Jan 13

Pluses and Minuses of Having Two Brains

Posted in Techniques
This entry is part 3 of 8 in the series Mind-Body Healing

Wouldn’t it be great to have a second brain to take care of some routine tasks?

Think Flickr.Think!
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Well, actually, we already do. I’m studying anatomy and physiology as part of my Health Science course, and I’ve just been learning about the “enteric nervous system” – the brain in your gut.

Inside your digestive system is a complex control mechanism which contains more neurons than your spinal cord and uses many of the same neurotransmitters as the brain in your head. The process of digestion involves a lot of complicated chemistry, rather like running a sophisticated chemical plant, and of course must adapt to a wide range of different foods with different chemical compositions and to different amounts of food at different, sometimes unpredictable times. It also needs to protect itself against infection. No wonder it needs its own brain.

Chemistry Lab
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The thing is, because the two brains are linked (through the vagus nerve and prevertebral ganglia as well as by chemical messengers), what affects one affects the other. If you’re emotionally upset, you can get an “upset stomach”, ranging from “butterflies” to diarrhea or even vomiting. Antidepressants can affect the digestion – they both affect serotonin, a neurochemical which the gut uses even more than the brain. And the connection goes both ways, as anyone who pays attention to how they feel emotionally after different meals will know.

The brain-gut link is well accepted now, and there’s a field known as “neurogastroenterology” which studies the interactions between the two. My anatomy and physiology textbook (Marieb and Hoehn) even includes emotional distress as a factor in one of its diagrams about digestion.

And yet, many medical professionals don’t consider the link. An overseas-based friend of mine had a very stressful and unrewarding job for several years, and was suffering from irritable bowel syndrome. He went to a gastroenterologist, who didn’t even ask him about his stress levels – yet when he was laid off from the job, his problems vanished almost immediately.

Miedo
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The brain-gut link is through the autonomic (“self-governing”) nervous system. Textbooks will tell you that we don’t voluntarily or consciously control the autonomic nervous system, and while this is true, it’s a bit like saying that the government doesn’t control the economy. While we can’t control our digestive system the way we can, for example, wiggle our fingers, there are things that we can do consciously and deliberately to improve our digestive functioning through the brain-gut link.

A 2004 article in Neurogastroenterology and Motility, for example, reports that patients can learn to use biofeedback to affect the electrical activity of their gastric muscles. The gut functions best when this activity is rhythmic and at approximately 3 cycles per second, and the study taught the participants to use relaxation methods together with a monitoring device to increase the amount of time that their gut was behaving in this way.

Actually, relaxation practices in general can improve gut function, as Herbert Benson and his colleagues have been finding for decades. Engaging the parasympathetic branch of the autonomic nervous system – which is a technical way of saying “relaxing” – enhances blood flow and nerve and chemical signals to the gut and puts it into an improved state for carrying out its functions. Stress, on the other hand, moves us into the sympathetic nervous system response, which takes priority away from digestion in order to focus on fighting or running away. This is why prolonged stress often has a negative impact on digestive function.

hang in there
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I have a number of posts on relaxation here in the Living Skillfully blog, which will give you some tools and techniques to use if more relaxation would be a benefit in your life. Hypnotherapy is known to be one of the more effective treatments for irritable bowel syndrome and similar issues. And in a future post, I’ll talk about the concept of a “blue prescription” and why doctors should start giving them.

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Sep 25

Psychosomatic illness: Your mind extends throughout your body

Posted in Background

Years ago now, I was struck down by a mysterious illness. I was tired all the time but couldn’t sleep, eating more but losing weight, couldn’t concentrate, and found loud noises and bright lights painful.

I was living in Australia at the time, which had a generous free health system, so I was extensively tested for everything from Ross River virus to brain tumours. According to all those tests, I was perfectly healthy.

I remember visiting a specialist physician, a highly qualified older man who was very thorough in getting me physically tested but extremely old-school about any non-physical factors to illness. I remember at our last appointment that he concluded that it was “just psychosomatic”, in a way which implied, “so there’s nothing we can actually do, I wash my hands of the problem.” He managed not to convey “just pull yourself together”, but it may well have been in his thoughts.

Stethoscope
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Now, for numerous reasons too tedious and painful to go into, I was very, very stressed at the time. Nobody had ever told me that stress could make me ill. The doctors I saw didn’t ask me about it. It was only when I heard a talk on stress (oddly enough, from the doctor who’d referred me to the old-school physician) and borrowed a book on it – William Wilkie’s excellent Understanding Stress Breakdown – that I made the connection between my emotions and my physical illness.

There’s an episode of The Simpsons in which Lisa’s teacher goes off sick because she thinks she has Lyme disease. When she returns, she explains that her illness was “psychosomatic”. One child asks “Does that mean she’s crazy?” Another explains, “No, it means she was making it up.”

