What one thing contributes more than anything else to unhappiness? As a doctor I can answer that: a long period of illness. It is a little frightening, when you think of it, because there are a thousand different ailments that this human clay is heir to, and one of them is as common as the other nine hundred and ninety-nine put together. A conservative estimate is that fifty per cent of all the people going to doctors today are victims of this one disease. Many would put the figure higher. At the Ochsner Clinic in New Orleans a report was published reviewing five hundred consecutive admissions to that institution; of those, three hundred and eighty-six—or seventy-seven per cent—were sick with this one disease. Persons of any age, in any walk of life, can contract it. Furthermore, it is a terrifically expensive disease to diagnose and treat.
I hesitate to give you its name because immediately you will get a lot of misconceptions. The first will he that it is not a real disease. But don't kid yourself. It used to be called psychoneurosis. Now it is known as psychosomatic illness. And it is not a disease in which the patient just thinks he is sick. The pain you get is often just as severe as the pain you get with a gallbladder colic.
Psychosomatic illness isn't produced by a bacterium, or by a virus, or by a new growth. It is produced by the circumstances of daily living. I have tried to find one word for it, but it takes three, each one of them meaning about the same thing but in different degrees. They are: cares, difficulties, troubles (c.d.t.). Whenever one has such a thick, impenetrable layer of c.d.t. that he can't get up above it into a realm of joy and pleasure occasionally, he gets a psychosomatic illness.
There are three general groupings of people who suffer from, c.d.t. In the first group are the people who are habitually crabby. A friend of mine has a beautiful farm. I drove past his farm one summer day and I thought to myself, "Those oats ought to make Sam happy." So I drove in, and I said, "Sam, that's a wonderful field of oats," and Sam said, "Yes, but the wind will blow it down before I get it cut." He got it cut all right, he got it threshed and he got a good price for it. Well, I saw him one day and I said, "Sam, how did the oats turn out?" And he said, "Oh, it was a good crop, and. I suppose the price was all right, but you know a crop like that does take a lot out of the soil."
People like Sam invariably get a psychosomatic illness, and when they get it they get it hard. As a rule, they are invalids for the rest of their lives. There is nothing you can do about it.
The second group, where most of us belong, are the people who all day long manage to be concerned, to be anxious, to be worrying about something. If there's nothing in the home or the business, they worry about Mrs. Smith down the street. Why doesn't she get her daughter in before eleven o'clock at night? Something is going to happen to her!
The third group is made up of those who have an acute case of c.d.t. Maybe they have got themselves into some kind of mess—financial ruin or domestic trouble, perhaps. They are usually easier to treat than those in the second group; And those in the second group are certainly easier to treat than those in the first group.
How does this c.d.t. bring on illness? To understand that, we must consider what thinking is and what emotion is. Thinking, we ordinarily suppose, is something that goes on solely in the brain, but that is quite wrong. Thinking involves the entire body in a series of correlated nerve impulses that centre in the brain. Particularly is this true when an emotion colours our thinking. The psychologist William James gave us the best definition that we have of emotion when he said that it is the state of mind that manifests itself by a perceptible change in the body.
One emotion we all recognize is anger. You don't have to be told when a man is angry. His face either gets white or it gets red; his eyes widen; his muscles tighten up so that he trembles. That is the state of mind manifesting itself by a perceptible change in the body. Another emotion is embarrassment. A person who blushes certainly doesn't have a disease of the skin. In his case embarrassment produces a dilation of the blood vessels in the face.
A third example in the group of unpleasant emotions is the man or woman who vomits or faints at the sight of blood. The sight of blood leads to such painfully disagreeable thinking that the stomach does the things that result in vomiting. Or the heart and the blood vessels leading to the brain do the things that result in fainting.
Now, how does all this bring about a disease? Very simply. Most of our disagreeable emotions produce muscle tightness. Suppose that all day long your thinking is acutely disagreeable. You are tightening up muscles. Take your fist and hold it loosely; it doesn't hurt; but hold it tight for a long time and it begins to hurt. The squeeze produces pain.
One of the first places to show tension is the group of muscles at the back of the neck. Another group that come into play very early are the muscles at the upper end of the oesophagus. When they squeeze down you feel a lump. It is difficult to swallow. If the muscles in the lower oesophagus contract, then it's more serious. Much more commonly the stomach is involved. And when the muscles of the stomach begin to squeeze down you are conscious of a heavy, disagreeable pressure inside. When the muscles squeeze down hard, then it hurts. And it hurts just as bad as any ulcer. In our town we had a grocer who had a pain exactly like that of an ulcer. He had plenty of trouble—a competitive business, a nagging wife, a wayward son—and he had this pain most of the time. Doctors assured him he had no ulcer. He finally began to believe them when he noticed that every time he went fishing the pain disappeared. And it didn't come back again until he was almost home.
This same kind of muscle spasm can occur in any part of the colon. Many persons who complain of a pain exactly like gallbladder pain don't have gallbladder trouble at all. They're dissatisfied, and the upper colon is squeezing down. And believe me, their suffering is real. If the pain happens to be lower down in the colon, it will seem just like appendicitis. And then it takes a very clever surgeon not to open that abdomen. Other muscles besides those in the intestinal tract respond to emotional stimuli, particularly the muscles of the
blood vessels. A good many of the people who have a headache severe enough to cause them to go to a doctor have that headache because some blood vessel inside or outside the skull is squeezing down so hard from nervous excitation that it produces pain.
