Does helping others help you?

John Holmes wrote “There is no exercise better for the heart than reaching down and lifting people up.”

We all know that exercise is good for us, but is the exercise of the heart, “reaching down and lifting people up” just as good for us?

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  Her meme of the day today was a claim that “Helping others can increase your lifespan.”  She explained that “Researchers found a link between serving others, improved health and decreased mortality! See more at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780662/pdf/AJPH.2012.300876.pdf”.

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The journal she referenced was a 2013 article by Poulin et al in the American Journal of Public Health [1].  Poulin and his colleagues examined data from nearly 850 people in the Detroit area.  At the start of their study, they asked their participants about stressful life events in the last year and whether they provided tangible assistance to friends or family members.  They then followed their participants for five years and analysed the characteristics of who died in that time.

According to the study by Poulin, those who helped others were younger, healthier, more likely to be White, of higher socioeconomic status, and higher in social support and social contact than those who didn’t help, all factors that have been shown to influence mortality.  They also noted that 70% of their cohort didn’t experience any stressful life events.  While they adjusted for these variables, their statistics would still be affected by them.  As it turns out, while their results were significant, their numbers had broad confidence intervals, so the effect they found is very weak.

What about other studies looking at the same question but in a different way?  Well, there are mixed findings.  Roth and colleagues published a study in 2013 in the American Journal of Epidemiology which also showed that care-givers had better life expectancy than matched controls [1] but then a number of other studies show the opposite.  The Caregiver Health Effects Study found that those who were providing care to a disabled spouse and who reported some strain associated with that care had a 63% elevated risk of death compared with non-caregiving spouses [2]. Other studies suggest that caregivers have poorer mental and physical health status than non-caregivers [3], and caregiving has been widely portrayed as a serious public health problem in the professional literature [4, 5].

So while Poulin found a loose association between helping others and decreased mortality, Dr Leaf has taken that a step too far:

> Firstly, correlation does not equal causation.  Just because a study found those who helped others had a decreased mortality doesn’t mean that the reverse, helping others increases your lifespan, necessarily holds.  There may be other explanations.
> Secondly, other studies show conflicting results, so Poulin’s study may be a statistical hiccough.

It’s not clear that helping others is actually good for our health.  That doesn’t mean to say we shouldn’t help others. I think we should, if for no other reason than the golden rule, “Do unto others as you would have them do unto you.”  But we can’t definitively say that helping others will help us directly by making us live longer.  That’s scientifically still up in the air.

References

[1]        Poulin MJ, Brown SL, Dillard AJ, Smith DM. Giving to others and the association between stress and mortality. Am J Public Health 2013 Sep;103(9):1649-55.
[2]        Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA : the journal of the American Medical Association 1999 Dec 15;282(23):2215-9.
[3]        Pinquart M, Sorensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 2003 Jun;18(2):250-67.
[4]        Talley RC, Crews JE. Framing the public health of caregiving. Am J Public Health 2007 Feb;97(2):224-8.
[5]        Centre for Disease Control and Prevention. Caregiving, A Public Health Priority.  2010, 7 Dec 2010 [cited 2016 Jan 16]; Available from: http://www.cdc.gov/aging/caregiving/index.htm

Dr Caroline Leaf and the case of the killer reactions

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Stress! Believe the media and seemingly every disease known to man is in some way linked to it. Heart disease = stress. Cancer = stress. Flatulence = stress.

Dr Caroline Leaf, Communication Pathologist and self-titled cognitive neuroscientist, has been of a similar opinion for the last couple of decades. Dr Leaf must have been kind enough to read my book, because after teaching for the last fifteen years that stress is toxic, a subtle shifting under the weight of evidence has appeared.

