“I have the conviction that when physiology will be far
enough advanced the poet, the philosopher and the physiologist will all understand each other.”
Claude Bernard
By now it must be obvious that I am a firm believer in the concept that our mental state influences our physical well being. This is the premise of mind body medicine and this is a fundamental tenet of Ayurveda. Only recently, however, has this seemingly commonsense and ancient understanding begun to receive serious scientific attention in the West. For many years, there had been an almost cynical rejection by medical science of the popular notion that good thoughts can influence disease and healing. A 1985 editorial in the New England Journal of Medicine, the Bible of Western medicine, characterized the presumed relationship between the mind and physical illness as “largely folklore,”1 but today modern science is recognizing the dynamic relationship between our emotions, our brain chemistry, and our physical bodies. This has created a new scientific field, psychoneuroimmunology, which studies the relationships between the mind (psyche), brain (neuro), and immune system (immunology).
There is good evidence that each and every thought, feeling, mood, desire, and experience is accompanied by corresponding and instantaneous changes in the brain’s chemical messengers. These messengers, which were initially discovered in the nervous system, are now known to communicate with every other physiological system in the body. They are like chemical keys searching for the correct lock to initiate a desired response. The “locks,” which are embedded on the surface of cells, are called receptors, and have been identified throughout the nervous system. We have learned that the cells of the immune system also have receptors for and respond rapidly to these same chemical keys. Immune cells also release many of these same chemical messengers, which feed back information to the nervous system on the body’s immune status.
Our mind body dialogue may sound like this:
MIND: Boy, am I tired. My boss is a real pain, my car needs a new muffler, and I think my girlfriend is interested in her fitness trainer.
BRAIN: I am reducing my production of pleasure chemicals and increasing my production and release of anxiety molecules.
IMMUNE CELL: Uh, oh. I’m feeling somewhat anxious today.
What is that protein particle doing here? I’m going to sound an alarm and mobilize all my buddies to react to this invasion.
CLINICAL RESULT: Allergic reaction to pollen.
MIND: Great. Not only are my job and relationships a mess, but now my allergies are acting up.
Under different circumstances the internal conversation may go like this:
MIND: My life is really great these days. I love my job, my family life is fulfilling, and I feel that I am really in a creative phase.
BRAIN: All physiological systems are working perfectly. The endorphin factory and immune-enhancing manufacturers are at 80 percent capacity and producing life-supporting chemicals very efficiently.
IMMUNE CELL: I feel invincible today. I’m going to escort this poor little virus who has apparently lost its way and ended up in my bloodstream out of the body, pronto.
CLINICAL RESULT: No symptoms despite exposure to a cold virus.
MIND: I feel so vital. I wonder what opportunities for success and enjoyment will present themselves today.
The principal function of the immune system is discrimination, which is the ability to separate self from non-self. To our immune system, “self” is understood as something that was present during the period of our earliest development. Proteins that existed during our cellular infancy display the right “identity card.” A protein, absent when our immune cells were maturing, is branded non-self, or alien.
COMMUNICATING IMMUNITY
When an alien protein enters the body, the immune cells identify it and begin a response. Part of this response includes sending information back to the nervous system, which then gives orders to regulate the body’s defenses. These orders are communicated by way of the endocrine (hormonal) and autonomic (involuntary) nervous systems, which form the links between the mind and the body’s immune responses.
There are many remarkable similarities between the nervous system and immune system.2
• They both contain a variety of highly specialized cells, which are designed for specific tasks. This specialization begins early in development, but remains adaptable even in adult life.
• Memory is an essential feature of both the nervous and immune systems. The brain, of course, has the most sophisticated ability to record and recall information, but immune cells also carry biological intelligence gained over millions of years of evolutionary experience. These biological memories are encoded in our genes. They allow us to respond to new challenges as if we’ve already faced and overcome them in the past.
• Both systems are designed for adaptation, which is the ability to maintain the dynamic balance known as homeostasis in an ever-changing environment. The body is constantly evaluating incoming impulses and deciding if they are potentially nourishing or potentially toxic. Both the nervous system and the immune system participate in continuous, active surveillance of the surroundings. Useful input is welcomed, while potential threats are quickly identified and avoided.
