用心理療法能治糖尿病和癌症

One day in the fall of 1981, eight men in their 70s stepped out of a van in front of a converted monastery in New Hampshire. They shuffled forward, a few of them arthritically stooped, a couple with canes. Then they passed through the door and entered a time warp. Perry Como crooned on a vintage radio. Ed Sullivan welcomed guests on a black-and-white TV. Everything inside — including the books on the shelves and the magazines lying around — were designed to conjure 1959. This was to be the men’s home for five days as they participated in a radical experiment, cooked up by a young psychologist named Ellen Langer.
1981年秋季的一天，新罕布什爾州一座經改建的修道院前，八名70多歲的老年男子走下了麪包車。他們步履蹣跚，其中一些人像關節炎患者一樣彎腰駝背，還有兩位拄着柺杖。他們進門後，就像進入了一條時間隧道。老式收音機裏傳來佩裏·科莫（Perry Como，人稱“C先生”，美國歌手、電視明星）的低聲吟唱。黑白電視機上，埃德·沙利文（Ed Sullivan，美國娛樂作家和電視節目主持人）正向嘉賓們表示歡迎。這裏的一切——包括書架上的書和四下裏散落的雜誌——都是爲營造出1959年的氛圍而設計和佈置的。在五天的時間裏，這裏將成爲這些老人暫時的家園。他們所參與的，是年輕的心理學家埃倫·蘭格(Ellen Langer)精心策劃的一項“激進實驗”。

The subjects were in good health, but aging had left its mark. “This was before 75 was the new 55,” says Langer, who is 67 and the longest-serving professor of psychology at Harvard. Before arriving, the men were assessed on such measures as dexterity, grip strength, flexibility, hearing and vision, memory and cognition — probably the closest things the gerontologists of the time could come to the testable biomarkers of age. Langer predicted the numbers would be quite different after five days, when the subjects emerged from what was to be a fairly intense psychological intervention.
雖然受試者們的健康狀況都相當不錯，但衰老已經在他們身上留下了痕跡。“那時還沒有‘75歲是新的55歲’這樣的概念，”蘭格說，如今67歲的她是哈佛大學任職時間最長的心理學教授。這些老人在抵達實驗地點之前接受了一系列檢查，如靈巧性、握力、柔韌性、聽覺和視覺、記憶力和認知功能——當年，這些很可能是老年學家掌握的最接近年齡測試生物標誌物的指標。蘭格預測，五天之後，當受試者們結束大強度心理干預的時候，這些指標都將大爲改觀。

Langer had already undertaken a couple of studies involving elderly patients. In one, she found that nursing-home residents who had exhibited early stages of memory loss were able to do better on memory tests when they were given incentives to remember — showing that in many cases, indifference was being mistaken for brain deterioration. In another, now considered a classic of social psychology, Langer gave houseplants to two groups of nursing-home residents. She told one group that they were responsible for keeping the plant alive and that they could also make choices about their schedules during the day. She told the other group that the staff would care for the plants, and they were not given any choice in their schedules. Eighteen months later, twice as many subjects in the plant-caring, decision-making group were still alive than in the control group.
在此之前，蘭格已經進行了兩項涉及老年患者的研究。其中一項發現，在獎勵的激勵下，處於記憶力減退早期階段的養老院老人能夠在記憶力測試中獲得更好的成績。這說明，在許多情況下，對外界漠然被錯誤地當作大腦退化。在另一項如今被公認爲社會心理學經典的研究中，蘭格將室內植物分發給兩組養老院老人。她告訴其中一組老人他們要負責養活這些植物，並允許他們對自己的作息安排做出選擇。而另一組老人則被告知，植物有工作人員照顧，且他們沒有得到作息安排上的任何選擇。18個月後，關懷植物、並能對自己的作息時間表做出決策的那一組仍然健在的老人是對照組的兩倍。

To Langer, this was evidence that the bioMedical model of the day — that the mind and the body are on separate tracks — was wrongheaded. The belief was that “the only way to get sick is through the introduction of a pathogen, and the only way to get well is to get rid of it,” she said, when we met at her office in Cambridge in December. She came to think that what people needed to heal themselves was a psychological “prime” — something that triggered the body to take curative measures all by itself. Gathering the older men together in New Hampshire, for what she would later refer to as a counterclockwise study, would be a way to test this premise.
在蘭格看來，這些證據顯示了當時的生物醫學模式——即心靈和身體分道而馳——陷入了認識誤區。12月，當我在她位於馬薩諸塞州劍橋的辦公室裏見到她時，她說，當時醫學界相信“病原體侵入是導致人體患病的唯一途徑，而要恢復健康，也惟有擺脫病原體”。她逐漸產生的一個設想是，人需要某種心理上的“觸發刺激”來自行痊癒，也就是觸發身體自行動用所有的康復手段。讓上文提到的老年男性匯聚新罕布什爾州，進行她後來所稱的“逆時針”研究，就是測試這個假設的一種方式。

The men in the experimental group were told not merely to reminisce about this earlier era, but to inhabit it — to “make a psychological attempt to be the person they were 22 years ago,” she told me. “We have good reason to believe that if you are successful at this,” Langer told the men, “you will feel as you did in 1959.” From the time they walked through the doors, they were treated as if they were younger. The men were told that they would have to take their belongings upstairs themselves, even if they had to do it one shirt at a time.
她要求實驗組的老人不要止步於對舊時光的緬懷，而是要讓自己穿越回去，棲息於其中——“從心理層面嘗試做回22年前的自己，”蘭格向我描述道。她還對他們說：“我們有很好的理由相信，如果你們能成功地做到這一點，你們會覺得自己還是1959年的那個人。”從他們進門的那一刻起，他們就被當做年輕人對待。他們被告知，他們必須自己把行李搬上樓去，哪怕他們一次只拿得動一件襯衫。

Each day, as they discussed sports (Johnny Unitas and Wilt Chamberlain) or “current” events (the first U.S. satellite launch) or dissected the movie they just watched (“Anatomy of a Murder,” with Jimmy Stewart), they spoke about these late-'50s artifacts and events in the present tense — one of Langer’s chief priming strategies. Nothing — no mirrors, no modern-day clothing, no photos except portraits of their much younger selves — spoiled the illusion that they had shaken off 22 years.
每天，他們討論着體育（約翰尼·尤尼塔斯[Johnny Unitas，曾獲國家橄欖球聯盟最有價值球員]或威爾特·張伯倫[Wilt Chamberlain，前美國NBA聯盟職業籃球運動員]）和“時事”（美國發射第一枚衛星），或是評析剛剛看過的電影（詹姆斯·斯圖爾特[Jimmy Stewart]主演的《桃色血案》[“Anatomy of a Murder”]）——他們使用現在時態談論這些50年代末的物品和事件，這也是蘭格主要的“觸發刺激”策略之一。不會有任何東西，包括鏡子和現代服裝，來擾亂這種“時光倒流22年”的幻覺，即使有照片，那也是他們自己年輕時的肖像。

At the end of their stay, the men were tested again. On several measures, they outperformed a control group that came earlier to the monastery but didn’t imagine themselves back into the skin of their younger selves, though they were encouraged to reminisce. They were suppler, showed greater manual dexterity and sat taller — just as Langer had guessed. Perhaps most improbable, their sight improved. Independent judges said they looked younger. The experimental subjects, Langer told me, had “put their mind in an earlier time,” and their bodies went along for the ride.
在這段小住結束時，這些老人再度接受了檢查。實驗組在多項指標上遠遠優於對照組。後者之前就來到了這所修道院，但研究人員只鼓勵他們回憶過去，而沒有要求他們想象自己重返年輕時代。實驗組老人的身體柔韌性更強，手部更加靈巧，坐姿時腰背也挺得更直——正如蘭格所猜測的那樣。也許最不可思議的是，他們的視力也有所改善。獨立的評委表示他們看上去更年輕了。蘭格告訴我，實驗組受試者“讓自己的心境回到了年輕時代”，他們的身體也隨之調整。

