Part 1/2: ‘When the Body Says No’ – Western Medicine, Eastern Medicine and Psychoneuroimmunology

Part 2/2 can be read here.

In part one of this two part series, I’ll be exploring the themes of Dr. Gabor Maté’s book “When the Body Say’s No”. These interpretations have been developed through hours of reflection and study, but I encourage you to adopt your own opinions based on the ideas presented.

Dr. Maté makes a strong argument for how emotional repression and stress are implicated in a wide range of physical conditions. He draws upon his experiences as a clinician and effortlessly blends western science with eastern wisdom. Through heart-felt anecdotes, the reader gains insight into why we must understand the human being behind the condition. The biomedical paradigm fails to consider the interplay between mind, body and soul. It also neglects family, environmental and cultural systems in relation to pain and disease. Modern clinicians have adopted the Biopsychosocial model as a more inclusive approach to healthcare, but we must continue to broaden our horizons to see the whole picture.

Limitations to Western Medicine

Western science start’s from the neck up; it is remarkably advanced and has the ability to solve serious problems through its hyper-rationality and rigor. Unfortunately, this rationality closes us off from other dimensions of the human experience – this rationality detaches us from “the heart”. The origin of the saying “listen to your heart” comes from the hearts ability to integrate our logical mind with gut instincts. Integration of the head, heart and gut will allow for a balanced perspective that appreciates the spectrum of human experience. “The more specialized doctors become, the more they know about a body part or organ and the less they tend to understand the human being in whom that part or organ resides”. We can’t understand a part of the human system without considering the whole.

Eastern Medicine and Psychoneuroimmunology

One of the core tenants of Eastern Medicine is the unity between body and mind. From a Western perspective, the study of Psychoneuroimmunology reveals how emotions are a full body experience driven by the nervous, immune and endocrine systems. The mind is the starting point since our subjective experience is unfolding in each moment and dictates our interpretation of the world. The hypothalamic-pituitary-adrenal (HPA) axis is the structural hub in the brain that responds to internal and external threat. Feelings of uncertainty, conflict or lack of control are examples of emotions that activate the HPA axis. For better or for worse, our psychological state promotes a cascade of physiological and biochemical processes that impact our entire body. In turn, our body influences our emotions through either augmenting or dampening our current mental state. When we repress emotions or are chronically stressed, this interplay is stunted and our bodies’ ability to self-regulate is impaired. Unresolved problems will continue to cause issues unless they are dealt with. This is how stress is transmutated into illness.

Our gut-brain relationship is a good example of the feedback loop between body and mind. We all intuitively understand the “gut-wrenching” feeling associated with emotional grief. The gut responds physiologically to emotions and relays the information back to the brain. The brain interprets and integrates these sensations and gives meaning to our “gut feeling” while reinforcing the original physiological effect. This is the basis for the old saying “trust your gut”. Gut feelings help us evaluate our environment and establish safety; they magnify the perception of our brain and guide us through instinct instead of logic.

The Nervous System

Recall the importance of the nervous, immune and endocrine systems in mind-body medicine. The functions of these sub-systems as it relates to disease and pain is well supported by the science of Psychoneuroimmunology. Pain is an output of the nervous system and occurs when there is a perception of threat. When our brain decides that pain would be helpful in some way, it will choose behavior that fosters protection. In this scenario, we could just as easily replace ‘pain’ with ‘stress’ in order to apply this concept more broadly. Healthy coping mechanisms, stress management strategies and support networks are necessary in order buffer stress.

The Immune System

The immune system is always involved with disease and pain states because its main goal is to maintain a healthy internal environment. Immune cells protect against foreign pathogens but can also release inflammatory mediators that cause local or systemic inflammation. In response, a healthy immune system can manage pain naturally by triggering the secretion of endogenous opioids. Dr. Maté points out how stress and perceived loneliness is linked with immunosuppression. It was found that cancer patients who had nurturing social connections and a “fighting attitude” activated more natural killer cells which can attack malignant cells and prevent further spread.

The Endocrine System

Finally, the endocrine system is responsible for the chemical environment that drives our physiology. If we have a healthy hormonal profile, the human system has a better ability to heal itself through self-regulation. Cortisol is the primary stress hormone and can lead to issues if left unchecked. For example, chronic cortisol production has been associated with intestinal ulcers, osteoporosis and impaired wound healing.

These examples only skim the surface of the interaction between mind and body. Identifying these subsystems as separate is potentially misleading, but divisions have been created so that we can discuss them in an intelligible way. In reality, these parts are not separate at all; they exist within the same place and rely on each other to create the total human experience.

In part two, I’ll be taking a deep dive into stress, emotional repression and what Dr. Maté calls “The 7 A’s of Healing”. Tune in next week for more!

References:

1. Chek P. Being True to Yourself. Lecture; 2016.

2. Maté G. When The Body Says No: The Cost of Hidden Stress. Toronto: CNIB; 2004.

3. Watts A. The Book: On the Taboo Against Knowing Who You Are. Vintage; 1989.