• The many diverse cells of the nervous and immune systems communicate with each other via potent chemical messengers. Many of these messengers, initially called neuropeptides, are now also known as immunomodulators. Electron microscopes have captured fascinating images of one immune cell directly releasing a chemical messenger into an immune cell of a different type. This process is almost identical to the exchange of information that takes place when a nerve cell releases a neurochemical that travels across a gap, or synaptic cleft, and communicates with a neighboring neuron.3
The close similarities in both form and function of the nervous and immune systems suggests that the immune system can be thought of as a circulating nervous system. Immune cells respond to our ever-changing states of mind and mood, whose fluctuations are reflected in the changing chemistry of our brain. In other words, our immune cells are constantly eavesdropping on our mind’s internal dialogue.
The various components of the immune system are designed to begin a defensive response whenever something unfamiliar enters our physiological environment. A potential enemy is usually identified by a protein antigen. Each “friendly” cell carries on its surface membranes identifying proteins, which tell the immune system that they are on the home team. If a substance cannot produce the right identification, the immune system goes on alert to identify and escort the potentially unfriendly invader out of the mind body system.
Some of the specific types of cells that comprise the immune system are described below:
• The cells that recognize and alert the other immune cells to the presence of an unfamiliar visitor are known as antigen presenting cells. The most common of these cells, called a macrophage, takes in the foreign protein, breaks it down into smaller components, binds it to another protein, and then presents the processed antigen on the surface of the cell in a form that other immune cells can easily recognize.
• T lymphocytes acknowledge the processed antigens and respond by producing chemical messengers called lymphokines. These molecules carry information to other lymphocytes, exciting them to respond to the newcomer.
THE IMMUNE DEFENSE SYSTEM
• Cells known as B lymphocytes produce antibodies to neutralize the invading cell. These antibodies are like missiles that are released from the B lymphocytes and attach to the foreigner. This may neutralize the invader or make it easier to be removed by other immune cells.
• If the invader is perceived to be potentially harmful, cytotoxic T cells and natural killer cells (NK) come into play. These are designed to directly attack and remove the invading organism.
When it’s functioning well, the immune system is a magnificently complex and coordinated sequence of responses. But as in any complex system, there exists the potential for things to go awry.
How does the body respond to stress? As discussed earlier in Chapter 5, Dr. Walter Cannon, an American physiologist in the 1930s described our response to a threatening situation as the “fight-or-flight” response.4 When we feel danger, an alarm system is triggered, resulting in some dramatic changes in our bodies:
• Our heart speeds up and pumps more forcefully.
• We start breathing faster and more deeply to increase the oxygen in our blood.
• Our blood pressure rises to ensure adequate circulation.
• We start sweating to cool our body.
• Blood is diverted away from our gut, where we were digesting our last meal, and shunted to the muscles of our arms and legs.
• Our liver releases sugars to supply energy.
• Our adrenal glands pump out adrenaline to rev up the whole system.
• The pupils of our eyes dilate to admit more light.
• Our mind becomes hyperalert.
Hans Selye, a noted Canadian endocrinologist, took a broader view of the body’s stress response in his studies of the endocrine system.5 He described the role of the pituitary gland in the brain as it stimulates the adrenal gland to release the hormone cortisol. This steroid hormone, which enhances immune response by mobilizing white blood cells from the bone marrow, can be beneficial under conditions of acute stress but over prolonged periods its effect is to exhaust the immune system. Eventually, the thymus gland and lymph nodes throughout the body shrink, resulting in a weakened defensive response.
Not only do the nervous and immune systems communicate through hormones, but there are actually direct links between them.6 Under an electron microscope, very fine sympathetic nerve fibers can be seen directly connecting with immune cells of the thymus gland, the bone marrow, the spleen, and various lymph nodes. Receptors for the neurotransmitters that are released by the nerve terminals have been documented on immune cells, and drugs that block the effects of these chemicals have been shown to abolish the responses.
