PDF Summary:The Mindful Body, by Ellen J. Langer

If you’ve ever felt your stomach turn in a moment of anxiety or felt like jumping up and down with excitement, then you’ve experienced the mind-body connection firsthand. In The Mindful Body, Harvard psychology professor and “mother of mindfulness” Ellen J. Langer argues that you can use this connection to take control of your health. By approaching your health mindfully—instead of mindlessly accepting labels from doctors and society—you can heal your body, reduce your pain, and live a longer, fuller life.

In this guide, we’ll explore Langer’s assertion that the mind and body are inextricable and discuss how this link manifests in health outcomes. We’ll also examine three limiting beliefs that shape health, including the view that health is a finite resource. Finally, we’ll touch on two research-backed strategies for approaching your health mindfully. In our commentary, we’ll dive into the philosophical and medical underpinnings of Langer’s work, and we’ll discuss further methods for achieving good health.

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Individuals who embraced the aging process experienced health advantages in addition to those demonstrated in Langer’s studies. These included reduced incidence of major diseases like diabetes, cardiovascular disease, stroke, and cancer. These participants also showed better mental acuity, maintained higher levels of physical exercise, and experienced improved sleep quality. From a psychological standpoint, these participants reported decreased feelings of isolation and depression while displaying greater hopefulness and a stronger sense of purpose.

How Limiting Beliefs Shape Health

In the previous section, we explored how the mind and body are intimately connected, and we looked at multiple ways this connection can affect our health. In this section, we’ll examine three common limiting beliefs that prevent us from taking full advantage of our minds’ healing powers: believing that rules and labels are absolute, that we can predict what’s going to happen, and that health is a limited resource.

Belief #1: Rules and Labels Are Absolute

Langer states that mindlessly adhering to rules and labels can be very damaging to your health. First, we’ll examine the dangers of believing that rules are absolute. Then, we’ll explore how labels influence health outcomes.

Rules Aren’t Absolute

Often, we interpret rules in healthcare (and other aspects of life) as if they’re set in stone, forgetting that they were created by people who are just as fallible as anyone. Additionally, many rules that affect our health were created for a specific subset of people at a different time. They don’t allow for variation among individuals or differences over time.

When you mindlessly follow medical rules, you may not get the care you need because your situation isn’t the same as that of the people the rule was based on. Instead, you need to assess your health mindfully, stay open to multiple possibilities, and consider any diagnosis or treatment in the context of your specific circumstances.

For instance, consider the common medical rule that short-acting blood pressure medication should be taken first thing in the morning. This guideline was established based on studies showing that most people’s blood pressure naturally rises in the early morning hours. However, suppose you work night shifts as a nurse. In that case, your circadian rhythm would likely be reversed—your “morning” blood pressure spike might actually occur in the late afternoon when you wake up for work.

Mindlessly adhering to the standard “take your medicine in the morning” rule could mean your blood pressure is poorly controlled during your active hours. Your medication could be wearing off precisely when you need it most—during the stressful late-night hours when you’re caring for patients. Solving this issue might take finding a different doctor who looks beyond the standard guidelines and considers your unique schedule. It might also require doing more individual research before talking to your doctor about adjusting the timing of your medication.

The Benefits and Limitations of Personalized Medicine

Medical care that’s tailored to each patient’s individual needs—known as personalized or precision medicine—is a growing field. Its goal is to address issues stemming from the mindless, one-size-fits-all approach that Langer criticizes. In personalized medicine, providers factor in their patients’ individual diets, lifestyles, genetics, and environments when deciding on the best courses of action. This approach applies to every stage of patient care, from prevention to diagnosis to treatment.

For about two decades, personalized medicine has improved treatment outcomes for cancer patients. For instance, immunotherapy—where medications help a person’s immune system detect and destroy cancer cells more efficiently—has greatly decreased melanoma-related deaths. Targeted, precise treatments such as this prevent patients from having to go through the emotional and physical exhaustion caused by less personalized, less effective therapies.

However, there are several practical limitations to medical treatments that are based on patients’ individual genetics. Primarily, the genetic data available to create treatments is severely lacking in diversity—the majority of studies on patient genomes have gathered information from Americans with European ancestry. Therefore, the advancements in genetically personalized medicine have mostly been accessible only to this population. Additionally, low-income patients who face barriers to healthcare have fewer opportunities to benefit from these treatments.

How Labels Change Health Outcomes

Langer also asserts that mindlessly accepting labels from doctors and society can seriously harm your health. This is especially apparent when you look at the difference between health outcomes in people who barely meet the criteria for a medical diagnosis and people whose markers are just shy of a diagnosis. Even though these groups have negligible differences in their actual markers, people who receive a diagnosis typically adopt the mindset that their situation is unalterable. Therefore, they tend to behave in ways that reinforce the diagnosis and stop looking for ways to change their situation, leading to poorer health outcomes.

