A conversation with Alan Cassels

Does the mental aspect of our health, influence health outcomes? “Absolutely it does,” responded Alan Cassels, a pharmaceutical policy researcher at the University of Victoria, in a recent conversation.

Cassels was speaking with me about his new book, Seeking Sickness – Medical Screening and the Misguided Hunt for Disease, for which he has been nominated for the Canadian Science Writers Award. The book questions whether these screening tests really can give us an accurate prediction of whether we may be susceptible to, or developing, a certain disease. What his research found was that, though some tests can be helpful, many are not only expensive, but also inaccurate and not scientifically proven to tell us much at all, beyond averages and probabilities.

What they may do though is start us down an expensive drug therapy road that once on, is hard to get off, and may not benefit our health at all, or lead to the quality of life we want. This approach could even increase our fear and uncertainty about our health.

“The search for health risk factors, and whether we have a likelihood of developing a disease is really about how we want certainty,” adds Cassels. “We are in danger of persuading ourselves into believing that if we know of these problems in advance, we can maybe head disaster off.” We may think that this “seeking sickness” is a rational approach to our healthcare, but Cassels feels it is more emotional.

For example, in his book, Cassels shares his foray into online self-screening for disease that is currently so popular. The subject he chose was adult ADHD. Cassels took the online test offered and was diagnosed with the likelihood he had the condition, as were his colleagues who took the test also. No one passed the test. So how are we seeing ourselves, if even a simple computer test can fool us into thinking we may have a mental or physical problem?

We all care about our health, and the health of our loved ones, and Cassels recognizes that, but suggests that a more rational approach to our health could begin with having confidence to calmly ask a question or two before taking tests. For example,

1.    Is this a screening test recommended by a quality independent body

2.    Who is pushing this test, and why?

These are great questions, and I would add some questions of my own, that are similar but different

3.    Am I just a passive passenger on the health train to inevitable sickness, and medication, or an active participant in my health?

4.    If the latter, what do I need to know to ensure a sound decision here?

5.    Am I aware of the role my thinking plays in my health?

6.   If so, what if instead of looking for and worrying about a disease, I begin to check the thoughts I know are unhealthy? 

In both cases, the process begins by understanding what is influencing one’s thinking. In my case, it covers checking the thinking itself to notice and put a stop to morbid fears of disease, and to allow a more rational and inspired view to form decisions.  We need a clear idea of what health means to us and what kind of care we want as a foundation to considering any medical tests that might be needed. And we need a way to weigh and make good decisions and to have control over those decisions. To achieve this, we can commit to not being influenced by outside pressures or emotion, but rather by information.

In our conversation, I asked Cassels whether he thought that a spiritual approach to improving our health had merit. Although admitting he did not know much about these modalities, he did point out the many promising studies on the benefits of meditation as a spiritual action that improves health, especially in the areas of pain management and stress related problems.

So, how does the spiritual meet the emotional and the rational in health choices?

I used to be quite a worrier about my health – always feeling concerned that something was not right. I think I would have been an ideal candidate for early screening for disease at that time, and I suspect they would have found something more for me to worry about. Studies are increasingly showing that our bodies are not separate from our thinking.  Emotions such as fear, hatred, anger, frustration or stress have a negative influence on our health, whilst, gratitude, joy and love have a strong influence for healthier outcomes.

The nexus of spiritual, emotional and rational coalesced for me when I realized that I could not deal with these emotions without a regular spiritual practice that helped me to overcome feelings I knew were destructive to my health.  One spiritual practice that has been in use for millennia is prayer. Discovering how to pray calmed my thought, and reduced fear. Eventually, the worries about my health just melted away. This helped me make more rational decisions about my health. And, my health improved.

Alan Cassels’ very readable book is certainly thought provoking regarding the need for searching questions and calm research before we make important decisions based on rationality.  And I would add that as we also cultivate calmer, healthier thoughts in this process, we may find we need fewer tests and fewer prescriptions.