Rudy Torres was just 13 days shy of his 33rd birthday when he found himself standing in the triage area at Jackson Memorial Hospital, gripping his chest and struggling to lift his 285-pound frame onto a gurney. Earlier that evening, he’d rushed to the ER with his wife after feeling “like an elephant was sitting on my chest.” But like the roughly 45.8 million other uninsured Americans, Torres was hesitant to go to the hospital that night. Even though he’d felt “kind of funny” the last few days, like he’d had a bad case of heartburn. Even though all the signs were there that he was about to have a massive heart attack. “I was invincible until that night,” Torres says. “I was the typical guy. I did construction work, went up and down ladders, carried buckets. Sure, I was heavy, but I did everything. I was the kid who jumped off the roof of our house, and I was so used to getting hurt as a kid, to falling and breaking bones and getting up and walking away.” But this time, Torres couldn’t walk away. While recuperating from a coronary artery bypass graft three days after entering the ER, he was approached by Elsa Velez Robinson, a University of Miami cardiac research nurse, about participating in a cognitive-behavioral therapy program at the University.

Cognitive-behavioral therapy is a form of psychotherapy that uses imagery, self-instruction, and related techniques to decrease emotional arousal and alter distorted attitudes and perceptions. According to Neil Schneiderman, the James L. Knight Professor of Health Psychology and a professor of medicine, psychiatry, psychology, and biomedical engineering, it is the therapy of choice for behavioral management of chronic diseases.

Torres is among an estimated 3,000 chronic illness sufferers who have been recruited into and helped by UM’s various group-based cognitive-behavioral stress management therapy programs over the last 20 years. These patients, all sufferers of illnesses such as heart disease, cancer, HIV/AIDS, chronic fatigue syndrome, and diabetes, have found hope in the form of these 10- to 12-week interventional studies.

“I didn’t even really know that it was cognitive therapy,” Torres says. “I was being taught how to eat and how to take care of myself. And the emotional support was really there.”

For more than 20 years Schneiderman has headed the Department of Psychology’s Behavioral Medicine Research Center, through which nearly 100 people on the Coral Gables and medical campuses conduct collaborative research on the relationship between psychosocial and behavior issues and health.

“Dr. Schneiderman has a real talent for searching across disciplinary boundaries to engage researchers in biopsychosocial problem areas,” says Rod Wellens, chairman of the Department of Psychology.

In his nearly four decades at the University, Schneiderman has assembled an accomplished team of researchers, each of whom works in more than one specialty, collaborating across illnesses. Gail Ironson, M.D. ’86, has headed studies in coronary heart disease, breast cancer, and HIV/AIDS; Patrice Saab has worked with adolescents and heart disease patients; Frank Penedo, Ph.D. ’99, has studied people with HIV/AIDS and prostate cancer; and Michael Antoni, Ph.D. ’86, has headed studies on HIV/AIDS and cancer.

Penedo, associate professor of psychology and bio-behavioral oncology in the College of Arts and Sciences and the Sylvester Comprehensive Cancer Center at the Miller School of Medicine, is leading several NIH-funded studies on coping with the consequences of prostate cancer treatment. With project coordinator Jason Dahn and a team of researchers and graduate students, Penedo has helped many men adjust to the challenges of prostate cancer treatment, including urinary incontinence, sexual dysfunction, emotional distress, and overall compromises in quality of life. He recently received a $2.1 million grant for an NIH study called Ethnicity Determinants of Quality of Life in Prostate Cancer.

“What group therapy does for the participants is give them a commonality,” Penedo says. “It is often the first time, outside of talking to their spouse or close relative, that they bond with another person.”

Penedo notes that the best time to offer psychological intervention to prostate cancer survivors is 6 to 12 months after they’ve completed treatment with either radiation or surgery. And that’s exactly when help was there for Robert Grandchamp, a 67-year-old retired professor and Red Cross volunteer who had a radical prostatectomy in 2001.