The results were almost too good. They beggared belief. “It sounded like Lourdes,” Langer said. Though she and her students would write up the experiment for a chapter in a book for Oxford University Press called “Higher Stages of Human Development,” they left out a lot of the tantalizing color — like the spontaneous touch-football game that erupted between heretofore creaky seniors as they waited for the bus back to Cambridge. And Langer never sent it out to the journals. She suspected it would be rejected.
實驗結果太棒了，簡直讓人難以置信。“聽起來就像盧爾德（法國南部小鎮，著名朝聖地，相傳人們可以在那裏治癒一切疾病——譯註）一樣，”蘭格說。雖然她和她的學生們在牛津大學出版社(Oxford University Press)出版的《人類發展的較高階段》(Higher Stages of Human Development)中用一個章節的篇幅介紹這項實驗，但他們省略了很多動人的情節，例如，在等巴士返回劍橋時，這些之前很僵硬，彷彿一動就會咯吱作響的老骨頭自發組織了一場觸身式橄欖球賽。出於對退稿的擔心，蘭格沒敢將這些內容寫在投稿給刊物的文章中。

After all, it was a small-sample study, conducted over a mere five days, with plenty of potentially confounding variables in the design. (Perhaps the stimulating novelty of the whole setup or wanting to try extra hard to please the testers explained some of the great improvement.) But more fundamental, the unconventionality of the study made Langer self-conscious about showing it around. “It was just too different from anything that was being done in the field as I understood it,” she said. “You have to appreciate, people weren’t talking about mind-body medicine,” she said.
畢竟，這只是爲期五天的一個小樣本研究，設計中存在大量潛在混淆的變量。（或許是整個實驗令人振奮的新穎性，或者是受試者爲了取悅測試者而格外努力，這些都可能在一定程度上解釋某些指標的顯著改觀。）但更爲根本的是，這項研究的標新立異使蘭格不太好意思到處展示。“在我看來，這跟該領域當時在進行的研究工作相去太遠，”她說。“要知道，那時沒有人談論身心醫學(mind-body medicine)。”

Langer did not try to replicate the study — mostly because it was so complicated and expensive; every time she thought about trying it again, she talked herself out of it. Then in 2010, the BBC broadcast a recreation, which Langer consulted on, called “The Young Ones,” with six aging former celebrities as guinea pigs.
蘭格沒有嘗試重複這項實驗，主要是因爲它太複雜，成本也太高，每次她產生再試一次的念頭，她都勸阻了自己。直到2010年，英國廣播公司(BBC)聘請蘭格擔任顧問，重複了這項實驗，並將其做成一檔節目，名爲“年輕一代”(The Young Ones)，把六位年邁的前名星當作實驗對象。

The stars were squired via period cars to a country house meticulously retrofitted to 1975, right down to the kitschy wall art. They emerged after a week as apparently rejuvenated as Langer’s septuagenarians in New Hampshire, showing marked improvement on the test measures. One, who had rolled up in a wheelchair, walked out with a cane. Another, who couldn’t even put his socks on unassisted at the start, hosted the final evening’s dinner party, gliding around with purpose and vim. The others walked taller and indeed seemed to look younger. They had been pulled out of mothballs and made to feel important again, and perhaps, Langer later mused, that rekindling of their egos was central to the reclamation of their bodies.
這些明星們被老式轎車送到了一幢精心改建成1975年風格（甚至包括那個時期俗氣的牆面藝術）的鄉間別墅。一週後，他們重新露面，一個個都顯得青春煥發，就像當年蘭格實驗中那些年逾七旬的老人一樣。他們的檢測指標也出現明顯改善。有個人進去時還坐着輪椅，出來時卻可以自己拄着柺杖行走了。還有一位，一開始就連穿襪子也要別人幫忙，到實驗結束前夕卻操辦了告別晚宴，意志堅定精神抖擻地忙進忙出。其他人步行時腰桿也挺得更直，確實看起來年輕多了。他們不再被束之高閣，而是再次覺得自己重要，有價值。後來蘭格想到，喚醒自我意識也許在他們身體重現活力的神奇變化中起到了核心作用。

The program, which was shown in four parts and nominated for a Bafta Award (a British Emmy), brought new attention to Langer’s work. Jeffrey Rediger, a psychiatrist and the medical and clinical director of Harvard’s McLean Hospital, was invited by a friend of Langer’s to watch it with some colleagues last year. Rediger was aware of Langer’s original New Hampshire study, but the made-for-TV version brought its tantalizing implications to life.
這檔分四集播出的節目獲得了英國電影學院獎（Bafta Award，相當於英國的艾美獎[Emmy]）提名，並引發人們對蘭格的研究產生新的關注。去年，蘭格的一個朋友邀請哈佛大學醫學院教學附屬麥克萊恩醫院(Harvard’s McLean Hospital)的精神病學家、醫務和臨牀主任傑弗裏·雷迪格(Jeffrey Rediger)與同事們一起觀看了這檔節目。雷迪格早就對蘭格當年在新罕布什爾州進行的研究略知一二，但這個爲電視製作的版本生動展現了該項研究的誘人影響。

“She’s one of the people at Harvard who really gets it,” Rediger told me. “That health and illness are much more rooted in our minds and in our hearts and how we experience ourselves in the world than our models even begin to understand.”
“蘭格是哈佛大學裏真正懂行的幾個人之一，”雷迪格告訴我。“也就是說，健康和疾病在更大程度上植根於我們的思想和心情，以及我們在世上如何體驗自己，而這是現有醫學模式根本不理解的。”

Langer’s house in Cambridge was as chilly as a meat locker when we arrived together, having walked from campus, last winter. The back door had been left open all day so that her aging, coddled Westie, Gus, could relieve himself in the yard. (Langer’s partner, Nancy Hemenway, who normally would be at home, was away.) Gus has a brain tumor. “He was supposed to be dead over a year ago,” Langer said. “But I think he might outlive us all.”
去年冬天，我和蘭格從校園裏一起步行到她家去，房子裏冷得好像冷藏室一樣。後門整天敞開着，好讓她寵愛的那條老西高地白梗犬格斯(Gus)可以自由地跑到院子裏去玩。（蘭格的伴侶，南希·海明威[Nancy Hemenway]通常在家，但那天正好出去了。）格斯患有腦腫瘤。“照說它在一年前就會死，”蘭格說。“但我覺得它說不定比我們所有人都活得久。”

In the kitchen, Langer began laying out wide noodles for a lasagna she was making for an end-of-term party. It was the last time she would meet with her students for a while; they were about to scatter for the winter break, and she was leaving for a sabbatical in Puerto Vallarta, Mexico, where she and Nancy have another home. (Langer planned to Skype into weekly lab meetings.)
蘭格在廚房裏忙活着，拿出寬麪條準備做意大利千層麪，好在期末聚會上招待大家。這是今後一段時間內她最後一次跟自己的學生碰面了——寒假開始後，大家將各奔東西，而她準備動身前往墨西哥的巴亞爾塔港休長假，她和南希在那裏還有一個居所。（蘭格計劃通過Skype參與每週一次的實驗室會議。）

