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The Balance Within: The Science Connecting Health and Emotions

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Since ancient times humans have felt intuitively that emotions and health are linked, and recently there has been much popular speculation about this notion. But until now, without compelling evidence, it has been impossible to say for sure that such a connection really exists and especially how it works.

Now, that evidence has been discovered.

A thrilling scientific detective story, The Balance Within tells how researchers finally uncovered the elusive mind-body connection and what it means for our health. In this beautifully written book, Dr. Esther Sternberg, whose discoveries were pivotal in helping to solve this mystery, provides first hand accounts of the breakthrough experiments that revealed the physical mechanisms - the nerves, cells, and hormones - used by the brain and immune system to communicate with each other. She describes just how stress can make us more susceptible to all types of illnesses, and how the immune system can alter our moods. Finally, she explains how our understanding of these connections in scientific terms is helping to answer such crucial questions as "Does stress make you sick?" "Is a positive outlook the key to better health?" and "How do our personal relationships, work, and other aspects of our lives affect our health?"

A fascinating, elegantly written portrait of this rapidly emerging field with enormous potential for finding new ways to treat disease and cope with stress, The Balance Within is essential reading for anyone interested in making their body and mind whole again.

272 pages, Paperback

First published May 23, 2000

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Esther M. Sternberg

13 books20 followers

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Displaying 1 - 30 of 46 reviews
Profile Image for GoldGato.
1,305 reviews38 followers
July 12, 2015
Fascinating. Looking at the way stress can overcome the immune system and explaining the process based on actual scientific results had me turning the pages faster than usual. I usually get stuck in medical tomes, as the scientific names overwhelm my limitations, but the subject matter here was different.

...a rich and varied fabric of positive relationships can be the strongest net to save us in our times of deepest need.

The book is written almost as a court case would be designed, in that each idea is backed up by lab results (usually with rats) and then explained so the reader can get the drift. It's an interesting take on the way we have all become un-healthier as lifestyles take us into more stressful existences.

1. The degree of stress responsiveness you are born with can determine whether you will be protected from disease or more disposed to it.

2. Just being stressed (especially being stressed for long periods) can change how your body reacts to disease.

3. Prolonged stress doesn't point one toward allergic or inflammatory illness, but instead toward infectious disease. Yin/Yang.

4. Interrupting a child's bonding with its mother during its first two weeks of life (even for just 15 minutes) can alter the child's future response to stress.

5. Children abandoned or abused before the age of ten are more prone to later physical and psychological problems.

6. Studies suggest that reliance upon social media leads to more isolation...and stress.

7. Business go-getters who willingly re-locate for each new job advancement have consistently high stress levels. But so do lower-placed co-workers, who have to deal with the stressed-out leaders.

8. On average, it takes fifty repetitions for anything to begin to gel (learning to play an instrument, memorizing a poem, coding software) and sleeping helps it all to gel. In essence, you are growing new nerve cells.

9. The placebo effect remains successful. If a sick person takes a sugar pill, believing that it is a cure, then that person will believe themselves to get better. The brain can will the body to health.

10. Do you like to knock yourself out while exercising, such as running rapidly on a treadmill? High stress activation.

With familiarity comes resolution of anxiety.

Through the first half of the book, I was engaged but only at a 3-star level. But when the whole mind/body detail took over, it was a bump up in quality. Thought-provoking but with the facts to back it up (along with a lengthy bibliography).

Book Season = Summer (just chill)
Profile Image for Paula Cappa.
Author 17 books514 followers
September 5, 2018
If you are struggling with an illness, this book is an eye-opening achievement in brain-body interactions and brain-immune system communications regarding healing. A wealth of evidence supports that “emotions and health are one.” Dr. Esther Sternberg has done 5-star research on this and takes it deep into the scientific core in easy to understand language. She reminds us that our brains have maps of our relationships. Loss, loneliness, rejection, isolation, disappointment, fears, anxiety and stress all affect our molecules and nerve pathways to cause disease and pain. To achieve this balance, Sternberg identifies healthy food, clean water, exercise, rest; however, she adds love, acceptance, belief and spirituality. A fine menu of nourishment!

