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Counterclockwise: Mindful Health and the Power of Possibility

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Michael Hogan, National University of Ireland, Galway: michael.hogan@nuigalway.ie

This review is based on my reading of all 4 of Ellen Langer's books, which I was inspired to read after meeting Ellen in Harvard recently.

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Ellen Langer is one of the most vivacious women I have ever met. Upon arriving to meet her in Harvard's William James Hall, I was actually extremely ill, but mindlessly ignoring the symptoms. The painful and yet irrelevant swelling in my right leg and the weak and feverish state that led me to sleep through a very stimulating lecture by Daniel Dennett, was in fact a serious blood infection that would later result in my hospitalization. Little did I know that my conversation with Ellen Langer would be the thing that completely transformed my hospital experience from a potentially stressful, painful nuisance into a very interesting and rewarding experience. And notwithstanding the fact that I could hardly talk, in our short walk from Ellen's office to the Harvard clinic (where Ellen was going to get a cut in her hand seen to, the cause of which she transformed into a very interesting story) we designed three experiments and I experienced firsthand, in vivo, decades of research on social and developmental psychology, and on mindfulness, creativity and decision-making.

To understand the transformative power of Ellen Langer's perspective, and to better understand her creative action, I believe it is useful to experience firsthand her version of mindfulness -- the act of noticing new things -- which is actually very easy to practice, if for no other reason than it energizes and engages us and opens us to new possibilities. Further, it is useful to consider the way Langer applies her version of mindfulness to understanding of social psychology and developmental psychology phenomena, and science generally. Her thought, as laid out in her four books on mindfulness and in her many empirical papers, represents a veritable stream of understanding that liberates one from a constrained, passive, rigid view of reality, possibility, and human potential.

Noticing new things

Ellen and I both teach social psychology. A critical reading of social psychology reveals much to us about the conditions under which people impose rigid, stereotyped views upon themselves and other people, and the conditions under which behavior is a rigid function of contextual control [1]. What is often so startling to students who first discover social psychology research is just how rigid, stereotypical, and limited our worldviews and our behaviors often are. Nevertheless, every year, one or two students in my first year social psychology class approach with great excitement and tell me how inspired they are to discover all these human limitations so carefully catalogued by social psychologists. Awareness of the conditions shaping rigid, stereotyped thinking and action, they tell me, has actually liberated them. Some report feeling more open to experience, less rigid in their evaluation of self, other, and world. They report clearer perception, greater awareness of the subtle nuances of experience. They are noticing new things. They are energized and inspired. Some go a step further, extrapolating and anticipating the open field of possibilities: they report a transition from mindless acceptance of all that they know and feel and do, to mindful awareness of all that they can know and all that they can feel and can do. Their prior learning no longer dominates the way they interpret the present moment. The fullness of the present moment itself and the possibility space that opens by virtue of the fusion of present moment with the ineffable future moment infuse their field of action with a new radiance. All is new. The well-springs of creativity are open. Reality and potentiality comes flooding in.

Mindless reading of health-related information

Some students, I believe, remember the raw significance of their inspired insight as they progress to higher levels of ability and skill -- they remember to notice new things -- they remember mindfulness. It's a subtle change in thinking, says Langer, although not difficult to make once we realize how stuck we are in culture, language, and modes of thought that limit our potential. Social psychology education provides a wonderful opportunity to shed light upon mindfulness and mindlessness. Experimental social psychology is full of examples of the price people can pay for mindless learning, or mindless assimilation of their `culture'. Research by Chanowitz and Langer (1981), for example, demonstrates the negative consequences of mindless reading of medical information. They provided students with information booklets about a disorder called "chromosythosis", a condition that could lead to diminished hearing. Some of the students were told that 80% of the population had the disorder and they were asked to imagine how they might help themselves if they were diagnosed as having "chromosythosis". Another group was told that only 10% of the population had it, making the disease seem less relevant to them, and they were simply asked to read through the information booklets. All students were then tested to see if they had the disorder and all were told that, yes, they did indeed have it.

In the next phase of the experiment, participants were tested using a series of objective hearing tests. Those participants who were led to believe that the disorder was less relevant to them and who simply read through the information booklets, performed significantly worse on the hearing tests than the group who were led to believe that the disorder was potentially relevant to them and who also thought through the consequences of having the disorder. Langer describes this as one example of the negative effects of premature cognitive commitments. Specifically, when information is mindlessly received and accepted without critical question or creative `what if' deliberation, we run the risk of implicitly committing to a singular, rigid understanding of the information. When later we are faced with a situation where this `prior learning' is brought to bear on our action in context, we may find ourselves functionally constrained by the rigid understanding we have implicitly established. Mindless reading and mindless learning result in mindless reactivity.