(Shortform note: Diagnoses and medical labels can also harm patients because of the stigmas and stereotypes associated with them. For example, stereotypes around who can get HIV, moral judgments about taking precautionary measures against HIV, and harmful beliefs about people “deserving” to get HIV because of their choices can seriously impact the health outcomes of those diagnosed. This discrimination may lead to denial of treatment by healthcare professionals, social isolation of people with HIV, feelings of shame, and delays in or avoidance of testing.)

To better understand the influence of labels, Langer and her team tested the relationship between diagnosis and health outcomes in a study on prediabetes. They looked at the results of A1C tests (which measure blood sugar levels) for two groups: people who measured at the threshold for a prediabetes diagnosis (5.7%) and people who measured just below the threshold for diagnosis (5.6%). According to endocrinologists—doctors who specialize in hormone-related conditions—the difference between these numbers is medically insignificant.

(Shortform note: An A1C test records what the average level of glucose (a simple sugar) in your blood has been over three months. Glucose comes from carbohydrates in the foods you eat and drink, is transported through your blood to your cells, and is an important energy source for your body. Certain metabolic functions help to control blood glucose levels, particularly the hormone insulin, which is created by the pancreas. When your body stops making insulin, doesn’t make enough, or isn’t using it efficiently, your blood glucose levels can get out of control, leading to diabetes.)

The study showed that the “prediabetic” label made a big difference in participants’ future health—even though their A1C numbers were basically the same, the people in the prediabetic group showed a sharp increase in their A1C over time, making them much more likely to receive a future diagnosis of diabetes.

Langer argues that, rather than prompting the participants to create a healthier lifestyle to avoid diabetes in the future, the prediabetic diagnosis made them feel as if getting diabetes was inevitable. Because they were placed into a frightening medical category, they may have felt they were past a point of no return. In turn, this may have made them less conscientious about diet and exercise than the 5.6% group, who still thought of themselves as healthy.

The Relationship Between Prediabetes, Diabetes, and Mental Health

Further research supports the connection between prediabetes, diabetes, and mental health. However, some findings suggest that the mental health of patients with these conditions suffers whether they’re aware of the diagnosis or not. In one study, researchers compared the mental health of people with newly diagnosed prediabetes to that of people without prediabetes. The participants with prediabetes weren’t aware of their diagnoses during the study. Researchers looked at several factors, including anxiety, depression, quality of life, and fatigue.

The results showed that the people who had prediabetes scored significantly worse in the psychological evaluations than the healthy participants, meaning they experienced more anxiety and depression and a lower quality of life. This indicates that the condition itself can be a contributor to mental health issues, regardless of whether or not the patient is aware that they have it.

That being said, mental health does have a documented effect on self-care habits and blood sugar levels, supporting Langer’s assertion that the stress of a prediabetes diagnosis could worsen health outcomes. For instance, if you become depressed as a result of a diagnosis, you may struggle with a sense of hopelessness and loss of energy, which makes it difficult to maintain healthy eating and exercise habits. Additionally, stress can contribute to sudden decreases or increases in blood sugar levels, which can make it difficult to manage insulin levels.

Belief #2: You Can Predict the Future

According to Langer, another false belief that limits our ability to lead healthy lives is that we can predict what will happen. We tend to believe that there’s a right and a wrong path to take and that we can control outcomes if we make the right choice. However, this is a misconception—we can only respond to the results of our choices and judge them through hindsight.

(Shortform note: In The Biggest Bluff, Maria Konnikova explains why we have a hard time understanding that outcomes are outside of our control. She says it’s because our brains aren’t wired to handle probabilities. We evolved to learn from our experiences and recognize patterns, like associating the rustle of leaves with the likelihood that a predator is near. Because of this, we make decisions based on gut feelings, and we assume that the small sample size of our experiences reflects the larger distribution of possibilities. Additionally, we struggle with percentages—people tend to interpret an 85% likelihood to mean that an outcome is certain, but Konnikova writes that 15% chances happen more often than we think.)

Instead of trying to control outcomes through your choices, focus on what you actually can control—how you respond after you’ve made a health decision. You can’t predict the future, but you can mindfully accept uncertainty, acknowledging that there are many possible outcomes that you can’t force or avoid. Decide that you’ll make the best of whatever happens as a result of your choices. Choosing to see and accept myriad possibilities in any situation frees you from the fear of making the wrong choice and a sense of regret, thus benefiting your mental health. At the same time, it empowers you by showing that you do have control over your perspective.