On the scientific side—stress can directly create inflammation in the body; the inflammation causes diseases like rheumatoid arthritis, lupus, fibromyalgia, multiple sclerosis, and many more. Learning how stress acts to stimulate the inflammation is the key. Sternberg identifies hormone response, parts of the brain and brain circuitry, imagery, learning and expectation, and biological mechanisms as all playing a role in the susceptibility and resistance to inflammatory diseases.

Chapter 9 “Can Believing Make You Well?” is especially comprehensive. Can we consciously choose to heal? Sternberg addresses the power of prayer on the mind, spirit, and body. “Repeated performances of a set of actions, like prayer, can become automatic and impart a sense of peace to soothe the immune responses (A Duke University study and other studies support this) and reverse the stress factor, decreasing the inflammation for healing. She cites two sides to prayer: “One is what happens to the believer praying, and the other is the prayer itself. A part of the prayer’s effect might come from removing stress—reversing that burst of hormones that can suppress immune cell function.”

A lot in this book comes down to rewiring the nerves, neurotransmitters, and thought as it relates to the brain and body in order to release healing endorphins. I have simplified too much here. But if learning, expectation, imagination, and spirituality are part of our belief system, then why couldn’t believing change pain and create healing? This book is not only an illuminating scientific read into health but also a guide to harmonizing the mind, body, spirit. Every medical doctor needs to read this.
Profile Image for Harika.
63 reviews1 follower
June 21, 2014
The book has been a good read, but I felt that it was touching the same topics that probably so many other articles. But having liked the style of writing I am pleased to recommend this book to someone who is new to the field.
Profile Image for JoDee.
7 reviews5 followers
December 29, 2015
Fascinating look at the history behind the discoveries that the immune system, endocrine system and the brain are all intertwined. Very specific medical information and basic science about the mind-brain interaction and the many ways stress affects us.
Profile Image for JA.
95 reviews6 followers
December 4, 2017
I wanted to like this book, and kept plodding along until I'd finished it, but I honestly didn't get much from it. To be fair, it is very complex subject matter. The level of detail was uneven, in many places giving specific citations for research studies on immune responses, but in others stating vague (and to me, unconvincing) generalities. For instance, the subject of dominance hierarchies was invoked with some hand-waving and simplistic statements (pretty clearly not in the author's wheelhouse). When focused on research areas closer to her own expertise, the author's enthusiasm is clear, and I wish it had been more contagious. YMMV.
Profile Image for Chole Allyson.
139 reviews5 followers
September 27, 2008
Great book. It helped me to remember that being a health care worker isn't just about helping to ease the disease or illness. Being a health care worker is about helping the patient as a whole, physically and spiritually. As we care for the spirit the body can also be cared for. Sometimes the patient can become healthier while their spirit is being nourished. Being happy is contagious and we need to remember that everyone is a child of God.
Profile Image for Heather Ferguson .
175 reviews2 followers
November 20, 2022
Interesting but dense. Lots of reference to scientific studies- which is good. But not an easy read. Interesting though to think about how the emotions affect the body and vice versa. Yes, stress can make you sick and there are biological reasons for that. Yes, optimism, prayer, meditation, healthy relationships can aid in wellness and getting better from illness- and there are biological reasons for that. We are whole beings-mind, body, soul- all working together.
Profile Image for Edward Amato.
456 reviews1 follower
March 18, 2022
It was refreshing to renew my acquaintance with immunology and cellular biology from undergraduate days in Pullman. Wow! talk about dusty shelves in the brain. The ultimate message of this book was the importance on interdisciplinary research in medicine and science. Well thought out.
Profile Image for J.D. Steens.
Author 3 books35 followers
November 19, 2023
There are two main themes in this book. One of them I agree with.

The overarching theme is that mind and body are integrated in the sense that, as per her most prominent example, psychological stress generates stress chemicals that affect the body’s health. In making this argument, Sternberg is critical of modern medicine - and the beginnings of science with Bacon and Descrtes - that separates bodily ills from mental causation. Psychiatry is an exception in that it bridges that gap somewhat by chemical treatment for “mental” ills and, somewhat, via deep probing and talk therapy.

In making the argument that mind and body are closely connected, Sternberg also has to, logically, argue that bodily ills can be corrected through various forms of mind control. For example, she quotes Norman Cousin’s mantra that laughter is the best medicine. She also notes the so-called power of prayer and religious belief systems that offer solace and hopes for cures. But her underlying argument here is more about the various forms of Stoic mind control, which is to push back negative thoughts and push forward the positive ones. This part of her argument is problematic. How does one laugh if one doesn’t feel laughter inside? Does fake laughter work? What happens to negative emotions when we deny them? Where does that energy go and, by the way, might that energy fester inside to create bodily ills?