“Mentally, I tried to prepare myself for what the fallout would be. I knew there would be erectile dysfunction. I knew there would be urinary incontinence, but I did feel some level of anxiety. I felt somewhat bewildered,” says Grandchamp, who also happens to have a Ph.D. in psychology. “Being a participant in the PC-SMART (Prostate Cancer-Stress Management And Relaxation Training) study recharged my knowledge about how to cope with stress. It helped me communicate with my wife better and helped me to focus on acceptance. And it provided a venue for me to get in touch with the fact that I was with men who were in the same boat. We’re all in this together.”

This “we’re-all-in-this-together” mentality is at the core of UM’s successful interventional group therapy programs. “A lot can happen in a group that meets every week for ten weeks,” says Antoni, professor of psychology and the author of Stress Management Intervention for Women with Breast Cancer. “Something happened in our breast cancer groups that was a clear trend. The people who went through the ten-week support groups showed a reduction in stress hormones and cortisol. Being in groups affected their immune functions, and in terms of interpersonal relationships, they learned to not sweat the small stuff anymore.”

At 81 years old, George Drucker has changed the way he reacts to stress, now employing a breathing technique he learned in the University’s Tele-SMART study, which assessed the effects of stress management on quality of life, immunity, and physical health among men who have been treated with hormone therapy for advanced prostate cancer.

“In the group we discussed difficult problems related to the illness, side effects from different medications, and just everyday things,” Drucker says. “In super-stressful situations such as hurricanes, or just in line at the supermarket, I feel I can cope with everything better.”

“The learning is the best part of the program,” says Rudy Torres, who recently moved with his wife and kids to Lehigh Acres, Florida, after Hurricane Wilma destroyed his North Miami Beach condominium. “I used to get all worked up and my heart rate would go up, and now it’s like, ‘Oh well.’”

In addition to teaching Torres how to temper his reactions, the program taught him how to read food labels and to not be deceived by food marketing companies. “Zero grams of transfat doesn’t necessarily mean zero grams of fat. And then there are the minor changes. Like instead of parking in front of the movie theater, I park at the end,” says Torres, a car salesman.

Shirley Clarke, a post-MI (myocardial infarction) cognitive-behavioral stress management study participant who is raising her five grandchildren, agrees that the sessions have contributed to her overall well-being. “I think the therapy program helped me very much with the walking because I had to write down that I did it. I had that homework. I walk twice a day, and it makes me feel much better mentally and physically,” she says.

As with most clinical studies, the big payoff is new knowledge that can be applied to enhance practice. The ENRICHD study (Enhanced Recovery in Coronary Heart Disease), a multicenter clinical trial funded by the National Heart, Lung, and Blood Institute of the NIH, produced some notable findings. Conducted from 1996 to 2001, the study included 2,481 depressed or socially isolated post-MI patients at different sites (270 from Miami).

“It turned out that in terms of improving health and saving lives, the interventions seemed to work on men but didn’t work on women and minorities,” Schneiderman says. “What we got out of the ENRICHD study was that clinicians have to be very sensitive to minorities and attentive to the needs of women. And we are. But we recognize that most health research was historically conducted on white men and that most of us grew up in a male-dominated society.”

Told of Rudy Torres’s newfound practice of reading food labels, Shirley Clarke’s walking regimen, and George Drucker’s breathing technique, Schneiderman flashes a small glance of satisfaction. A glance that speaks volumes about what the power of science combined with good old-fashioned listening can do. “The best thing we’ve been able to see is people who lost hope but are now leading productive lives,” Schneiderman says.

And there is no truer testament than Rudy Torres, who at the end of every day—and often in the middle of a particularly hectic one—stops whatever he’s doing to breathe in and out. Deeply. Like the way he was taught to breathe in group therapy. “It’s the best thing I learned,” says Torres, feeling at that moment very far removed from that night in the ER.

Jill Bauer is a book author and freelance writer in Miami, Florida.