The Psychophysiology of Body—Mind Healing
Genevieve M. Bartol
Nancy F. Courts
Nurse Healer OBJECTIVES
Theoretical
Articulate a comprehensive conceptual model of body-mind interactions.
Interpret the application of selected models, theories, and research in the field of psychoneuroimmunology.
Explain the interconnections of mind modulation and the autonomic, endocrine, immune, and neuropeptide systems.
Clinical
Recognize the implications of body-mind interactions for clinical practice.
Incorporate the knowledge of body-mind interactions in planning nursing interventions.
Personal
Identify one’s own patterns of body-mind interactions as expressed in attitudes, tensions, and images.
Recognize the implications of one’s own body-mind patterns for self-care and selfhealing.
DEFINITIONS
Allostasis: The adaptation process to maintain homeostasis and well-being.
Allostatic load: Occurs when one experiences overwhelming stress or has inadequate coping skills.
Autopoiesis: The self-organizing force in living systems.
Bifurcation: A point at which transformational change occurs in a complex system; at a fork in the road of life.
Body-mind: A state of integration that includes body, mind, and spirit.
Chaos: The stable and orderly but irregular, unpredictable behavior of a complex system.
Cycles: One of the simplest nonlinear behaviors that is periodic and recurrent.
Epigenetics: The study of how genes produce their effect on the phenotype of the organism.
Information Theory: A mathematical model that helps explain the connections between consciousness and body-mind healing.
Limbic-hypothalamic system: The major anatomic modulating link connecting the brain/mind and the autonomic, endocrine, immune, and neuropeptide systems.
Mind modulation: The bidirectional interrelationships of thoughts and feelings with neurohormonal messengers of the nervous, endocrine, immune, and neuropeptide systems that support body-mind connections.
Network: Interconnected and interrelated system.
Neuropeptides: Messenger molecules produced at various sites throughout the
body to transmit body-mind patterns of communication.
body to transmit body-mind patterns of communication.
Neuroplasticity: The ability of the nervous system to respond to intrinsic and/or extrinsic stimuli by reorganizing its structure, function, and connections.
Neurotransmitters: Chemicals that facilitate the transmission of impulses through nerves in the body.
Psychoneuroimmunology: A branch of science that strives to show the connections among psychology, neuroendocrinology, and immunology.
Receptors: Sites on cell surfaces that serve as points of attachment for various types of messenger molecules.
Self-Regulation Theory: A person’s ability to learn cognitive processing of information to bring involuntary body responses under voluntary control.
Traumatic stress response (TSR): Occurs when the normal stress response is altered as a result of overwhelming and/or ongoing stress.
▪ NEW SCIENTIFIC UNDERSTANDING OF LIVING SYSTEMS
Developments in science and concomitant advances in technology continue to reveal human beings in new ways. The mechanistic view of the body-mind has given way to a holistic view. The habit of looking at persons from their component parts while ignoring interactions and contexts is misleading and creates problems of its own. The body can no longer be considered a machine powered by the mind or spirit to which healthcare practitioners apply assorted therapies to effect healing. Humans are complex, highly integrative systems embedded in and supporting other systems. As we free our scientific imagination and increase our knowledge of laws that are the opposite of mechanistic, such as the concepts of nonlocality and superposition of states in quantum physics, our understanding of living systems will continue to change.1,2 The term body-mind can include the body, mind, and spirit as a unified whole.
Quantum Theory
Discoveries in quantum physics negate the old ways of viewing phenomena. Heisenberg described the changed world as a complicated tissue of events, in which connections of different kinds alternate, overlap, or combine, and thereby determine the texture of the whole.3 In the past, the properties and behavior of the parts were believed to determine those of the whole. Now it is clear that the whole also defines the behavior of the parts.
The realization that systems are integrated wholes that cannot be understood simply by analysis shattered scientific certitude. No longer was it possible to believe that given enough time, effort, and money, all questions would have answers. Rather, all scientific concepts and theories have limitations. Scientific explanations do not provide complete and conclusive answers, but instead generate other questions.4 The more we learn, the more we discover how much we do not know. Even one additional piece of data can change the whole configuration. It is important to remain open to all possibilities because absolute certainty is an illusion.2pp25-26
Increasingly, scientific findings demonstrate a changing world. Planck found radiant energy was emitted from light sources in discrete amounts or quanta, and that changes in the amount of radiant energy occurred in leaps, not sequential steps.3 Bohr extended Planck’s discovery to the field of subatomic particles and showed that electrons could move from one orbit of energy to another. The behavior of light does not follow one set of rules. Light possesses the qualities of both waves and particles. One explanation is not correct and the other wrong; both interpretations are useful in explaining the behavior of light in different situations.
