October 24, 2013

KRISTA TIPPETT, HOST: Who knew that the architect behind St. Paul’s Cathedral was also an anatomist who diagrammed the human brain? Fast-forward three centuries, and new scientists of the brain are learning why our sensory experience in a place like a cathedral — the incense, the soaring music, the stained glass, and the light — is physiologically good for us. Esther Sternberg is an immunologist and a pioneer on this new frontier that’s giving rise to disciplines like neuroimmunology and environmental psychology. Architects are working with scientists to imbue the spaces we move through — the sights, sounds, and smells of them — with active healing properties. And Esther Sternberg says all of us can create surroundings and even portable sensations to manage stress and tap our brain’s own internal pharmacies.

ESTHER STERNBERG: What is it about beautiful vistas of mountains, about the infinite horizon of the ocean, about a cathedral? There are certainly physiological and neuroscientific bases to that feeling, and I am convinced — I know — that these things can be measured. And that’s the exciting new frontier for me, to ask exactly that question.

MS. TIPPETT: I’m Krista Tippett. This is On Being.

I spoke with Esther Sternberg in 2012. She grew up in Canada surrounded by scientists. Her father survived a concentration camp in Russia to become a pioneer of nuclear medicine. She trained with a good deal of scientific skepticism that emotions play any role in health. But she had a radical change of mind between breakthroughs in medical research, the illness of her mother, and her own diagnosis of arthritis. Some listeners may remember my popular interview with her a few years ago about stress and the balance within. Esther Sternberg’s unfolding passions are outlined in her newer book, Healing Spaces: The Science of Place and Well-Being.

MS. TIPPETT: I wanted to just start with these words “place” and “well-being.” Where does your mind go back earliest in your life when you put those two words together, “place” and “well-being”? I’m curious about that.

MS. STERNBERG: Well, it goes back to — actually, I was very small, probably in grade one or grade two, and I was sitting at breakfast with my father outside on the terrace. And he used to read while he ate breakfast, and there was probably a mystery story propped up against his coffee mug [laugh]. And he looked up from his mug — it was early spring and he looked up at me and he said, “Listen to the sounds of peace.” And I had no idea what he meant. And all I could hear was a dog barking and the pock-pock of a tennis ball across on the — at the courts across the street and the birds chirping. And I only understood many, many years later that, for him, he was only about 10 years away from the war, from World War II. And my mother also — my mother and her siblings had escaped literally on the last moments when the trains were leaving Rumania, Germany, and, you know, eventually they got to Canada.

And so we were washing the dishes, you know, after dinner, and we really couldn’t see the sunset from our house, but you could tell that it was going to be a beautiful sunset. So we’d all drop everything and my father would drive us to the top of the hill where the University of Montreal sits and we’d sit and look at the sunset. And my parents explicitly instilled in me the knowledge that we should look, hear, smell, touch everything in our surrounding environment and savor it because this could be your last day. They actually said that to me a number of times, especially the sunset. Look at it as if it’s your last.

MS. TIPPETT: Gosh. And so you make this observation in your more recent work that physicians and nurses know that a patient’s sudden interest in external things is the first sign that healing has begun. And you ask, do our surroundings in turn have an effect on us? And you’re part of these new encounters between neuroscience and other kinds of scientists and architecture and people involved in all kinds of spaces, from how hospitals are designed to civic spaces to contemplative spaces. So there’s a drama unfolding. There’s a cast of characters and there’s this whole new body of knowledge. It’s really exciting. And one of the milestones in this story that you’ve talked about is Roger Ulrich’s study called “The View from a Window” study of 1984, which was the beginning of one of these pieces of this new puzzle of what you now call environmental psychology.

MS. STERNBERG: Right. Well, so Roger Ulrich is an environmental psychologist who took advantage of a naturalistic experiment, if you will, where in patients were admitted to a ward for gallbladder surgery. Back in those days, you actually stayed in hospital for a number of days after you had gallbladder surgery. And some of them randomly were assigned to beds with a view of a brick wall and others had a view of a grove of trees. And he simply took the clinical data and measured how much pain medication these patients needed during their recovery, how long they had to stay in hospital, in other words, how quickly they healed, the number of negative nurse’s notes where they were complaining or had pain or such, and he controlled for everything: age, sex, you know, med — other medication use, other disease use. And all of these patients were taken care of by the same doctors and nurses. So it was an extraordinarily well-controlled study. And even with all these controls where the single variable that differed between patients was the view out the window, what he found was that the patients with a view of a grove of trees left hospital on average a day sooner, needed less pain medication, and had fewer negative nurse’s notes than patients who had a view of a brick wall.