“Family recipe?” I asked of the dinner.
“這是家傳的菜譜嗎？”我問起了晚餐。

“I don’t follow recipes — you should know that,” she said. She piled on an immoderate amount of cheese. “Besides, if I blow it, what’s going to be the cost?” Langer said. “Is it anyone’s last meal?” She added, “My students aren’t going to love me if my lasagna’s no good?”
“我從不拘泥於菜譜的——這你知道，”她一邊說，一邊往面上大量地堆奶酪。“再說，就算我搞砸了又怎麼樣？這又不是誰最後的晚餐；就算我做的千層麪不好吃，難道我的學生們就會因此不愛戴我？”

Langer was born in the Bronx and went to N.Y.U., becoming a chemistry major with her eye on med school. That all changed after she took Psych 101. Her professor was Philip Zimbardo, who would later go to Stanford and investigate the effects of authority and obedience in his well-known prison experiment. Human behavior, as Zimbardo presented it, was more interesting than what she’d been studying, and Langer soon switched tracks.
蘭格出生於布朗克斯，在紐約大學攻讀化學專業，想着以後進醫學院。然而，在她聽了《心理學101》(Psych 101)課之後，一切都改變了。她師從的菲利普·津巴多(Philip Zimbardo)教授後來去斯坦福大學任教，並在著名的監獄實驗中研究了權威和服從的影響。蘭格從津巴多教授的講課中發現，人類行爲比她之前學的東西更有意思，於是她很快換了專業。

She went on to graduate work at Yale, where a poker game led to her doctoral dissertation on the magical thinking of otherwise logical people. Even smart people fall prey to an “illusion of control” over chance events, Langer concluded. We aren’t really very rational creatures. Our cognitive biases routinely steer us wrong. Langer’s notion that people are trained not to think and are thus extremely vulnerable to right-sounding but actually wrong notions prefigured many of the tenets of “behavioral economics” and the work of people like Daniel Kahneman, who won a Nobel Prize in economic sciences. But unlike many researchers who systematically work out one concept until they own it, Langer’s peripatetic mind quickly moved on to other areas of inquiry. “I was never — and maybe this is a character flaw — the type of person who is going to take one idea and beat it to death,” she said. “Part of that is that I have so many ideas. If whatever it is I’m excited about now doesn’t happen, it doesn’t matter, because there’s always the next possibility.”
她的研究生階段在耶魯大學(Yale)度過，在那裏，一場撲克遊戲給了她啓迪，使她寫出一篇有關通常講究邏輯的人們迸發突發奇想的博士論文。蘭格的結論是：即使聰明人也容易陷入對於偶然事件的“控制錯覺”。我們真的算不上一種高度理性的生物。認知偏見經常將我們導向錯誤的方向。蘭格認爲，人們養成了不假思索的習慣，這使他們很容易被似是而非的理念誤導。這一觀念的形成早於許多流派的“行爲經濟學”，也早於諾貝爾經濟學獎得主丹尼爾·卡尼曼(Daniel Kahneman)等人的研究。但與許多鍥而不捨地鑽研某個概念、直到它爲自己所有的研究者不同，蘭格的思維經常信馬由繮地轉向其他研究領域。“我從來不是能追着一個問題打破砂鍋問到底的人，或許這是一種性格缺陷，”她說。“部分原因是我總是有太多的想法。如果現在讓我激動不已的東西沒能搞出名堂，那沒關係，因爲始終存在下一個可能性。”

By the 1970s, Langer had become convinced that not only are most people led astray by their biases, but they are also spectacularly inattentive to what’s going on around them. “They’re just not there,” as she puts it. When you’re not there, Langer reasoned, you’re very likely to end up where you’re led. She set up a number of studies to show how people’s thinking and behavior can easily be manipulated with subtle primes.
到了20世紀70年代，蘭格逐漸確信，多數人不僅被自己的偏見帶上歧途，還對身邊發生的事情極其漫不經心。就像她所說的，“他們就是心不在焉。”蘭格的推理是，當你心不在焉的時候，你很容易被牽着走。她設立了多項研究，旨在揭示人們思路和行爲很容易被細微的“觸發刺激”所操縱。

In one, she and her colleagues found that office workers were far more likely to comply with a ridiculous interdepartmental memo if it looked like other official memos. In another, created with her Yale mentor, Robert Abelson, they asked behavioral and traditional therapists to watch a video of a person being interviewed, who was labeled either “patient” or “job applicant,” and then evaluate the person. The behavioral therapists regarded the interviewee as well adjusted regardless of whether they were told the person was a patient or an applicant. But the traditional therapists found the interviewee labeled “patient” significantly more disturbed. Even trained observers “were mindlessly led by the label,” Langer says.
在一項研究中，她和同事們發現，只要看起來跟其他官方的內部通知差不多，哪怕是一份內容荒謬的跨部門通知，也會讓上班族們照辦。在另一項與她在耶魯大學的導師羅伯特·艾貝爾森(Robert Abelson)合作創建的研究中，他們要求行爲治療師和傳統治療師觀看某個身份被標註爲“患者”或“求職者”的人接受採訪的視頻，然後對此人做出評估。無論是對所謂的“患者”還是“求職者”，行爲治療師認爲這位受訪者相當自如得體。但是在傳統治療師眼裏，“患者”身份的受訪者明顯更加不安。蘭格指出，這說明，即使訓練有素的觀察者“也很容易被標籤搞得沒頭沒腦”。

If people could learn to be mindful and always perceive the choices available to them, Langer says, they would fulfill their potential and improve their health. Langer’s technique of achieving a state of mindfulness is different from the one often utilized in Eastern “mindfulness meditation” — nonjudgmental awareness of the thoughts and feelings drifting through your mind — that is everywhere today. Her emphasis is on noticing moment-to-moment changes around you, from the differences in the face of your spouse across the breakfast table to the variability of your asthma symptoms. When we are “actively making new distinctions, rather than relying on habitual” categorizations, we’re alive; and when we’re alive, we can improve. Indeed, “well-being and enhanced performance” were Langer’s goals from the beginning of her career.
蘭格表示，如果人們能夠學會多留點心，始終察覺到身邊可以把握的選擇，那麼，他們將能充分發揮自己的潛能，並改善自己的健康。蘭格所說的達到專注狀態的技巧與在當今大行其道的東方式“正念禪修”不同，後者是對你的腦海中飄過的思想和感受達到不加評判的認知。而蘭格強調的是留心你身邊每時每刻的細微變化，從早餐桌對面配偶臉色的差異，到你的哮喘症狀的改變。當我們在“積極主動發現新的差別，而不是依賴於習慣性的”分類時，我們會真正覺得自己活着；而當我們覺得自己活着，我們就能改善。的確，在職業生涯伊始，蘭格就以“福祉和增強的表現”爲目標。

Martin Seligman in the past two decades has come to be recognized as the father of positive psychology. Tal Ben-Shahar, who taught a popular undergraduate course at Harvard on the subject until 2008, calls Langer “the mother of positive psychology,” by virtue of her early work that anticipated the field.
過去20年裏，馬丁·賽裏格曼(Martin Seligman)被公認爲積極心理學之父。而憑藉其在該領域的早期研究工作，蘭格被2008年之前在哈佛大學講授一門深受歡迎的本科課程的塔爾·班夏哈(Tal Ben-Shahar)譽爲“積極心理學之母”。

