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Book Forum: Stress   |    
The Balance Within: The Science Connecting Health and Emotions
VICTOR I. REUS, M.D.
Am J Psychiatry 2001;158:1179-1179. doi:10.1176/appi.ajp.158.7.1179
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By Esther M. Sternberg, M.D. New York, W.H. Freeman and Co., 2000, 250 pp., $24.95.

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The idea that thoughts and emotions might influence bodily health and do so through mechanisms worthy of scientific investigation is no longer a heretical notion. But Esther Sternberg, in this elegantly written book, reminds us how recent and formidable the resistance was to the idea that mental states and immune response affect each other in reciprocal fashion. The account that unfolds is both historical and personal, scientific and literary, anecdotal and data driven, and, most impressively, expansive and succinct. With references to Hittite kings and Wilder Penfield, to Proust and Guys and Dolls, to John Donne and Claude Bernard, Sternberg develops a compelling vision of how science and society defined the meaning of sickness and the paths to wellness.

Modern medical conceptions of mind-body interactions derive from the contributions of Bernard, Sherrington, and Cannon, but it was Hans Selye’s popularization of the concept of stress that led to a scientific schism discrediting this field of inquiry for decades. Sternberg, whose father was also a professor at McGill in the 1950s, chronicles her childhood memories of Selye’s flamboyant persona and weaves a description of her own scientific career into a broader referencing of animal and human studies that illuminate the ways in which the brain and immune system communicate with each other. Handsome illustrations guide the way, and a peckish critic will find only a few textual errors. Wally Nauta is acknowledged as a famed neuroanatomist, but his name is misspelled nonetheless, and most historians credit the initial conception of a "limbic" region to Broca, not McLean.

Though Sternberg’s vision is an attractive one, the thought remains that perhaps too much is being promised and too little critiqued, and that the complexity of the systems under examination is underemphasized. The term "cytokine" for example, is used frequently, but most of the references are to interleukin-1 alone, with little mention of the scores of other immune-related polypeptides that are likely to be involved. The last chapter, "Prometheus Unbound," a vividly imagined reflection of how society might deal with the knowledge that awaits, seems prematurely Utopian but manages to temper this concern through the sheer force of its humanism. In the end, the images of the author as both a true believer and a believer in truth become one.

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