With every new act, Brian distanced himself from the past: His father, explosive and often unemployed, had pounded him with names like “moron” and “jerk.” His life on the streets beyond the family’s Bronx apartment had been difficult, too. One of just a few white kids in a neighborhood of Hispanics and blacks, he felt he had to be macho and tough. It’s no wonder that Brian wanted to be a writer — he had stories to tell. But he also had issues, including a glaring lack of self-esteem. Still, he had fight in him — he plugged through college, earned a Ph.D. in literature and secured a coveted professorship at a university.

In the wife he chose (cultured and moneyed), in the way he vacationed (Hamptons one year, Greek islands the next), in the books he read (literary, experimental), Brian disposed of his prior self, layer by layer, as if he were shedding skin. But the core remained, so he began writing a book about life in the ‘hood. The more he took on, the more he compensated for his insecurity with braggadocio, eventually insisting his novel (always “a work-in-progress”) would win a Pulitzer Prize. “Read this, it’s genius,” he said, pushing passages on friends, ignoring the voice inside that whispered, “This writing is bad.”

Yet Brian was in fact gifted: A top New York publisher finally bought his novel, fulfilling his lifelong dream. But for Brian, it proved too much. “At first he just seemed depressed,” says his former wife, Meg, who witnessed the tailspin. But depression turned into alcoholism, then obesity and finally heart disease. When the book came out, Brian was too ill to go on tour.

Brian’s downfall seems counterintuitive: Shouldn’t success bring happiness, boosting the immune system and improving our overall health? Not according to research from psychologists at Duke. Enormous success is healthy only for people with self-esteem to match, it turns out. For someone struggling with a poor self-image, like Brian, hitting a ball out of the park may tax the immune system, helping the body to spiral into disease. Instead, say the Duke scientists, the Brians among us stay healthier when success is more modest and slower to arrive.

The Duke research is just one example of a new paradigm in psychoneuroimmunology (PNI), the study of the link between emotion, immunity and the brain. While we’ve long equated positive emotion with health and negative emotion with illness, studies have added nuance and subtlety to these broad ideas, proving them just partially correct and in many cases wrong.

Among the surprising findings: Stress can prime the immune system, making us stronger. Too much optimism may be an immunological drain. And health improves when self-esteem and success stay in sync. With thousands of new studies and a better understanding of immunity, today’s experts agree that the link between emotion and immunity is robust. But it is also intricate and filled with surprises that open a dramatic new window on the nature of emotional health.

Healthy Stress Raises Immunity

Conventional wisdom holds that stress is ruinous, and who can argue? Too much stress increases blood pressure and the risk of heart disease. Studies tie stress to immune suppression, including a surplus of flu and colds.

Yet the “rule” didn’t apply to Rachel, a special education teacher with the autoimmune disease lupus. She suffered a relapse a few years back, over the summer, and was still so tired by Labor Day, she didn’t see how she could return to work. “I was better, but drained, and I thought the strain of the commute alone would do me in,” she recalls. Encouraged by her doctor, she went back anyway. And instead of crashing under the burden, Rachel thrived. “Each day was a shot of energy,” she says, explaining how good she felt when one of the children made a breakthrough or gave her a hug. “I went home to chill.”

In Rachel’s case, the ebb and flow of daily stress, much of it ultimately rewarding, provided a health boost. The harmful effects of stress occur “when the stress is chronic,” explains Monika Fleshner, a neuroimmunophysiologist at the University of Colorado in Boulder. It’s extreme, constant stress over a long period of time that impairs the immune system. But “short-term stress, under most circumstances, actually boosts immunity. It all makes sense in light of our evolutionary past. When we’re threatened or frightened, we become hyperalert, primed to get out of what could be a life-or-death situation,” she explains.

To prove the point, Fleshner replicated her scenario with rats in the lab. All the rats were exposed to bacterial infection, but some were also stressed by receiving electric shocks to the tail. The rats that were infected and shocked at the same time resisted disease and stayed far healthier than rats not given the shock. This finding may warrant notice in emergency rooms, where overwhelmed patients are frequently treated with antianxiety drugs. Yet if a patient has an infection, reducing anxiety may depress the very immune response the patient needs to get well.

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Last reviewed:
  On December 5, 2007
  By John M. Grohol, Psy.D.