Real vs Imaginary in the Brain and Body

Head with colored cogs inside

The brain, in many ways, doesn’t distinguish real from imaginary.

Take a simple example of stress. Your brain responds to a stressful situation by releasing stress hormones. But your brain also releases the stress hormones when you remember a past stressful event or even when you vividly imagine one. Whether you’re really there in the stressful situation, you’re remembering it or imagining it, is all much the same to your brain. It releases stress hormones each time.

Another thing to consider is that a stressful event is not absolutely a stressful event. All you can be certain of is that it is stressful for you. The same event might be experienced differently for someone else. So, the event itself is not stressful. It’s how you think about it that’s stressful and that results in your feelings of stress. And it’s your feelings of stress that produce the stress hormones. So, you produce stress hormones because of how you feel, regardless of whether you’re there (in the stressful situation) in person or there in your mind.

In other blogs and in my books, I’ve written than kindness is the opposite of stress. Most people assume that peace is the opposite of stress. Peace is an absence of stress, not it’s opposite. In physiological terms, the feelings associated with kindness produce opposite effects to the feelings associated with stress. So, does the same type of real vs imaginary effect apply to kindness?

It seems so. The feelings associated with kindness, what social scientist Jonathan Haidt has called elevation, are produced regardless of whether you’re having a direct experience of kindness (as the giver or receiver or even as a witness to it), or whether you’re remembering an experience of kindness, or even whether you are vividly imagining one. The same feelings are produced in each instance. And just as with stress, it’s the feelings that produce the hormones. In the case of kindness, it’s kindness hormones.

The main kindness hormone is oxytocin, otherwise known as the love drug, the hug drug, the cuddle chemical, or any other similar affectionate name. It’s the feelingsof warmth and connection that produce oxytocin.

So, whether you’re being kind, receiving kindness, or witnessing kindness in a real or imaginary setting, you feel the same feelings and therefore produce the same kindness hormone. Just as with stress, your brain doesn’t distinguish between real and imaginary.

Can the same be said with other systems of the body? It seems so. Numerous studies have shown that imagining touching or moving a part of the body activates the corresponding brain region as if we really did touch or move that body part. For example, researchers at the Karolinska Institute in Sweden showed that when a person imagined moving fingers, toes, or even their tongue it activated the fingers, toes, and tongue regions of the brain as if they really were moving their fingers, toes or tongue.

The famous ‘piano study’ is an excellent example from neuroscience. Researchers at Harvard University, led by Alvaro Pascual-Leone, compared the brains of people playing a sequence of notes on a piano with the brains of people imagining playing the notes. The region of the brain connected to the finger muscles was found to have changed to the same degree in both groups of people, regardless of whether they struck the keys physically or mentally.

It is this phenomenon – the fact that the brain processes imaginary as if it were real – that allows sports people to benefit from visualisation practices. Several studies have shown that players can improve on their golf shots, tennis strokes, net shots in basketball, ice skating, football, or just about anything. Studies have shown people increasing their muscle strength by imagining themselves flexing muscles or lifting weights. In a study, for example, at the Lerner Research Institute in Cleveland, imagining flexing the little finger for 15 minutes daily for 3 months was shown to increase muscle strength by 35% … and the volunteers hadn’t even lifted a finger. 🙂

The technique has also allowed people who have had a stroke to recover faster, as has been demonstrated in several studies that compare patients receiving physiotherapy with patients doing visualisation of movements as well as the physiotherapy. According to these research studies, those who do the visualisation practices recover faster than those who do physiotherapy alone. A 2014 meta-analysis of the use of ‘mental imagery’ in stroke rehabilitation noted this compelling evidence and concluded that it could be a ‘viable intervention’ and that it renders ‘unlimited practice opportunities’.

The benefits rely on the fact that when a patient visualises movement, the brain processes it as if they really are moving, and so imagined movement becomes like extra physical practice as far as the brain is concerned.

We can even extend the idea onto eating. In a study led by Carey Morewedge, at Carnegie Mellon University, volunteers either ate or imagined eating small sweets. Some volunteers were asked to imagine eating several sweets and others were asked to imagine eating only a small number. When given the chance to eat real sweets later, those who imagined eating the most had less appetite for more. It was concluded that imagining eating impacted the brain like real eating does and actually supressed the appetite for more, just as real eating does. It was as if the brain were saying, “OK, that’s enough. I’m full now” even though the person hadn’t actually eaten anything but had just imagined it.

In other words, in some ways the brain processed imagining eating as if the person really was eating. A word of caution here, though. Research hasn’t investigated whether imagining eating affects the body in other ways, like perhaps without actual food a person might deprive their bodies of needed nutrition. But the point is, again, that the brain isn’t making a noticeable distinction between real or imaginary.

How far does this go?

Studies even suggest that the immune system responds in a similar way. Volunteers asked to imagine increasing levels of certain antibodies, or immune cells, were able to increase their numbers. Furthermore, in a randomised controlled trial of breast cancer patients undergoing chemotherapy, around half of the patients were asked to also imagine their immune cells like piranha fish and to imagine them destroying cancer cells. In those who visualised, immune system activity was higher than it was in those who didn’t visualise. In fact, the immune systems of those who visualised were showing high levels of cytotoxicity even after the fourth (and final) cycle of chemotherapy.