In her 2009 book [1], Dr Leaf wrote,
“The result of toxic thinking translates into stress in your body.” (p15)
“Stress is a global term for the extreme strain on your body’s systems as a result of toxic thinking.” (p15)
“Stress is a direct result of toxic thinking.” (p29)
“These stages of stress are scientifically significant because they illustrate how a single toxic thought causes extreme reactions in so many of our systems.” (p39)

In 2013, her position on stress hadn’t really changed that much: “Even a little bit of these negative levels of stress from a little bit of toxic thinking has far-reaching consequences for mental and physical health”, and “The association between stress and disease is a colossal 85 percent.” [2: p36-37]

Again in her 2009 book [1], Dr Leaf devotes an entire chapter to the alleged effects of the toxic stress pathway on our body (chapter 4, p39-43).

Now in her latest social media update, tucked in amongst the gratuitous selfies and holiday snaps, comes something that’s actually about mental health: “Stress does not kill… is good for us! Its our negative reactions to stressful events that pushes into negative stress…and this is what kills! Sistas 2014 NZ”

The problem for Dr Leaf is that any stress, whether it’s caused by our “negative” reactions or not, doesn’t actually kill us.

There is a phrase used in science, “Correlation does not equal causation”. This simply means that just because two things occur together, one doesn’t necessarily cause the other. For example, do my red watery eyes cause my hives? They always appear together, but they don’t cause each other. The common element that causes both of them is actually the cat that I’ve just patted.

Just because stress is correlated with certain illnesses does not mean that stress causes or contributes to those illnesses. In fact, one of Dr Leafs own pivotal references, an article by Cohen and colleagues in the Journal of the American Medical Association in 2007, discussed the weakness of assuming that stress causes most diseases. As they say, “Although stressors are often associated with illness, the majority of individuals confronted with traumatic events and chronic serious problems remain disease-free.” [3]

Even if it were true that it how we react to stress contributes to the outcome of that stress, Dr Leaf’s statement about our killer reactions incorrectly presumes that both how we cope with stress, and the physical outcome of stress are the result of our choices.

Our levels of stress, and the way we cope with our stress, is mostly caused by our genetics. Some people will be naturally less stressed, and some people will be naturally better at coping with stress (see chapter 5 of my book [4] for a full discussion on the science of resilience). Just because you’re more prone to stress doesn’t mean that it’s all down to your bad choices. Assumptions like these only add to your already high levels of stress.

That’s not to say that we don’t have a way to improve our responses. For those of us at the stressed end of the spectrum, successful psychological therapies such as Acceptance and Commitment Therapy will help to improve our coping, and certainly have been shown to improve (not cure) mental illnesses like anxiety and depression, and other chronic conditions like chronic pain (see [5] for a review).

ACT and other modern psychological therapies recognise that trying to change our thoughts doesn’t make any difference to how we cope. So like I said before, it’s partly true that how we react to normal life experience will help us live full and productive lives, but it’s not about fighting or changing our thoughts. It’s about being mentally flexible enough to make room for our thoughts and fears and move forward towards meaningful action. I’m sure that the ladies at ‘Sistas 2014’ wouldn’t be hearing that from Dr Leaf.

Anyways, I’m glad that Dr Leaf is changing her tune on stress, but there’s still more room for change before she meets up with current scientific understanding.

For an in-depth review of the teachings of Dr Leaf, visit http://www.smashwords.com/books/view/466848 where you can download a free copy of “Hold That Thought: Reappraising the work of Dr Caroline Leaf.

References

  1. Leaf, C., Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. 2009, Inprov, Ltd, Southlake, TX, USA:
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:
  3. Cohen, S., et al., Psychological stress and disease. JAMA: the journal of the American Medical Association, 2007. 298(14): 1685-7
  4. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848
  5. Harris, R., Embracing Your Demons: an Overview of Acceptance and Commitment Therapy. Psychotherapy In Australia, 2006. 12(6): 1-8 http://www.actmindfully.com.au/upimages/Dr_Russ_Harris_-_A_Non-technical_Overview_of_ACT.pdf