By Vanit Nalwa September 1997 A new discipline, gives more evidence of the mind – body link in health and disease DID YOU KNOW?If you are a pessimist in early adulthood, you are more likely to have poor health in middle and late adulthoodThat it is never too late to change…change in your behavior could alter your health status You are more likely to live longer if you have supportive friends and family Nausea and pain can be controlled and lessened by the use of creative visualization exercises LAUGHTER LESSONS Blood tests reveal that when we laugh, endorphins are produced which act as a painkiller, and our immunity increases A scientist says that as children we laugh 400 times a day, but as adults only 10 to 15 times Genuine laughter is never at anyone’s expense Never laugh at people, laugh with them. This will give you inner peace and create a feeling of fellowship and brotherhood —Dr. Krishan Chopra in Your Life is in Your Hands He made her melancholy, sad, and heavy; and so she died; had she being light like you of such a merry, nimble, stirring spirit, she might ha’ been a grandma ere she died; and so may you, for a light heart lives long. Love’s labour’s lostWilliam Shakespeare. Ancient wisdom never lies. Four thousand years ago in India, it had been stated in the Mahabharata (the longest epic in the world): ‘There are two classes of diseases—bodily and mental. Each arises from the other, and neither can exist without the other. Thus mental disorders arise from physical ones, and likewise physical disorders arise from mental ones.’ In more recent times, Sir William Osler, often considered the father of modern medicine, was said to have observed that in order to predict the out come of pulmonary tuberculosis, it was as important to know what was going on inside a man’s head as what was going on in his chest. The placebo effect has been long known to medical science—this is a cure effected by sugar pills, which the patient believes to be medicine. Faith healing is yet another demonstration of how mere belief can influence the body to heal. Now there is scientific proof available to back all this and the new discipline of psychoneuroimmunology shows how this happens. Psychoneuroimmunology turns the searchlight on to the common belief that our personalities and emotions influence our health. How does what you think and feel (psyche) influence the brain and nervous system (neuro), which in turn tempers the body’s disease fighting system (immuno)? In other words, to what extent can depression, anxiety, psychological distress, social support, or an optimistic outlook change our ability to resist disease? Can we alter immunity and hence susceptibility to disease through psychological intervention? THE INNER WORLD The way we think and feel, our way of dealing with events, our defense mechanisms, our ability to remain happy and healthy must impinge on the question: ‘Who am I?’ It must seek to address the nature of our uniquely individual personality our distinctive pattern of thought, emotions and behavior which characterize our style. Consider an ordinary event to see how your interpretation of an event has a bearing on ‘your child has failed the final exam’. Depending on how you explain this event to yourself, will determine whether it will be a major source of trauma for you and for your child. Whether you judge it as your inability to devote enough time to your child, or his reluctance to work, or put it down to the fact that you moved house around the time of the exams, will decide the stress factor posed by this event. It is not the event itself that is stressful; rather it is your perception of it that makes it so. Suppose you react strongly to the failure, giving full vent to your anger at the sight of the report card; notice your physical reactions. Your explosive outburst will immediately bring about bodily changes (in the heart rate, blood pressure, breath count, tense muscles) in both you and your child. Even long after the event you may notice such psychological reactions as anxiety, anger and aggression, apathy and depression, and an inability to think clearly. In fact, in time you might not even connect the residual bad feeling, which may persist with the event that originally caused it. Months later you may wonder at the cause for your child’s persistent apathy or aggression. Our bodies obviously react deeply to the way we think and feel about different happenings that touch our lives. Topping the list of the countless events, which may jolt our mental balance, are natural and man-made disasters, life events like the death of a spouse, divorce, marital separation, marital reconciliation and even marriage itself. Other events that strongly affect our psyche include the death of a close family member, personal injury or illness, losing a job, and retiring can trigger off bad feelings—be it getting stuck in traffic, a forthcoming examination, an argument with your boss, a telephone disconnection for nonpayment of an incorrect bill. Strong emotional reactions to ‘negative’ life-changing events or even cutting off all responses by blocking or suppressing emotions can sap motivation, corrode interest in life, weigh one down with negative thoughts and cause disturbance and disharmony at the body levels, often resulting in sleep disruption, loss of appetite, and fatigue. At a deeper level it can begin to play havoc with your immune system and make you prey to serious illness. The more life-changes you experience, the harder you need to work to stay well. Psychologists have found that people could be trained to improve their resistance to disease by recognizing the mind-body link in disease and learning to deal more effectively with emotionally challenging events. FROM THE MEDICAL WORLD Immunologists, neurobiologists, endocrinologists, and psychologists at the National Institutes of Health (NIH), Maryland, Bethesda, a premier medical research facility in the USA, are actively involved in unraveling the mysterious connection between the mind and disease. According to Dr G.Chrousos, an endocrinologist at NIH: ‘It has not been shown scientifically but mental states can influence the body’s resistance to disease.’ Though researchers have known for over a decade that the brain can shape the immune response, it is only recently that they have come close to explaining the ‘how’ more fully. It was once considered that the body’s network of immune defenses was a system unto itself. Research over the past few years has shown that this is not so. The immune system is connected, both physically and chemically, with the nervous and endocrine systems. Neurons, or nerve cells of the spleen and the lymph nodes. The communication between the brain and the immune system is two-way. The brain apparently registers the stress and then activates the release of certain chemicals that carry the information to the immune system, which in turn signals back to the brain to cause the body to react. At the Third International Congress of the International Society for Neuroimmunomodulation, held in November 1996, Dr Esther Sternberg, a rheumatologist, observed: ‘We are making important advances in understanding the infrastructure of how these systems communicate and how breaking the communications can result in disease.’ THE IMMUNE SYSTEM Your body’s immune system consists of specialized cells that protect it from disease. The function of the immune system is the identification and destruction of foreign cells such as microorganisms. Your immune system is able to ward off an attack by bacteria, viruses, fungi and parasites. Disease occurs when this defense breaks down. Research shows that the immune system is affected by stress and other psychological conditions. Whether you are happy or sad determines your susceptibility to infectious diseases, allergies, cancers, and autoimmune disorders such as lupus and rheumatoid arthritis, in which the immune cells themselves attack the normal tissue of the body. When a person has been stressed for some time, there will be changes in his behavior, his central nervous system, and in the balance of hormones in the body. All three are interrelated and influence body cells that provide protection from disease-the immune system. It is as if the fortifications have been damaged. The result is that the person runs the risk of disease. THE MIND-BODY LINK AND DISEASE Evidence from disparate sources suggests that stress affects the ability of the immune system to defend the body. Invasion of the body by a disease-causing agent is not sufficient cause for. Disease occurs when the person’s defenses are compromised or unable to recognize the foreign material. For example, one study published in 1991 in The New England Journal of Medicine validated the common belief that we are more likely to catch a cold when under stress. Simply being in the presence of someone who has a bad cold is not enough reason to get one, the probability that you will catch it when exams are round the corner is much higher! Disruptive daily events and chronic family stressors have now been clearly associated with greater susceptibility to upper respiratory infections. Susceptibility to influenza, for instance, is higher in families that are rigid and chaotic than in balanced families.The reverse is true as well. Psychologists have found that people could be trained to improve their resistance to disease by recognizing the mind-body link in disease and learning how to deal more effectively with emotionally challenging events. In such cases, what is important is the extent to which you can bring change in yourself by recognizing and altering the patterns of behavior that characterize you. For example, a person
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