Langer came to believe that one way to enhance well-being was to use all sorts of placebos. Placebos aren’t just sugar pills disguised as medicine, though that’s the literal definition; they are any intervention, benign but believed by the recipient to be potent, that produces measurable physiological changes. Placebo effects are a striking phenomenon and still not all that well understood. Entire fields like psychoneuroimmunology and psychoendocrinology have emerged to investigate the relationship between psychological and physiological processes. Neuroscientists are charting what’s going on in the brain when expectations alone reduce pain or relieve Parkinson’s symptoms. More traditionally minded health researchers acknowledge the role of placebo effects and account for them in their experiments. But Langer goes well beyond that. She thinks they’re huge — so huge that in many cases they may actually be the main factor producing the results.
蘭格認爲，增強福祉的途徑之一是利用各種各樣的安慰劑。安慰劑並不只是僞裝成藥物的糖丸（儘管那確實是字面上的定義）；沒有危害、接受者相信有效，能夠產生可測量的生理變化的任何干預措施都可稱爲安慰劑。安慰劑效應是一種引人注目的現象，至今仍未獲得很好的理解。目前已經涌現出了心理神經免疫學和精神內分泌學等完整的研究領域，專門探討心理與生理過程之間的關係。神經科學家試圖跟蹤記錄當僅憑期望就減輕疼痛或緩解帕金森氏病症狀時，大腦中究竟發生了哪些變化。意識較爲傳統的醫學研究人員承認安慰劑效應的作用，並在自己的實驗中計入這些效應。但蘭格走得更遠。她認爲，安慰劑效應是巨大的——在許多情況下，它們實際上可能是產生結果的主要因素。

As an example, she points to a study she conducted in a hair salon in 2009. She got the idea from a study undertaken nearly a decade earlier by three scientists who looked at more than 4,000 subjects over two decades and found that men who were bald when they joined the study were more likely to develop prostate cancer than men who kept their hair. The researchers couldn’t be sure what explained the link, though they suspected that androgens (male hormones including testosterone) could be affecting both scalp and prostate. Langer had another theory: “Baldness is a cue for old age,” she says. “Therefore, men who go bald early in life may perceive themselves as older and may consequently be expected to age more quickly.” And those expectations may actually lead them to experience the effects of aging. To explore this relationship between expectations of aging and physiological signs of health, Langer and her colleagues designed the hair-salon study. They had research assistants approach 47 women, ranging in age from 27 to 83, who were about to have their hair cut, colored or both. They took blood-pressure readings. After the subjects’ hair was done, they filled out a questionnaire about how they felt they looked, and their blood pressure was taken again. In a paper published in 2010 in the journal Perspectives on Psychological Science, they reported that the subjects who perceived themselves as looking younger after the makeover experienced a drop in blood pressure.
她援引自己2009年在一家美髮沙龍進行的研究作爲例證。該研究的靈感來源於近10年前三位科學家進行的另一項研究，他們在20年期間追蹤調查了4000多名受試者，發現在加入研究時禿頂的男性比頭髮豐茂的男性更容易患前列腺癌。研究人員不能肯定這種關聯從何而來，但他們懷疑這也許是因爲雄激素（包括睾酮）對頭皮和前列腺都有影響。蘭格則提出了另一種理論：“脫髮是衰老的暗示之一。因此，早早禿頂的男性可能感覺自己更老，結果預期自己會更快衰老。”而這種預期實際上可能導致他們遭遇衰老效應。爲了探討對衰老的預期與健康的生理體徵之間的這種關係，蘭格和她的同事們設計了一項在美髮沙龍進行的研究。他們讓研究助理們去接觸來美髮沙龍剪髮、染髮或者先剪後染的47名女性（其年齡從27歲到83歲不等），並記錄下她們的血壓讀數。受試者們做好髮型之後，就各自對自己外貌的觀感填寫了一份調查問卷，並再次測量血壓。在這篇2010年發表於《心理科學透視》(Perspectives on Psychological Science)期刊的論文中，他們報告稱，那些認爲自己在做好髮型後顯得更加年輕的受試者血壓有所下降。

A few years earlier, Langer and one of her students, Alia Crum, conducted a study, published in the journal Psychological Science, involving 84 hotel chambermaids. The maids had mostly reported that they didn’t get much exercise in a typical week. The researchers primed the experimental group to think differently about their work by informing them that cleaning rooms was fairly serious exercise — as much if not more than the surgeon general recommends. Once their expectations were shifted, those maids lost weight, relative to a control group (and also improved on other measures like body mass index and hip-to-waist ratio). All other factors were held constant. The only difference was the change in mind-set.
幾年前，蘭格和她的學生阿莉婭·克拉姆(Alia Crum)進行了一項研究，並發表在《心理科學》(Psychological Science)雜誌上。該研究涉及84名酒店客房女服務員。她們大多報告稱，自己在典型的一週工作期間沒有什麼鍛鍊機會。研究人員引導實驗組的女服務員換一種心態看待自己的工作，告訴她們：打掃房間其實是一種強度不小的鍛鍊，運動量不比衛生局局長所建議的要少。在她們的預期改變後，這些女服務員的體重相對於對照組有所減輕（其他指標，如身體質量指數[BMI]和腰臀比也有所改善）。其他所有因素都保持恆定。唯一變化的只有受試者的心態。

Critics hunted for other explanations — statistical errors or subtle behavior changes in the weight-loss group that Langer hadn’t accounted for. Otherwise the outcome seemed to defy physics. “To which I would say, ‘There’s no discipline that is complete,’ ” Langer responds. “If current-day physics can’t explain these things, maybe there are changes that need to be made in physics.”
批評者尋找其他解釋，如統計錯誤，或者蘭格未能計入的體重下降組的細微行爲變化。否則，那樣的結果似乎有悖於物理學。“對此我想說，‘沒有一個學科是絕對完美的’，”蘭格迴應道。“如果當代的物理學無法解釋這些現象，也許是物理學本身需要一些改變了。”

In the course of her career, Langer says, she has written or co-written more than 200 studies, and she continues to churn out research at a striking pace. Just before winter break, in her final meeting with two dozen or so students and postdocs, Langer went around the table checking the progress of nearly 30 experiments, all of which manipulated subjects’ perceptions. Some used a special clock that could be set to run at half-speed or double-speed. In one study, sleeping subjects were fooled, upon awakening, into thinking they had more or less sleep than they actually did. She posits that the scores on measures of short-term memory and reaction time will vary accordingly, regardless of how long the subjects actually slept. In a yet-to-be-published diabetes study, Langer wondered whether the biochemistry of Type 2 diabetics could be manipulated by the same psychological intervention — the subjects’ perception of how much time had passed. Her theory was that the diabetics’ blood-glucose levels would follow perceived time rather than actual time; in other words, they would spike and dip when the subjects expected them to. And that’s what her data revealed. When a student emailed her with the results this fall, she could barely contain her excitement. “This is the beginning of a psychological cure for diabetes!” she told me.
蘭格說，在她的職業生涯中，她已經獨立撰寫或與他人合作撰寫了200多篇研究論文，如今她繼續以驚人的速度發表大量研究。就在寒假前，她與二十多個學生和博士後最後一次開會時，蘭格圍着桌子檢查着近30項實驗的進展，這些實驗都涉及操縱受試者的感知。一些實驗使用了特製的時鐘，這些鍾能夠以正常時鐘的一半速度或者兩倍速度運轉。在某一項研究中，受試者一覺醒來後受到矇騙，讓他們以爲自己睡得比實際時間更久或者更短。蘭格設想，這些受試者的短期記憶和反應時間等指標的得分將發生相應變化，而無論他們的實際睡眠時間有多長。在一項尚未發表的糖尿病研究中，蘭格想知道2型糖尿病患者的生化檢查結果是否也能通過同樣的心理干預——即受試者對於已經過去了多長時間的感知——來操縱。她的理論是，糖尿病人血糖水平會跟隨受試者感知到的時間（而不是實際時間）波動；換句話說，它會按照受試者的預期上升或者下降。而實驗數據揭示的情況正是這樣。今年秋天，當學生通過電子郵件向她報告實驗結果時，她幾乎無法抑制自己內心的激動。她告訴我說：“這是用心理療法治療糖尿病的開端！”