The second theme is that emotions are responses to triggering events. While a standard way to see emotions, this conceptualization of emotions has all sorts of problems. Sternberg’s conceptual model rests on the role of the immune system. Invaders from the outside - germs and such - trigger the body’s defenses. Medically, this is what happens and clearly there is a triggering event. So, by analogy, she takes two standard defensive emotions, fear and anger (though also an offensive emotion), to argue that they are triggered by outside threats, which of course makes total sense – for fear and anger: “Incoming” necessitates an “outgoing” response, which are fear and anger. And, to her theme, these emotions flood the body’s chemicals to do other things, and this, if chronic, starts to eat away at the body’s health (held-in anger and fear).

But any discussion of emotions must also include the so-called positive ones, like love. Sternberg takes on this subject in her chapter on connecting with others. That we, generally though variably, need to do so, is clear enough but, in Sternberg’s model, our love connection is triggered from the outside through various social signaling, beginning with the baby’s cry that “brings in a burst of hormones in the mother.” True to form, humans send signals to each other, so that the others can react in ways that strengthen social connection. And, again, per her theme, when such is missing, we get stressed out from loneliness which has a consequence for bodily health.

All in all, Sternberg has a passive view of humans and their emotional makeup. There is “e-motion,” to be sure but it is reactive movement. Humans are static beings awaiting a triggering event that makes them move against (fear and anger) or toward (via social signaling). Something is very wrong about this picture, beginning with its minimal connection to evolutionary theory. If the baseline ends of being are survival (or the body survives as a vehicle for reproduction), and self-interest (generally, welfare), then certain needs are foundational to make this happen. The body needs nurturing, the social group, and a sexual mate. The body does not want threats or harm to its survival or well-being needs. The body is like a good cell. It’s open to bringing the world into itself to satisfy need, and it’s closed to threats or harm to its body.

Needs are emotions that move us to act in the world. We seek nurture because we need food-energy and bodily well-being and eventually, self-fulfillment (we nurture ourselves that way). We seek to be a group member in good standing because this is the way we survive. We need a sexual mate to reproduce. Likewise, we resist threats and harm to our needs, prompted by fear and anger. We are seeking and defending-resisting beings. We actively seek from the outside world what we need and we actively search for what we need. When we find what we want from the outside, we have so to say, a match. The trigger is only so because the outside speaks to what the inside motive force is looking for. With defending-resisting, the outside harm only triggers because the inside is threatened or harmed. The inside is fundamental. The outside trigger is secondary to that.

Sternberg’s conceptualization of emotion, the motive force is missing, i.e. why does the self care about the outside world. This was Schopenhauer’s point. The self is moved by pain, what we want, what we don’t want, and both are activated by our overarching need for survival and well-being. At the broadest level, pain that moves to act and react is one of two emotions. When we are successful, there is pleasure and movement stops. If we are unsuccessful, pain remains and we try again or we have to deal with the negative consequences.

Seen this way, the commonly-stated basic emotions - for example, the universally recognized facial expressions” as highlighted by Ekman - begin to make sense: we signal anger and fear for what we don’t want (broadly, disgust is a form of anger). When we are successful, there's “enjoyment.” When not, there’s “sadness.” And now we are in Spinoza’s territory, and his lumping of all emotions into three categories: We are moved by desire (pain, what we want, or don’t want, which is sort of an anti-desire). When there’s success we have joy. When not we are sad.

The mind and body connection is integrated in the sense that Ledoux suggests: The body expresses the emotion first, and consciousness follows a fraction of a second later and adds helpful context. Ledoux states that this model might have broader applications to the mind’s role vis-a-vis the emotion, and not limited just to fear: the body responds first and the mind follows by supplying added context.