MS. TIPPETT: So interesting, yeah.

MS. STERNBERG: Well, and one of the scientists that we interviewed, Irving Biederman, has a great quote where he says, you know, obviously, looking at a view does something positive to the brain. And his hypothesis is that endorphins are released in that part of the brain that recognizes a beautiful or preferred view. And he said, why else would we pay hundreds of dollars more for a hotel room with a beautiful view?

MS. TIPPETT: Right.

MS. STERNBERG: You know, that really tells you that people are willing to put money out to pay for a view.

MS. TIPPETT: Yeah, but we don’t think of it in terms of this is good for us. We don’t even think it that through that much. We just know that’s what we want. So let’s talk about some different kinds of experiences that, again, we have and maybe things we kind of know without processing. I mean, so I think most people or certainly many people would agree that being in a place of beautiful nature is somehow nourishing, uplifting. You know, people would use different words. That it feels good and is good for us and we often know that we’re restored afterwards. So what do you know — what do we know now about what is happening in us physiologically in those experiences?

MS. STERNBERG: I — I want — Because you used the word “restore,” can I read something, a favorite psalm of my father’s?

MS. TIPPETT: Yes, of course. [laugh]

MS. STERNBERG: So my father was not a very religious man, but he would read his favorite psalm, which was the 23rd, sometimes after dinner. He’d pull the Bible off the shelf and he’d read it with both wisdom and calm. And it starts: “The Lord is my shepherd; I shall not want. He maketh me to lie down in green pastures; He leadeth me beside the still waters; He restoreth my soul. Yea, though I walk through the valley of the shadow of death, I will fear no evil.” I think that psalm — and I didn’t realize it until I got to the last chapter of the book and I put that in there because my father used to read it. I didn’t realize that that really comes to the core of what I’m talking about there.

MS. TIPPETT: Yeah. I actually read that in your book as well and was so struck by it. I mean, that’s the 23rd Psalm. You’re father was Jewish. For Jews and Christians, it’s incredibly meaningful. I remember working on a floor with patients with Alzheimer’s disease and so many people there who had lost everything, every memory, could still recite the 23rd Psalm. But I also had never considered how much that it’s visual. It’s a picture of place, right? It’s the still …

MS. STERNBERG: Right.

MS. TIPPETT: Still waters, the green pastures, and how that works things in us.

MS. STERNBERG: Right, and it does take you there. So those environmental variables are really important. They’re affecting the brain’s stress response and the brain’s relaxation response.

MS. TIPPETT: Another really basic thing that your work makes me be conscious of is light and color. Again, maybe we know this, but when you talk about or you describe the places where I think many of us have memories of being invigorated by these things, of being most aware of them, would be gardens or, on the other end of that, stained-glass windows, that somehow captures some of that same, you know, almost not just the restorative, but the energetic properties of those things.

MS. STERNBERG: Well, I think that’s the very interesting point because, in general, we don’t want to be always in a soporific state, right? You want to be that way when you’re relaxed, when you’re at the beach, when you’re going to sleep. But equally, you want to be energized, you want to be happy, you want to have some sense of desire, you want to be alive. Being alive means that you respond moment to moment to different external stimuli in an appropriate way, and people want to feel alive. I mean, I think that’s why they go to places like theme parks, like Disneyland, Disney World. You know, you get on a ride and you really feel that zing, which comes from controlled stress response really, which when it’s just a little bit in the right circumstances, is actually energizing. People in theater, people in movies figured all this stuff out a long time ago.

MS. TIPPETT: A long time ago, before doctors did, yes, yes.

MS. STERNBERG: A long time ago, by trial and error. You know, what’s the first thing that happens when you go into a movie theater or a theater? What’s the first thing that happens?