So, generally speaking, insofar as the above examples go, it seems to be that the brain and body don’t distinguish between whether something is real or whether we just imagine it as real.

The question now becomes: what does that mean for us?



All references and more complete discussions can be found in David R Hamilton PhD, ‘How Your Mind Can Heal Your Body‘, (Hay House, 2019). Individual references are below.

Fingers, toes and tongue study
H. Ehrsson et al., ‘Imagery of voluntary movement of fingers, toes, and tongue activates corresponding body-part-specific motor representations’, Journal of Neurophysiology, 2003, 90(5), 3304-3316. Link to study

Piano study
Pascual-Leone et al., ‘Modulation of muscle responses evoked by transcranial magnetic stimulation during the acquisition of fine motor skills’, Journal of Neurophysiology, 1995, 74(3), 1037-1045. Link to study

Little finger strength study
K. Ranganathan et al, ‘From mental power to muscle power – gaining strength by using the mind’, Neurophysiologia, 2004, 42(7), 944-956. Link to study

Stroke rehabilitation meta-analysis
Y. Kho et al., ‘Meta-analysis on the effect of mental imagery on motor recovery of the hemiplegic upper extremity function’, Australian Occupational Therapy Journal, 2014, 61(2), 38-48. Link to study

Immune system visualisation for cancer study
O.Eremin et al., ‘Immuno-modulatory effects of relaxation training and guided imagery in women with locally advanced breast cancer undergoing multimodal therapy: A randomised controlled trial’, The Breast, 2009, 18, 17-25. Link to study

Nature’s Catch 22

Image from Wordswag

I’ve written a lot about the “side effects” of kindness. There’s five of them: Kindness makes you happier, it’s good for the heart, it slows ageing, it improves relationships, and it’s contagious.

There’s talk sometimes where people say there is no truly altruistic act, that if you benefit from kindness then you’re being somewhat selfish and you’re therefore not doing it for the right reasons. It’s almost as if for a kindness to be pure, we have to suffer by doing it.

To be honest, I try not to get too weighed down with the academic debates about altruism. My opinion is that nature has built into us, that is, we have evolved, a system that encourages us to be kind for the right reasons, because being kind is the right thing to do.

I call it Nature’s Catch 22.

Here’s what I mean. The health-related side effects of kindness only occur because of how being kind makes you feel. That’s the key. It’s the warm feelings that come with kindness that release the kindness hormone, aka, the cuddle chemical, the hugging hormone, the love drug, or formally, oxytocin, a 9 amino acid-long hormone. It impacts not only brain circuits that make us feel connected, trusting, and happier, but it also acts on blood vessels to lower blood pressure and serves as a potent anti-oxidant too.

Therefore, you can only benefit from an act of kindness if you mean what you do. Why? Because you have to mean it to feel it! I’ll say that again. You have to mean it to feel it. And only by feeling it do you release oxytocin. To generate the kindness hormone and receive its benefits, your act of kindness must be real, honest, heartfelt.

It’s the feelings that generate the positive effects. Just as feelings of stress create negative effects in the body (and produce stress hormones), so feelings associated with kindness thus create positive effects.

So, a person trying to make themselves happier or improve their cardiovascular health by doing some half-hearted acts of kindness is futile. Of course, on one hand it still benefits the other person so that’s a good thing regardless, but there is no benefit to themselves because they didn’t mean what they were doing.

Perhaps I have side-stepped some of the altruism debate, but I believe that most of us are genuinely moved by the pain or suffering of others, and this makes our acts of kindness genuine.

I believe we have evolved to feel compassion, we have evolved to care, and as a result, we have evolved to be kind.

Nature’s Catch 22 has ensured it.

Our ancient ancestors who were kind for the right reasons derived more health benefits and were therefore more likely to survive and pass their genes onto the next generation.

So, we have evolved to mean it when we’re kind and to feel how it feels when we’re kind. And as a result, we receive the side effects of our kindnesses.

My new book, ‘The Little Book of Kindness’ (Gaia, Feb 2019) is due to be published on 7th Feb. I’m offering a FREE 4-lesson online course (on The Biology and Contagiousness of Kindness) to everyone who pre-orders the book before 7th Feb (pre-order quantities are used by booksellers to make decisions whether to stock a book or not). You can check out the free course HERE.

And you can pre-order the book from:

Amazon UK (Flexibound) Amazon UK (Kindle) (Flexibound) (Kindle) (Flexibound) (Kindle) (Flexibound) (Kindle)
Barnes and Noble (Flexibound) Barnes and Noble (Nook)

Kindness on the curriculum

I spent some time in New York City last weekend. I’m writing a series of pieces for Psychologies Magazine called ‘The Kindness Conversation’ where I basically have, well, conversations about kindness. In New York, I had my kindness conversation with Cynthia Germanotta, mother of Lady Gaga.

Cynthia is president and co-founder (with her daughter) of Born This Way Foundation, a charity whose mission it is to create a kinder and braver world. They focus much of their efforts on inspiring kindness in young people.

After our conversation (which will be in Psychologies Mag in a few months’ time), we headed out to Baldwin High School, a school on Long Island, to participate in a kindness project that the kids there have been involved with. These kids had bought over 400 Christmas presents for children whose families are homeless.

When we arrived at the school, all of the presents had been gathered together in a large hallway in the school before the kids took armfuls each and carried them out to a school bus. They literally packed the bus full of presents. Once filled, the bus was then driven to Bethany House, which provides emergency and transitional housing for homeless families in Long Island.

