In recent decades, the study of the relationship between mind and body has become more accepted within Western medical circles. Most of us are familiar with the term “psychosomatic medicine”. If we don’t fully understand its meaning and implication, we at least understand it has something to do with the mind influencing the body, which is partly true. But perhaps it’s time to more properly investigate the role our mind plays in the health of our body and, conversely, the part our body plays in our mental and emotional wellbeing.
It’s usual for both clients and many therapists to think “psychosomatic” only describes how mental processes influence our somatic (experienced in the body) health. This view is understandable but is only half the reality of how the human mind and body work. It’s looking down one side of a two-way street. To complete the picture, we must understand that the “information flow” also goes the other way; that is, the body’s experience also informs the brain. This has enormous implications for helping to bring about changes to mental and emotional problems. Let’s first take a look at the facts surrounding the two-way link between the mind and body.
What we know
Much has been written about how “every thought affects every cell in the body” and the many variants of this idea. But some scientists, medicos and practitioners seem to think it’s a new revelation, that it’s somehow the property of modern science and contemporary thought. Certainly, the past century has seen tremendous growth in psychosomatic medicine but, like many things science “discovers”, it was always there.
Early philosophers well understood there was no separation between how the two aspects of self interacted, that the division between mind and body could not be delineated. Oh, they argued and debated about it, but were not really serious about any version of duality. In fact, most early Greek, Roman and Persian philosophers did not even consider the idea there was a division.
Later philosophers, notably René Descartes (1596-1650), could not get their head around the idea that conscious thought (mind experience) had anything to do with “extended substance”, and so was born the dualistic view of human experience, the idea that feeling and thought exist separately from somatic experience. This reductionist view allowed the growth of a medical system that honoured the idea that specialised fields of medicine could concentrate on symptoms of the body without consideration of the wellbeing of the mind.
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The 20th century saw a blessed increase in scientific study that began to turn the tide back toward a more unifying notion of human experience, one that understands that the mind cannot experience or process anything without the body reacting in some way, and that the inverse applies. We are slowly getting back on track.
Research by groups such as the Laboratory for Affective Neuroscience at the University of Wisconsin has shown that it’s not really thoughts that affect the body; rather, the feelings that generate or surround those thoughts create the electrochemical signals that ultimately affect our somatic experience.
In recent years, treatment approaches such as Network Care Chiropractic and Af-x have recognised that the science is “right”: our brain and central nervous system are set up to register initial feelings stored in the amygdala of the brain rather than more sophisticated thought patterns. Af-x recognises that all mental or emotional experiences are manifest in the body, an idea that hasn’t gained much traction in modern society but is scientifically undeniable.
Think, for instance, of how you know you’re in a depressed state. Do you know it just because you know it? Or do you know it because your shoulders slump, you feel weighed down, you don’t leap out of bed in the morning, a feeling of indolence sets in? You can’t seem to chew through the straps to lift yourself into a sense of “being OK”.
Think about how you know you are anxious. You know because your breathing rate increases, your hands shake, your body can’t rest or relax, and because of all the other little signals that make up your awareness of the problem. Interestingly, akathisia, defined as “an inability to sit or stand still” and as “severe subjective restlessness”, is seen by mainstream medicine as being a neurological problem. Simply put, akathisia is a direct marker, expressed bodily, of a state of mood. An extension of this would be that akathisia is anxiety and that our body is our mood.
These body experiences and signals are what are known as “somatic markers”. They are the means by which you know you are not well.
What does all this tell us? That there is no division between mind and body. By extension, it may even mean the term “psychosomatic” is redundant and should be replaced by the simple word “whole”. Our state of wellness or unwellness should never be confined to either body or mind but is a global experience that embraces our whole selves. Attending to one and not the other is only carrying out half the task.
Is there a problem with “psychosomatics”?
An idea that replicates itself within a culture or concretes itself within a person’s mind by adding supporting packages of ideas is known as a meme. Generally, a meme involves building a “package of understanding” that may be represented by a word, a phrase, a piece of music, a smell or any sensory signal, and the full “factual” understanding (right or wrong) floods forward when the memetic representation occurs. In this case, the word “psychosomatic” is the meme. And the “problem” with psychosomatic is not what it truly represents but what our culture and many of us have stored in our understanding of its meaning. For many people, the memetic idea of the very existence of a psychosomatic dynamic raises difficulties.