Mindful Health and the power of possibility

Langer considers how mindfulness operates when people learn that they have cancer. Although science is learning that cancer can be a chronic condition or even fully treatable, most of us, says Langer, mindlessly assume that cancer is a "killer". Rather than being mindfully aware of our symptoms and the conditions associated with the presence and absence of symptoms at any given moment in time, rather than being mindfully aware of the variable nature of our interactions with medical professionals, friends, and family, or changes in the way we work and play, and so on, one possible outcome is that the trauma associated with the diagnosis of cancer leads us to identify fully with the label "cancer patient". As soon as we identify with the label, all the preconceived ideas we ascribe to the label come to control our behavior.

But this is only one possibility and not everyone responds in the same way when diagnosed with cancer. Langer refers to research by Sarit Golub (2004) conducted in Harvard. Golub found that while some people diagnosed with cancer add cancer to their identity, others let the diagnosis take over their identity, with the latter group faring less well on measures of recovery and psychological well-being.

Langer suggests that mindfulness makes us more optimistic because we are open and attentive to possibilities, and that this in turn facilitates recovery. Research does suggest a relationship between mindfulness and optimism [2], and between optimism and recovery from coronary artery bypass surgery [3]. Converse to the view that optimists have a rosy view of their future that invariably leads them to ignore their present circumstances, Langer believes that mindful optimists are likely to pay greater attention to their recovery than do pessimists, and in so doing they aid the recovery process and help anticipate complications.

Nevertheless, mindless optimism and mindless pessimism may lead people to invest more heavily in positive or negative systems of belief than in reality itself and the possibilities that reality presents [4]. Thus, mindful optimism is unique: optimal well-being, according to some, hinges on a capacity to open oneself to the subtleties and complexities of reality and thus inhibit cognitive commitments that pit belief against experience [5]. One belief that Langer asks us to be mindful of in this context is the belief that science trumps experience. If, for example, we blindly assume that medical science is simply better than our own experience in informing our judgment and action, we may be inclined to mindlessly hand over control of our health to the `experts' and thus ignore the subtle variation in our experience (e.g., our experience of symptoms) and contextual variables that impinge upon our experience. Again, by accepting some label attached to us in consultation with a doctor (e.g., "chronic pain patient") we may come to assume more stability in our condition than there is; we may hand over control of our condition to others, and thus negate the possibility space that opens to us when we are mindfully aware of our condition.

Mindful awareness of our state can enhance our ability to control our state. For example, Delizonna, Williams, and Langer (2009) demonstrated that, when compared with a group who were asked to measure their heart rate upon first waking in the morning and just before going to bed, people who are asked to measure their heart rate regularly throughout the day, thus attending to its "variability", later demonstrate greater capacity to speed or slow their heart rate without instruction. More generally, those who scored higher on the Langer Mindfulness Scale exercised greater control over heart rate regulation.

Langer accepts that if you are ill you should consult a medical professional, but she warns against mindless acceptance of medical advice. She argues that diagnoses, prognoses, research methods, and statistics are all necessary for efficient, ethical, and meaningful medical care, but in light of the inherent uncertainty due to variability, medicine, like all domains of study, should be regarded not as a collection of answers but rather as a way of asking questions. How much exercise is a healthy exercise level? Observe the science and you will see that there are no simple answers that apply across all individuals. In this context, we need to attend to both the medical facts and our own bodily states, and we need to be aware that much like our bodily states vary over time, so too do the facts of science. For example, exercise may well be good for us in many ways, but women who exercise too much may be more at risk of developing ovarian cancer [6].

The observation of science, much like the observation of our environment generally, exposes us to a great deal of variation. Variation in the set of facts and relations open to observation in the field of science may be enough to completely inhibit our adaptive movement, particularly if we are looking for hard and fast rules in relation to any aspect of our future adaptive action. On the other hand, if we embrace the fact that medical science, and science generally, deals largely in probabilities and not certainties, and that these probabilities allow us to anticipate to some extent the consequences of a unique path of action in a unique context, we open ourselves to the possibilities latent in the observed variation - and we do not fail to see the importance of our own action in this field of possibility.

Langer's definition of mindfulness is very interesting, because it aligns more with definitions of critical thinking than with definitions of mindfulness as a meditative acceptance of all that is. Langer's mindfulness is very pro-active, energized, engaged, optimistic, constructive, and uninhibited in the face of failure. Langer believes that the future is largely indeterminate, not uncontrollable. We don't know for sure whether or not we can control something unless we try, and if we fail this does not imply that we cannot control the thing we set of to control, only that we failed to control it at the time of trying - the situation remains indeterminate, but the possibility of control is still a possibility. Langer maintains a beautiful balance: she is skeptical and constructive at the same time, open to the possibility that she may be right or wrong, or right and wrong - only experience will tell and only mindful experience will transform.