(Shortform note: The attitude that Langer suggests adopting towards things we can and can’t control mirrors the teachings of ancient Stoic philosophers. For instance, in The Enchiridion, the Roman Stoic Epictetus writes that the only things we can control are our thoughts, responses, and voluntary actions. We aren’t disturbed by events themselves, but rather by our reactions to them, which we have agency over. We should treat everything else—the future, the past, outcomes of our decisions, and so on—with a viewpoint of detachment. Focusing on the things we can control rather than things we can’t leads to a sense of tranquility and liberation.)

How Viewing Outcomes and Decisions Mindfully Affects Health

Langer explains that your ability (or inability) to view possible outcomes mindfully affects how you deal with developments in your health. For instance , if you’re diagnosed with a progressive illness, you may get information about its typical progression and consequences from your doctors, the internet, and so on, along with options for treatment.

If you accept this information mindlessly, you may feel as if your future is guaranteed to be full of struggle and ever-worsening symptoms, with limited options for help. This may make you feel like there’s no point in trying different therapies because the result will be the same. However, if you stay mindfully open to many possible outcomes, you’ll be free to explore what works for your unique situation.

The Three Chronic Illness Mindsets

Psychology researchers have named three mindsets people commonly adopt when living with a chronic illness: the management mindset, the catastrophe mindset, and the opportunity mindset.

• Management Mindset: You recognize that symptoms come and go, you’ll have good and bad days, and you have the power to alter your circumstances. You believe in your ability to withstand suffering because it’s a normal part of life. (This mindset is the one that most closely adheres to Langer’s advice.)

• Catastrophe Mindset: You believe that your illness is a great and terrible thing, you have no agency over your situation, and your life will never get better. Thus, suffering feels intolerable.

• Opportunity Mindset: You believe that your illness can be a source of strength because your suffering can encourage the development of positive qualities, such as equanimity, courage, wisdom, and empathy.

If you have a chronic illness, you’ll likely go through periods where you experience all three of these mindsets depending on factors like the severity of your symptoms, how well treatments are working, and moments of personal growth.

If you find yourself slipping into a catastrophe mindset, first ask yourself whether you’re truly in imminent danger. When you’re in a lot of pain, you may feel like it’s going to last forever, or you may experience strong emotions such as fear, grief, and anger. Instead of equating these feelings to a source of danger, experts say that you should recognize them as emotions to be felt and moved through. Finally, consider actions you can take to begin shifting to a management or opportunity mindset, such as journaling or engaging in gentle movement.

Belief #3: Health Is a Limited Resource

Finally, Langer states that many people think of health as a limited resource, which keeps them in a fixed mindset that hinders their improvement. This is due to a pervasive scarcity mindset—the belief that there’s only a certain amount of every quality and resource available. In this belief system, you may have a fixed idea of how much of each quality or resource you and other people are allotted. For instance, you may believe that you have an inherently low athletic ability, but a higher-than-average allotment of math skills.

(Shortform note: Scarcity mindsets are harmful because they keep us focused on things we don’t have. According to psychology experts, obsessing over what we lack can make it hard to stay in the present moment, retain information, and regulate impulses. These challenges leave us unable to see possible solutions for our problems. Remaining in this headspace can lead to poor mental health, relationship issues, and high-risk behaviors. To break from a scarcity mindset, consider keeping a gratitude journal to reorient your thoughts toward things you do have. Additionally, try to cultivate relationships with people who encourage a more positive outlook, rather than those who share your negative thought patterns.)

Langer argues that this scarcity mindset exists to create an artificial hierarchy—it’s in the best interest of those with the majority of a resource to stay at the top. However, the standards used to measure personal qualities and achievements aren’t absolute or objective. They’re always determined by people and are therefore inherently changeable and flawed. Once you realize this, more possibilities open up for you. You see that resources and qualities aren’t fixed, and you can do a lot to change your circumstances.

How Alter Egos Can Help You Improve Your Circumstances

In The Alter Ego Effect, Todd Herman offers a strategy for harnessing the malleable nature of personal qualities to help you change your life. He argues for the use of alter egos—a science-backed tool that lets you adopt the traits, behaviors, and demeanor of a person who excels in a particular area.

When using an alter ego, you set aside your usual mindset and behaviors and instead take on those of your alter ego. You intentionally choose which traits you’ll draw on to succeed in a given situation. Thus, qualities that may otherwise feel unavailable to you become accessible. For example, say you want to build a regular exercise routine for your health, but you don’t normally feel like you belong in the fitness world. To get yourself through your workouts, you could assume the alter ego of Lara Croft from the Tomb Raider series, as she’s known for her stamina, strength, and “can do” attitude.

How a Scarcity Mindset Influences Your Health

Langer explains that people—especially those with chronic illnesses—often think of health in terms of fixed scarcity or abundance, believing that it can only stay the same or get worse. They then stop looking for ways to help themselves or change their situation. Langer disputes this belief: She argues that anyone can live a healthy life.