As a final note, though Sternburg’s argument is to integrate the mind and body, there is in her thinking a mind-body separation nonetheless in the sense that the body is subservient to the mind and its control. The tripartite separation of the mind-body apparatus is emotion, thinking and behavior. Thinking oversees emotion and thereby guides behavior. This, in effect, in the West at least, is the Standard Model. The separation, though, is too severe. Emotions supply the motive force - they explain why and what we do; in a fundamental sense they are about values. With instinct and automatic behavior, the reason for acting/reacting is built into the “how” to act/react and the behavior itself. With humans, the cognitive element becomes, in the Western model, separated from the non-instrumental values that explain, fundamentally why we do X and resist Y. With humans being conscious of their consciousness, they focus on how to do something, including the use of instrumental means and ends, and behavior. In doing so, the value part, in the essential, fundamental sense, recedes into the background and gets lost. By default we then come to think that the overt reasons we act-react are the real reasons we act and react when it’s not nearly as clear cut as that.
Profile Image for Fran.
124 reviews4 followers
October 9, 2015
Very technical, to me, slow going.
7 reviews
April 29, 2020
The author takes you in an interesting journey on the recent developments and discoveries on the connection between the disciplines of immunology, endocrinology and nervous systems.
The underlying idea is that modern medicine has been alienating people due to its over specialisation and over reliance on purely physical effects fn illnesses, ignoring the psychological factor.
Thus people have been turning towards alternative types of medicine, more emphatic and focused on the psychologycal aspect of facing an illness.
However, the connection between mind and body has been increasingly subject of study, and there is an accumulating body of evidence backing up the role feelings play in potentially exarcebating an illness, or on the contrary on helping recovery.
This books give practical examples of this connection (results of lab tests, current drugs use, etc), especially on the interaction of the immune and nervous system and their reciprocal influence on each other, opening a future window on a new approach for medicine in treating and thinking about illness and potential cures.
Profile Image for Alexandra.
9 reviews8 followers
March 24, 2019
This book is riddled with mistakes. I have a degree in pharmacology so most of the underlying material I have learn at university. At first, I thought I did not remember things properly. But then.. Author talks about Harvey Cushing and says he is a British physician. Having just read a well over 500 pages biography on the guy, I can assure you he was american. He was born in Cleveland. Spent most of his life in America. He spent a brief period overseas during his residency but that’s about it. Plus, she talks about a James Lister who was a pioneer in aseptic techniques in surgery... the guy is actually named Joseph Lister...I can now not trust any of the informations mentionned in the book. Waste of money and time. Really saddening because I was really lookin forward for the relationship between informations I had learned back in University.
103 reviews1 follower
December 11, 2021
I was pretty into this concept and see an important value in the topic. However, I couldn't get past the preface. Sternberg chose to start the book with 30 year old tea about how this field was snubbed in the past. It really struck me as whiny and I-told-you-so tattle-tale piece. Do I care about this? No. Do I care the that author can convince me of the importance of this work? Yes. I felt that the quality of the writing was not for me and a disappointing contrast to the importance of the topic. My recommendation is to read Bessel Van Der Kolk's The Body Keeps the Score instead of this work.
Profile Image for Dana Paxson.
35 reviews
October 9, 2020
Some works raise one's eyebrows at the very beginning, but then carry the reader into strange new territories of thought and meaning. Sternberg links our emotions and our bodily and mental health at the very-detailed and disciplined levels of our immune systems, their responses to stress, and the resulting impacts on the way our brains cope with the consequent chemical changes. A vital new perspective.
Profile Image for Dr. Ashori.
226 reviews6 followers
January 26, 2025
It's a great book for understanding how emotions and thoughts and social structures affect our health. The book is a bit dull but filled with very interesting scientific tidbits. There is a lot of animal research where they tortured this or that rat to prove that negative emotional states have negative physical consequences. I would have wanted more real world scenarios than animal related anecdotes. But still worth a read.
Profile Image for Iuliia.
13 reviews5 followers
March 5, 2019
Beautifully written, descriptive, informative and suitable for the most unprepared reader. It takes you on a journey throughout the history of medical research in neuroscience, physiology, anatomy and other related fields and shows how we've learnt what we know today about the brain-immune connections. It's a truly enjoyable read.
Profile Image for David.
70 reviews7 followers
December 29, 2019
As my human biology is rusty at best, the book is a bit challenging at times to keep everything straight in terms of how the endocrine system works in our bodies, but this book is fascinating. Dr Sternberg presents information at a steady rate, building up the reader's understanding of what's going on in our brains and our bodies and connecting science with emotion.
2 reviews
July 9, 2023
I really enjoyed this book overall. It's quite technical at points and I had to push myself to get through a few chapters. But in the end I do recommend this to anyone seeking to learn more about this subject. The fact that we can alter our immunity by the way we feel and think is pretty incredible.
Profile Image for Daniel Spaniel.
4 reviews1 follower
February 29, 2020
A wonderful and accessible summary of Sternberg's research and anecdotal understanding of how we are all subject to complex factors that control and influence our levels of stress, inflammation, and ultimately well being.
Profile Image for Raynald Provost.
327 reviews8 followers
February 11, 2022
Tout ce qui est science est bien expliqué. On ne peut que s'émerveiller devant la complexité du corps humain et l'ingéniosité des chercheurs pour l'étudier. Mais pour ce qui est de l'aspect émotion du livre, ce n'est pas la spécialité de l'autrice et cela parait.
Profile Image for Heather.
49 reviews
September 10, 2024
This book was interesting to read. At times, there was a lot of scientific detail that I had had to really focus on and follow carefully in order to understand. Despite the sometimes hard jargon, the brain/body connection was pretty cool to learn about!
14 reviews
January 3, 2025
Excellent!