As part of their ‘Multiply Your Good’ campaign, Born This Way Foundation matched the number of presents with gifts of clothing for the children from one of their partners, thus doubling the volume of donations and so that the children of Bethany House would receive toys and clothing at Christmas.

As I write this, I am in awe of the kindness I witnessed at the school. It touched me deeply. Similar to my last experience in a school (see My Day Talking Kindness to Young Children), I found myself blown away by what I witnessed. People have often remarked that I am a kind person because I write and speak about kindness. In some ways, I am trying to use my skills to spread kindness, which is why I write and teach. But I cannot help but feel that there is a difference from writing and speaking about it and actually being on the front line doing it, like these kids were. It was a real humbling experience.

The teachers at the school deserve a special applause too for having the vision and desire to involve the school kinds in such a rewarding programme where, at their young age, they could have first-hand experience of kindness, what it means, and how it makes a difference. I think it’s a great idea to involve kids in kindness projects like this, so that they can learn about kindness through experience at a young age and also, through further school work, can explore the consequences of kindness, the impact it can have on people’s lives.

Surely, learning about kindness while at school is as important as learning to read and write, as important as maths, science, music, art and languages. Kindness is fundamental to our interactions with each other. It’s a way of being, a way that colours the nature of these interactions. It is fundamental at all levels of society. It is fundamental in building and maintaining healthy communities.

Kindness is getting more column space in newspapers and magazines now than at any other time I can remember. Perhaps it’s an antidote to some of the aggression and division we see so much of in the world at the moment, especially on the political scene. Perhaps we subconsciously seek to counterbalance division with kindness, because kindness unifies.

Kindness brings people together. It dissolves disagreement and hatred. Or as philosopher, Albert Schweitzer, wrote, “Constant kindness can accomplish much. As the Sun makes ice melt, kindness causes misunderstanding and hostility to evaporate.

Kindness is like glue that holds us all together. What would we be without kindness? Where would we be if we all sought to look out only for ourselves? Kindness includes others.

I think kids should be learning what kindness is in school; how it matters, why it matters, its consequences. Kindness should be on the curriculum of all schools.

I was bullied at school when I was 16-17 years old. I often wonder if things would have been the way they were for me if kindness had been on our school curriculum. Would I still have been bullied? Perhaps! Perhaps not! But I do believe that, in general, a curriculum that included studies on kindness, with opportunities for further study in later school years, would result in a noticeable drop in bullying and a significant increase in tolerance and unity and perhaps even academic performance.

Kids could be learning why kindness matters, how it impacts our health, how it spreads by inspiring ‘pay it forward’ behaviour in others. They could be learning how to actually be kind, the multiple forms it can take, from saying thank you, to paying a compliment, to listening, to being there for a friend or family member, to volunteer work, to helping people in the community, to refraining from bullying.

They could learn about the science of kindness and how it impacts our health, from how it makes us happier, can reduce risk of depression and anxiety, how it helps build resilience by counteracting stress, to how it impacts the heart and arteries, the nervous system and immune system.

The curriculum could involve practical experience of volunteering in the community, with a written report that encourages the kids to reflect on the impact of the work they did. Older kids studying kindness may even, as part of their own projects, help tutor younger kids in some of their school subjects.

Perhaps kindness as a compulsory subject on the school curriculum would have further reaching consequences too, as kids move on after school and take what they have learned into the wider world. Perhaps it would have knock-on effects in business, in how business is conducted, on the reasons why business is conducted.

Many kids who learned kindness at school may become business leaders and influence how business is done. Many could find their way into politics and their knowledge and experience of kindness may influence decisions taken at national and international levels, which surely will benefit all of us. I think we may then see the world coming together in greater ways as we recognise and embrace our common humanity, as we celebrate our similarities instead of squabbling about our differences.

“We look for a glorious dénouement [end result],” said Archbishop Desmond Tutu in the film and book, Choice Point (which I’m also in), “when we will discover that we are actually members of one family.” I think kindness on the curriculum might really help us with such a goal.

This might sound idealistic or even fanciful thinking, but I think it’s already happening. There are pockets of this happening everywhere, even if not formally, not least at Baldwin High School, but also in the school that my friend John teaches at, where he teaches young kids on the ASD spectrum. Their whole school did a kindness project. Some of the kids in John’s class wrote letters to me a few weeks later to tell me the sorts of acts of kindness they had been doing and what kindness their classmates had shown them. I know there are many more schools making kindness a fundamental part of children’s education and experience.

Kindness matters. Kindness makes a difference. Being kind also inspires kindness in others. It is contagious. That is a fact. I think it’s spreading through schools now. And at a time of year when we worry about catching a cold or flu, kindness is one ‘bug’ that I think we would all do well to catch.

How belief can drive recovery

When I worked in the pharmaceutical industry, the placebo effect was frequently dismissed as ‘all in the mind’ or ‘psychosomatic’. It wasn’t a real improvement, it was believed, merely that people ‘think’ they’re feeling better.

This was conventional wisdom at that time and is still a widely held belief today. When a mother kisses a scrape or graze on their child’s knee, the pain seems to reduce. Sometimes, an adult will feel better once they arrive to see the doctor. We tend not to imagine that some physical change in the brain has actually caused the improvements.