Which is good humour, but bad healthcare – yet there are still a lot of old-style medically-trained people like that prominent physician I encountered who dismiss psychosomatic illness as somehow “not real” and who don’t have – and aren’t interested in having – tools to deal with it. I read a telling story in (I think) Martin L. Rossman’s Guided Imagery for Self-Healing of a conversation between a doctor and patient. The patient was complaining of stomach problems, and the doctor, having examined and tested him thoroughly, told him that they were “all in his head”. The patient leaned forward and said very seriously, “No, doctor, they’re in my stomach.”

Summer Belly
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And he was absolutely right. Because, as I hinted in How mind-body healing works, there is such a profound connection between the mind and the body that they form a single system. In fact, it’s not inaccurate to say that your mind extends throughout your body.

What I mean by that is that the various communication systems to and from the brain extend throughout the body, and that mind – whatever “mind” is – inhabits the whole of them. The nervous system is a single physical system which reaches all parts of the body, for example. We’re used to localizing our mind in our brain, as if the other parts of the nervous system were just distant adjuncts, but this is in a way quite arbitrary. There’s no fundamental change that occurs when a nerve fibre enters or leaves the skull. It’s all one system.

In the same way, the chemical communication systems of the brain, mainly coordinated through the hypothalamus, extend throughout the body via the blood, lymph and cerebrospinal fluid. Again, there’s no magical thing that happens when these chemicals enter or leave the confines of the skull. They don’t become a different thing just because they’re not inside your head any more. They’re continuous with the brain and the mind.

The digestive system, in particular, is almost like a primitive nervous system. It maintains a complicated homeostasis – a balance in a constantly changing situation – by sophisticated feedback mechanisms, most of them chemical, some of which are known to link into the brain. It is also host to a significant number of nerves. No surprise, then, that hypnosis – which acts on the brain – can significantly help with irritable bowel syndrome, a “psychosomatic illness” – which simply means, an imbalance in the mind-body system.

It’s time to ditch the idea that “psychosomatic” means “all in your head” or “imaginary” or “not real”, and it’s definitely time to ditch the idea that it means “we can’t do anything to help”. Later in this series, I’ll explore how many researchers are showing that indeed there are things, very effective and in some cases very simple things, that we can do to restore the balance of our mind-body systems. Make sure you subscribe if you haven’t already.

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Feb 19

Hypnotherapy Works for Irritable Bowel Syndrome

Posted in News

Tara Parker-Pope reports in the Health section of the New York Times website on a review in the Journal of Family Practice of non-drug treatments for the very common affliction Irritable Bowel Syndrome (IBS). Unfortunately the study isn’t available in full online (not even the abstract – shame, Journal of Family Practice, shame!) without paying $10 US, and I had to sign up to even find out how much it costs.

According to Parker-Pope, however, “In studies involving a total of 644 patients, about 80 percent reported relief of symptoms after hypnosis. Hypnosis was less likely to work in men whose predominant I.B.S. symptom was diarrhea.” She also links out to a thorough listing of research on hypnosis for IBS, including a famous study published in The Lancet in 1984 which was placebo-controlled and showed dramatically clear benefits from 7 sessions of hypnotherapy.

Most of these studies seem to have used a large number of sessions, between 6 and 12. That’s an unusually high number for a hypnotherapy treatment, but it may be necessary, as one study that used only 4 sessions showed less effectiveness (only 20 out of 33 improved, and retained the improvement after 3 months – still a good result).

In my own case study on the use of hypnosis for the treatment of irritable bowel syndrome, you’ll notice that I used only two sessions. I’m still in occasional contact with the client, and he still has symptoms, but they were definitely relieved at the time of the treatment.

So why does this work? According to a study reported in the journal Digestive Diseases and Sciences, it works basically because IBS is exacerbated by stress and hypnotherapy reduces the stress.

Nerves extend into the gut, and of course it’s affected by the chemical state of the body; the nervous system and body chemistry are both powerfully affected by long-term or acute stresses. It’s also a natural reaction to empty the gut at times of stress, so we can run faster (less weight). There’s probably a psychological component as well, since disappearing off to the toilet is a good way to avoid uncomfortable emotions (I remember a particularly excruciating date where my subconscious adopted this strategy). So hypnotherapy can help both by calming the stress response and providing alternative methods of dealing with stress.

Like many other “irritability” issues which are worsened by stress – skin conditions, asthma, allergies – IBS generally has a physical basis. Your body actually is sensitive to certain foods. However, the sensitivity is made much worse by stress, and relieving the stress helps to relieve the symptoms (though it doesn’t take away or cure the underlying physical/biochemical sensitivity).

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