Fantastic and informative. I especially enjoyed Chapters 5-8 regarding the immune response and the connections to the immune system. This was a very informative read. Highly recommend.
Profile Image for Sandra.
659 reviews41 followers
February 4, 2018
Es pura ciencia, lo que no es malo en absoluto pero sí algo decepcionante si esperas algo que todavía no somos capaces de comprender.
Profile Image for Stephanie.
608 reviews
April 24, 2019
I read this book as part of a book group. I cannot remember much of it because I found it quite tedious and technical.
Profile Image for CinderBelle615.
123 reviews8 followers
May 2, 2019
fantastic read. highly interesting. i love the imagery the author managed to write in in such a technical and science filled book. super recommended.
Profile Image for Margaret Heller.
Author 2 books37 followers
December 29, 2020
This is is the exact sort of book I love, but I think reading it in late 2020 (20 years after it was published) was the best time.
42 reviews1 follower
March 4, 2014
The mind and immune system are intertwined from birth, yet modern medical science has until recently considered them as entirely separate entities. In The Balance Within, Dr. Sternberg attempts an explanation of the complex interactions between the two systems, and why medical science took so long to uncover them. The story and content of this research is the epicentre of this book. Her message is simple, yet confounding to many doctors: a holistic approach is necessary to truly understand how the body works.

The synthesis between the fields of immunology and neurology is a recent development, so the age of this book (2000) means that it lacks many recent scientific insights. Nevertheless, it is well worth a read for anyone wanting a better understanding of the topic, especially for those with immune disorders. The ego-infused barriers between medical specialists have done great harm to both patients and scientific progress as a whole, but it is comforting to know that they are gradually being dissolved by doctors such as this author. The more they cooperate with eachother, the less appeal the rich and corrupt alternative medicine industry has. Ignorance-slashing books like this catalyze this crucial process!
Profile Image for Woody Hayday.
Author 1 book8 followers
April 2, 2024
Sternberg does well to ground the reader as she weaves geographical and architectural introductions into many chapters, before blowing your head off with some science, and overall she manages to convey the fascinating depths of the scientific best working-model understanding of emotion-immune system interplay.

I'd recommend this to anyone seeking to understand more about stress, and emotional impacts on health, but not to vaguely interested parties. Though the author manages in many places to pull off the science/literature cross, this is not the book's strong point, and at times there are sentences double-explaining points that any editor should have cut.

Further, if you like rats, or animals, maybe don't read this. 30% of paragraphs contain some form of rat testing example.

I read this as part of an exploration into my burnout, having broken myself with stress.

Feb 24 update: Read my Burnout recovery post & Burnout Book List
Profile Image for Margaret Pinard.
Author 10 books87 followers
January 18, 2016
Fascinating! I admit my eyes glazed over a bit reading about receptors on cells, interleukins, lymphocytes, and such, but much of the text was related in an easy to explain manner. Sternberg used metaphors and explained the order of events clearly so that even non-medical readers could get the gyst of the experiments she describes.
It's not at all a 'woo-woo' book, even the chapters that talk about the possible effects of belief at the end. I enjoyed learning about the body's stress response, its immune functions, and how the brain coordinates so much of both. I would recommend it to anyone looking to learn more about how their body works, especially in the interest of being healthier.
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