The truth is, physical changes do occur in the brain and they are caused by what the person believes or expects will happen.

Take research into what is known as placebo analgesia, for example, the reduction in pain that occurs when a person receives a placebo that they believe is a real painkiller. The analgesia occurs because the person’s brain produces its own painkillers. They don’t just ‘think’ they’re feeling less pain. They actually DO feel less pain.

A similar kind of thing has been observed with research into Parkinson’s Disease. Fabrizio Benedetti, a neuroscientist at the University of Turin School of medicine and who runs the most advanced placebo research lab in the world, identified production of dopamine in the brain of Parkinson’s patients who received placebo injections.

He even measured activation of individual neurons that fired according to the how much placebo they’d received. The net gain in movement and reduction in tremors wasn’t just ‘all in the mind’ of the patients, nor did the patients just think they could move better but really they couldn’t. The improvements were real and they were due to real physical changes in the brain driven by what the patients believed or expected would happen.

In another of Benedetti’s experiments, he enlisted volunteers to receive an injection of capsaicin (aka chilli peppers) into their hands or feet. The volunteers thought they were participating in a trial of a new and powerful local anaesthetic, but the anaesthetic was really a placebo. They had the placebo cream applied to one of their hands or feet but not to the other and then the chilli pepper was injected into both. So, they might have the cream applied to the left hand but not the right, but the chilli pepper would be injected into both hands so that a comparison could be made.

Upon injection, the pain was substantially less in the hand or foot that had the placebo anaesthetic cream applied but there was maximum pain in the other hand or foot. When Benedetti examined the brains of the volunteers, he found that the brains of the volunteers had produced their own natural versions of morphine, known as endogenous opioids.

But even more impressive was that these opioids were produced only in the specific region of the brain governing the specific region of the left hand or foot that had the placebo cream applied.

In other words, the person expected to have no pain in one specific region of their hand or foot and, as a consequence, endogenous opioids were produced in the necessary region of the brain required to deliver that precise result. As Benedetti noted, the entire brain was not flooded with endogenous opioids, only the specific region governing the hand or foot that had the placebo applied. In some ways, the human mind acts with surgical precision.

Perhaps we should rebrand the placebo effect as ‘The specific impact of expectation or belief on the brain and body’ … or maybe that’s a bit of a mouthful and ‘placebo effect’ is just easier. The point is that the word placebo, for many, conjures up the idea that nothing is actually happening, that improvements really are just ‘all in the mind’. But that is simply not so.

Expectation or belief produces real changes in the brain and body, often consistent with what the person expects or believes will happen, and these changes drive physical effects throughout the body.

Of course, there are limits and we shouldn’t automatically think that belief will instantly cure disease. It is wise to follow medical advice. But as more research is undertaken into the placebo effect, we’re learning that some systems of the body previously thought inaccessible to the placebo effect are accessible after all. It just takes a little longer.

Researchers have shown that placebos can be used to suppress the immune system, for example, and an active line of research is ongoing into PCDR – or Placebo Controlled Dose Reduction – where a dose of a drug is gradually lowered and replaced by a placebo over a number of days. It’s called conditioning,

The patients get a result each time they take their meds. As the mental association between taking the drug and the result strengthens, some of the drug can be replaced by a placebo and the patient’s growing conditioned belief compensates by generating its own physical effects.

Scientists believe this might be helpful for patients who take immunosuppressant drugs, like organ transplant patients and even those who have particular autoimmune disorders. The reduction in volume of drug required as it is gradually replaced by a placebo would surely be a cost saver for society and that money could be put to other uses. And perhaps side effects would be minimised.

We are living in an exciting time for placebo research and for research into the broader mind-body connection. We’re now learning that the contents of our minds can deliver real consequences in the body.

The skill for harnessing the effect, perhaps, is in believing that this is actually true and also learning to be more in control of the contents of our minds.



This article is based on Chapter 2 (The Power of Believing) of, ‘How Your Mind Can Heal Your Body‘, by David R Hamilton, PhD. All references are listed at the back of the book.

Can you visualise drugs working?

I recently chatted with a girl who has had rheumatoid arthritis since she was a child. Now in her late 20s, she’s taken painkillers for years.

When she was first diagnosed, a nurse instructed her to imagine her painkillers travelling to her joints and then dissolving into little particles and spreading out over the joints, soothing them and reducing swelling and pain. After a moment or two, the nurse would ask, “Can you picture it?” And when she said she could, the nurse would add, “Can you feel it? Can you feel it dissolving into the joint and taking the pain away?” And she could! She believed that the visualisation really helped her and has been using it regularly for over 20 years now.

Even as an adult, she spontaneously does the visualisation every time she takes a painkiller, closing her eyes and visualising for a moment or two right after she swallows the tablet with some water.

It’s a terrific way to use visualisation. I’ve written about visualisation and how it works in other blogs, and also teach it in my book, ‘How Your Mind Can Heal Your Body’. Mostly people use visualisation to imagine a state of illness changing into wellness, or to imagine their immune systems working to destroy bacteria or viruses, but like the girl above, some people visualise their medicines doing their jobs too.

Some people who take antibiotics imagine them destroying infection. From the moment they put the tablet in their mouth and take a sip of water, they imagine antibiotic particles travelling inside their body and going straight to where they need to go, neutralising infection there. The visualisation only takes a moment but is done consistently each time they take a pill.