MS. TIPPETT: Well, it’s dark. I mean, it’s a whole enveloping experience.

MS. STERNBERG: Yes, that’s it. Well, the lights go out.

MS. TIPPETT: Yeah.

MS. STERNBERG: What that does is it takes away your own reality and it allows the producer to replace your reality with their reality because they’ve taken away the visual cues. So now you can immerse yourself in another place, in an imaginary place, and you forget about your surroundings.

MS. TIPPETT: One of the really interesting pieces of history that you tell is that Christopher Wren, who is the architect who designed St. Paul’s Cathedral, that he started out — did he start out as an anatomist and he was doing illustrations for an anatomist?

MS. STERNBERG: Yeah. I was speaking at the Royal Society of Medicine in London and this august society has been around for, I don’t know, several hundred years. I learned this interesting piece of information when I actually went to their library, and you can look at the original drawings of Sir Thomas Willis, the anatomist who first described the brain in perfect detail. He has this huge tome from 1664 where he — every page shows engravings of the brain in perfect detail. We cannot do better today. There’s cross-sections and elevations and three-dimensional and two-dimensional and every possible visual rendering of the brain.

And at the very beginning of this, you know, 400-year-old book, there is a dedication to Christopher Wren — my colleague, Christopher Wren — who is the one who actually drew those drawings. You know, who better than an architect to draw the drawings of the brain? So there was this collaboration across disciplines, which today we are carrying on in a different iteration.

MS. TIPPETT: So one of the big interesting places this points out is at what we have traditionally called “the placebo effect.” And there’s been a lot of interesting thinking and revisiting of that term recently, and your work is, you know, very much speaking to that. How would you describe what you’re learning what you know that, I don’t know, would not only make us rethink, but perhaps rename this thing we call the placebo effect?

MS. STERNBERG: Well, the placebo effect really is the brain’s own healing process, and that’s a long word, so it’s probably easier to say the placebo effect. But the problem with the word placebo is it carries with it a lot of baggage.

MS. TIPPETT: Yeah. It feels like a trick or there’s nothing to it somehow.

MS. STERNBERG: Right. The word placebo is usually preceded by a four-letter word: “just.”

MS. TIPPETT: Right.

MS. STERNBERG: Oh, it’s just the placebo effect. Well, you know, when you look, there’s controversy about this too, the exact numbers, but when you look at placebo-controlled trials, the reason we have to do placebo-controlled trials to determine the “true biological effect of a drug or intervention” is we have to subtract out the placebo effect where people have an expectation that just taking a pill or having an injection or whatever the intervention is, they have an expectation that that will heal and, in fact, it does. It reduces pain, it can reduce inflammation to a certain degree, and it’s hard to estimate and it differs with different conditions.

But the percent of effect of the placebo effect in any given intervention has been estimated to be somewhere between 30 and 90 percent. Ninety is probably a little high and 30 may be a little low, so let’s say 50 percent. A drug that has the ability to help reduce pain by 50 percent is a very powerful drug. So, you know, it’s not a trick; it is your brain activating anti-pain pathways releasing those endorphin molecules, releasing those desire molecules, dopamine, to shift and reducing the stress response.

MS. TIPPETT: It’s in fact the drug that is a trick, right? Because what we do with the drug is trick our brains into doing that.

MS. STERNBERG: Absolutely, that’s it. You know, so why not use this in a sort of a carefully titrated way and say, OK, why not put the individual who needs to heal into the most healing environment where the stress response is not activated and, to the extent that we can, it’s reduced where you have positive emotional memories that flood you. Put them into a situation where they’re likely to release these positive, these anti-pain molecules and these, you know, dopamine molecules of reward, and that will allow their body to heal or to receive the drugs that you are then giving them.

So I’m not saying, you know, don’t go to a desert island and don’t take your cancer chemotherapy, but I’m saying don’t fight against it by putting yourself in a stressful situation. Do the maximum that you can with things like meditation and yoga and prayer to help amplify these pathways in the brain that we know ultimately can help the immune system do its job to heal.

MS. TIPPETT: I’m Krista Tippett, and this is On Being — conversation about meaning, religion, ethics, and ideas. Today exploring “The Science of Place and Healing,” with immunologist Esther Sternberg.