We have evolved a remarkable system to transmit our mental and emotional states into bodily reactions. Through the mind-brain-endocrine-immune-system network we continuously monitor our internal and external environment and orchestrate a response. These changes can happen instantaneously but have effects that extend well beyond the moment of the event. Learning how to influence these consequences is a hallmark of mind body approaches.
The pathway between the brain and immune system is bidirectional. Immune cells not only receive information from the brain, but also provide it through chemical messengers that directly communicate with the nervous system. The best studied example is interleukin-1 (IL-1), which stimulates the production of a hormone called corticotrophin releasing factor (CRF).7 CRF is produced by the hypothalamus, which sits just below the brain, and is in continuous communication with the pituitary gland. CRF stimulates the pituitary to release adrenocorticotrophin hormone (ACTH), which in turn causes the adrenal glands to release cortisol. As we’ve already discussed, cortisol dampens the immune response, so IL-1 functions to prevent an overly aggressive reaction.
If you immunize an animal, electrical changes can be measured in the hypothalamus before any measurable changes are seen in the immune cells. As soon as an immune cell detects an intruder, it not only calls for help from its teammates, but immediately sends off a message to central control. The brain receives information and begins regulating the immune response at a very early stage.
IMMUNE FEEDBACK
The field of modern psychoneuroimmunology came into being when Robert Ader, at the University of Rochester, performed an exciting experiment.8 He exposed rats to water that was sweetened with saccharin and simultaneously injected them with cyclophosphamide. Cyclophosphamide is a potent immune suppressant that is commonly used as a cancer chemotherapy drug. It has a major side effect of causing nausea. Therefore, when the rats were given the cyclophosphamide they became severely nauseated and vomited. Over the next several days, they also showed the expected suppression in their immune function. Days later, when the rats were reexposed to the saccharin-sweetened water, they promptly vomited even though they were not given the cyclophosphamide. They had been conditioned to become nauseated in association with the sweetened water. This part was not surprising as it was an example of conditioning, not unlike Ivan Pavlov training a dog to salivate when he rang a bell.
But something else very unexpected was discovered. When the rats were exposed to the saccharin-sweetened water the second time without the cyclophosphamide, they again showed a marked suppression in their immune function. The rats’ immune systems had also become conditioned to be suppressed when the rats tasted saccharin-sweetened water. Blood studies showed a reduction in antibody production and impairment in the cell-mediated responses. This was dramatic evidence that the mere expectation of an effect could create weakness in immunity. The immune cells had learned (inappropriately) that sweetened water was harmful to them.
If we can teach our immune cells to be negatively conditioned, can we teach them to respond positively? A study from Japan showed this was easy to accomplish.9 Two groups of poor mice were stressed using random electrical shocks in a testing chamber. When they weren’t being tormented, they were housed in safe enclosures that had cedar shavings on the floors of the cages. Over time, the recurrent stress caused a range of immune-function abnormalities. Later in the experiment, the stress-inducing procedure was repeated, but this time some of the animals were exposed to the aroma of the cedar shavings. Under these conditions there was a much milder effect on their immune cells. The sense of security associated with the aroma of the cedar shavings blunted the impact of stress. I find this study fascinating because aromas have been used as healing tools in many natural-medicine systems for thousands of years. As discussed in Chapter 6, aroma therapy is an integral part of Ayurveda.