Common among cancer patients is to visualise chemotherapy drugs as piranha fish or pac men chomping on cancer tells or tumours. In their minds’ eyes they imagine the cells being destroyed or tumours shrinking smaller and smaller until they vanish. Rather than thinking of the drugs as poison, then, which a number of people do and which can make them feel stressed as a consequence, they picture the drugs doing what they are supposed to do and only destroying the cancer while leaving everything else intact. It gives them a sense of control and seems to reduce stress.

Similarly, people undergoing radiotherapy imagine the radiation as bolts of lightning burning tumours and leaving all other areas intact.

A friend once had to take the chemotherapy drug ‘carboplatin’ as a treatment for lung cancer. She asked me to help her think of something to visualise. I explained that carboplatin is shaped like a square with an atom of platinum at the centre. I explained that it works by sitting across the strands of tumour cell DNA, essentially grabbing hold of the individual strands (the technical term is ‘bonds’ to), thus interfering with the DNA and preventing cancer cell replication.

I drew a little diagram (above) showing how the platinum rigidly holds the DNA strands. She loved it and used that visualisation through her treatment. She’d never tried visualisation before, but she told me that it gave her something positive to do with her mind.

Could these visualisations be helping? I don’t know of any research specifically around visualising drugs working, so any conversations I’ve had with numerous people who’ve visualised in this way might only be considered anecdotal. But I feel it’s worth knowing what some people do because at the very least it gives a person something positive to do with their mind while they take medicines, which might be a welcome replacement for worry or stress.

Perhaps, as some believe, any benefits are simply due to a reduction in stress or the person gaining a more optimistic attitude. But maybe there’s more to it than that. Given the overwhelming amount of evidence for the different ways that the mind impacts the body, my hunch is that visualising like this does add something extra a lot of the time.

Maybe it’s something to do with the action of imagining the physical condition improving. In other blogs, I’ve shared that the most common use of visualisation that I know of is where a person thinks of the site of injury, illness or disease, and imagines it being repaired or healed. And they do this repetitively. Perhaps this repetitive visualisation of the drug doing its thing is producing a real effect.

Some research has shown that repetitively visualising the immune system working can enhance the immune system and this technique has now even been shown to be beneficial in randomised controlled trials of patients undergoing treatment for cancer. In these trials, patients who visualised experienced a higher clinical response to their treatment than patients who didn’t visualise.

We also know through placebo research that some drugs work better when a person believes in them, or believes in the doctor who prescribed them, so the mind certainly seems to deliver an effect.

So, I’m inclined to believe, just like the girl who has imagined her painkillers working since childhood, that visualising medicines working might well have beneficial effects over and above the action of the drug alone – some, or even a lot, of the time.


The above piece is based on research and content from my book, ‘How Your Mind Can Heal Your Body’.

How your mind can heal your body

Yay! It’s book launch day. ⭐️⭐️⭐️ My book, ‘HOW YOUR MIND CAN HEAL YOUR BODY’ is officially on sale now from everywhere that sells books. 😀 It’s the 10-year anniversary edition.

The book was first published 10 years ago and usually, when I write a book, I kind of just put it out there and don’t give it that much thought, so I never imagined I’d ever be writing a new edition, but my publisher (Hay House) asked me if I could update it. So I did.

I was only supposed to add wee bits and pieces but so much has happened in the world of the mind-body connection in 10 years, so I ended up adding 4 new chapters and sprinkling new stuff all throughout. Oops. 😁

These cover things like how to use visualisation to enhance your immune system and I even share studies where this has been done in randomised controlled trials of women undergoing treatment for breast cancer. Typically, half do visualisation in addition to chemotherapy and radiotherapy, while the other half don’t. The visualisation group had a higher clinical response to treatment, which might be assumed to be the result of the extra impact of the immune system, as the researchers noted that the immune systems showed high levels of cytotoxicity even during treatment.

New chapters also deal with how visualisation works and how to actually do it and also include the application to sports, including how to enhance performance whether elite or beginner, or even learn a new skill, and even rehabilitation from stroke. I’ve also included several new stories from people who used visualisation as part of their recoveries from injury, illness or disease – including cancer, heart conditions, psoriasis, post-polio syndrome, and many more.

If you’re new to the book altogether, the first part discusses the placebo effect, sharing multiple examples in different settings, but also explaining how it works. Chapters also cover positive attitude, meditation, and how the brain doesn’t distinguish real from imaginary.

There’s also an A-Z list of visualisations for a large number of medical conditions.

If you’re interested in checking it out, you can find links on the ‘Books’ tab of my website, or just try anywhere that sells books, including Amazon, Barnes and Nobel, Waterstones.

It’s available as paperback, kindle, ebook, and audiobook. 😀

Here’s some quick links.

Amazon UK:
Amazon USA:
Amazon Canada:
Amazon Australia:

My day talking kindness to young children

I spent a day earlier in the week at a primary school where I was talking to young children about the importance of kindness.

It was a school outside Glasgow, Scotland, on the invitation of my friend, John – aka Mr McLellan. The school has a dedicated ASD unit.

I was a little nervous as I’m not used to speaking to children. Almost all of my talks, lectures and workshops have been for adults. I usually talk a lot about the science of how kindness impacts health, as well as various aspects of the mind-body connection and self-esteem, so I wasn’t sure if I’d be able to simplify things for the children or even make what I do sound remotely interesting.