MS. TIPPETT: It’s very striking to me that, yes, we’re talking about some things like yoga and meditation and prayer. You’re also talking about light and windows and color and the right amount of noise, all of these sensors.

MS. STERNBERG: Yes, yes, sound, music, yeah.

MS. TIPPETT: Yeah, but it does turn out that a lot of the examples you give and that other doctors give or end up studying do have some connection with spiritual traditions, whether it’s looking at the architecture of a cathedral or, you know, Richard Davidson studying the brains of meditating monks and therein making some of these amazing discoveries. You also devote a chapter on healing spaces to labyrinths, which is a very ancient phenomenon and kind of being rediscovered in the 21st century.

MS. STERNBERG: Right, and labyrinths are so interesting, you know, I think partly because of the Minotaur, the Greek myth. Originally when you say labyrinth, people would say, oh, that’s a maze. A labyrinth is very different from a maze. And labyrinths are calming, walking meditations and or allow you to walk calmly and meditate, and mazes are stressful places. So what’s the difference? In a maze, you walk into a maze — and there’s a wonderful maze outside of Hampton Court near London, which was built by one of the kings of England. You know, you walk into this hedge — it’s got an eight- or 10-foot hedge — so right away you don’t see where you’re going.

MS. TIPPETT: Right, but as you said, a lot of our buildings also feel like mazes when you walk into them, these big corporate buildings.

MS. STERNBERG: Well, absolutely, and the reason they feel like that, well, hospitals are built like mazes because typically you have the old original small hospital building and then they keep adding wings to it, which hospitals until recently were designed really to optimize the diagnostic tools, you know, the X-ray equipment and the blood-drawing and so on rather than the human being that’s going to be in that building. Airports too. Just think about an airport.

MS. TIPPETT: Yeah, yeah.

MS. STERNBERG: But getting back to a maze, and — and, you know, it’s funny, when I was writing the book, I described these old dusty cathedrals and mazes and things and my editor said on the first draft, “You’ve got to put something in there that young people would want to read. What about Harry Potter and the Goblet of Fire?” Of course, I hadn’t read Harry Potter. My daughter was old enough that I hadn’t read any of it, I’m embarrassed to say. So I quickly ran out and bought The Goblet of Fire, and indeed the description of Harry Potter in that maze and how he feels is exactly the stress response.

It’s a perfect, perfect description of the physiological stress response that is triggered when you are in a place where you’re trying to navigate it with a time limit, you know. It’s getting dark, you want to do this before it gets dark. You come to a decision point, so you have to have multiple decision points. That’s very stressful. You don’t know if there’s a dead end and, if there is a dead end, there could be a monster lurking there, you know, so the fear is a very primal. Fears are raised by these mazes. And if you put it back to going into a hospital, you’re already stressed because you’re anxious about your illness or your loved one’s illness; you can’t find your way. There are these, as I said, monster machines lurking in different corners where you’re going to be exposed to them. And so it really is a very stressful experience, whereas a labyrinth is just a pattern on the floor. I described the Chartres Labyrinth outside of Paris.

MS. TIPPETT: From the 13th century.

MS. STERNBERG: Yes, and it’s just a pattern of stones in the floor, which has been perfectly preserved because the church didn’t look kindly on labyrinths, so they made sure that the benches covered the labyrinth. So as a result, it’s been well preserved. And the rose window of the cathedral is placed in such a way that the sunlight on the summer solstice comes right in and falls directly on the labyrinth. There’s all kinds of theories as to how that came about and all sorts of very interesting theories about these structures that are found all over Europe, also throughout the globe.

And there are structures where you walk the path and you find you’ve come to the middle and then you stand and you meditate in the middle or you sit and meditate in the middle and then you walk the path and come out, but you see where you’re going. You don’t have any dead ends. You know, you have all your senses. You can see and hear and you don’t have to think about navigating, and so you’re able to get into this place of peace where you’re just — there’s something about movement.

