By the time he joined the UCLA faculty in 1978, Norman Cousins was a giant in 20th-century America — known as a writer, as editor in chief of the iconic Saturday Review magazine, and as a citizen diplomat and leading advocate for world peace. But it was during his final chapter, at UCLA — which extended until his death in 1990 — that he made what is arguably his most enduring impact.
Cousins was convinced that emotions played a powerful and overlooked role in human health and disease — a belief rooted in experience. In 1964, Cousins was diagnosed with a painful and debilitating disorder. Conventional medicine had little to offer, so he prescribed his own therapy: liberal doses of vitamin C and laughter. For the latter, Cousins relied on Marx Brothers films and reruns of TV’s Candid Camera, among other movies and shows. His doctors were skeptical, but the patient laughed his way to a successful recovery.
In his best-selling book Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration — published in 1979, the year after he joined the UCLA School of Medicine faculty — Cousins documented that experience, along with his beliefs about the mind-body connection. The book’s publication coincided with some of the first studies suggesting a link between mind and body — specifically, the interaction of human psychology with the immune system. “People were focused on how stress and other adverse experiences could have negative health consequences, but Norman flipped that on its head and said, ‘Let’s look at how we can improve or alter emotional responses to reverse disease,’” says Michael R. Irwin, the Norman Cousins Distinguished Professor at the David Geffen School of Medicine at UCLA.
Cousins recognized that his ideas amounted to heresy in most medical circles. “Norman knew that in order for this concept to gain any traction, he had to place it within a medical school of high repute, such as UCLA’s, and engage scientists capable of asking difficult questions about what might underlie these associations,” Irwin says. So Cousins brought together leading experts in psychology, neuroscience and immunology to begin developing the evidence; at the same time, he sought to move medicine toward a more humanistic approach that involved patients in their healing and care.
Today, the Norman Cousins Center for Psychoneuroimmunology at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, under Irwin’s leadership, carries forward the legacy of its namesake, in part through research into the mind/body connection and the role of the psyche in health and healing. A central focus of the work is mindfulness, which Irwin describes as “paying attention with openness and curiosity to the present moment.” Cousins Center researchers have found that mindfulness approaches such as meditation improve sleep and mood while reducing anxiety and stress. More intriguing, and a testament to Cousins’ prescience, are the center’s studies indicating that mindfulness alters not only symptoms, but also genetics, in ways that are associated with positive health outcomes.
Irwin is interested in translating the knowledge obtained by Cousins Center researchers into practical approaches to harnessing the mind’s power toward better health. He offers the following advice:
Mindfulness is an easily acquired skill that lays the foundation for all mind-body approaches to promoting health, Irwin says. The UCLA Mindful Awareness Research Center, part of the Cousins Center, offers in-person and online mindfulness classes, but the basic technique is simple. It starts with paying attention to your breath, remaining present in the moment and aware of your surroundings. “We’re all going to have thoughts racing through our minds, but instead of going in the direction of those thoughts, observe them in a nonjudgmental way and then return to the present,” Irwin suggests. Within that state, Irwin and others say, it’s easier to react calmly to concerns and find creative solutions to problems. Mindfulness can be practiced through activities such as meditation, yoga and tai chi, or while standing in line or sitting in rush-hour traffic.“It’s something we can implement at any time during our daily experience,” Irwin says. “It produces a state of calmness and serves as a reset so that we can be engaged in whatever is going on in our life.”
Irwin has devoted a significant portion of his research to the issue of sleep, because, he says, “It’s a behavior we can easily modify, and it has profound effects on health outcomes.” Insomnia and other sleep problems can weaken our immune defenses, increase inflammation and accelerate the aging process, Irwin notes, while elevating the risk of cardiovascular disease, cancers and depression. The research conducted by Irwin and his colleagues shows that mindfulness practices improve sleep quality, and that cognitive-behavioral therapy and tai chi are effective in treating insomnia in older adults and breast cancer survivors while reducing insomnia-related inflammation.
We don’t typically view our friends and family as medicine, but without them, our health suffers. Particularly for older adults, social isolation and loneliness are major risk factors for disease, decline and earlier death. “Social isolation is now rampant, especially in the older-adult population,” says Irwin. “That’s why so many of the strategies we use bring people into groups and teach them how to take these approaches back into their communities to build their social networks.”
Irwin and his Cousins Center colleagues are pursuing the possibility, suggested by promising preliminary research, that practicing kindness through activities such as volunteering or simply being good to those around us could alter our biology in a way that benefits our health. Irwin views mindfulness as a path toward a more compassionate outlook. “It puts you in a state of not being judgmental with yourself, which tends to carry over into how you interact with other people,” he explains. His group is even testing the hypothesis that the changes in physiology resulting from mindfulness might actually play a role in steering individuals toward these prosocial behaviors.
Irwin also points to research indicating that people who think positively and find meaning in their lives — the feeling of contentment described as eudaimonia by Aristotle — fare better in genetic measures of health. “It’s about finding broader purpose in one’s life,” Irwin says. “Those are the people who appear to be thriving in our studies.” To whatever extent possible, he recommends reframing challenges as opportunities and drawing on our social network for support as we seize those opportunities. Expressions of gratitude and acts of compassion, fueled by mindfulness practices, can contribute to a eudemonic state, Irwin says. “I can’t say what Norman would have thought about mindfulness, because it wasn’t talked about much when he was alive,” he says. “But it very much resonates with his message.”