"Pain was the hurdle that prevented these patients from working to strengthen their muscles and ligaments. Once that hurdle could be overcome by the power of the mind, then the necessary rehabilitation could proceed. Without hope, nothing could begin; hope offered a real chance to reach a better end. Hope helps us overcome hurdles that we otherwise could not scale, and it moves us forward to a place where healing can occur.

      The escalating pain and sense of suffocation from his strangling lymphoma flooded his brain with the kind of visceral input that solidified his hopelessness. This further reinforced the assumption that his outcome would be no different from that of his suffering friend.

      This is a vicious cycle. When we feel pain from our physical debility, that pain amplifies our sense of hopelessness; the less hopeful we feel, the fewer endorphines and enkephalins and the more CCK we release. The more pain we experience due to these neurochemicals, the less able we are to feel hope.

      To break this cycle is key. It can be broken by the first spark of hope: Hope sets off a chain reaction. Hope tempers pain, and as we sense less pain, that feeling of hope expands, which further reduces pain. As pain subsides, a significant obstacle to enduring a harsh but necessary therapy is removed. 

      The body-mind connection should be thought not only in extreme cases, where a patient is literally suffocating, but in instances where symptoms may be routine and not life-threatening. Among these non-life-threatening but significant symptoms is fatigue.

      People with a variety of maladies ranging from cancer to neurological disorders to circulatory diseases complain of unremitting fatigue. For decades I would simply acknowledge the expected when my patients told me how exhausted they were. Now I look for ways to alleviate some of the fatigue, because even small reductions in that symptom can have a major impact on a patient's sense of hope. 

      Kindling and sustaining hope depend not only on images that may be conjured in the mind but also on how those images are brought into focus or blurred by the ongoing input of nerves from organs and tissues to the brain."

- The Biology of Hope