用心理疗法能治糖尿病和癌症

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，兰格的这种感性有时会与当代学术界的严谨格格不入。有时候，她会对信手拈来的灵感和经过同行评议的研究给予同等份量。她含糊地告诉我，她在新罕布什尔州做过的“逆时针”研究，已经在英国、荷兰和韩国“重复”了三次。但这些都不是在严格的实验室条件下开展的实验，而是为制作电视节目而搞的活动。宾夕法尼亚大学(University of Pennsylvania)医学院心理学荣誉退休教授、经常发表文章揭露伪科学的詹姆斯·科因(James Coyne)称，当年那项可以说令兰格成名的研究（养老院老人与植物），“在今天看来并没有多少可信度，也不会满足如今收紧之后的严谨标准。”（但科因也承认，“20世纪70年代的大多数工作，包括我自己的那项‘抑郁症患者可导致其他人抑郁’的研究，也是这种情况。”）科因表示，兰格的长期贡献“将体现于它们所鼓舞的思维和实验”。

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，兰格及其同事在《心理科学》上发表了一项研究，这是与新罕布什尔州“逆时针”研究在精神上最接近的一项研究。这项研究的安慰剂仍是某种健康触发刺激，某种情景暗示。研究者把两组受试者分别送入飞行模拟器，要求其中一组受试者设想自己是空军飞行员，并让他们在操纵模拟飞行时穿着飞行服。而另一组受试者则被告知，模拟器坏了，他们只需要假装在操纵飞机。随后，两组人接受了视力测试。结果“飞行员组”的检测结果比另一组高出40%。兰格总结道，显然“操纵心态可以抵消假定的生理局限”。如果某种提示可以改变视力的话，兰格认为，那就没理由不敢尝试几乎任何东西。在那之后，她多次表示，终极目的是将“健康的控制权交还给我们自己”。

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，兰格和博士后研究员德博拉·菲利普斯(Deborah Phillips)在聊天时谈起了“逆时针”研究。自那以来的30多年里，兰格探索了健康心理学的多个层面，做了很多利用思维的威力来缓解各种病痛的试验。也许现在终于到了再次进行“逆时针”的时候了。但是，如果真的要做，这次她想要加大赌注：他们能够缩小癌症患者的肿瘤么？兰格常说，她不知道自己那些稀奇古怪的想法从何而来，但这一次，她的灵感源泉显而易见：在她29岁时，她的母亲因转移性乳腺癌去世，享年仅56岁。

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，或许她们应当从被认为治愈希望较大的早期癌症着手，但兰格的态度很坚决：必须是一种死亡率较高、常见、传统的西方医学束手无策的癌症。最后，她选择了4期转移性乳腺癌。此类病例的治疗通常被框定于所谓“舒适护理”的范畴。兰格说：“医学界已经放弃了这些患者。”

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.)
该研究计划将在春季开展，设计招募三组患有4期乳腺癌、病情稳定且正在接受激素治疗的妇女，每组24人。其中两个组将在墨西哥圣米格尔德阿连德的度假胜地集合，接受兰格和她手下研究人员的监管。实验组将“穿越”回2003年——也就是她们仍然身体健康，人生尚未被死亡阴影笼罩，对未来充满憧憬的年代——在这样的环境中生活一周。她们将被告知尽量做回当年的自己。度假区内部不会出现任何与当下有关的东西（就此而言，度假区外也将是这样）。生活区里摆放的将是世纪之交之时的杂志，还有《泰坦尼克号》(Titanic)和《谋杀绿脚趾》(The Big Lebowski)等电影DVD。圣米格尔德阿连德素以其附近具有神秘治愈能力的矿物温泉而著称，被联合国教科文组织列为世界遗产(Unesco World Heritage Site)，这里的许多建筑看起来与几百年前一样。兰格说：“该镇宛如一个时间胶囊。”（圣米格尔的另一组受试者将得到癌症病友的支持，但不会穿越回过去；第三组则不会受到任何研究干预。）

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.
与最初的“逆时针”实验一样，受试者在实验前后会接受相关指标的检测，这一次主要检测的是肿瘤的大小和血液中已知由癌细胞产生的循环蛋白的水平，此外还有情绪、精力以及疼痛程度等变量。实验组还会像当年新罕布什尔州实验的参与者那样，携带一些帮助营造当年氛围的触发刺激，如自己年轻时的照片。“我们不会要求她们自己把行李搬上楼，”兰格说，但在其他方面会鼓励她们尽可能自立。

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.”
研究人员将鼓励这些妇女换一种方式思考自己的处境，力求摒弃她们之前在医疗系统接受治疗期间吸收的负面信息。兰格表示，这一点至关重要，因为正如心态可以让事情向更好的方向发展，它也可能使事情变得更糟。反安慰剂效应是更为积极的安慰剂效应的另一面。兰格称，最糟糕的反安慰剂效应之一可能发生在患者从医生那里得知自己患病的消息时。兰格说，诊断本身就是患者预期自己将会感受到的种种症状的触发刺激。“如果你在这里或那里换一个词，结果可能截然不同，”她表示。她向我介绍了一项她在2010年进行、但尚未发表的研究。该研究发现，与自认为已经“治愈”的乳腺癌幸存者相比，那些认为自己“处于缓解期”的患者身体功能和整体健康状况都较差，还往往感到更加疼痛。