MS. TIPPETT: Right. I have to say, I walked a labyrinth just recently at the new year. I haven’t done that much of it, but also what’s different from what you described about the mazes or being in a hospital is somehow you know exactly where you’re going to step next and you’re not worried about that, but you stop being so oriented towards getting to the end, which is an unusual experience in my life where I’m always ticking off my next thing on my to-do box.

MS. STERNBERG: You know, that’s a very interesting point that I hadn’t thought of until now. So when you talk about a place of peace, which is really what I’m talking about here, how do you find your place of peace? There is an element of time to it or forgetting time or not worrying about time. And we’re so conscious of worrying about time and the time pressure in our world that it’s hard to strip that away. And things like walking slowly, it forces you to walk slowly, right? You can’t be running through a labyrinth, although I have seen kids running through a labyrinth. [laugh]

MS. TIPPETT: You actually feel like slowing down. I’m just thinking about this myself too, but there’s something about the experience that makes you want to draw it out and slow down, and that in itself is kind of an unusual instinct.

MS. STERNBERG: Yes. I think you’re right. Another similar sort of experience I’ve had is with a Buddhist prayer wheel or drum, I guess it is, that was put into a lovely meditation garden in Sun Valley — near Sun Valley, Idaho. It was done when the Dalai Lama visited there, and it was a garden especially dedicated to him. When you push this prayer wheel around, it’s actually quite heavy and it forces you to slow down. In order to just turn it around and keep the right pace so you’re not falling off the platform, it really does force you to slow down and look around you and just be quiet and meditate.

MS. TIPPETT: It’s very striking to me how many of these examples have to do with, it’s like you said, theater people have known this for a long time about creating an environment. And it’s also true of religious spaces and it’s everything from gardens, to prayer wheels, to labyrinths, to stained-glass windows, to incense, to music …

MS. STERNBERG: Right, yes.

MS. TIPPETT: … actually creating this environment that you are learning helps heal us, can help heal us.

MS. STERNBERG: Absolutely, absolutely.

MS. TIPPETT: Isn’t that interesting?

MS. STERNBERG: It is. And it’s, uh, you know, I talk about frankincense and how fascinating it is that frankincense actually turns out to have immune-boosting features. And, you know, ’cause I always — as a non-Christian, I always thought it was rather odd that …

MS. TIPPETT: In the Christmas story, the Three Wise Men?

MS. STERNBERG: … that in the Christmas story, the gifts of the Magi, right. You have frankincense, myrrh, and gold, and I said why are they giving these weird things, frankincense and myrrh? They should be giving diamonds and rubies. [laugh] In fact, those fragrant resins and oils were very — they were far more valuable than gold or diamonds or rubies in those times because they actually used — the Roman soldiers — it was said that the Queen of Sheba was said to have given the plants to King Solomon and then, when the Romans came into the Holy Land, they took those plants back to Rome and had them guarded by sentries because these resins were used to heal after battle, to heal wounds, to prevent infection. And new studies show that in fact frankincense and these kinds of molecules do have beneficial or boosting effects on the immune system. So there’s a lot of, you know, lore that can be studied now in a rigorous scientific way to understand how it works.

MS. TIPPETT: Listen to this program again and share it with others at onbeing.org. There you can also hear my entire, unedited interview with Esther Sternberg and find a link to our previous conversation, called “Stress and the Balance Within.”

Coming up, Esther Sternberg on creating portable healing places. I’m Krista Tippett. Stay with us.

[Announcements]

MS. TIPPETT: I’m Krista Tippett, and this is On Being. Today with immunologist Esther Sternberg, exploring new knowledge about how the physical spaces of our lives can stress us, make us sick, or help us be well. One of the influential family friends of Esther Sternberg’s childhood was Hans Selye, a physician who single-handedly coined the word “stress,” the way we use it now, and implanted it in nearly every major world language.

Esther Sternberg later became one of the people who helped explain the physiological and neural connections between stress, illness, and well-being. Now, as we’ve been hearing, she’s working with neuroscientists and architects — and they’re bringing new science to bear on the way we create our hospitals, workplaces, and homes.