The world is complex and unified; parts complement one another and participate in the whole. Similarly, all parts of the body work together. Health and illness are indivisible; both are natural and necessary. Hyperpyrexia (fever) may be seen as a sign of illness as well as a sign of the body’s healthy response to a threat. Fever indicates that the hypothalamic setpoint of the body has changed.5 The alteration occurs in the presence of pyrogens (e.g., bacteria, viruses).
A mild temperature elevation up to 39 degrees Centigrade (102.2 degrees Fahrenheit) stimulates the body’s immune system, increases white blood cell production, and reduces the concentration of iron in blood plasma, thereby suppressing the growth of bacteria. Fever also stimulates the production of interferon, which protects the body against viruses. Using medications to lower the body temperature prematurely, particularly in the first 24 hours, may actually interfere with this important defense mechanism.
A mild temperature elevation up to 39 degrees Centigrade (102.2 degrees Fahrenheit) stimulates the body’s immune system, increases white blood cell production, and reduces the concentration of iron in blood plasma, thereby suppressing the growth of bacteria. Fever also stimulates the production of interferon, which protects the body against viruses. Using medications to lower the body temperature prematurely, particularly in the first 24 hours, may actually interfere with this important defense mechanism.
Systems Theory
The major traits of systems thinking appeared concurrently in several disciplines during the first half of the 20th century, but it was von Bertalanffy’s General Systems Theory that established systems thinking as the predominant scientific movement.6 Resultant theories and models of living systems initiated a radical shift in the understanding of human beings. It is now believed that persons and their environments make up an interconnected dynamic system in which a change at any point may effect changes at other points. The idea that the world is hierarchical, with each level organized separately, has been replaced with a new understanding of relatedness and context.
Human beings are living systems, organizationally closed and structurally open, embedded within the web of life.7 They are organizationally closed because they are self-organizing; that is, they establish their own order and behavior rather than submitting to those imposed by the environment. They are structurally open because they engage in a continual exchange of energy and matter with their environment. Words like feedback, integration, rhythm, and dynamic equilibrium account for the continually changing components of living systems. These components do not operate in isolation from each other. A dysfunction in any one system of the body reverberates in the other systems. For example, a dysfunction of the endocrine system referred to as hypothyroidism may manifest itself by thinning hair or clinical depression.8 Hypothyroidism, in fact, may be secondary to a dysfunction in another organ system and not represent primary failure of the thyroid gland. Thyroid deficiency may occur when the pituitary gland is malfunctioning or when there is damage to the hypothalamus. It is not possible to identify conclusively a single cause of what was formerly named a primary dysfunction. All body systems participate in the biodance; changes in one system result in changes in the other systems and, in circular fashion, changes in itself, just as the pituitary gland increases its secretion of thyroidstimulating hormone (TSH) when the thyroid gland is underproducing thyroid hormone.
Theory of Relativity
Einstein developed a system of mechanics that acknowledges the relative character of motion, velocity, and mass, as well as the interdependence of matter, time, and space.3 The theory is based on the principle that there is no absolute frame of reference independent of the observer. Each person views others from his or her own perspective, including his or her particular biases.
Scientists can no longer describe their work as finding a piece to a puzzle or as adding a building stone to a firm foundation of knowledge. Rather, it has become increasingly apparent that scientific knowledge is a network of concepts and models, none of which is any more fundamental than the other. All things (objects) and events (happenings) in one’s life are connected and relative within the whole. The mind and body are inseparably intertwined. Whatever happens in one’s life is interconnected. Thoughts, feelings, and actions influence a person’s state of health and illness, as discussed in this chapter.
Koenig and associates reported that Christian persons who attend religious services at least once per week and who read the Bible or pray regularly have consistently lower diastolic blood pressure readings than those who do not.9,10 A lower diastolic reading, which indicates the blood pressure when the heart relaxes, is associated with improved health. It is not known how these religious activities influence the blood pressure or if a specific spiritual orientation accompanies these activities and accounts for the difference.