Some of the new experiments rely on variables that change self-perception. In a study using avatars, scheduled to take place at the popular gaming facility Second Life, subjects will watch a digital version of themselves playing tennis and gradually getting thinner from the exertion. Langer is exploring whether watching an avatar will have a physiological effect on the real person. “You see yourself, you’re playing tennis,” Langer said. “The question is: Will people lose weight? We’ll see.”
有些新實驗依賴於改變自我感知的變量。在一項擬在流行的虛擬遊戲世界“第二人生”(Second Life)中進行的研究中，受試者將觀看自己的數字化身打網球，並因爲體力消耗而逐漸變得苗條起來。蘭格希望研究觀察化身會否對真人造成生理影響。“你看到自己在打網球，”蘭格說。“問題是：人們會因此減肥麼？我們拭目以待。”

Some of Langer’s colleagues in the academy see her as a valuable force in psychology, praising her eccentric intelligence and ingenious study designs. Steven Pinker, the writer and Harvard professor, told me that she filled an important niche within the school’s department, which has often harbored “mavericks with nontraditional projects,” including “B. F. Skinner’s utopian novels and manifestoes and Herb Kelman’s encounter groups between Arab and Israeli activists — not to mention Timothy Leary and Richard Alpert,” who would become Ram Dass.
蘭格在學術圈內的一些同事肯定了她在心理學領域的價值和影響力，讚賞她的獨到智慧和巧妙研究設計。哈佛大學教授和作家史蒂文·平克(Steven Pinker)告訴我，她在學院內部佔有重要的一席之地，該學院經常孕育出“搞出非傳統項目的特立獨行者”，包括“伯爾赫斯·弗雷德裏克·斯金納(B. F. Skinner)的烏托邦小說和宣言、赫布·克爾曼(Herb Kelman)組織的讓阿拉伯與以色列活動人士匯聚一堂的會心小組——更不用說蒂莫西·利裏(Timothy Leary)和理查德·阿爾珀特（Richard Alpert，已更名爲拉姆·達斯[Ram Dass]）了。”But Langer’s sensibility can feel at odds with the rigors of contemporary academia. Sometimes she will give equal weight to casually hatched ideas and peer-reviewed studies. She spoke loosely to me of her New Hampshire counterclockwise study as having been “replicated” three times — in Britain, the Netherlands and South Korea. But none of these were lab experiments. They were events made for television. The study that arguably made Langer’s name — the plant study with nursing-home patients — wouldn’t have “much credibility today, nor would it meet the tightened standards of rigor,” says James Coyne, professor emeritus of psychology at the University of Pennsylvania medical school and a widely published bird dog of pseudoscience. (Though, as Coyne also acknowledges, “that is true of much of the work of the ’70s, including my own concerning depressed persons depressing others.”) Langer’s long-term contributions, Coyne says, “will be seen in terms of the thinking and experimenting they encouraged.”
然而，蘭格的這種感性有時會與當代學術界的嚴謹格格不入。有時候，她會對信手拈來的靈感和經過同行評議的研究給予同等份量。她含糊地告訴我，她在新罕布什爾州做過的“逆時針”研究，已經在英國、荷蘭和韓國“重複”了三次。但這些都不是在嚴格的實驗室條件下開展的實驗，而是爲製作電視節目而搞的活動。賓夕法尼亞大學(University of Pennsylvania)醫學院心理學榮譽退休教授、經常發表文章揭露僞科學的詹姆斯·科因(James Coyne)稱，當年那項可以說令蘭格成名的研究（養老院老人與植物），“在今天看來並沒有多少可信度，也不會滿足如今收緊之後的嚴謹標準。”（但科因也承認，“20世紀70年代的大多數工作，包括我自己的那項‘抑鬱症患者可導致其他人抑鬱’的研究，也是這種情況。”）科因表示，蘭格的長期貢獻“將體現於它們所鼓舞的思維和實驗”。

Four years ago, Langer and her colleagues published in Psychological Science a study that came closest in spirit to the original counterclockwise study in New Hampshire. Here, too, the placebo was a health prime, a situational nudge. They had two groups of subjects go into a flight simulator. One group was told to think of themselves as Air Force pilots and given flight suits to wear while guiding a simulated flight. The other group was told that the simulator was broken and that they should just pretend to fly a plane. Afterward, they gave each group an eyesight test. The group that piloted the flight performed 40 percent better than the other group. Clearly “mind-set manipulation can counteract presumed physiological limits,” Langer said. If a certain kind of prompt could change vision, Langer thought, there was no reason, that you couldn’t try almost anything. The endgame, she has said many times since, is to “return the control of our health back to ourselves.”
四年前，蘭格及其同事在《心理科學》上發表了一項研究，這是與新罕布什爾州“逆時針”研究在精神上最接近的一項研究。這項研究的安慰劑仍是某種健康觸發刺激，某種情景暗示。研究者把兩組受試者分別送入飛行模擬器，要求其中一組受試者設想自己是空軍飛行員，並讓他們在操縱模擬飛行時穿着飛行服。而另一組受試者則被告知，模擬器壞了，他們只需要假裝在操縱飛機。隨後，兩組人接受了視力測試。結果“飛行員組”的檢測結果比另一組高出40%。蘭格總結道，顯然“操縱心態可以抵消假定的生理侷限”。如果某種提示可以改變視力的話，蘭格認爲，那就沒理由不敢嘗試幾乎任何東西。在那之後，她多次表示，終極目的是將“健康的控制權交還給我們自己”。

Last spring, Langer and a postdoctoral researcher, Deborah Phillips, were chatting when the subject of the counterclockwise study came up. Over the more than 30 intervening years, Langer had explored many dimensions of health psychology and tested the power of the mind to ease various afflictions. Perhaps it was finally time to run the counterclockwise study again. But if they did, she wanted to raise the stakes: Could they shrink the tumors of cancer patients? Langer often says she has no clue where her ideas come from — but in this case it was crystal clear: Metastatic breast cancer killed her mother at 56, when Langer was 29.
去年春天，蘭格和博士後研究員德博拉·菲利普斯(Deborah Phillips)在聊天時談起了“逆時針”研究。自那以來的30多年裏，蘭格探索了健康心理學的多個層面，做了很多利用思維的威力來緩解各種病痛的試驗。也許現在終於到了再次進行“逆時針”的時候了。但是，如果真的要做，這次她想要加大賭注：他們能夠縮小癌症患者的腫瘤麼？蘭格常說，她不知道自己那些稀奇古怪的想法從何而來，但這一次，她的靈感源泉顯而易見：在她29歲時，她的母親因轉移性乳腺癌去世，享年僅56歲。

Phillips suggested that perhaps they should start with early-stage cancers, ones perceived as more curable, but Langer was firm: It had to be a big, common killer that traditional Western medicine had no answer for. She settled on Stage 4 metastatic breast cancer. Treatment of such cases is usually framed in terms of so-called comfort care. “The medical world has given up on these people,” Langer says.
菲利普斯提出，或許她們應當從被認爲治癒希望較大的早期癌症着手，但蘭格的態度很堅決：必須是一種死亡率較高、常見、傳統的西方醫學束手無策的癌症。最後，她選擇了4期轉移性乳腺癌。此類病例的治療通常被框定於所謂“舒適護理”的範疇。蘭格說：“醫學界已經放棄了這些患者。”