For instance, say you’re diagnosed with arthritis. You view your condition as one that guarantees decline, thinking of yourself as one of the people who got a lesser share of good health. You believe you have a fixed amount of mobility and energy, and it’ll only decrease over time. You stop doing activities you enjoy, like yoga and gardening. You stop trying new treatments and abandon your exercise routine, thus carrying out a self-fulfilling prophecy.

However, if you view good health as something you can access, you’re more likely to look for ways you can improve your health. Instead of accepting your fate, you try new activities like gentle stretching, swimming, and cooking anti-inflammatory recipes. Your arthritis won’t disappear, but you can potentially live an even fuller and healthier life than you did before your diagnosis.

(Shortform note: The power of a growth mindset—the belief that you can change your situation for the better—has proven effects in the health outcomes of children with chronic illnesses. For example, research conducted on children with Type I diabetes found that children with growth mindsets had lower glucose levels than children who had a fixed mindset about their condition. Pediatricians believe growth mindsets positively affect children’s health for the same reason Langer explores—-because if you think your health can be improved, you’re more likely to improve it, such as by following doctors’ treatment advice.)

How to Approach Health Mindfully

Now that we’ve examined some of the common beliefs that keep us from unlocking our best health, we’ll take a look at two of Langer’s strategies for approaching your health mindfully: Spending time with mindful people and paying attention to fluctuations in your health.

Strategy #1: Spend Time With Mindful People

According to Langer, just spending time around people who exhibit mindful traits can make you more mindful, which is beneficial for your health. Mindful traits include paying attention to details, thinking critically, and noticing small behavioral changes.

(Shortform note: To find mindful people, you could join local interest-based groups like yoga or meditation classes, or you could look for spiritual or wellness events on websites like Meetup and Eventbrite. Additionally, seek out communities centered on personal growth, health, and conscious living, and foster connections by engaging with other people with sincerity and curiosity in everyday interactions.)

Langer describes how one of her studies found that patients with traumatic brain injuries had better health outcomes when the people taking care of them exhibited mindful traits. This could be for multiple reasons: First, patients may have become more mindful themselves because of the influence of their caregivers. Second, the more mindful a caregiver is, the better they can respond to changes in the patient’s symptoms and behavior.

(Shortform note: To be a mindful caregiver, you must first take care of yourself—ignoring your own needs can lead to resentment, burnout, and your own physical decline. Mindful practice can be part of your self-care routine, benefiting both you and the person you’re caring for. Experts suggest trying to do at least one mindful activity a day, which could include breathing exercises, journaling, meditation, yoga, and walking, among other things.)

Strategy #2: Pay Attention to All Types of Health Changes

To avoid getting into the fixed health mindsets and limiting beliefs we touched on earlier, Langer suggests that you pay attention to all types of changes in your health. We tend to be more aware when symptoms and health challenges get worse, mindlessly accepting that our condition will only deteriorate. However, it’s important to notice positive fluctuations in your health as well.

In practice, this may look like:

• Considering what factors could have contributed to your symptoms worsening or improving at different points in time
• Noting the intensity of your symptoms in different circumstances
• Consciously paying attention to times when symptoms are absent as well as the times they’re present

Tracking your health changes in these ways will help you notice controllable factors and circumstances that affect your symptoms. This habit will ensure that you remain open to possible solutions for your health challenges.

Monitoring your health changes can also make you less dependent on things like medications and medical devices. For instance, say you experience motion sickness when you’re on road trips. If you mindlessly accept that this’ll always happen, you may depend on a drug like Dramamine, which makes you feel extremely drowsy. However, if you experiment and mindfully pay attention to your symptoms, you may find that sitting in the front seat helps, or that chewing ginger candy reduces your nausea enough that you don’t have to take Dramamine. Thus, you’ll have a way to reduce motion sickness and be awake during road trips.

How to Keep a Health Journal

You can document fluctuations in your health and the different factors that cause them in a health journal. Doctors often ask patients with chronic illnesses to keep a symptom diary so they can create a more comprehensive, effective care plan. It’s very difficult to keep track of all of your health information without a written record, and having something physical to look back on can help you see the positive alongside the negative, even in difficult moments.

Experts suggest the following tips for people starting their health journaling practice:

• Be honest with what information you share. If you omit things from the record (such as certain foods you eat that you aren’t supposed to), you and your doctor won’t have an accurate picture of what affects your symptoms.

• Keep the format of the journal simple and consistent. Write down the same information every day. Information to include could be things you eat and drink, the quantity and type of exercise you do, changes in your mental state, and the dates and times of any flare-ups.

• Include summaries of any patterns in your health that you’ve noticed. These can be helpful for you and your doctor.