John assured me that I’d be fine, that they mostly just want to know what I do and then ask me questions. My first class was John’s class, a small class of 8.

I brought a couple of my books with me and began to talk about my job as a writer. I explained that I’m an ‘author’ and showed them some of my books and various international translations, including the same book in English, German, Romanian and even Japanese, which they found fascinating. I told them that I mostly write and teach about being kind and how important that is.

I asked if any of them knew what being kind meant. A sea of hands shot up, each of the children politely waiting to be asked. I went around them one-by one, amazed as they gave lovely examples of kindness; like helping someone up if they’ve fallen down, saying nice things to people, saying ‘thank you’, paying compliments, holding a door, even being respectful.

After a little more talk about kindness they had a chance to ask questions. Mr McLellan had given them all cards the day before so that they could write their questions and read from them.

One of the first questions was, “What age are you?” so we had a guessing game, followed by another guessing game around how many pages my book has and another about how many words are in it. Faces swelled with pride when they got answers right.

I was also asked things like, “What’s your favourite TV show?” and “Do you have a car? What kind is it?” It was so incredibly nice for the children just to get to ask what they want to know, and I enjoyed it immensely.

I repeated the same thing three more times through the day for children at all ages, including whole-year assemblies for primary 7 children (ages 11 and 12) as well as primary 1 (ages 4 and 5). In one class, I talked about how I went to university and then worked as a scientist making medicines. I asked if any of them knew what a scientist is. Many of could describe some aspects of different kinds of science. Between them, they painted a good picture of what a scientist does. Since my PhD was organic chemistry, which consists of sticking atoms together to make molecules, many of which end up as medicines, I asked if anyone knew what atoms were.

I wasn’t prepared for the following answer from a small boy:

“They’re tiny little particles that make up everything. They’re so tiny you can’t see them and everything is made up of millions of them.” Then he put his finger on the table and said, “I’m touching atoms right now.”

Few adults could give such a precise answer. I was actually speechless. That he mentioned the word ‘particles’ and had a sense of their size and relative quantities just blew me away. He must have been about 9 or 10 years old.

During lunch, I sat in on choir rehearsal, where Mr McLellan played some music that the children sang along to. It was a rehearsal for an audition later in the week for BBC Children in Need.

It took my breath away. These young children, singing together, some looking at each other for comfort or approval, moved me to tears. I can’t quite express in words how moving it was.

As I write this, I still see in my minds’ eye, happy, smiling faces from some of the children I spent most time with in John’s class. Their personalities are infectious. They left a really big impression on me.

The day was an unexpected pleasure for me. As I wrote above, I was a little nervous when I arrived because I’m not used to communicating what I write and teach about to young children, but my fears were unfounded. The children really just wanted to know about me and a little bit about what I did.

I was warmed by how much they knew about kindness, how they were learning at school what it is and how important it is. They were even being recognised for being kind with little awards. I don’t ever remember formally learning about kindness when I was at school, so this was great to see.

Overall, I was deeply inspired by the teachers and classroom assistants too. People often say to me that I’m doing a great job in spreading the word about kindness by writing about it and collecting scientific studies together into books and blogs that others can quote. People call me a kind person for this reason.

To be honest, I don’t see it like that. I really don’t. What inspired me deeply was John and his colleagues. How they were with the children. How they spoke with them, taught them, comforted them. I mentioned to John that he had such a kind and gentle way with the children that you would think he was their parent. These are people – like many other teachers, carers, service workers, etc, all around the world – who are on the front line actually doing the kindness. I write about it. They doit! It really moved me.

I am so grateful that there are so many people in the world on the front-line doing kindness daily, as well as the millions of people who are simply just kind people, acting on opportunities as they present themselves daily.

I think there is a lot more kindness in the world than most of us typically see. The experience has left me with more hope, gratitude, and a good feeling that things are changing for the better, even if it’s not always immediately obvious to see.

The vagus nerve and cancer

DNA with light shining behind itI recently read a scientific paper, published this year in the Journal of Oncology (see paper), with great interest. It linked the activity of the vagus nerve with cancer prognosis.

Why is this important?

I’ve written quite a bit about the vagus nerve in some of my blogs and books (The Five Side Effects of Kindness), mainly because the vagus nerve produces an anti-inflammatory effect in the body. I’ve also emphasised how this effect is even amplified by the experience of compassion.

That’s why I found the paper so exciting because it reviewed 12 scientific studies, involving 1822 patients, and suggested a link between high vagus nerve activity and better cancer prognosis. The effect, the authors wrote, was most likely due to an anti-inflammatory effect created by the vagus nerve.

I’ve summarised the main findings of the paper below.

The authors pointed out that three main biological factors contribute to the onset and progression of tumours. These are: oxidative stress (free radicals), inflammation, and excessive sympathetic [nervous] activity (stress).

Amazingly, the vagus nerve seems to inhibit all three.

Many of the studies measured heart rate variability (HRV), which is the main index of vagus nerve activity. Briefly, when we breathe in, heart rate quickens a little, only to slow down again when we breathe out. The vagus nerve is responsible for the slowing down, and thus the difference between this increase and decrease (high and low) of heart rate – heart rate variability (HRV) – is considered an indicator of vagus nerve activity.