The study, which is planned for the spring, is designed to include three groups of 24 women with Stage 4 breast cancer who are in stable condition and undergoing hormonal therapy. Two groups will gather at resorts in San Miguel de Allende, Mexico, under the supervision of Langer and her staff. The experimental group will live for a week in surroundings that evoke 2003, a date when all the women were healthy and hopeful, living without a mortal threat hanging over them. They will be told to try to inhabit their former selves. Few clues of the present day will be visible inside the resorts or, for that matter, outside them. In the living areas, turn-of-the-millennium magazines will be lying around, as will DVDs of films like “Titanic” and “The Big Lebowski.” San Miguel de Allende, which has historically been a place known for its nearby healing mineral springs, is a Unesco World Heritage Site, and many of its buildings look as they did a few hundred years ago. “The whole town is a time capsule,” Langer says. (The other group at San Miguel will have the support of fellow cancer patients but will not live in the past; a third group will not experience any research intervention.)
該研究計劃將在春季開展，設計招募三組患有4期乳腺癌、病情穩定且正在接受激素治療的婦女，每組24人。其中兩個組將在墨西哥聖米格爾德阿連德的度假勝地集合，接受蘭格和她手下研究人員的監管。實驗組將“穿越”回2003年——也就是她們仍然身體健康，人生尚未被死亡陰影籠罩，對未來充滿憧憬的年代——在這樣的環境中生活一週。她們將被告知儘量做回當年的自己。度假區內部不會出現任何與當下有關的東西（就此而言，度假區外也將是這樣）。生活區裏擺放的將是世紀之交之時的雜誌，還有《泰坦尼克號》(Titanic)和《謀殺綠腳趾》(The Big Lebowski)等電影DVD。聖米格爾德阿連德素以其附近具有神祕治癒能力的礦物溫泉而著稱，被聯合國教科文組織列爲世界遺產(Unesco World Heritage Site)，這裏的許多建築看起來與幾百年前一樣。蘭格說：“該鎮宛如一個時間膠囊。”（聖米格爾的另一組受試者將得到癌症病友的支持，但不會穿越回過去；第三組則不會受到任何研究干預。）

As with the original counterclockwise experiment, subjects will be tested before and after on relevant measures — in this case the size of their tumors and the levels of circulating proteins in their blood known to be made by cancer cells — in addition to variables like mood and energy and pain levels. The experimental group will bring with them the same kinds of primes that the New Hampshire men did, like photographs of their younger selves. “We won’t make them haul their bags up the stairs,” Langer says. But otherwise they will be nudged to do all they can for themselves.
與最初的“逆時針”實驗一樣，受試者在實驗前後會接受相關指標的檢測，這一次主要檢測的是腫瘤的大小和血液中已知由癌細胞產生的循環蛋白的水平，此外還有情緒、精力以及疼痛程度等變量。實驗組還會像當年新罕布什爾州實驗的參與者那樣，攜帶一些幫助營造當年氛圍的觸發刺激，如自己年輕時的照片。“我們不會要求她們自己把行李搬上樓，”蘭格說，但在其他方面會鼓勵她們儘可能自立。

The staff will encourage the women to think anew about their circumstances in an attempt to purge any negative messages they have absorbed during their passage through in the medical system. This is crucial, Langer says, because just as the mind can make things better, it can also make things worse. The nocebo effect is the flip side of the more positive placebo effect, and she says that one of the most pernicious nocebo effects can occur when a patient is informed by her doctor that she is ill. The diagnosis itself, Langer says, primes the symptoms the patient expects to feel. “You change a word here or there, and you get vastly different results,” Langer says. She told me about a yet-to-be-published study she did in 2010 that found that breast-cancer survivors who described themselves as “in remission” were less functional and showed poorer general health and more pain than subjects who considered themselves “cured.”
研究人員將鼓勵這些婦女換一種方式思考自己的處境，力求摒棄她們之前在醫療系統接受治療期間吸收的負面信息。蘭格表示，這一點至關重要，因爲正如心態可以讓事情向更好的方向發展，它也可能使事情變得更糟。反安慰劑效應是更爲積極的安慰劑效應的另一面。蘭格稱，最糟糕的反安慰劑效應之一可能發生在患者從醫生那裏得知自己患病的消息時。蘭格說，診斷本身就是患者預期自己將會感受到的種種症狀的觸發刺激。“如果你在這裏或那裏換一個詞，結果可能截然不同，”她表示。她向我介紹了一項她在2010年進行、但尚未發表的研究。該研究發現，與自認爲已經“治癒”的乳腺癌倖存者相比，那些認爲自己“處於緩解期”的患者身體功能和整體健康狀況都較差，還往往感到更加疼痛。

So there will be no talk of cancer “victims,” nor anyone “fighting” a “chronic” disease. “When you’re saying ‘fighting,’ you’re already acknowledging the adversary is very powerful,” Langer says. " ‘Chronic’ is understood as ‘uncontrollable’ — and that’s not something anyone can know.”
因此，實驗中將不會提到癌症“受害者”，或者與“慢性”疾病“戰鬥”。“當你使用‘戰鬥’這個詞時，你已經承認了對手非常強大，”蘭格表示。“而‘慢性’往往被理解爲‘無法控制’——這不是可以讓受試者知道的事情。”

Of course, the subjects hope to get better, and everything about the setup is nudging them in that direction. So the study becomes a kind of open placebo experiment. Langer has long believed it’s possible to get people to gin up positive effects in their own body — in effect, to decide to get well. Last fall, she tested that proposition, but in reverse: She recruited a number of healthy test subjects and gave them the mission to make themselves unwell. The subjects watched videos of people coughing and sneezing. There were tissues around and those in the experimental group were encouraged to act as if they had a cold. No deception was involved: The subjects weren’t misled, for example, into thinking they were being put into a germ chamber or anything like that. This was explicitly a test to see if they could voluntarily change their immune systems in measurable ways.
每個受試者當然都希望自己好轉，整個實驗的設計都是爲了鼓勵她們進入好轉的軌道。因此，可以說這項研究是某種公開的安慰劑實驗。長期以來，蘭格一直相信，有可能讓人們激發自己體內的積極效應，換句話說就是“決定”讓自己好起來。去年秋天，她從反面對這個命題進行了測試：她招募了一批健康的受試者，並交給他們一個任務：讓自己感覺不舒服。受試者們觀看了人們咳嗽和打噴嚏的視頻，周圍放了很多紙巾，研究人員鼓勵實驗組像感冒時那樣行爲。這項實驗沒有任何欺騙成分：比如受試者沒有受到誤導，以爲自己身處病菌室之類。這是一場明確的試驗，目的是看看他們能否以可衡量的方式從主觀上改變自己的免疫系統。

In the study, which is ongoing, 40 percent of the experimental group reported cold symptoms following the experiment, while 10 percent of those in control group did. Buoyed, Langer ordered further analysis, looking for more concrete proof that they actually caught colds by testing their saliva for the IgA antibody, a sign of elevated immune-system response. In February, the results came in. All of the experimental subjects who had reported cold symptoms showed high levels of the IgA antibody.
在這項仍在進行的研究中，40%的實驗組受試者報告在實驗後出現感冒症狀，而對照組中僅有10%的人報告感冒症狀。這一結果令蘭格大受鼓舞。她要求進行進一步的分析，通過檢測受試者唾液中的IgA抗體水平（免疫系統反應升高的表徵），尋找他們確實患了感冒的更確鑿證據。今年2月，結果出來了。報告出現感冒症狀的所有受試者的IgA抗體水平都較高。