Studies using imaging devices show that mindfulness meditation strengthens the neurological
circuits that calm a part of the brain that acts as a trigger for fear and anger and increases the amount of activity in the brain associated with positive emotions. Fear and anger can provoke harmful actions. Happiness and inner balance are crucial to survival. We need to cultivate our inner development if we are to keep our destructive emotions in control.11
circuits that calm a part of the brain that acts as a trigger for fear and anger and increases the amount of activity in the brain associated with positive emotions. Fear and anger can provoke harmful actions. Happiness and inner balance are crucial to survival. We need to cultivate our inner development if we are to keep our destructive emotions in control.11
Principles of Self-Organization
The key ideas of current models of self-organizing systems were refined and extended during the 1970s and 1980s, and a unified theory of living systems emerged.7,12 This unified theory encompassed the creation of structures and modes of behavior in the processes of development, learning, and coevolution. In the past, living systems were viewed from two perspectives: in terms of physical matter (structure) and the configuration of relationships (pattern). Structure is concerned with quantities, things weighed and measured. Pattern is concerned with qualities and is expressed by a map of the configuration of relationships. Qualities, such as color or size, were considered accidental characteristics. A bicycle may be red or green; may stand 24 or 26 inches high; may have a light or heavy frame, but remains a bicycle as long as it has the configuration of relationships consistent with a bicycle.
Systems, whether nonliving or living, are configurations of ordered relationships whose attributes are the properties of pattern. The bicycle, a nonliving system, consists of a number of components arranged to perform a particular function. The various kinds of bicycles (e.g., mountain bicycles, touring bicycles) embody the essential characteristics known as a bicycle. In brief, bicycles have a structure with specific components and operate as bicycles as long as the pattern of relationships that defines them as bicycles remains.12p85 Living systems, however, are fundamentally different from nonliving systems. Living systems do not function mechanically and are not explained just by physical principles. The components of living systems are interconnected by internal feedback loops in a nonlinear fashion and are capable of self-organization.
Not only is the activity of living systems purposeful, but also it appears to be under the direction of an overall design or purpose.7p40 The pattern of organization of living systems includes a fundamental self-organizing force known as autopoiesis.13 If the pattern of a living system is destroyed, the system dies even though all the components of the system remain intact. A living system cannot be restored simply by re-creating the pattern. However, a nonliving system, like a bicycle, will regain function if the parts are reassembled correctly. Living systems do not rest in a steady state of balance as do nonliving systems but rather operate far from equilibrium.14 Stability in living systems embodies change. Relationships are not linear, but extend in all directions. Bifurcation occurs and generates new feedback loops.7pp38-39 Living systems regulate and re-create themselves.
Life process (cognition) is the link between pattern and structure in a living system.13pp150-162 Life process is “the activity involved in the continual embodiment of the system’s pattern of organization.”13p162 It is related to autopoiesis, and they may be considered two distinct facets of the same phenomenon of life. All living systems are cognitive systems, and cognition indicates the existence of an autopoietic network.15 Structure, pattern, and process are inextricably intertwined in a living system.
Organisms appear to be under the direction of an overall design or purpose and do not just function mechanically. For example, the symptoms experienced by humans represent attempts to gain health and, therefore, are signals of stability, not breakdown. The human immune system recognizes an invading organism as dangerous and quickly reacts to counter the threat. Symptoms are really signs of the inherent organization and adaptability of a living system. We cannot unerringly predict the outcome of these complex relationships among organisms—one person may become sick and die while another may be seemingly unaffected and yet infect others with whom he has contact. Even invading organisms, also living systems, learn and adapt. The ability of pathogens to modify themselves and develop resistance to antibiotics is a striking example of the ability of a living system to reorganize.
Bell’s Theorem
Cause-and-effect thinking with its before, after, now, and later sequence is no longer acceptable.
According to Bell’s Theorem, the whole determines the actions of the parts, and changes occur instantaneously.7pp35-36,16 Experience teaches us that not all people respond in the same way to the same treatment. Peptic ulcers, for example, were once considered the result of excessive production of stomach acid stemming from stress. Treatment was directed toward reducing the stress with rest and counteracting the acid with a special diet. Some patients recovered after submitting to this regimen; others did not. Did those who recovered do so because of the treatment of diet and rest or did some other intervening factor bring about this change? Surely for some, the enforced rest increased their stress and the restrictive diet exacerbated the ulcer. We have since learned that peptic ulcers are associated with a common bacterium and may be healed with an antibiotic. We also learned that we can prevent the development of peptic ulcer in patients experiencing stress from trauma with prophylactic administration of ranitidine hydrochloride (Zantac).
