Can Words Cure Cancer?
The negative language that we use to describe cancer could lead a patient down a deadly road—even when in remission.
By Ellen J. Langer published July 1, 2000 - last reviewed on June 9, 2016
At 56, my mother died of breast cancer. At least, that's what the medical world reported. I'm still not sure. Before she died, her cancer went into complete "remission." Her death was decades ago and to this day, I don't know what "remission" really means. If two people go for a checkup to see if they have cancer and one never had the disease while the other person is in "remission," the test results look the same. Psychologically, however, "remission" may be very different from a "cure."
Language has the interesting property of being able to increase and decrease our perceptions of control. Different word choices can direct our thoughts about a single situation in many different ways.
Consider the way we deal with cancer. If somebody has cancer and the cancer goes away, we say it is in remission. The implication is that the same cancer will recur. Is it in "remission," or has it actually been "cured"?
Now, contrast cancer with a cold. Every cold we have is seen as a different cold. Each time we beat a cold, we become more persuaded that we can beat the next one. While there are surely similarities among the various colds we have had over the course of our lifetimes, there are also many differences from one cold to the next. Who decided whether we attend to the similarities or differences among various colds? Most of us are oblivious to the idea that there is any choice involved. We were simply led early on to believe that we can master colds, that each one is different from the last. The psychological evidence for this is that our last cold left at some point. We were successful in beating it.
With respect to cancer, however, being in "remission" means that we are waiting for "it" to return. If "it" does return, this recurrence is seen as the same cancer. Psychologically, this may lead us to feel defeated. For each new cold we beat, we implicitly think, "I beat it before, I can beat it again." If the cancer comes back, however, we think,"'It' is winning. I am just not as strong as 'it' is." Surely the cancer will in some ways bear a similarity to the last cancer, but in other ways, it is surely just as different. Our language leads us to see similarity in recurring episodes of cancer while with the common cold we see dissimilarities.
Ever since my mother's death, I've been somewhat ambivalent about the medical world. I would turn to medical doctors if I were seriously ill, yet I think, in general, that they may underestimate the power of psychology to influence health. The psychological literature is now replete with examples of the physical consequences of giving up; people are more likely to die soon after the death of a spouse of many years, or to die after holidays rather than before them, for example. Even if one were not as persuaded by the experimental data as I am, it is clear that giving up impairs people's physical health and keeps them from wanting to survive. Why exercise or take medication if one is likely to die soon anyway? Did cancer kill my mother, or was it the language that we use to describe cancer that led her to give up?
A friend of mine had breast cancer, which is now in remission. She has every reason to believe that she is now fine, but even so, she is scared. When we talk about her cancer, all of the events surrounding my mother's death vividly return to me. Would things have turned out differently if my mother had thought that her second episode of cancer was not identical to the first? Would my friend be more at ease now if we didn't use the word "remission" to describe her state?
The same kinds of issues arise in the simple difference between characterizing an alcoholic as "recovering" instead of "recovered." If an alcoholic has not had a drink in 10 years, it seems odd to characterize that person as still recovering. As with cancer, the word "recovering" suggests that we are victims and are helpless.
Purportedly, people view themselves as recovering instead of recovered to remind them that they should not drink. It seems to me that it may be easier, however, to refrain from drinking when one feels strong. "Recovering" suggests that you've never quite beaten the problem. "Recovered" suggests conviction and strength. It seems to me that the stronger one feels, the less likely they are to revert to harmful behaviors.
Consider also the choice of whether to call alcoholism an allergy or a disease. If one had a severe allergy to alcohol, why would he or she drink? People who are allergic to shellfish typically don't eat shrimp or mollusks. The word "allergy" suggests the person who has it is in charge of treating it, while a "disease" seems much less controllable.
This outlook casts an interesting light on the way we think about antidepressants. If I take Prozac or Paxil, for example, my depressive symptoms may go away, but I still consider myself a depressed person. I am likely to attribute most of the joy I experience to the medication, but the misery always remains mine. If I take an aspirin to treat a headache, however, I believe the headache has "gone away," even if I am regularly prone to headaches.
If antidepressants are effective in removing depression just as aspirin works to remove headaches, it seems to me that people on this type of medication should not see themselves as being depressed any longer. If there are no symptoms of depression, then it follows that there should be no depression.
And what about vitamins? Even though they come in pill form, and may be taken to alleviate problems like arthritis and fatigue, they are still seen as vitamins. Yet while we take "vitamins" to stay healthy, we take "pills" when we are sick. To my mind, "to be healthy" is not the same thing as "not to be sick." Each time someone says they're taking a vitamin, their perception of being healthy gets a boost. Pills, in contrast, may reinforce the perception of illness.
The way we use language encourages people with cancer, alcoholism or depression to consider these disorders an intractable part of who they are. Colds and headaches, by contrast, describe how we are at the time, not who we are. We might be able to improve how we are if we make decisions about what to call our ailments based on differences from one episode to the next. If I enter the physician's office with stomach pains, for example, I leave feeling somewhat better knowing I have "gastroenteritis." Having a name for our disorders gives us some comfort. But we have much more control, however, once we realize that a particular name and its implications are just one of several we could have chosen. Most of us remain oblivious to the way the name is just one of several we could have chosen.
Sometimes we become aware of the word choices available to us when we encounter someone who interprets words differently than we do, or who describes the same situation in which we find ourselves in a different way. A humorous example of this arose when I tried a new dictation program for my computer. I had injured the middle finger of my right hand and, to get on with writing my new book, I decided to dictate it to the computer. When I told it about my "gastroenteritis," it told me, "Castro decided to invite us." When I told it about a "belief," it took me on a trip to "Belize"! While not especially useful for its original purpose, the software has proved very entertaining. I can't seem, though, to get the machine to understand me. It may not have the choice of interpreting my language, or of looking at my illnesses in different ways, but I do.