Generally, the paper found that the higher a person’s HRV, or vagus nerve activity (also known as vagal tone), the slower the progression of cancer, and this was true for all cancers studied. The effect was especially pronounced in late stage, metastatic cancers.

The authors suggested that in early stages of cancer, the treatment a person receives is the overwhelming positive factor and so swamps out any observable effects of the vagus nerve, but at later stages, when treatments are often less effective, the vagus nerve’s workings are far more apparent and the vagus nerve becomes the main determining factor.

So much so, in fact, that the authors found that survival time in patients with high HRV (or vagus nerve activity) was 4 times greater than in patients with low HRV (or vagus nerve activity).

The effect of the vagus nerve on inflammation was suggested as the main factor. It is known as the ‘Inflammatory Reflex’. The vagus nerve basically turns off inflammation at the genetic level by turning down a gene that produces TNF-alpha (Tumour Necrosis Factor), which is an inflammatory protein in the body that sets off a cascade of inflammation. Thus, the vagus nerve can effectively control inflammation in this way. Therefore, higher vagus nerve activity usually means lower inflammation.

In one study of patients with advanced pancreatic cancer, for example, patients with high HRV (or vagus nerve activity) survived longer and had lower inflammation levels than patients with low HRV (vagus nerve activity).

The study authors wrote that, the vagus nerve “may modulate cancer progression by inhibiting inflammation.”

The study also showed that tumour markers in other cancers (like PSA – prostate specific antigen – for example) were also lower in patients with highest vagus nerve activity.

So, the question is: can we increase our vagus nerve activity?

The answer is yes.

There are a few ways, in fact, that include:




-practice of compassion

I’d like to draw your attention to the latter because I’ve written about this before and it demonstrates a powerful link between mind and emotions and physical health.

Studies have shown a link between compassion and vagus nerve activity, an idea first put forward by Stephen Porges, a professor at the University of North Carolina at Chapel Hill, and now widely known as polyvagal theory.

For example, vagus nerve activity has been shown to increase through regular practice of a compassion meditation (the Buddhist’s metta bhavana or ‘Loving Kindness’ meditation). Here, we consistently cultivate a feeling of kindness and compassion for ourselves and others.

The same meditation has also been shown to lower a person’s inflammatory response to stress, presumably via increasing vagus nerve activity.

So, yes, we can increase vagal tone!

For me, this research is extra evidence that exercise, meditation, yoga, and even compassion, offer us far more protection from illness than we have imagined up until now. Now we are beginning to see the underlying biological mechanisms that explain why these practices are so beneficial.

Of course, exercising, meditating, doing yoga or being a nice person doesn’t mean a person will be immune to cancer. We all know that’s not true. But it might mean that they offer us a degree of protection, perhaps lessening the impact of some of the factors that do cause cancer.

Can kindness boost the immune system?

In other blogs, I’ve written how kindness is the opposite of stress in terms of its physiological effects. At first, one might imagine that peace is the opposite of stress, but peace is more the absence of stress than its opposite.

In a number of different ways, kindness produces opposite effects from those that stress causes.

It is very well known that stress supresses the immune system. Part of this is due to the stress hormone cortisol. So effective is cortisol in suppressing the immune system, in fact, that millions of people use it every day as hydrocortisone cream without realising that hydrocortisone cream is cortisol, but in cream form. It acts to reduce inflammation (part of the immune response), which is why it is used to treat conditions like eczema, itching, and rashes.

When we are kind, at the very least it spares us some stress and so, by default, allows the immune system to work more optimally by minimising cortisol production.

But can kindness do more than this and even enhance the immune system?

The Mother Theresa effect was named after a Harvard University study where volunteers watching a video of Mother Theresa carrying out acts of kindness and compassion experienced an immune boost.

In the study, researchers took secretory immunoglobulin-A (s-IgA) samples from 132 volunteers before and after watching the video. Found in saliva, it is the immune system’s first line of defence if a person eats something that’s contaminated, and is generally considered a fairly good indication of overall immune function.

After watching the film, their s-IgA levels were significantly elevated and remained elevated for a while afterwards as the volunteers kept thinking about particular scenes from the film.

In a different experiment, researchers at the HeartMath Institute, in Boulder, Colorado, asked volunteers to cultivate feelings of care and compassion for just 5 minutes. Similarly, they also received an immune boost, with s-IgA levels increasing by around 50% and again staying elevated for some time.

Empathy is a relative of kindness. One might think of empathy, in fact, as the seed that grows into kindness. It starts when we feel moved by the pain of a person (or animal). This is empathy – I feel your pain. It eventually evolves into a willingness to act to ease the suffering or to help in some other way.

A randomised controlled trial of 719 patients with the common cold found a connection between empathy shown to them in a doctor’s consultation and how quickly they recovered, indicating a link between empathy and immune function.

In the study, the volunteers were asked to rate how much empathy they were shown during a consultation. This is by no means meant as a criticism of doctors. There are a number of reasons why a doctor might be perceived as not showing empathy, which can include having so many patients and almost always be under time pressure, which sometimes means having to fill out forms while consulting.

Anyhow, each patient was asked to score the doctor for empathy shown to them on a 1-10 scale, using a CARE questionnaire (Consultation And Relational Empathy). Of those who scored the doctor a perfect 10 (around a third of patients), they had reduced severity of symptoms, recovered faster and also had higher immune function.