During the past decade and a half, many doctors who have struggled to understand the psychosomatic issue and proclaim themselves practitioners trying to deal with the “whole self” have been disappointed by the general lack of interest in their newfound specialty. This lack of interest may actually be fear of the memetic understanding of what is implied by any symptom having a “mind factor”, because it generates the memetic idea that there’s something mentally ill about the person. Professor Julian Jaynes called this general cultural thought “collective cognitive imperative”, meaning “everybody thinks it, right or wrong, because it’s defined by a social trend of thought, not by its correctness or otherwise”.
So being identified as a “psychosomatic practitioner” or someone practising “psychosomatic medicine” can actually have the opposite effect of what it tries to achieve and can keep people away in droves, simply through a lack of understanding and appreciation of the mind-body facts.
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Dr Nada Stotland, a professor of psychiatry and obstetrics-gynaecology at Rush Medical College in Chicago, says, “Some doctors bungle attempts to apply mind-body medicine by appearing to blame patients for their symptoms. This can be true especially for disorders that are poorly understood and difficult to diagnose, such as chronic fatigue syndrome or fibromyalgia. The minute you say, ‘You have an anxiety disorder on top of your cardiac disorder’, it becomes a stigma. We all know perfectly well that emotions affect the body. But there is a way to make it make sense to people and take away the stigma.”
Marc Feldman, a Duke University psychiatrist, found that having the sign “Psychosomatic Medicine” on his office door made many of his patients cancel appointments because, he said, “They were convinced that I was going to tell them, It’s all in your head.’”
Thanks to many not-so-positive experiences with patients, mainstream medicine has come to believe that the word “psychosomatic” is a term to avoid because “it tends to confuse patients who think they’re being labelled as mentally ill”. Many people simply don’t understand the principle of psychosomatics, often mistaking it for imaginary illnesses; in extreme cases, thinking they are being blamed for their illness or that they are “mad”. This is not only unfortunate but could be the very thing that ultimately prevents a full recovery!
For practitioners steeped in the understanding of the inexorable link between soma and psyche, there is no problem with the idea that our feelings, thoughts, body sensations and symptomology must be all equally considered in defining illness and treatment. It’s obvious the problem lies in centuries of being convinced, philosophically and medically, that one exists without the others, and one can be treated without the others. This is the message our culture has received as a general memetic understanding. It will take some time to deconstruct the myth of duality in health.
Taking a broader path
To set out on the path toward resolution, let’s begin by looking at a favoured part-cure for depression. Some practitioners, at least, would prefer this to more intrusive treatments such as pharmaceutical management. Advocates of “self-help out of depression” often say “get out in the garden and work” or “take up a sport” to beat the blues. Without fully realising why these might be ideal cures for their clients or patients, they are hitting on the perfect action that can utilise the psychosomatic dynamic in the quest for a manageable cure.
Whenever we apply ourselves to a meaningful occupation, particularly if it involves manual labour, our body starts to experience what can only be described as “feeling good”. In line with holistic psychosomatics, we know that this, in turn, presents the central nervous system with a “somatic marker”. The somatic marker cannot exist on its own, separated from the system’s overall dynamic, so sends to the mood-oriented centres of the brain — the amygdala, the hippocampus and amygdaloid-hippocampal pathway — a signal that is processed by the mind as “I feel good”, and not just an experience felt in the body. This may rightly be called a soma-psyche process rather than a psychosomatic one. Same thing in the opposite direction.
This example of how changing the body’s experience can alter the mood regulators of the brain can, of course, be turned around to examine the way in which resolving feeling and emotional stressors must, by extension, make a difference to the body’s experience. It’s well known that attitudes, feelings, mood states and habitual emotional reactions can dramatically influence the state of the digestive system and intestinal tract.
For many years we’ve known that the mood and emotional regulators of our limbic brain (brain stem) and central nervous system insist on our digestive system operating in ways that are driven by our psychological states and that, in times of emotional stress, the autonomic nervous system heightens activity in those somatic systems that are stimulated by the fight-flight syndrome, while “shutting off” the activity in those systems not immediately required for fighting or fleeing.
