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

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 system 2 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. THE BASIC NEUROPHYSIOLOGIC SYSTEMS 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