The Mind, Immune System, and Health. Can we control it?
By Montserrat Markou, MS, L.Ac., LMT
June 15, 2005
Introduction to Psychoneuroimmunology
Hippocrates, the father of Medicine, believed that the mind and the body should be considered as a whole. Chinese medicine agreed in the representation and connection of the different organs of the body and various emotional conditions. Practitioners would look into the person's life, interpret the events happening that may lead to a change in the balance of the organism within their environment. These psychological situations help them decide on what course of treatment to follow. In contrast, Western medicine adheres to Descartes' principle: that "there are two distinct and separate substances in the world: matter, which behaved according to physical laws, and spirit, which was dimensionless and immaterial." Diseases are caused by specific microorganisms - physicians interview the patients, ask for their signs and symptoms, order laboratories/diagnostic procedures, and after which prescribe a specific drug to "kill" the offending pathogen.
In the 1920s, Dr. Walter Cannon, professor of physiology from the Harvard University, studied the relationship between the effects of emotion on the autonomic nervous system, giving birth to the term "homeostasis". It was defined as the condition in which essentially all of the organs and tissues of the body perform functions that help to maintain the constituents of the extra cellular fluid relatively constant. Hans Salye's general adaptation study followed. His experiment entailed putting animals in different physical and mental adverse condition, and then noting the ways by which their body adapted to recover. He had noticed that when humans were stressed for prolonged periods of time they demonstrated characteristic internal responses affecting the hormonal and immune system. He was able to show that continued environmental stress affects the immune system, leading to immuno-compromised state, and eventually, to death.
The term psychoneuroimmunology was coined by Dr. Robert Ader, director of the division of behavioral and psychosocial medicine at New York's University of Rochester in 1975, which stemmed from his theory that our state of mind is linked to our health and our ability to heal ourselves. His study showed that it is possible to condition the immune system. He experimented by feeding mice with saccharin while simultaneously injecting a drug that caused stomach upset. The mice learned to avoid the saccharin, and it was observed that the drug used suppressed the immune system. When the experiment was repeated, this time the drug was not given to reverse the aversion, a majority of the subjects formally injected died when receiving saccharin alone. He hypothesized that since apparently the conditioning was very good that saccharin alone suppressed the organisms' immune system, then, it may also be possible that when the organism is physically or mentally stressed, the body can produce lethargy and other ailments.
What is Psychoneuroimmunology?
It was widely believed in the past that the immune system was autonomous and that there was no connection among ones' perception of the world around them, their behavior, the way their brain functions, and their immune system. Psychoneuroimmunology is the branch of medicine that attempts to dispute that. As defined by Reber, it is "an interdisciplinary science that studies the interrelationships between the psychological, behavioral, neuro-endocrinal processes and immunology". Therefore, it studies the interaction between the nervous, the endocrine, and the immune system.
The central nervous system, composed of the central and the peripheral nervous systems, is an array of connection which incorporates the sympathetic and the parasympathetic systems. Recent research showed that the nervous system also controls the defense mechanism, and that a chemical link exists between our emotions, and the regulatory systems of the endocrine and immune systems through the central nervous system. Modern researches suggest a bi-directional loop between the brain, the organs, the stress mechanism, and the immune system. It is maintained by neuron activity, neurochemicals, hormones, and molecules such as peptides, endorphins, enkephalins and cytokines.
The immune system recognizes cells that are part of the body and cells that are foreign. It manufactures the T-cell, which originates from stem cells in the bone marrow and differentiates in the thymus, and B-cells, which come from stem cells in the bone marrow and continue their differentiation within the bone marrow and peripherally, where they cluster in the germinal centers of lymph nodes and in the lymphoid follicles of the spleen. The immune system is triggered by either hormonal secretion or by the central nervous system. The hormone pathway is the neuro-endocrine system, which includes the hypothalamus and the pituitary gland. It releases cortisol, adrenocorticotropic hormone, growth hormones, and beta-endorphins into the system, and also includes adrenaline and noradrenalin. The central nervous system controls the release of the chemicals and the neurotransmitters into the bloodstream. Emotional factors inhibit the immune system by affecting the limbic system, which is responsible for sending emotional information to the hypothalamus. Homeostasis is maintained by the hypothalamus. During periods of stress, the hypothalamus secretes hormones which act on the immune system and eventually result in heightened awareness and energy for a fast response.
