Book review: Counterclockwise: Mindful Health and the Power of Possibility, by Ellen J. Langer.

This book presents ideas about how attitudes and beliefs can alter our health and physical abilities.

The book’s name comes from a 1979 study that the author performed that made nursing home residents act and look younger by putting them in an environment that reminded them of earlier days and by treating them as capable of doing more than most expected they could do.

One odd comment she makes is the there were no known measures of aging other than chronological age at the time of the 1979 study. She goes on to imply that little has changed since then – but it took me little effort to find info about a 1991 book Biomarkers which made a serious attempt at filling this void.

She disputes claims such as those popularized by Atul Gawande that teaching doctors to act more like machines (following checklists) will improve medical practice. She’s concerned that reducing the diversity of medical opinions will reduce our ability to benefit from getting a second opinion that could detect a mistake in the original diagnosis, and cites evidence that North Carolina residents have an unusually high tendency to seek second opinions, and also have signs of better health. But this only tells me that with little use of checklists, getting a second opinion is valuable. That doesn’t say much about whether adopting a culture of using checklists is better than adopting a culture of seeking second opinions. The North Carolina evidence doesn’t suggest a large enough health benefit to provide much competition with the evidence for checklists.

One surprising report is that cultures with positive views of aging seem to produce older people who have better memory than other cultures. It’s not clear what the causal mechanism is, but with the evidence coming from groups as different as mainland Chinese and deaf Americans, it seems likely that the beliefs cause the better memory rather than the better memory causing the beliefs.

Two interesting quotes from the book:

certainty is a cruel mindset

to tell us we’re “terminal” may be a self-fulfilling prophecy. There are no records of how often doctors have been correct or not after making this prediction.