Dr. Schubiner's Blog Social Contagion and Mind Body Syndrome

Originally written by Dr. Schubiner on September 21, 2009


More on the “contagiousness” of Mind Body syndrome:

Over the past couple of years, a new line of research has been developed which documents that certain disorders are socially contagious. Nicholas Christakis and James Fowler have published articles in the New England Journal of Medicine and in the British Medical Journal documenting that smoking, obesity and happiness all share the ability to be affected by those around us. The more people you know who are smokers, the more likely it is that you will be a smoker. The same is true for having contacts who are overweight. And if you have more friends and relatives who are happy, you are more likely to be happy! It seems obvious that these issues can be affected by being in close contact because these issues are generally thought to be caused by our values, our thoughts and our behaviors. That is, we can choose whether we smoke, how much we eat and exercise, and how to respond to the stresses in our lives.

Reading these articles made me think once again about the contagiousness of mind body syndrome. I wrote a blog about this last year (Blog #6, June 20, 2008), but we now have some data and a way to measure this construct that we call social contagion. Can physical symptoms be contagious? We know that the flu or the common cold are contagious, i.e. you can catch it by being in close contact with someone who has it due to being exposed to the virus which causes it. We would never think that you can catch cancer or heart disease because these are diseases caused by something that goes wrong inside your body, not something you catch from someone else.

If you read this blog, you are familiar with Mind Body syndrome, which is when one gets physical symptoms, such as back pain, headaches, fibromyalgia, irritable bowel syndrome or irritable bladder syndrome, due to stress and emotions that are either suppressed or unexpressed. If these syndromes can be caused by stress and emotions, they may have many similarities with smoking, obesity and happiness, which are also related to stress and emotions.

Dr. Christakis referred me to one of his articles in which he suggests that headaches can be contagious. He also indicated an article on back pain by Dr. Raspe and colleagues in Germany (Raspe, et. al. International Journal of Epidemiology 2008;37:69-74).

In this study, they gathered surveys on the amount of back pain reported by East Germans and West Germans, both before and after the fall of the Berlin Wall and the reunification of Germany. Surprisingly, the prevalence of back pain was much lower in East Germany prior to reunification, however, after the two countries unified the amount of people with back pain in East Germany gradually increased to the level of that seen in West Germany, where it has remained. The authors suggest that the cause of the rise in back pain in East Germans that back pain is socially contagious. This is their explanation: “We hypothesize that back pain is a communicable disease and suggest a harmful influence of back-related beliefs and attitudes transmitted from West to East Germany via mass media and personal contacts.”

If headaches and back pain are shown to be socially contagious, this would be a huge advance in the understanding of what causes them. The concept of Mind Body syndrome is not widely understood by physicians or by patients, even though everyone knows that you can get physical symptoms when under stress. As I often say, your face turns red when you get embarrassed, your stomach tightens up when you have to give a speech, and you get a headache after a stressful day. Doctors have recognized that stress and emotions can cause paralysis in the absence of a disease process such as a stroke or an infection, which is known as a conversion disorder. However, most doctors do not realize that stress and emotions can cause chronic pain.

The work of Christakis and Raspe now offers the possibility of showing that certain disorders are related to stress and emotions, at least in part. If we are able to use research methods similar to those used in these studies, we will hopefully be able to better understand the causes of common pain syndromes that are causing a tremendous amount of suffering in the world. Let’s hope that this research goes forward. The sooner these disorders are clearly understood, the sooner we will be able to help decrease suffering as well as medical testing and procedures which are unnecessary.

To your health,

Howard Schubiner, MD