Stress and the Immune System
The correlation between stress and the immune system was demonstrated by Stone, Reed, and Neale (1987). The experiment entailed exposing the subjects to an upper respiratory microorganism and the appearance of symptoms was documented. Stress was defined as the increase of undesirable events and the decrease of desirable events. Subjects with perceived stress developed the symptoms. Subjects with no stress did not. Another study b Glaser et al on seroconversion of Hepatitis B vaccine showed that subjects with greater stress and less social support were less able to seroconvert the vaccine. While there is a clear correlation between the factors as demonstrated by the experiments, the differences in the definition of stress is a confounding variable, which, although not enough to render the studies invalid, is worthy of future exploration. It is an inborn biologic mechanism, the purpose of which is to protect and ensure survival of the organism. It operates through the "fight or flight" concept.
Importance of Psychoneuroimmunology
When developed, this field will be useful to a variety of professionals which include the medical doctors, naturopaths, osteopaths, Chinese medicine practitioners, psychiatrists, psychologists, psychotherapists, and even social workers. Patients may opt for guided imagery or visualization uses symbols to imagine the changes that the patient desires to take place. An example of this is the Simonton's work.
Dr. O. Carl Simonton and wife Stephanie Matthews-Simonton started a program among terminal cancer patients in which they educate them and helped them reduce their stress and fears about their ailment. Modern medicine believed that cancer is a strong overwhelming process leading to death, and the Simonton's convinced these patients to believe otherwise. The patients were taught to visualize their immune system attacking and destroying the cancer cells and watching the cancer cells being subdued. Many patients who were previously told they were incurable were said to be able to stimulate their immune system and eliminate cancer entirely. They were able to establish that the body's defense mechanism can be activated to act against illnesses, and beliefs, thoughts, and emotions can promote reversal of illness and healing.
Another study was done by Dr Richard Smith, a psychiatrist at the University of Arkansas, wherein a woman who had contracted the chickenpox virus and who already developed a natural defense mechanism to it, was injected under the arm with the virus. Swelling was observed at the injection site, which disappeared later, showing that her immune system was working well against the virus. CBC showed an increase in her white blood cells as a response to the virus. She used visual imagery to reduce the size of the swelling each time she was injected again with virus over the next three weeks. Each subsequent injection resulted in a smaller swelling, and lower WBC count. This showed that positive imagery may boost the immune system and help the body fight disease.
Another method is the use of biofeedback, which is a term used to describe laboratory procedures like the electromyography (EMG) ad the electro dermal (EDR). These sensors allow the patients to monitor their own muscle relaxation, heart rate, breathing patterns and perspiration, so that they may control them through the visual or auditory information provided by the machines. Relaxation is important in the treatment by this method. This may be used in the treatment of anxiety, migraine, and Reynaud's disease.
Hypnotherapy is not a new concept, as it dates back to as far beyond as the 1700s with Franz Anton Mesmer's animal magnetism. In 1843, British surgeon James Braid used this to operate without anesthetic. Modern research showed our bodies go through rhythms even during the day, called the ultradian rhythm, generally around ninety minutes to two hours in length, creating a break response stimulus. It is believed that during this period, the body focuses on its healing. This is utilized by hypnotherapists to assist the patients in creating a link between their goal and natural physical abilities to heal. Some conditions and thoughts exist only in one's unconscious mind - for a patient to be able to communicate to his unconscious mind, he is guided by the therapist to a relaxed state.
The use of placebo is also now widely recognized. They have been proven to be very useful in dealing with hypochondriacs. For them to be effective there should be a positive expectation both by the patient and the health care provider. The favorable effect of giving placebo in clinical practice is credited to the response of the mind/body which gives strength to the immune system and speeds up the healing process.
Psychoneuroimmunology, like any other science, is associated with dangers in its approach. The patient normally develops a strong trust to the therapist, leading to blind acceptance of treatment suggestions, without the patient examining the option closely. This whole-hearted acceptance works in majority of cases and brings about positive changes and healing. However, for some, it can backfire - a misplaced statement can cause a negative response. And it may even be possible that if the chosen modality does not bring out the desired change, the patient may be depressed which will eventually cause further derangement to the patient's health.
The mind is no longer believed to be an abstract phenomenon separate from the processes of the body and emotion. Interconnections of the mind, the body and the spirit exist, and understanding these interactions will help treat diseases. It shows that these diseases are not only organic, but also psychological in nature, which supports the premise of health care without always turning to drugs.
Psychoneuroimmunology is a new field and thus requires more research. While Western medicine offers empirical treatment for many illnesses and diseases, there are still some with which it has not been successful. The challenge therefore is to further justify that the immune system can be enhanced through thoughts, belief, emotion, and behavior. Who knows, maybe several years from now, through this approach, there will be no need for drugs in treating diseases like SLE, rheumatoid arthritis, some motor-neuron diseases, and even cancer.
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Reber, A. S. (1995). Dictionary of psychology (2nd ed.). New York, NY: Penguin Books
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Montserrat Markou, MS, L.Ac., LMT is New York State Licensed and Board Certified Acupuncturist and Massage Therapist.