatever the case, this book is vital, first in explaining how “community” leads to physical health and secondly, in providing some tips and ideas on how to begin the development of the spirit of community.