There has been an explosion of research over the past ten years in an effort to document and understand how the immune system mirrors our emotional state—how perceptions of stress can weaken our immunity. The best way to study the effects of stress on health is to look at people who are under a lot of stress. Most people would agree that medical students fit into this category, particularly during final exams. And, if we measure their immune function at this time, they show a decline in several aspects of their cellular immunity.10 If we rank this same group of future doctors according to their sense of loneliness, we discover that the lonelier they feel, the less they are able to resist the infection of common viruses.11
A groundbreaking study published a few years ago in the New England Journal of Medicine measured people’s recent stress level and then had them sniff a dose of the virus that produces a cold. To no grandmother’s surprise, the study showed that the more stressed you’ve been lately, the more likely you are to start coughing and sneezing soon.12
Loss is always attended by stress, and loss of a spouse through divorce or death is consistently ranked as one of the most stressful occurrences of life. To add insult to injury, the emotional and psychological pain of losing a mate is accompanied by major changes in our ability to cope with immune challenges. White blood cells become less capable of fighting infection after the death of a spouse, mirroring mental depression.13 Even more than death of a spouse, divorce leads to long-term weaknesses in immune function in both men and women, reflecting the ongoing distress that accompanies the breakup of a family.14 Caring for a spouse with Alzheimer’s disease, which is very similar to watching your loved one die slowly, is also associated with a measurable fall in immunity.15
As would be predicted, these changes in immune function as a consequence of a major life stress result in more serious sickness. A widower’s risk of developing cancer or dying from any type of illness is higher for at least ten years after the loss of his spouse.16,17 It is accurate to say that a major loss not only hurts us emotionally, but can make us physically sick and result in early death.
I’ve made the case that emotional stress can harm our immunity and raise our risk for future illness. Fortunately, mind body approaches can be successful in strengthening our immune systems when we are attempting to recuperate from a major life stress, although recognition of these approaches by mainstream health care has until recently been limited.
Teaching a simple meditation technique to geriatric residents improves their immune function.18 Their reduction in anxiety and improved sense of well being is promptly reflected in improved cellular immunity.
A similar benefit holds for people infected with the AIDS virus. Relaxation training and assertiveness exercises in people with HIV infection result in improved cellular immunity.19 We now recognize that despite the same AIDS virus, people show a wide range of clinical expressions. Mind body approaches are inexpensive, nontoxic, and provide psychological and physical benefits.
A useful and easy means to process emotional pain is to write about it, for in the mere act of expressing it, some of the hurt can be dissipated. Undergraduate college students encouraged to write about events that were experienced as stressful or traumatic have improved immune function and make fewer visits to the campus health clinic.20
In his landmark book, Anatomy of an Illness, Norman Cousins described his personal experience with a serious rheumatic disorder.21 Through good humor, self-empowering relationships with his physicians, and unwavering confidence in his healing abilities, he was able to overcome his illness. While watching reruns of Marx brothers movies and Candid Camera, his laughter sent positive messages to his immune cells, reminding them of their legitimate purpose. The culturing of a positive attitude means more than putting on a happy face. It requires being rooted in a state where panic and dismay are incapable of arising, the creation of a compelling future, and the active development of a healing environment. Reports demonstrating the positive physiological and immunological benefits of laughter are confirming that it is indeed the best medicine.22,23
In a widely quoted study, Dr. David Spiegel provided group support meetings for women with metastatic breast cancer.24 He intended to prove that this simple intervention would not influence their life span. To his surprise, the women in the support groups not only felt their quality of life improved, but actually lived twice as long as women who did not participate in groups. Other studies have confirmed that patients receiving cancer-therapy programs that employ meditation, stress management, emotional release, and education will show improved immune function and live longer.25,26
I take care of many people who are simultaneously using mind body approaches along with standard cancer treatments and time and again see the benefits of an integrated approach. A retired businessman receiving radiation therapy for throat cancer who is meditating, performing daily yogic breathing exercises, and gargling with herbalized oil has so few side effects that his radiation oncology now recommends a similar program to other patients. A woman receiving chemotherapy for her breast cancer sees a dramatic reduction in her nausea during treatments and her fatigue afterward since beginning meditation, a daily massage, and using a fragrant essential oil. I recommend a complementary approach using the best of the Eastern and Western healing sciences.
By discriminating between “self” and “non-self,” the human immune systems can respond to a wide range of internal and external challenges. But in a sense the basis of this discrimination is quite arbitrary. Our sense of self derives from identifications that form during our developmental years. Although psychobiological development is generally held to be complete around the time of adolescence, our true nature in the realm of consciousness remains flexible throughout our lives. The consciousness-based approach suggests that new connections can be established based on spiritual experiences that transcend the limits of biology as it is usually understood. Ongoing development is always possible; experience can be interpreted and reinterpreted; and we can continue to evolve throughout life.
