Combating illness with more than medicine

"I think of myself as being first and foremost an interdisciplinary and multidisciplinary researcher, and this has its advantages and disadvantages. The advantage is that there’s room for movement and innovation in the space and interplay between subjects. The disadvantage is that I sometimes feel a bit like an academic vagabond. It's exciting to be in the interface between subjects, but it comes at a cost”. 

Bobby Zachariae, whose full name is actually Hugh James Robert Zachariae, has spent most of his career exploring how psychological and social conditions affect illness and health. This applies to how illnesses and their treatment impact our quality of life – and vice versa – how psychological and social conditions affect the course of illness, primarily cancer. 

We conduct research into how we can most effectively remedy sleep problems, and thereby alleviate fatigue and other complications that have no effective medical treatment.

^{Bobby Zachariae, professor at Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University..} 

Health and quality of life 

"Even though the World Health Organisation, the WHO, began defining health as a state of complete physical, mental and social well-being and not just the absence of illness back in 1948, our healthcare system has been dominated by a more biological approach. This means that we, in practice, have overlooked the psychological and social aspects of illness and treatment,” says Bobby Zachariae.  

Considerable progress has been made within many areas of biomedical research, including cancer treatment. This means that more and more people are surviving or living with cancer. However, it comes at a cost.  

“Today, more than 375,000 people are living with or have survived cancer, and many experience physical and psychological symptoms and delayed complications that affect their quality of life and ability to function on a day-to-day basis. Many suffer from depression, a fear of relapse, pain, sleep problems, fatigue and cognitive difficulties. And rarely does a person experience just one of these symptoms. They usually have several, and those symptoms maintain and amplify each other,” says Bobby Zachariae. 

“For example, we know that sleep problems increase the risk of depression, fatigue and cognitive difficulties, while also making it more difficult to handle pain and anxiety. We conduct research into how we can most effectively remedy sleep problems, and thereby alleviate fatigue and other complications that have no effective medical treatment." 

Hypnosis and visualisation 

Since the 1990s, Bobby Zachariae has been interested in the interplay between psychology and biology, and his early research into the correlation between psychological processes and the immune system made him a pioneer within the research field of psychoneuroimmunology. 

Through a number of experiments, which he can still describe in detail by the way, he was able to demonstrate how psychological techniques such as hypnosis and visualisation can affect the immune system, e.g inflammatory skin reactions and the function of white blood cells. In other experiments, he and his research partners showed how different emotional states induced during hypnosis can affect the immune system. 

This research led to Bobby Zachariae obtaining a higher doctoral degree in medicine in 1996 with his dissertation "Psychological Modulation of Immunological and Inflammatory Parameters”. 

"It was somewhat controversial at the time, and I remember the scepticism I sensed from senior medical researchers during one of my first presentations. They acknowledged the method used in the studies but nevertheless said: "We don't really believe it. The immune system is an autonomous system”,” says Bobby Zachariae. 

Our healthcare system continues to be dominated by a biomedical model and mindset. But we can't medicate or operate our way out of everything.

^{Bobby Zachariae, professor at Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University.}

Research to benefit patients  

However, the Danish Cancer Society was interested in the psychological and social consequences of cancer and cancer treatment. So when the large patient association in 1999 funded a five-year research council professorship in psycho-social cancer research at a cancer department, Bobby Zachariae applied for and received the grant. 

He used the grant to establish a Psychooncological Research Unit at the cancer department at the former Aarhus Municipal Hospital. In 2011, the unit became permanent and was renamed the Unit for Psychooncology and Health Psychology (EPoS) in collaboration with Aarhus University and Aarhus University Hospital. 

Together with employees at EPoS, his colleagues at Aarhus University Hospital and his collaboration partners in the USA, Australia and Netherlands, Bobby Zachariae has over the years explored the symptoms and delayed complications of cancer and cancer treatment and how they can be alleviated with the help of psychological treatments. However, Bobby Zachariae stresses that good research is not a satisfactory outcome of these efforts, the research must in the end benefit patients.  

"While we encounter a good amount of goodwill and interest in the psychosocial aspects of our work from colleagues and partners at the hospital and in the healthcare system, implementing the research results for the benefit of patients is still an uphill battle. Our healthcare system continues to be dominated by a biomedical model and mindset. But we can't medicate or operate our way out of everything," he says and continues: 

"If we are to truly understand, prevent and treat diseases in all their complexity while increasing health in society overall, then a broader biopsychosocial approach is needed. For example when it comes to alleviating the delayed complications experienced by many cancer survivors. There’s no getting around the fact that funding for this area needs to be prioritised as well. We don’t, for example, have a cross-disciplinary clinic for delayed complications here in Central Denmark Region,” he says. 

Digital solutions 

EPoS is committed to ensuring that the results of research are implemented in the healthcare system and benefit patients. One of the challenges is unfortunately a lack of qualified practitioners, which is why Bobby Zachariae and his research group have forged new paths and are increasingly working with internet-based solutions and smartphone apps. 

"And it’s actually working. We’ve seen really good results with these solutions," he states. 

Bobby Zachariae is delighted about receiving Aarhus University’s prestigious award for scientific research. 

“This award is a huge acknowledgment, and not just of me. Research is team work and the award is also a recognition of the many employees, colleagues and collaboration partners I’ve worked with over the years.” 

CV 

Hugh James Robert (Bobby) Zachariae, MSc in Psychology and DMSc. 68 years old 

• Professor, Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University 

• Professor, Department of Oncology, Aarhus University Hospital 

• Head of the Unit for Psycho-Oncology and Health Psychology, Aarhus University and Aarhus University Hospital 

• National research coordinator for the Danish Center for Breast Cancer Late Effects 

• Has published 360 articles, book chapters and books. Has been cited more than 16,500 times. 

About the Rigmor and Carl Holst-Knudsen Award for Scientific Research: 

• AU's oldest science prize, awarded for the first time in 1958 

• The award is named after one of AU's founders, High Court Attorney Carl Holst-Knudsen   

• The award includes a cash prize of DKK 100,000 

• Previous recipients of the award