The Physiology of Hope
Could the power of hope alone be enough to save your life? According to the science, yes!
Let’s dive in.
content warning: suicide, suicidal ideation
A few years back, I was listening to an episode of This American Life that stopped me in my tracks. In Episode 646, titled “The Secret of My Death”, host Ira Glass introduces a variety of different narratives, all involving or touching upon the topic of death in poignant or surprising ways.
One such story, "Act Three: Funeral for a Stranger," tells the tale of a retired Navy officer called "Charlie" (not his real name). Charlie emailed the show an essay he wrote after attending, at the request of a friend, a funeral for someone he'd never met—35-year-old Navy SEAL, Eddie Furlani.
At the funeral, Charlie wrestles with the discomfort of being in a room full of “6 foot plus, 300 pound, athletic Navy SEALs,” all who appear to him as uncharacteristically helpless in the face of Furlani’s 7-year-old daughter breaking down into tears and begging her mother to leave.
Charlie elaborates on his discomfort, stating: “You lose a degree of empathy in the military because empathy is not an advantageous skill to have in most—especially comrade-in-arms—fields. Empathy is not a useful emotion to have.”
By the time Charlie returned to his car at the end of the service, he’d discovered that Furlani did not die in combat or by accident, like he’d originally assumed, but, instead, by suicide. This realization is a gut punch for Charlie, who flew medevac helicopters in Iraq in 2007 and recalls wrestling with his own bouts of suicidal thoughts—an experience that he says eventually ended his military career.
When asked if he wrote and submitted his essay because he felt it could have so easily been his own funeral instead of Furlani’s, Charlie says, no, that's not it.
Instead, he said he knew from his time doing medevac flights that the mere sound of a helicopter approaching on the battlefield can be enough to improve the vital signs of a person on the verge of death.
"I wrote you,” he says, “because I wanted to be the sound of a helicopter to someone."
Charlie's story, among other things, reveals the dehumanizing impact of the military on people's psyches (such as empathy being seen as "not useful"). It also highlights the direct connection this impact has on service members, leading to alarmingly high rates of mental health issues and suicidality. There is so much to unpack here, but for this post, at least, I want to focus on hope.
While Charlie's message is undoubtedly beautiful, what stopped me in my tracks upon hearing it was learning that the sound of an approaching helicopter can have a tangible, physiological impact on an injured person near death. The idea that hope—in and of itself—can improve a person’s vital signs long enough for help to arrive—and even save their life—was so striking to me that I had to learn more.
Hope, simply put, can be understood as a state of mind characterized by the belief that something positive or desired will happen in the future. Hope encompasses a sense of optimism and the expectation that things will improve, even in challenging or uncertain times. Hope fuels the idea that our obstacles are surmountable, acting as the proverbial light at the end of the tunnel that can guide us through difficult times and help us overcome adversity.
Beyond hope as a cognitive, emotional, and motivational state, however, Charlie’s story shows us the power of hope as a physiological state as well.
The physiology of hope is a fascinating topic that brings together psychology, neuroscience, and biology to help us understand how hope affects our bodies and minds. Beyond hope being an important psychological strength that helps individuals overcome obstacles and work toward their goals, the experience of hope materially involves various brain regions, such as the prefrontal cortex, anterior cingulate cortex, and amygdala. These areas are responsible for decision-making, emotional regulation, and motivation.
Neurotransmitters like dopamine and serotonin are also involved in the process, contributing to feelings of motivation, reward, and well-being. Additionally, hope has been linked to increased persistence in pursuing goals, which in turn leads to more successful outcomes. This is partly due to the release of dopamine, a neurotransmitter vital for motivation and reward-seeking behavior.
In his book, The Anatomy of Hope: How People Prevail in the Face of Illness, Jerome Groopman explores whether hope has a biological mechanism that contributes to clinical recovery. Drawing from research findings in placebo studies across various medical fields, Groopman suggests that belief and expectation—key components of hope—can indeed be enough to release endorphins and enkephalins, the body's natural painkillers that have been likened to morphine, ultimately blocking pain.
Hope has also been found to moderate our stress response, reducing the release of cortisol, a hormone associated with chronic stress, and research has even gone so far as to suggest that hope may have a positive effect on immune system function. Increased levels of hope have been associated with higher levels of immune system markers, indicating a more robust immune response to external threats, such as infections or illness.
Lastly, we know that hope contributes to psychological resilience, which is the ability to recover from difficult situations or adversity. Hopeful individuals tend to have a more positive outlook and are better at finding alternative solutions when facing obstacles, leading to overall better coping and adaptation.