MS. TIPPETT: I wonder if you’ve ever heard of the recently deceased Irish poet, philosopher John O’Donohue? He talked a lot about landscape and that there are outer landscapes and there’s inner — there’s an inner landscape, which is another way of talking about, you know, what’s going on in that psalm that your father loved, the Psalm 23, but also that we all have these landscapes. And also, I think his point was we can create them, you know, we can choose to keep images of beauty inside ourselves even when that’s not what is directly around us. I don’t know. I just wonder how you hear that knowing what you know about the science and what’s going on in our brains.

MS. STERNBERG: Well, I think it’s absolutely true from a scientific point of view. There is a part of the brain that specializes in memory of place, the hippocampus. I mean, it’s important in all sorts of memory, but it’s very key in memory of place. And one of the things that it seems that the hippocampus does is it integrates all of these incoming sensory signals from the visual cortex, from the auditory cortex, from the olfactory bulb. So what you hear and see and smell and touch. The hippocampal cells that are actually called place cells because they tell you where you are in the world, so it’s kind of like your internal GPS system, those little GPS cells actually have inputs from all the sensory modalities in the brain and they integrate those senses and instill the whole in memory.

So in fact, from a neuroscience point of view, the poet was right, that we do have an internal place that we can go to from our memories if we could dip into it. Ideally, yes, we would all love to be able to go to our favorite Greek island, you know, and I describe that. [laugh]

MS. TIPPETT: Yes, where you had a real healing experience.

MS. STERNBERG: I had a real healing experience when I went to this tiny village in Crete called Lentos. You know, that was when my arthritis first appeared. I serendipitously ended up going there with neighbors and, in a 10-day period, I began to feel so much better. I didn’t heal. It wasn’t like the miracle of Lourdes, but I realized I could recreate this world at home.

So I have on my deck in Washington a gardenia tree and jasmine bush, and I can sit there in the evening in the summer and listen to the crickets and inhale the scent that reminds me of the orange blossoms and lemon blossoms from the Mediterranean. And I have lavender and I have basil, you know, all these fragrant plants that I find very soothing and healing. You can create your own little space wherever it is. And if you don’t have a deck, you can put a few plants in a window. And if you don’t have a window, you can read the 23rd Psalm. [laugh]

MS. TIPPETT: And you’re really saying this is medicine. It’s interior decoration maybe on some level, but it’s medicine. [laugh]

MS. STERNBERG: It’s medicine and it is being applied now. The wonderful thing is the designers and architects and urban planners can now and are being able to incorporate these features into their designs. So hospitals are being designed with beautiful views and with windows and with places for social support. We haven’t talked about that, but social support is important in healing and with, you know, smells, to mask the horrible smells and the sounds and so on.

MS. TIPPETT: Right, but you have to create spaces for social support. I mean, even in workplaces.

MS. STERNBERG: Well, so — and this is — it comes back to the practicalities. Yes, so it comes back to the practicalities and why the architects and designers and urban planners need the science, and more and more research is being done now. That’s, I think, the frontier to get the numbers to say it is worth spending extra money up front to put in more of these windows and spaces and so on. And some of the work has been done.

The Center for Health Design in San Francisco sponsored, together with the Robert Wood Johnson Foundation, a series of studies called the Pebble Project, where they understood that you’re not going to build a whole hospital from scratch. They started these studies where various aspects of health outcomes were measured in patients in new wings of hospitals that incorporated these different features.

And then Derek Parker, who was one of the principals involved in this, added up all of the actual costs from these different kinds of extra wings that were built on 50 different — or 30 different hospitals and said, OK, this is how much it costs extra. He calculated it would cost about $12 million extra to build such a hospital, but you recouped about $11 million in the first year of operation because of the savings on not only the health of the patients, but the health of the staff.

So, you know, that’s the kind of evidence that we need, and more and more is being done now to really document that it’s good not only for the human being in the space that you build, but it’s good for the bottom line. Architects are just embracing this all over the world. So what I tell them when I speak to these audiences is you, the designers, the people who create the built space that we, the rest of us, live in, you are our partners, our meaning the health professionals’ partners, in the health of the nation. You are our partners in prevention of illness, in helping to reduce the stress response, in helping people to find a place of peace because you’re the ones that build those places of peace.

