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New Orleans, Louisiana, United States
Admire John McPhee, Bill Bryson, David Remnick, Thomas Merton, Richard Rohr and James Martin (and most open and curious minds)

30.8.09

Getting Older

Here's an innovative way to lower health care costs: Set everyone's biological clock back 20 years. Senior citizens of 75 will enjoy the strength and stamina they had at 55, meaning they will need far less medical attention. The energetic elderly will remain productive members of their community later into life, which could also ease the strain on Social Security.

Granted, this sounds like an unusually wonky episode of The Twilight Zone. But three decades ago, Harvard University psychologist Ellen Langer conducted a landmark experiment that suggested reverse aging needn't be relegated to the realm of science fiction. Her revealing study, the many follow-ups it spawned and the implications of their findings are the subject of her fascinating new book Counterclockwise: Mindful Health and the Power of Possibility.

It's a brightly written work — Langer has a knack for metaphors — that deftly challenges an array of assumptions we hold about health. She reminds readers that many definitive-sounding diagnoses are in fact best guesses, and that no study, however elegant and persuasive, can truly tell us the best course of treatment for any particular patient. Physicians, she counsels, should be thought of as "consultants." Ultimately, we know our own bodies best.

In a sense, this is a book about the limits of empirical knowledge. But as Langer sees it, the ambiguity that inevitably accompanies medical research can be profoundly liberating. If we can't be sure that a diagnosis — or a widely accepted truism such as "memory loss is inevitable with age" — truly applies in our case, we're less likely to stick ourselves with a self-limiting label. "While many of our experienced disabilities may be a natural part of aging," she writes, "many are instead a function of our mindsets about old age."

The ingenious counterclockwise experiment was conducted in 1979. Langer and her students recruited two small groups of elderly men to spend a week living in a secluded New Hampshire monastery. Those in the control group spent the seven days reminiscing about the past, while those in the experimental group effectively re-entered the past. Their environment was designed to convey the impression they were living in 1959. They watched movies, listened to songs and read magazines from that era and discussed "current events" such as the first U.S. satellite launches.

"Both groups came out of the experience with their hearing and memory improved," Langer reports. (It appears our bodies respond to being intellectually and emotionally engaged.) But members of the experimental group experienced more dramatic benefits. They were more likely to improve their scores on an intelligence test; more likely to show improvement in joint flexibility and dexterity; and more likely to look younger, as judged by a group of outside observers who compared before-and-after photos. Also, their fingers were longer. Since their arthritis declined in severity, they were able to extend their digits past the point they could a week earlier.

A fluke, perhaps? Well, Langer offers plenty of other data suggesting a strong link between self-perception and health. My favorite involves a group of hotel maids who reported their long hours and family responsibilities didn't give them time to exercise. They were then told that their work, with all its bending and scrubbing, in fact involves quite a bit of exercise. So informed, they lost an average of 2 pounds over the next four weeks. Langer, who has spent several decades studying the effects of mindfulness, notes the women were paying renewed attention to activities that long ago became routine and mechanical. That, she suggests, is the key: If you're noticing the precise condition of the carpet rather than daydreaming as you vacuum, chances are you'll push the machine a little bit harder.

Langer defines mindfulness not in the sense of meditation and detachment popularly associated with Buddhism, but rather as being aware enough to notice subtle changes in ourselves and in our environment. The health implications of such alertness are obvious: If we notice small shifts in how we feel, we can address problems before they become acute. She argues we will also begin to realize that the distinction we make between being "sick" and "well" is often arbitrary and usually unhelpful, in that it prompts us to bounce back and forth between willful ignorance of our body's workings and helpless dependence on a medical professional.

Langer wrote a best-selling book on mindfulness in 1990, and this latest volume may also climb the charts: A Hollywood movie focusing on the counterclockwise experiment, starring Jennifer Aniston as the research psychologist, is scheduled for release next year. No doubt the renewed interest in Langer's research reflects a widespread fear of aging among baby boomers, many of whom will resonate to her ideas. How many have the discipline to follow through on her recommendations is another question. Living a fully engaged life in which we constantly question not only society's assumptions about aging but also our own ingrained beliefs is a bit more involved than getting a Botox injection.

Nevertheless, policymakers and health educators need to be exposed to these concepts. (Her chapter about the consequences of language used by doctors should be taught in medical schools. Does anyone really feel better when told their cancer is "in remission"?) Langer persuasively suggests it is no coincidence that a society that worships youth and considers the elderly somewhat embarrassing is bankrupting itself with health care costs. If pop culture and the mass media equate being old with being weak, helpless and irrelevant, why wouldn't the elderly feel feeble?

So the fountain of youth may in fact be the flood of chemicals in our brain that processes both internal and external messages about old age and dutifully passes them on to our joints, blood vessels and vital organs. Perhaps it's time to start noticing these cerebral downloads and disregard the disempowering ones. Personally, I'm planning to pop in a tape of When Harry Met Sally into the VCR and celebrate the fall of the Berlin Wall. It turns out 1989 was quite a year.

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