According to Bell’s Theorem, the whole determines the actions of the parts, and changes occur instantaneously.7pp35-36,16 Experience teaches us that not all people respond in the same way to the same treatment. Peptic ulcers, for example, were once considered the result of excessive production of stomach acid stemming from stress. Treatment was directed toward reducing the stress with rest and counteracting the acid with a special diet. Some patients recovered after submitting to this regimen; others did not. Did those who recovered do so because of the treatment of diet and rest or did some other intervening factor bring about this change? Surely for some, the enforced rest increased their stress and the restrictive diet exacerbated the ulcer. We have since learned that peptic ulcers are associated with a common bacterium and may be healed with an antibiotic. We also learned that we can prevent the development of peptic ulcer in patients experiencing stress from trauma with prophylactic administration of ranitidine hydrochloride (Zantac).
Even a fleeting thought or a passing feeling can hasten or hinder recovery. Changes do not happen in an orderly stepwise sequence. Healing does not take time, but is dependent on hope and belief beyond time. Beliefs, thoughts, and feelings are all part of the configuration, and each affects the human states of wellness and illness. Individuals have personal preferences for coping with adverse events. Miller classifies people as monitors and blunters.17 Monitors need information to reduce their stress whereas blunters prefer distraction. Explaining the details of upcoming surgery to a monitor can be expected to reduce stress and promote healing. Blunters prefer to trust in the skills of the caregiver and do not even want to hear how that will be accomplished.
Personality and Wellness
Researchers have unsuccessfully tried to link specific illnesses with particular personality constellations.18 Yet, individuals with peptic ulcers have as many personality configurations as does the general population. Several researchers, however, have uncovered particular personality traits associated with wellness.10pp713-715,15pp683-688,19 Schwartz discovered that persons who with willful, mindful effort attend to symptoms, sensations, and feelings and who believe they can do something about their symptoms can alter their brain chemistry and move toward health. Kabat-Zinn found that healthy attention and meditation helped persons effectively cope with chronic illness and intractable pain. Pennebaker found that persons who admit their feelings to themselves and others have healthier psychological profiles and had fewer illnesses than those who do not.
Scientific studies of forgiveness have revealed that whenever people choose to forgive a transgression, areas in the emotional limbic center of the brain are activated.20 The activity decreases when the person focuses on the unfairness of the situation, but increases when the person imagines forgiving the offender. Multifaceted research studies on the relationship of forgiveness and health repeatedly show that forgiveness is good for our physical, mental, and emotional well-being. Not forgiving creates a state of anger, bitterness, hostility, and possibly hatred that leads to a stress response and increases the risk of illness.
There is increasing interest in the benefits of positive emotions on the immune system.21 Altogether, studies suggest that transient positive mood states such as humor and joy are associated with an up-regulation of components of the innate immune system among healthy volunteers and a reduction in allergic responses among allergy sufferers. Even though a direct cause-and-effect relationship between any personality factor and health or illness cannot be determined, the research suggests that developing personality strengths to protect one from the stresses of living seems to bolster one’s defense against illness.
Information Theory
Patterns of communication and patterns of organization in organisms can be viewed analogously.13 Information Theory, a mathematical model, was developed to define and measure amounts of information transmitted through telegraph and telephone lines. The theory was used to explain how to get a message coded as a signal to determine what to charge customers. A coded message (signal) is essentially a pattern
of organization. Information flow (i.e., pattern of communication and pattern of organization) in human beings is able to unify physiologic, psychological, sociological, and spiritual phenomena in a holistic framework. Information flow is the missing piece that makes it possible to transcend the body-mind split because information resides in both the body and the mind. Our emotions and feelings are sources of vital information. Emotions-proper are life-regulating phenomena that help maintain our health by making adaptive changes in our body states and form the basis for feelings.22 The information generated by these processes is designed to be protective and is more complex than reflexes.23
of organization. Information flow (i.e., pattern of communication and pattern of organization) in human beings is able to unify physiologic, psychological, sociological, and spiritual phenomena in a holistic framework. Information flow is the missing piece that makes it possible to transcend the body-mind split because information resides in both the body and the mind. Our emotions and feelings are sources of vital information. Emotions-proper are life-regulating phenomena that help maintain our health by making adaptive changes in our body states and form the basis for feelings.22 The information generated by these processes is designed to be protective and is more complex than reflexes.23