In each of the above studies, the effects are likely because of how empathy and kindness make us feel. Feelings generate biochemical products. For example, feelings of stress generate stress hormones (including cortisol). Feeling happy generates dopamine and serotonin. Feeling uplifted or excited can produce the brain’s natural versions of morphine. It is also known that feelings associated with empathy and compassion produce oxytocin. It seems that they also produce products that alter immune function.

So, to answer the question in the title of this article, I’d say, Yes. It seems to me that kindness can boost the immune system.



All references are cited in David R Hamilton PhD, ‘The Five Side Effects of Kindness‘ (Hay House, 2017)

Do drugs work better if we believe in them?

It seems to me that they do – broadly speaking.

Paying more for a simple painkiller, for example, seems to make it work better. A study of differently packaged aspirin tablets, for example, found that those that were branded to look more expensive worked much better than those that looked plain and generic.

In other words, paying ten times more for branded painkillers than for generic ones actually seems to enhance their effect. There’s nothing chemical going on. It’s the same drugs. It’s our perception of them that’s going on. We perceive something that’s more expensive as being better. Ultimately, it’s our own perception that enhances the painkilling effect. In this case, our brain produces its own natural (endogenous) painkillers.

Generally speaking, looking at stats for placebos, they work better for pain in the US if they’re injected, yet they work better if they’re tablets in the UK. It’s our perception that matters. People in the US have more faith in ‘getting a shot’. People in the UK have more faith in ‘popping pills’.

Studies of anti-ulcer treatments in different countries reveal a similar kind of effect. A trial of Tagamet in France found it to be 76% effective with the placebo coming in at 59%. Yet a trial in Brazil found Tagamet to be 60% effective. In other words, a placebo in France was almost as good as the actual drug in Brazil!

What we believe matters. Having faith in a particular doctor is likely to mean that her or his prescriptions will work better for you.

In a British Medical Journal paper a few years ago, doctors who gave a ‘positive consultation’ (for minor ailments), where they reassured the patients that they would be better in a few days, were compared with doctors who gave what were defined as ‘negative’ consultations for the same kinds of ailments, where the doctors were less reassuring. Two weeks later, 64% of those who had a positive consultation were symptom free, yet only 39% of those who had a negative consultation were symptom free. Over and above the effect of an actual medicine prescribed, and your beliefs about it, is your thoughts, feelings, and beliefs about the doctor.

Did she/he listen to me? Did she/he show me empathy? Was she/he confident and reassuring? Or even, was she/he old even enough to understand my case properly? And she/he did look and sound very intelligent!

These are all conversations we have with ourselves during and after a consultation. The thing is, the dominant thoughts and feelings that we settle on matter.

And it would be wrong to think that any benefit of how we think, feel and believe is ‘just psychosomatic’. The contents of our minds shift our biochemistry. Placebo research suggests that our brains very often produce the chemistry that is required to deliver a result we’re expecting to happen.

What does this overall kind of effect above say about our own minds? It shows us that what we think about, how we feel, and what we believe, matters. It’s not a reason to ditch our medicines, of course. Taking and acting on medical advice is sensible. But it shows that our own thoughts, feelings and beliefs about the medicines and about doctors play an important role in recovery and healing.

Taking it a little further, I would even extend it and say that, for some people, their thoughts, feelings and beliefs about the medical systems, insurance companies, and even pharmaceutical companies also matters.

The latter point is something I’m quite familiar with. I’m a trained organic chemist and worked as a scientist in the pharmaceutical industry several years ago. I often hear people say that they mistrust the industry in general. As such, some think of the drugs they are prescribed with suspicion; some imagine that they are poisons, or that they’re only being prescribed them so that the system can make a profit.

All I can say is that most of the people I worked with in the pharmaceutical industry wanted to save lives. If you are prescribed medicine, rather than imagining it as something poisonous, imagine it instead doing the job it’s supposed to do. Picture it as an animated character swimming through the bloodstream to where it needs to go and doing what it needs to do. If you’re prescribed medicine, this is a much better use of your mind.

So it seems that some drugs do work better if we believe in them, or if we believe in the doctor who prescribed them.

The deciding factor, it seems, is what you believe!



For the study on branded vs generic aspirin tablets, see: A. Branthwaite and P. Cooper, ‘Analgesic effects of branding in treatment of headaches’, British Medical Journal, 1981, 282, 1576-1578.

For the study of placebo injections vs placebo tablets in the US and UK, see: A. J. de Craen et al, ‘Placebo effect in the acute treatment of migraine: subcutaneous placebos are better than oral placebos’, Journal of Neurology, 2000, 247(3), 183-188.

For the Tagamet study in France, see: R. Lambert et al, ‘Treatment of duodenal and gastric ulcer with cimetidine: A multi-centre double blind trial’, Gastroenterologie Clinique et Biologique, 1977, 1(11), 855-860.

For the Tagamet study in Brazil, see: J. A. Salgado, et al, ‘Endoscopic findings after antacid, cimetidine and placebo for peptic ulcer – importance of staging the lesions’, Arquivos De Gastroenterologia, 1981, 18(2), 51-53.

For the study comparing positive vs negative consultations, see: K. B. Thomas, ‘General practice consultations: is there any point in being positive?’, British Medical Journal, 1987, 294, 1200-1202.