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，实验中将不会提到癌症“受害者”，或者与“慢性”疾病“战斗”。“当你使用‘战斗’这个词时，你已经承认了对手非常强大，”兰格表示。“而‘慢性’往往被理解为‘无法控制’——这不是可以让受试者知道的事情。”

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.
每个受试者当然都希望自己好转，整个实验的设计都是为了鼓励她们进入好转的轨道。因此，可以说这项研究是某种公开的安慰剂实验。长期以来，兰格一直相信，有可能让人们激发自己体内的积极效应，换句话说就是“决定”让自己好起来。去年秋天，她从反面对这个命题进行了测试：她招募了一批健康的受试者，并交给他们一个任务：让自己感觉不舒服。受试者们观看了人们咳嗽和打喷嚏的视频，周围放了很多纸巾，研究人员鼓励实验组像感冒时那样行为。这项实验没有任何欺骗成分：比如受试者没有受到误导，以为自己身处病菌室之类。这是一场明确的试验，目的是看看他们能否以可衡量的方式从主观上改变自己的免疫系统。

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.
在这项仍在进行的研究中，40%的实验组受试者报告在实验后出现感冒症状，而对照组中仅有10%的人报告感冒症状。这一结果令兰格大受鼓舞。她要求进行进一步的分析，通过检测受试者唾液中的IgA抗体水平（免疫系统反应升高的表征），寻找他们确实患了感冒的更确凿证据。今年2月，结果出来了。报告出现感冒症状的所有受试者的IgA抗体水平都较高。

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.
此前已经证实安慰剂效应可作用于免疫系统。但这项研究可能首次展示这种效应以一种不同的方式（即一种意志行为）发挥作用。安慰剂效应的权威专家、意大利神经学家法布里齐奥·贝内代蒂(Fabrizio Benedetti)表示：“据我们目前所知，免疫系统中的安慰剂反应可归因于无意识的经典条件反射。”在贝内代蒂的实验中，植入受试者思维中的心理暗示直接引起了生理反应，就像晚餐铃引发狗的唾液腺分泌一样。（在一项研究中，健康的志愿者得到这样一种安慰剂：一种心理暗示，让他们以为自己所经受的任何疼痛其实都有益于身体健康。结果，他们体内产生的天然镇痛剂水平有所提高。）贝内代蒂指出：“尚无证据表明预期也能发挥作用。”现在，兰格计划进一步分析受试者的唾液，看其中是否确实存在鼻病毒，而不只是偏高的IgA抗体水平。

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.
公开安慰剂（即我们知道自己服用的只是糖丸，但它还是会产生药物的效果）的潜在影响是十分诱人的。如果无需欺骗就能收到安慰剂的效果，困扰安慰剂研究的很多伦理问题将不复存在。在2010年发表于《公共科学图书馆期刊》(PLOS One)的一项研究中，哈佛医学院教授特德·卡普特查克(Ted Kaptchuk)及其同事们给予患有肠易激综合征的试验组患者标有“安慰剂”字样的安慰剂。与无治疗的对照组相比，他们的症状显著减轻了。兰格说：“在某种程度上，每个人都意识到自己就是安慰剂。”

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.)
兰格的癌症研究在启动之前必须得到三个人类受试者伦理委员会的批准。这三个机构一个位于墨西哥，一个位于哈佛大学心理学系，南加州大学(University of Southern California, U.S.C.)医学院一度也是其中之一，为兰格的研究招募受试者的肿瘤学家德布·崔帕蒂(Debu Tripathy)直到不久前一直是那里的医学教授。今年6月，当南加州大学的委员会要求他们对所用的语言“稍加改进”后，该项目陷入了停滞。“实验的很多内容对这个世界是离谱的，”当时兰格对我表示。“他们要我增加一份同意书，让受试者签字声明：他们知道该实验对他们没有任何已知的益处。但是，这恰恰引入了一个反安慰剂效应！”（目前该研究需要得到位于休斯敦的得州大学安德森癌症中心[University of Texas M.D. Anderson Cancer Center]的伦理委员会的批准，崔帕蒂现在在那里工作。）

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.
就像新罕布什尔州研究中的老人那样，兰格的圣米格尔研究中的癌症患者也将度过精彩纷呈的一周。这一次将开设美术课、烹饪课和写作课，帮助她们分散对自己病情的极度恐惧，重新投入生活。崔帕蒂表示，像身体现实那样，对晚期癌症的恐惧本身也可能削弱患者的能力。他说，有些患者表现出类似于创伤后应激障碍(PTSD)的症状。目前已经有强有力的证据表明，其他人的支持可大大提高癌症患者的生活质量，但这种支持能够改善患者健康前景的证据相对较少。