Placebo effects have already been proven to work on the immune system. But this study could show for the first time that they work in a different way — that is, through an act of will. “As far as we know today, the placebo responses in the immune system are attributable to unconscious classical conditioning,” says the Italian neuroscientist Fabrizio Benedetti, a leading expert in placebo effects. In Benedetti’s experiments, a suggestion planted in the minds of test subjects produced physiological changes directly, the way a dinner bell might goose the salivary glands of a dog. (In one study, healthy volunteers given a placebo — a suggestion that any pain they experienced was actually beneficial to their bodies — were found to produce higher levels of natural painkillers.) “There’s no evidence that expectations play a role as well,” Benedetti says. Langer plans to further analyze the subjects’ saliva to see whether they actually have the rhinovirus and not just elevated IgA.
此前已經證實安慰劑效應可作用於免疫系統。但這項研究可能首次展示這種效應以一種不同的方式（即一種意志行爲）發揮作用。安慰劑效應的權威專家、意大利神經學家法布里齊奧·貝內代蒂(Fabrizio Benedetti)表示：“據我們目前所知，免疫系統中的安慰劑反應可歸因於無意識的經典條件反射。”在貝內代蒂的實驗中，植入受試者思維中的心理暗示直接引起了生理反應，就像晚餐鈴引發狗的唾液腺分泌一樣。（在一項研究中，健康的志願者得到這樣一種安慰劑：一種心理暗示，讓他們以爲自己所經受的任何疼痛其實都有益於身體健康。結果，他們體內產生的天然鎮痛劑水平有所提高。）貝內代蒂指出：“尚無證據表明預期也能發揮作用。”現在，蘭格計劃進一步分析受試者的唾液，看其中是否確實存在鼻病毒，而不只是偏高的IgA抗體水平。

The implications of the open placebo — that is, we know the sugar pill is just a sugar pill, but it still works as medicine — are tantalizing. If placebo effects can be harnessed without deception, it would remove many of the ethical issues that surround placebo work. In a study published in the journal Plos One in 2010, Ted Kaptchuk, a professor of medicine at Harvard Medical School, and his colleagues administered a placebo labeled “placebo” to a test group of patients suffering from irritable bowel syndrome. Their symptoms declined significantly as compared with a no-treatment control group. “At some level everybody realizes they themselves are the placebo,” Langer says.
公開安慰劑（即我們知道自己服用的只是糖丸，但它還是會產生藥物的效果）的潛在影響是十分誘人的。如果無需欺騙就能收到安慰劑的效果，困擾安慰劑研究的很多倫理問題將不復存在。在2010年發表於《公共科學圖書館期刊》(PLOS One)的一項研究中，哈佛醫學院教授特德·卡普特查克(Ted Kaptchuk)及其同事們給予患有腸易激綜合徵的試驗組患者標有“安慰劑”字樣的安慰劑。與無治療的對照組相比，他們的症狀顯著減輕了。蘭格說：“在某種程度上，每個人都意識到自己就是安慰劑。”

Langer’s cancer study has had to clear the hurdles of three human-subjects ethics boards — one from Mexico, one from Harvard’s psychology department and, for a time, one from the University of Southern California’s medical school, where until recently Debu Tripathy, an oncologist who is recruiting subjects for Langer’s study, was a professor of medicine. In June, progress stalled when the board at U.S.C. asked that the language be tweaked. “There’s so much stuff that’s totally outrageous in this world,” Langer told me at the time. “They want me to add a consent form for the people to sign saying there’s no known benefit to them. But that just introduces a nocebo effect!” (The study now has to clear the ethics board at the University of Texas M.D. Anderson Cancer Center in Houston, where Tripathy presently works.)
蘭格的癌症研究在啓動之前必須得到三個人類受試者倫理委員會的批准。這三個機構一個位於墨西哥，一個位於哈佛大學心理學系，南加州大學(University of Southern California, U.S.C.)醫學院一度也是其中之一，爲蘭格的研究招募受試者的腫瘤學家德布·崔帕蒂(Debu Tripathy)直到不久前一直是那裏的醫學教授。今年6月，當南加州大學的委員會要求他們對所用的語言“稍加改進”後，該項目陷入了停滯。“實驗的很多內容對這個世界是離譜的，”當時蘭格對我表示。“他們要我增加一份同意書，讓受試者簽字聲明：他們知道該實驗對他們沒有任何已知的益處。但是，這恰恰引入了一個反安慰劑效應！”（目前該研究需要得到位於休斯敦的得州大學安德森癌症中心[University of Texas M.D. Anderson Cancer Center]的倫理委員會的批准，崔帕蒂現在在那裏工作。）

Like the men in New Hampshire, Langer’s cancer patients in San Miguel will pass a richly diverting week. In this case, art classes, cooking classes and writing classes will help distract them from the brute dread of their circumstances and re-engage them in life. The terror of late-stage cancer can be as debilitating as the physical reality, Tripathy says. Some sufferers, he says, show symptoms akin to PTSD. There’s strong evidence that the support of other people boosts the quality of life for cancer patients. There’s less evidence that it improves their health prospects.
就像新罕布什爾州研究中的老人那樣，蘭格的聖米格爾研究中的癌症患者也將度過精彩紛呈的一週。這一次將開設美術課、烹飪課和寫作課，幫助她們分散對自己病情的極度恐懼，重新投入生活。崔帕蒂表示，像身體現實那樣，對晚期癌症的恐懼本身也可能削弱患者的能力。他說，有些患者表現出類似於創傷後應激障礙(PTSD)的症狀。目前已經有強有力的證據表明，其他人的支持可大大提高癌症患者的生活質量，但這種支持能夠改善患者健康前景的證據相對較少。

I asked Tripathy whether there’s any precedent for what Langer is trying to do. “Well, there are many examples in medicine where improvement in the emotional state seems also to bring about some improvement in the disease state,” he said. “We know, for example, that Tibetan monks can meditate and lower their blood pressure. People with hypertension, they embark on behavioral changes, and you can see the improvement in the medical indexes, like fewer heart attacks. But cancer? That’s a harder thing to fathom.”
我向崔帕蒂請教蘭格試圖進行的研究有沒有任何先例。“嗯，醫學上情緒狀態的改善似乎帶來病情改善的例子還挺不少的，”他說。“例如，我們知道，西藏僧侶可以通過打坐冥想降低血壓。高血壓患者在做出行爲改變後，醫學指標會有所改善，比如，心臟病發作減少了。至於癌症，那就更難說清楚了。”

Positive psychology doesn’t have a great track record as a way to fight cancer. Indeed, when James Coyne and colleagues followed 1,093 people with advanced head-and-neck cancer over nine years, they found even the most optimistic subjects lived no longer than the most pessimistic ones.
積極心理學在對付癌症方面的記錄並不太好。的確，詹姆斯·科因和他的同事曾經對1093名晚期頭頸癌患者進行長達九年的隨訪，結果發現，即使是最樂觀的受試者也並不比最悲觀者活得長。

Some cancer patients respond to interventions better than others, Tripathy notes. “But even with high-dose chemotherapy, you rarely see ‘complete response,’ which is total disappearance” of advanced breast cancer. “So if we saw anything like that, boy, that would hit the medical journals in a hurry.”
崔帕蒂指出，有些癌症患者對干預的反應好於其他人。“不過，即使是使用大劑量化療，你也很少能看到‘完全反應’，即（晚期乳腺癌）完全消失……所以，如果我們能看到那樣的結果，那很快會在醫學期刊上引起轟動。”