1. Myers, D.G., Social psychology. 6th ed. 1999, Boston: McGraw-Hill College. xiii, 737.
2. Weinstein, N.D., K.W. Brown, and M.R. Richard, A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being Journal of Research in Personality, 2009. 43 (3): p. 374-385
3. Scheier, K.A. and C.S. Carver, Effects of optimism on psychological and physical well-being: theoretical overview and empirical update. Cognitive Therapy & Research, 1992. 16(2): p. 201 - 28.
4. Hogan, M.J., Enlightened happiness and pragmatic systems science - positive psychology meets Colin Feltham's anthropathology thesis. . The Irish Psychologist 2009. 35 p. 138-148.
5. Labouvie-Vief, G. and M. Márquez González, Dynamic Integration: Affect Optimization and Differentiation in Development, in Motivation, emotion, and cognition: Integrative perspectives on intellectual functioning and development., D.Y. Dai and R.J. Sternberg, Editors. 2004, Lawrence Erlbaum.: Mahwah, N.J. p. 1 - 36.
6. Gertig, D., J. Hooper, and G. Graham, A prospective cohort study of the relationship between physical activity, body size and composition, and the risk of ovarian cancer. . Cancer Epidemiology Biomarkers and Prevention, 2004. 13: p. 2117 - 25.
7. Pinker, S., How the mind works. 1997, New York: Norton. xii, 660.

This challenging and insightful book will likely transform the way you view medicine and help you change from a passive recipient to an active and informed participant in the care of your own health. Definitely worth reading. Warning: if you have already read Dr. Langer's previous works such as Mindfulness, the general message of this book may be a little redundant. Still, it never hurts to be reminded of good advice (and to be fair, Dr. Langer has never before taken her message about the benefits of a mindful life and applied it to the field of medicine to such an extensive degree).

In Counterclockwise, Ellen Langer provides a revolutionary perspective on the topics of health and aging. Langer grabs your attention with eloquent philosophical anecdotes, and then drives her main point home with (very accessible) explanations of shocking scientific studies. No matter who you are (student, doctor, regular dude), this book will change the way you think about health and medicine. It's a great read.

Counterclockwise: Mindful Health and the Power of Possibility is a mind expanding, enthralling book with implications for living a mindful, happy life. Dr. Langer's experiment of the 1959's living environment is enough to say to us how much we can control in our lives and how much control we give away in many ways because of our often mindless living. The book is a page-turner with its abundance of experimental examples and the very poignant stories of life in nursing homes and excerpts from Dr. Langer's own life experiences. She has made psychological experimental science very accessible to readers and in doing so it compels us to examine the way we live and the choices we make. A very compelling challenge done so well and so empathetically.

Counterclockwise is a wonderful glimpse into how we can rise above even our own expectations. It illustrates how we allow others to define us and how this can restrict our own growth and development. We enthusiastically recommend it to anyone who wants to grow and to remain excited about the future!

This book, along with all of Ellen Langer's books, will change the way you think. In this case, it relates to an incredibly pertinent subject--your health. Counterclockwise is incredibly empowering as it breaks down the barrier between the mind and body and places control back in your hands. A must-read!

For everyone interested in viewing the world a bit differently and creating a healthier and more fun life, this book is it... It is a fun read with amazing insights. Sounds almost a bit too good to be true, but then again, we should think about the possibilities

Ellen Langer shares her fascinating findings on the power of possibility in this enlightening book. A must read for people interested in living longer and more healthy lives!

The concept of mindfulness is interesting, and clearly applicable in many situations. The book bogged down, seeming to repeat the key ideas endlessly. It would have made a really great professional journal article.

Ellen Langer, noted Harvard psychologist and author of "Mindfulness" (about 1998-99, maybe earlier) writes this provocative and insightful book about how mindfulness practices can increase one chances for good health, and aging gracefully. I liked this book, though I thought Langer got bogged down in lengthy descriptions of experiments, some of which were either directly the ones from the earlier book, or newer studies of the same ilk.
I would rather have read more of her broad conceptual thinking about the topic, than details of the experiments.
Still, her mission here is compelling and important, especially to aging baby boomers, which includes me, as well as Langer--- both born in 1947. It's worth buying this, and picking it up every once in a while just before you are about to think, "Well, I'm getting older, so of course I feel this (insert physical pain of choice) now." She will prove to you that you can and should have a different attitude, which can directly affect your quality of life. And that is definitely worth the price of this book!