MS. TIPPETT: Find out more about the Pebble Project on hospital design on our website, onbeing.org. I’m Krista Tippett, and this is On Being. Today with immunologist Esther Sternberg. Her latest book is Healing Spaces: The Science of Place and Well-Being.

MS. TIPPETT: There’s a beautiful succinct and very profound sentence in your writing: “If illness and health are nouns, then healing is a verb.” I wondered if I could ask you that, on a more personal level, you are one of the people who helped demonstrate the science of how rheumatoid arthritis, for example, is a very good example of how mind and body, emotions and physiology are connected, and you also are a person now who lives with arthritis. So with all of this we’ve been talking about as a background, you know, what does healing look like as you move through the world now and what does it look like differently because of all these things you’re learning?

MS. STERNBERG: Wow, that’s a good question. So healing, when I say it’s a verb, the body is constantly repairing itself. That’s what life is. You know, a rock just sits there and it eventually gets into sand or mud or something as the elements affect it. But a living being is constantly repairing itself against all of these different insults at a very, you know, molecular level, at a cellular level, at an emotional level.

So disease happens when the repair process is not keeping up with the damage process, right? So it’s like very active processes are going on under your skin and actually on your skin [laugh] at every moment of the day and night. So that’s what healing is to me. There are other, you know, there’s many studies asking the question what is healing, and different people have different concepts of what the word healing is and to be healed. You know, you can die healed if you use the word in an emotional sense.

MS. TIPPETT: Right, right, not cured but healed.

MS. STERNBERG: Healed, right. You can feel at peace, you can feel in balance. For me, I guess it is feeling at peace and in keeping up with that damage process. So I have become very conscious of the kinds of things that I do that will trigger my symptoms to be worse and the kinds of things that I can do, to the extent possible, to reduce those symptoms when I’m going overboard. So there’s no question that, when I’m trying to burn the candle at both ends, I get worse. When I don’t sleep enough, I get worse.

When I don’t exercise gently on a regular basis, and what I’ve found is the most helpful is swimming three to four days a week or in the summer even more, or walking 30 minutes a day, which has been shown to be beneficial for maintaining health and maintaining the strength of the immune system, having a place to sit and quietly contemplate or meditate, and social support and love is very important. So these are the kinds of things that, when I forget — you know, I’m human. I do frequently forget and push myself and I get stressed. You know, as Hans Seyle said, “Stress is life and life is stress.” I mean, forget about it. You can’t stop stresses from happening.

MS. TIPPETT: Which actually helps my stress level to acknowledge that. [laugh]

MS. STERNBERG: Right. Well, so — but what happens is, when I do realize that I’m pushing myself too far, I remember how bad I felt when I didn’t stop and I do those things that I know will help me. I did design my deck at home and my sunroom at home in such a way that I do have my place of peace, and actually that’s where I end up doing most of my work. I used to have my computer in a different room and I found that I kept moving it to the sunroom and I finally said, OK, this is obviously where I want to be. I need to have this atmosphere.

MS. TIPPETT: Well, that’s interesting because I think computers are part of a lot of our stress. But you’re actually saying that maybe even that can be, in the right environment, can be more positive.

MS. STERNBERG: It gives you a way to — yes, I mean, one of the things with the stress response is you don’t need to go offline — I mean, offline, off your brain’s line, not off the computer line — for very long to kind of reset things. So if you’re cognizant of this, if you feel your stress level mounting, and you just turn away and look at the trees and listen to the birds and be quiet for a few moments. You can bring it down. You can titrate it. You know, there are tools now available that are really offshoots of biofeedback where you can do this, like computer games actually, where you put a little sensor on your finger or your earlobe and it senses your blood flow and it will tell you when you breathe deeply.

So deep breathing is one thing that calms you because it reduces the stress response. It kicks in the vagus nerve and that improves heart rate variability and blood flow. We’re going to breath here on the radio. [laugh] And so you can actually see your heart rate variability improve and shift from a stress mode to a relaxation mode when you use these little games. So you can actually teach yourself to go offline, to have that shift into a relaxation mode on a moment-to-moment basis. And then you can go back and focus on whatever it was you were doing. And being in a place that allows you to do that helps you to do that more efficiently.

