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April 26, 1993

Pleasure Heals: The Role of Social Pleasure—Love in Its Broadest Sense—in Medical Practice

Author Affiliations

10 Nob Hill Gate Roslyn, NY 11576

Arch Intern Med. 1993;153(8):929-934. doi:10.1001/archinte.1993.00410080005001

THE THERAPEUTIC benefits of love and hope, and of trusted physicians and clergymen, can be explained by the physiologic healing effects of pleasurable stimuli.1 Those effects may also underlie the placebo effect, some nonspecific therapeutic effects of corticoids, and sleep's facilitation of healing and growth.

Organisms experience stimuli as painful, pleasurable, or both as they respond to them. Those experiences are mediated by midline systems in the central nervous system2 that help determine the objective intensity of the responses at the time and the subjective "emotionality" associated with those stimuli, both then and in the future.


Pain/Avoidance and Pleasure/Approach  The midline system concerned with pain is called "self-preservative" or ergotropic (energy-turning or energy-releasing)3 because it mediates activities involved with safety and survival, removing stress, and emergency "fight or fight"—ie, with pain and eliminating its causes. Avoidance of painful stimuli, the basic movement involved, involves