Today, the fight-flight dynamic is pervasive as we seek to achieve more material successes and ignore or squander our opportunities for rest, relaxation, meditation and other mood regulators. The result? Instability and imbalance of our natural body wisdom in maintaining a healthy digestive tract. Provided our mood states are well balanced and we get the right amount of rest and relaxation — mental as well as physical — our nervous system always returns to a state of perfect tune (homeostasis), meaning, by extension, the stomach lining and intestines are able to function perfectly. This is only one example of the mind and body’s interconnected relationship. We now know, scientifically as well as through astute observation, that emotions, feelings and attitude can play a big part in the development and maintenance of a plethora of physical symptoms including asthma, eczema, migraine, psoriasis, irritable bowel syndrome, chronic musculoskeletal problems, chronic (psychosomatic) pain and muscular tension, to name just a few.
This is all indicative of how far our professional culture has come in returning to the “given” knowledge that many (some would say all) physical illnesses and their symptoms have either a direct emotional cause or are at least influenced by emotional learnings. We also know that many physical and biological diseases and illnesses have an “affect”, or emotional factor, associated with their maintenance that may not necessarily be a direct cause. Yet an acceptance of the opposite effect — that all mood disorders, mental or emotional, are expressed solely in body experience as “somatic markers” — is slow in coming.
One of the modern pioneers in addressing all aspects of the self to bring about cures and (at least) comfortable management of psychogenic illnesses is Dr Jon Kabat-Zinn, who for more than three decades has run the Stress Reduction Clinic at the University of Massachusetts Medical Center. Interestingly, much of the underlying premise surrounding his work and programs is grounded in the changes any human being goes through “once we have become mindful of the full range of experience”.
This is echoed by Dr John Sarno in The Mindbody Prescription, a book that acknowledges the importance of observation of the body’s experience in its relationship to stress-related issues in curing back pain. Sarno proclaims, “Knowledge is the cure.” He says that by simply shifting attention, observing the whole experience, understanding a little more about the relationship between your biological and psychological mechanisms, the mind-body system starts to “cue the brain differently” and bring about shifts in experience at all levels.
Complex and unusual though it may seem, it is a fundamental tenet of human experience that whenever we observe aspects of ourselves differently and sustain that attention for any time, we cannot avoid making a change to what is being observed, particularly when it applies to our emotional and mental mechanisms. The style of meditation we call mindfulness is a key process in the programs developed and followed by both Kabat-Zinn and Sarno, utilising observation and knowledge as important elements in the cures they so successfully achieve.
The Australian-developed Af-x program is built on the recognition that many physical symptoms are driven by emotional and “affect” concomitants, and that the converse applies; that mood disorders (mental and emotional) are not expressed within the domain of the brain but as somatic markers; and that “whole help” is about acknowledgement that change must be brought about “wholly”, body and mind together, soma and psyche.
It’s all in the word
The problem with “psychosomatics”, then, is that in our culture the understanding of the word is one-sided. We seek, for instance, neurological answers for depression, believing the conventional view that the cause is only in the chemistry of the brain and must be alleviated by pharmaceutical control. We look for external causes of our stress-related discomforts, believing any relief must come from a change in circumstance or environment.
We may focus on a mind-related cause of physical distress as described in the principles of psychosomatic medicine, but rarely do we acknowledge that our depression, our stress, our anxieties live in the body. To listen to our body and bring that into the whole arena of healing may well serve to cure the whole self, rather than dwell in the belief that emotional and mental disorders are only a brain and mind problem.
The meme, the “collective cognitive imperative”, that depression, stress and anxiety reside only within the brain/mind complex may be directing our efforts into the wrong territory, preventing us from bringing about whole and enduring balance. If these emotional and mental issues live more in the body as somatic markers than in the brain, where should we be seeking to do rebalancing work? Perhaps in our society we are delving into the wrong realms to find the answers. The existence of psychosomatic experience as a neurophysiological fact opens up a four-lane highway to healing across the full range of our existence. If only we would not use just two lanes.
Ian White developed the therapeutic modality known as Af-x therapy and has trained practitioners in Europe, the US and Australia. He is a member of the Advisory Council of the International Center for the Study of Psychiatry and Psychology (New York). T: (02) 4571 3902, E: afx@hawknet.com.au, W: www EmotionsInBalance.com.