I have previously referred to Dr. Jonas Salk’s concept of metabiological evolution in which he suggests that for humanity to endure, our human species must progress from “survival of the fittest” to “survival of the wisest.”27 Applying this idea to immunity, we can see that what is really needed is not an overtly aggressive immune system, but one that is continuously evolving. Evolution occurs when a wide repertoire of experiences is embraced and integrated into meaningful responses. Evolution is, therefore, a continual expansion of the concept of self until the self embraces the whole universe. Ultimately, nothing can threaten the fully evolved self because everything is included within it.
When the relationships between consciousness, mind, and body are integrated and harmonious, immune cells are unerringly able to discriminate potential sources of nourishment from sources of toxicity. But when basic harmony and integration are lacking, the immune system may become either too aggressive, or, conversely, it may fail to perform its defensive functions. Allergies, for example, are the result of an overactive immune response to external provocations, while autoimmune disorders such as rheumatoid arthritis and multiple sclerosis are a result of excessive reaction to internal stimuli. Infections are brought on by weak immune response to external challenges, but cancer is the result of an inadequate response to internal threats.
| IMMUNE RESPONSE | INTERNAL THREAT | EXTERNAL THREAT |
| Excessive | Autoimmune Diseases | Allergies |
| Inadequate | Cancer | Infections |
From a mind body perspective, allergies and autoimmune diseases are expressions of an internal dialogue of threat and alienation that results in self-destructive hostility; cancer and susceptibility to infection are immune-system expressions of internal conflicts that result in desperation and hopelessness; health, however, is a state of flexibility that integrates all challenges and experiences into a meaningful response.
An ancient Vedic expression declares, “Infinite flexibility is the secret of immortality.” The stability of the body’s immune system depends upon the flexibility of our responses to the challenges of daily experience. Stability is built upon a foundation of dynamic non-change in the midst of numberless swirling and chaotic influences. The essential feature of a healthy immune system is the capability to mount a dynamic response while maintaining stability and integrity.
The healing traditions of the world have always asserted the mind’s influence on the body, but modern science is just beginning to understand how thoughts, feelings, and perceptual interpretations of the world can influence well being. When our lives are in balance and our internal dialogue is harmonious, our immune systems and every other aspect of our being receives the message of health.
1. Listen to your internal dialogue. Is it one of lamenting or blaming? Realize that you have a choice in the way that you interpret your circumstances.
2. Identify sources of toxicity in your life. Choose one to reduce or eliminate.
3. Spend time in nature. Stroll in the park, hike in the woods, walk by a stream.
4. Simplify your diet for two weeks (this page–this page).
5. Perform a daily massage with the appropriate dosha-specific oil for one week (this page–this page).
6. Take one-half ounce of aloe vera juice twice per day for two weeks.
7. The Ayurvedic herbs traditionally used to balance and nourish the immune system include amalaki (Indian gooseberry) brahmi (Indian pennywort), hapusha (juniper berries), katphala (bayberry), and tulsi (basil).
8. If you are having allergies:
• Use a neti pot each morning and (see below) perform ghee or sesame-oil nasya several times per day for one week (see below).
• Use agni-enhancing digestive aids such as fresh ginger, coriander, fennel, or long pepper.
9. Laugh regularly at the world and at yourself. Lighten up!
A neti pot is a small container with a spout that can be gently placed in one’s nostrils through which warm salt water is administered. Following the warm-water cleansing, the membranes just inside the nostrils should be lubricated with a little ghee or sesame oil. A small amount of oil is placed on a finger, gently applied into both nostrils, and then sniffed up into the nasal passages. This procedure reduces the concentration of allergens and provides some protection to the mucous membranes to reduce allergic reactions. If this is done a couple of times a day, decongestants and antihistamines may be avoided.
NETI POT