And a third of all skin diseases treated by dermatologists are produced by blood vessels in the skin reacting to anxiety, worry, disgust, and so on. Each time certain individuals become upset or irritated or peeved, serum is actually squeezed out through the wall of the blood vessel and into the skin. The tissue becomes thickened with serum. Finally, the serum is pushed up through the surface of the skin where it becomes scaly, crusty and itchy, and the patient has a neurodermatitis.
One favourite place for nervous tension is the muscles in the upper left part of the thorax. People rarely come to see us doctors because they have a pain on the right side. It's almost always on the left. if it's on the right—pshaw! —it doesn't amount to anything. If it's on the left—ah! —could be heart trouble! Then they start watching for it. And merely watching for it can bring the pain on.
Muscle tension is just one way in which the symptoms are produced in a psychosomatic illness. One of the other ways is the effect that emotion has on the endocrine system. Most of you have driven down a street in a motor car too fast when suddenly somebody has backed out from a side road. You started to breathe deeply, your heart started to pound, and you grew a little faint. Acute fear in your mind produces these bodily changes. An impulse is sent to the adrenal glands, which squeeze adrenaline into the blood stream. When that adrenaline hits the heart, the heart starts to thump. When it hits the respiratory centre in the brain, you start to gasp. When it hits the blood vessels going into the brain, they narrow down and you feel woozy.
There are other organic effects of psychosomatic illness. If it happens to be the blood vessels of your heart that squeeze down every time you get excited or angry, it is serious. John Hunter, the physiologist, had that kind of heart, and he always said, "The first scoundrel that makes me angry will kill me." And that's exactly what happened. He got up in a medical meeting on one occasion to refute something that he didn't like, and in a fit of anger produced such a contraction of the blood vessels of his heart that he fell dead.
Many victims of psychosomatic illness are up and about. Many are in hospitals. Thousands have been in bed at home for years. To avoid psychosomatic illness, you must learn to think right. There ought to be in every university a course called "The Art of Human Living" It should teach us how to make our attitude and as pleasant and cheerful as possible. It would be idiotic for me to tell you that you can be pleasant and cheerful all the time. Of course you can 't. But I can offer certain suggestions which will help you to think right about yourself.
First, stop looking for a knock in your motor. Don't be analysing your feelings all the time, looking for trouble.
Second, learn to like to work. To get anywhere in this world you've got to work. One of the things you will escape, if you learn to like to work, is work tension, the tension that comes to those who look upon work as something that has to be got over.
Third, have a hobby. A hobby is an important element in getting your mind off work tension. During the day when you are hurrying and worrying, just relax for thirty seconds by thinking briefly about that thing you're making in the basement, that community project you're interested in or that fishing trip you're taking next weekend.
Fourth, learn to like people. Carrying a grudge or dislike can have disastrous bodily effects. We had a man in the hospital who got there because he had to work in an office with a man he didn't like. He said, "I don't like the way he combs his hair; I don't like the way he whistles through his teeth; I don't like the way he always starts a sentence with `Listen! '" On questioning the patient I found that he never liked anybody—his mother or his father or any member of his family. But you have to meet people. You've got to live with them, so learn to like them.
Fifth, learn to be satisfied when the situation is such that you can't easily change it. A young lady was in a hospital with a psychosomatic illness because she had become dissatisfied with her life. She had been a secretary, had held a war job in Washington. There she married an Army captain. After the war she found herself living in a caravan, with three children to bring up. She didn't like to live in a caravan, didn't like to bring up children in a caravan, wasn't sure that she liked to live with her husband in a caravan. She wanted to be a secretary, back in Washington. I didn't tell her what her trouble was. I just advised her to send to the library and get the four Pollyanna books and read them. She did, and she returned to live in the caravan and like it. She had learned that it is just as easy under most conditions to be satisfied as it is to be dissatisfied, and it is much more pleasurable.
Sixth, learn to accept adversity. In this life you're going to meet some adversity. You may meet a lot, but don't let it bowl you over. I had a patient who hadn't worked for a year. Then his wife died. A month later his son was killed. And he sat about thinking "How unfortunate I am—why did this have to happen to me!" He became very ill. He hadn't learned to accept adversity. A lot of people start a psychosomatic illness after an adversity.
Seventh, learn to say the cheerful, humorous thing. Never say the mean thing, even if you feel like doing so. In the morning, look at your wife or your husband and, even if it isn't so, say, "My dear, you look good this morning." It will make her (or him) feel better, and it will make you feel better.
Finally, learn to meet your problems with decision. About the worst thing to do is to have a problem and to mull it over and over in your mind. If you have a problem, decide what you are going to do about it, and then stop thinking.
These are some of the things that you have to learn if you want to escape the most common disease of all. The key is: I'm going to keep any attitude and my thinking as pleasant and as cheerful as possible. There isn't any better definition for happiness.