Achieving Happiness Column for 2-13-05 By Tom Muha, Ph.D. MAXIMIZING YOUR MEDICAL TREATMENT   Do you have a serious illness such as heart disease or cancer? Perhaps you have a family history that leaves you vulnerable to these illnesses? You can make important contributions to regaining your health, or to remaining healthy even if you have risk factors. Psychologist Albert W. Scovern has studied how people can improve their chances of recovering from a disease, or avoid getting sick in the first place. He found two essential elements: 1. The patient’s ability to keep both their state of mind and their relationships positive. 2. The ability of the physician and patient to create a healing relationship. PATIENT CONTRIBUTIONS People who apply an optimistic mind set to their physical well-being are able to remain hopeful in spite of the fact they have physical problems. They expect that they’ll get better, so they organize a plan of action they believe will be best suited for their body. Then they become proactive in pursuing their goal of recovery. Conversely, people who allow their fears to overwhelm them lose hope, resulting in increased health complications and poor treatment outcomes. The findings of a recent longitudinal study of 2,428 men clearly demonstrate the effects of hopelessness. The men who felt that their future looked bleak had more than three times the risk of death, primarily from cardiovascular disease and cancer. A 25-year study of doctors and lawyers discovered that those who had the highest levels of hostility and cynicism were four to five times more likely to develop coronary disease. In a related study, patients in cardiac rehabilitation who were taught how to reduce their level of anger were significantly less likely to have a second heart attack or other fatal complications. Other researchers have explored the factors that predict survival times for women who have had a recurrence of breast cancer. The foremost factor determining survivability was the length of time since the initial treatment. But the second most powerful predictor of the women who live significantly longer was psychological in nature. It was the amount of joy they experienced, as reflected in feelings of being cheerful, glad, hopeful and optimistic. SOCIAL SUPPORT Social support has also been shown to be beneficial to women coping with breast cancer. Patients who participated in group therapy were found to live twice as long as those in a control group. After four years, none of the women in the control group were alive, but one third of the group therapy patients were still living. Relationships have consistently been shown to be a significant factor in producing positive outcomes with both cancer and coronary patients. Those who were happily married, had close contact with their family, or had good connections with a group of friends were found to be two or three times less likely to die over a ten-year period. PHYSICIAN CONTRIBUTIONS Healing, it’s been found, is a distinctly human process based in large part on the relationship that is established between a doctor and patient. Although some health care systems mechanically prescribe treatments, abundant research reveals that effective medicine is far more than a mere technological enterprise.  Without a strong doctor-patient connection, 50% of patients refuse to take action when given referral advice, 75% miss follow-up appointments, and half of those with a chronic illness drop out of treatment within a year. Physicians who get the best results form a good alliance with their patients by allaying anxiety, instilling hope and confidence, and communicating a belief in the treatment they’re recommending. They also encourage their patients to engage in a collaboration in which responsibility for achieving a positive outcome is shared appropriately. Numerous hospital studies have shown that patients who have high levels of preoperative fear and anxiety also have the most postoperative pain and longer hospital stays. But if the doctor talks to the patient before surgery and helps to reduce the patient’s concerns, their recovery is much easier and faster. A doctor who can create a good alliance will have good listening skills, an interest in your attitude and relationships, clear and confident explanations of the treatments being recommended, and strong support for your own efforts to regain your health. Exceptional physicians take the time to form a personal relationship with their patients that promotes trust, caring and optimism. These are essential healing components for helping you to make it through treatment and for assisting you to adopt healthy new behaviors. Find a physician with whom you can relate. Your life may depend on it.   Tom Muha is a psychologist in Annapolis. He welcomes your comments and questions. To contact him call (443) 454-7274 or email him at tom@achievinghappiness.com.