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ARTICLE |

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

Nathaniel S. Lehrman, MD
Arch Intern Med. 1993;153(8):929-934. doi:10.1001/archinte.1993.00410080005001.
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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.

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

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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