One day in Puerto Vallarta in February, Langer sat on the patio of her hillside home. An iguana the length of a celery rib scooted across a high railing, and the dogs went bananas. “That’s Ada,” Langer said. “Or is it Ida? There are two — it’s hard to tell them apart.” When the iguanas first appeared and began devouring the hibiscus, Langer was startled. Now she and Nancy feed them petals for lunch. “That’s the way it is,” she said. “You can be scared. You give it a name, and then it’s a pet.”
2月的一天，蘭格坐在她位於巴亞爾塔港的山景房的露臺上。一條有芹菜莖那麼長的鬣鱗蜥飛快地翻越了高高的欄杆，幾隻狗狂躁不已。“這是埃達，”蘭格說。“是艾達嗎？它們有兩個，很難分得清。”當鬣鱗蜥第一次出現，並開始狼吞虎嚥地吃芙蓉花時，蘭格嚇了一跳。現在，她和南希自在地把花瓣餵給它們吃。“事情就是這樣的，”她說。“你可能會害怕。你也可以給它取個名字，讓它變成一隻寵物。”

Langer peered out over the deep blue sea, in the direction of a lagoon, where early in her career she conducted experiments on whether dolphins were more likely to want to swim with mindful people. In the last few days, she had been exchanging emails with a writer who wanted to come stay with her for a couple of weeks, taking notes for a screenplay for a Hollywood biopic.
蘭格凝視着環礁湖方向上深藍色的大海，在她的職業生涯早期，她曾做實驗研究海豚是否更願意跟處於正念狀態的人一起游泳。在過去的幾天裏，她在與一位作家互通電子郵件，那人想要和她一起待上一兩個星期，爲一部好萊塢傳記片的劇本採集素材。

Langer told me that she chose San Miguel for her new counterclockwise study primarily because the town had made “an offer I couldn’t refuse.” A group of local businesspeople, convinced of the value of having Langer’s name attached to San Miguel, arranged for lodging to be made available free to Langer. They also encouraged her to build a Langer Mindfulness Institute, which will take part in research and run retreats. (A local developer donated a beautiful casa, next to his Nick Faldo-designed golf course, to serve as staff quarters for the institute.) Starting sometime next year, adults will be able to sign up for a paid, weeklong counterclockwise experience, presumably with a chance at some of the same rejuvenative benefits the New Hampshire test subjects enjoyed.
蘭格告訴我，她選擇在聖米格爾進行新的“逆時針”研究，主要是因爲該鎮提供的優厚條件讓她“無法拒絕”。一羣當地商人深信將蘭格的名字與聖米格爾聯繫在一起將很有價值，於是他們爲蘭格的實驗安排了免費住宿。他們還鼓勵她建設一座蘭格正念研究所(Langer Mindfulness Institute)，既開展研究，又運營靜思休養之地。（當地的一位開發商還捐贈給她一棟精美的城堡，用作研究所員工的宿舍，這座城堡位於他那由尼克·佛度[Nick Faldo，英國職業高爾夫球手]設計的高爾夫球場旁邊。）從明年的某個時候開始，成年人將可以報名參加爲期一週的“逆時針”付費體驗，想必將和新罕布什爾州實驗的受試者們一樣，有機會享受某些返老還童的益處。

Langer says she is in conversation with health and business organizations in Australia about establishing another research facility that would also accept paying customers, who will learn to become more mindful through a variety of cognitive-behavioral techniques and exercises. She has already opened a mindfulness institute in Bangalore, India, where researchers are undertaking a study to look at whether mindfulness can stem the spread of prostate cancer.
蘭格說，她也正在與澳大利亞的一些保健和商業組織商談建立第二家研究機構，該機構也將接受付費客戶，他們將通過多種認知行爲技巧和練習來學習變得更加專注。她已經在印度班加羅爾開設了一家正念研究所，那裏的研究人員正在進行一項研究，探討正念能否阻止前列腺癌的擴散。

Langer makes no apologies for the paid retreats, nor for what will be their steep price. (This, too, is calculated: In the absence of other cues, people tend to place disproportionate value on things that cost more. Dan Ariely, a psychologist at Duke, and his colleagues found that pricier placebos were more effective than cheap ones.) To my question of whether such a nakedly commercial venture will undermine her academic credibility, Langer rolled her eyes a bit. “Look, I’m not 40 years old. I’ve paid my dues, and there’s nothing wrong with making this more widely available to people, since I deeply believe it.”
蘭格不認爲這種靜養機構將會收費，而且價格高昂有什麼錯。（這一點其實也是經過盤算的：在缺乏其他暗示的情況下，人們傾向於超出比例地注重比較昂貴的東西。杜克大學[Duke]心理學家丹·艾瑞里[Dan Ariely]及其同事們發現，價格較高的安慰劑比便宜安慰劑更有效。）我問她，此類明顯商業化的項目會不會削弱她的學術可信度？蘭格微微轉了轉她的眼睛。“你看，我不是40歲的人了。我已經做出了自己該做的貢獻，再說，將它推廣給更多的人並沒有什麼不妥，因爲我深信它一定有效。”

Medical colleagues have asked Langer if she is setting herself up to fail with the cancer study — and perhaps underappreciating the potential setbacks to her work. It’s also possible that subjects who don’t improve could feel more demoralized by the experience. In her memoir, “Bright-sided,” the journalist Barbara Ehrenreich wrote scorchingly about the sunshine brigade that bombarded her with “positive thinking” as she suffered through breast cancer. Under those conditions, patients who don’t get better might feel as if they themselves were somehow to blame.
醫學界的同事們問蘭格，她這項癌症研究會不會弄巧成拙，害自己栽個跟頭？或許她低估了自己一輩子的研究成果因此遭遇挫折的潛在風險？還有一個可能性是，病情沒能好轉的受試者因這一體驗而更加意志消沉。記者芭芭拉·埃倫賴希(Barbara Ehrenreich)在她的回憶錄《失控的正向思考》(Bright-sided)中，尖銳地批評了當她身患乳腺癌時，各路“陽光族”向她狂轟濫炸“積極思維”。在那種情況下，病情未見起色的患者會覺得彷彿是自己做錯了什麼。

After a lecture in 2010, in which she’d discussed how when we talk about “fighting” cancer we actually give the disease power, a man buttonholed Langer and laid into her. His wife had died of breast cancer. “He said she had fought it, and I made it seem that it was her fault,” Langer told me.
2010年，蘭格在一個講座上談到，當我們說“與癌症戰鬥”的時候，我們實際上賦予了疾病威力。講座結束後，一名男子攔住了她，劈頭痛斥了她的觀點。原來他的妻子死於乳腺癌。“他說她一直在與病魔抗爭，而按照我的說法，似乎這全是她的錯，”蘭格向我轉述道。

Langer apologized to the man. “Those are good points, and I’m sorry I didn’t address them,” she said. “But let me explain to you that it’s the culture that teaches us that we have no control. I’m not blaming your wife; I’m blaming the culture.” Langer imagines a day when blame isn’t the first thing people reach for when things go awry. Instead, we will simply bring to bear the power of our own minds — which she believes will turn out to be far greater than we imagined.
蘭格向那名先生道了歉。“你說的這些都很有道理，我很抱歉我沒有應對這些問題，”她說。“但請讓我解釋，是文化讓我們覺得自己無能爲力。我並沒有埋怨你的妻子；我只是在譴責這種文化。”蘭格夢想着有那麼一天，當事情出錯時，人們最先做出的反應不是責備。相反，我們將只是充分發揮自己的思維威力——她相信，這力量將比我們所想像的大得多。