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.”
我向崔帕蒂请教兰格试图进行的研究有没有任何先例。“嗯，医学上情绪状态的改善似乎带来病情改善的例子还挺不少的，”他说。“例如，我们知道，西藏僧侣可以通过打坐冥想降低血压。高血压患者在做出行为改变后，医学指标会有所改善，比如，心脏病发作减少了。至于癌症，那就更难说清楚了。”

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.
积极心理学在对付癌症方面的记录并不太好。的确，詹姆斯·科因和他的同事曾经对1093名晚期头颈癌患者进行长达九年的随访，结果发现，即使是最乐观的受试者也并不比最悲观者活得长。

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，有些癌症患者对干预的反应好于其他人。“不过，即使是使用大剂量化疗，你也很少能看到‘完全反应’，即（晚期乳腺癌）完全消失……所以，如果我们能看到那样的结果，那很快会在医学期刊上引起轰动。”

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，兰格坐在她位于巴亚尔塔港的山景房的露台上。一条有芹菜茎那么长的鬣鳞蜥飞快地翻越了高高的栏杆，几只狗狂躁不已。“这是埃达，”兰格说。“是艾达吗？它们有两个，很难分得清。”当鬣鳞蜥第一次出现，并开始狼吞虎咽地吃芙蓉花时，兰格吓了一跳。现在，她和南希自在地把花瓣喂给它们吃。“事情就是这样的，”她说。“你可能会害怕。你也可以给它取个名字，让它变成一只宠物。”

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.
兰格凝视着环礁湖方向上深蓝色的大海，在她的职业生涯早期，她曾做实验研究海豚是否更愿意跟处于正念状态的人一起游泳。在过去的几天里，她在与一位作家互通电子邮件，那人想要和她一起待上一两个星期，为一部好莱坞传记片的剧本采集素材。

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.
兰格告诉我，她选择在圣米格尔进行新的“逆时针”研究，主要是因为该镇提供的优厚条件让她“无法拒绝”。一群当地商人深信将兰格的名字与圣米格尔联系在一起将很有价值，于是他们为兰格的实验安排了免费住宿。他们还鼓励她建设一座兰格正念研究所(Langer Mindfulness Institute)，既开展研究，又运营静思休养之地。（当地的一位开发商还捐赠给她一栋精美的城堡，用作研究所员工的宿舍，这座城堡位于他那由尼克·佛度[Nick Faldo，英国职业高尔夫球手]设计的高尔夫球场旁边。）从明年的某个时候开始，成年人将可以报名参加为期一周的“逆时针”付费体验，想必将和新罕布什尔州实验的受试者们一样，有机会享受某些返老还童的益处。

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.
兰格说，她也正在与澳大利亚的一些保健和商业组织商谈建立第二家研究机构，该机构也将接受付费客户，他们将通过多种认知行为技巧和练习来学习变得更加专注。她已经在印度班加罗尔开设了一家正念研究所，那里的研究人员正在进行一项研究，探讨正念能否阻止前列腺癌的扩散。

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.”
兰格不认为这种静养机构将会收费，而且价格高昂有什么错。（这一点其实也是经过盘算的：在缺乏其他暗示的情况下，人们倾向于超出比例地注重比较昂贵的东西。杜克大学[Duke]心理学家丹·艾瑞里[Dan Ariely]及其同事们发现，价格较高的安慰剂比便宜安慰剂更有效。）我问她，此类明显商业化的项目会不会削弱她的学术可信度？兰格微微转了转她的眼睛。“你看，我不是40岁的人了。我已经做出了自己该做的贡献，再说，将它推广给更多的人并没有什么不妥，因为我深信它一定有效。”

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.
医学界的同事们问兰格，她这项癌症研究会不会弄巧成拙，害自己栽个跟头？或许她低估了自己一辈子的研究成果因此遭遇挫折的潜在风险？还有一个可能性是，病情没能好转的受试者因这一体验而更加意志消沉。记者芭芭拉·埃伦赖希(Barbara Ehrenreich)在她的回忆录《失控的正向思考》(Bright-sided)中，尖锐地批评了当她身患乳腺癌时，各路“阳光族”向她狂轰滥炸“积极思维”。在那种情况下，病情未见起色的患者会觉得仿佛是自己做错了什么。

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，兰格在一个讲座上谈到，当我们说“与癌症战斗”的时候，我们实际上赋予了疾病威力。讲座结束后，一名男子拦住了她，劈头痛斥了她的观点。原来他的妻子死于乳腺癌。“他说她一直在与病魔抗争，而按照我的说法，似乎这全是她的错，”兰格向我转述道。

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.
兰格向那名先生道了歉。“你说的这些都很有道理，我很抱歉我没有应对这些问题，”她说。“但请让我解释，是文化让我们觉得自己无能为力。我并没有埋怨你的妻子；我只是在谴责这种文化。”兰格梦想着有那么一天，当事情出错时，人们最先做出的反应不是责备。相反，我们将只是充分发挥自己的思维威力——她相信，这力量将比我们所想像的大得多。