MS. TIPPETT: From that scientist’s scientist who you were when you first started getting into this unlikely connection between emotions and physiology and where you’ve come now as a person who rearranges her physical space thinking of her physiological health, if I ask you this way, how has your sense of what it means to be human — how do you think that’s changed?

MS. STERNBERG: Um, how has my sense of being human changed? I think I’m much more accepting of these notions that I was skeptical about before. I was coming from the scientific tradition, and the tradition was if you can’t see it, it isn’t real; if you can’t prove it, it isn’t real. And I think I’m much more accepting that, you know, maybe there is stuff that we can’t see or prove, but that are — these things really are affecting our emotions and our health. And I think I’m much more open to these new concepts. And so that’s one thing.

I am definitely much more conscious of the physical place around me. And I, you know, you started by saying as a person who rearranged my physical space on purpose based on these principles. Actually, it was the other way around: I rearranged my physical space without realizing what I was doing. And then, when the construction was finished, I stood there and looked at it and I said, oh, I just rebuilt my parents’ deck. [laugh] So that, you know …

MS. TIPPETT: That place of peace.

MS. STERNBERG: Place of peace, right, the memories, the memories. So I guess I’m more aware of these things and I’m able to look at these phenomena and think, oh, OK, now I see why I’m doing that, consciously aware of how place affects me and those around me and my emotions and my health.

MS. TIPPETT: There is a phrase that especially occurs in Celtic spirituality: thin places. I don’t know if you’ve ever heard that.

MS. STERNBERG: Yes.

MS. TIPPETT: The idea is, well, a lot of people would think of cathedrals as thin places or, you know, green pastures, still waters. Um, being in a place where — and this is the way some people will say it — it feels like the veil between heaven and earth has worn thin, where there’s a sense of being, you know, planted in the earth and yet also having some kind of almost physical sense of transcendence. I just wonder how you react to that, knowing what you know.

MS. STERNBERG: Well, I react to that. I have heard of that notion and I am actually very interested in exploring what is it about such places, about beautiful vistas of mountains, about the infinite horizon of the ocean. What is it that makes you feel that way about a cathedral? There are certainly physiological and neuroscientific bases to that feeling, that sense of awe. And I am convinced — I know — that these things can be measured and that’s the exciting new frontier for me, to ask exactly that question: What is it that makes one feel transcendent and is the environment something that we can consciously manipulate to find those feelings of transcendence? You know, if we’re so grounded in clay is there a way to at times, by simply going to a different place, achieve that sense of awe and transcendence?

MS. TIPPETT: Again, I mean, Christopher Wren knew something about that, didn’t he, a couple of hundred years ago?

MS. STERNBERG: He did, he did. You know, when I visited, it was very interesting because I walked from the Royal Society of Medicine to St. Paul’s Cathedral, which is not a short walk, but a very interesting walk in London. And I got there and it was just before Easter and there was a single man, the soloist, I guess, of the choir, who was practicing. I believe it was from The Messiah. He was standing in the middle of this dome and with this crystal clear voice that rose to the ceiling, it just gave — gave me shivers. It was really a sense of awe. So it wasn’t only the physical place. It was what that place did to sound.

MS. TIPPETT: Mm-hmm.

MS. STERNBERG: I think the most important point that I came to in my own journey in writing this book is that we really can create places of peace not only in our real world, in our physical environment that surrounds us, but in our own mind’s eye. And those kinds of places of peace are portable. As you said, in many different traditions, like the Buddhist tradition or in virtually all religious traditions, you close your eyes and you visualize something. That’s a way of carrying these environments, these healing places, within you. It’s wonderful if you can go to them, but if you can’t, you can bring them to yourself.

MS. TIPPETT: Esther Sternberg is Research Director at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson. She was formerly at the National Institutes of Health. Her books include Healing Spaces: The Science of Place and Well-Being and The Balance Within: The Science Connecting Health and Emotions.

You can listen to this show again or my unedited interview with Esther Sternberg on our website, onbeing.org. And you can follow everything we do by subscribing to our weekly email newsletter. Find the newsletter link on every page at onbeing.org.

On Being is Trent Gilliss, Chris Heagle, Stefni Bell, Lily Percy, Mikel Elcessor, and Megan Bender.