When Little Makes Much in Psycho-Somatics
When looking at the psyche as ‘just that,’ it may be hard to acknowledge that it can substantially impact bodily matters in health and sickness.
The psyche may seem somatically insignificant because it is invisible also at the deeper meaning level.
Scientifically, we are already a pretty long way beyond the ‘mind=body’ breakthrough, even – since some years – increasingly visualizing the subconceptual level in the brain, but the practice didn’t follow. We’re still pretty much stuck in a basic cognitive illusion that leads us not to see this. Scientists are not exempt.
Mind being body, we can expect significant influences from this whole upon this whole. ‘Mind’ – as well as ‘body’ – is just a way of looking at this whole, and a means of communication as in this text.
This is relevant to the entire domain of psycho-somatics.
Due to the complexity of the mind, one should not only envision linear causes and consequences. Small causes may have huge implications if they appear at the right – or wrong – place and time. This is so within an acute frame and even more so within a chronic frame. And even more so within an acute-upon-chronic frame; for instance, when acute stress befalls someone after a long-lasting negative stress-onslaught. For one thing, the immune system reacts very differently to an acute stressor with or without chronic stressors. The process has several names, such as ‘sensitization.’
We don’t usually notice this because the deeper mind – if acknowledged at all – is still generally seen as something conceptual, while, of course, any present-day scientific view from under the hood shows an entirely different picture.
The psyche does not add up in any summation towards provoking illness or healing.
COVID, a viro-psycho-socio-neuro-immunological disease
Given much surrounding science, there is no doubt about this. The only question is to what degree each of these factors plays a substantial role.
Might a large chunk of the COVID problem be mind-related? Maybe not at first sight, but look at it as a multi-causal self-enhancing whirlpool phenomenon, and it becomes clear that this whirlpool is something to better keep away from. The deeper mind is involved in many ways within the whirlpool phenomenon, causally to several degrees. Some of the elements may themselves be relatively minor whirlpools in which the mind is involved. For instance, think of diabetes which is clearly stress co-created.
The result may be highly energetic, just like a natural whirlpool. If one is standing at its border, a slight movement can mean disaster or precisely not. Little makes much.
In the case of a temporary and potentially deadly whirlpool, it may be like standing at the crossroads between the way towards health or severe illness, even life or death.
Another example may be myocardial infarction.
Let’s see:
- “Between 20% and 40% of sudden cardiac deaths are reportedly precipitated by acute emotional stressors (notably anger-like stress).” [Vlastelica, 2008]
- In one study of 304 patients with stable angina, 47% had angiographically normal or near-normal coronary arteries. In 62% of these patients, testing provoked coronary spasm (heart-related vasoconstriction), showing that abnormal coronary vasomotion plays a pathogenic role. [Ong et al., 2012] This involves the big arteries around the heart and as recent research increasingly shows, probably much more the previously overlooked microvasculature [Meadows et al., 2020; Shah et al. 2020].
- Can the mind lead to local vasoconstriction/dilatation? Of course, think of blushing or turning white in the face. Note that few people can consciously simply decide to blush. It is a ‘non-conscious competence.’ Moreover, this has been proven to be pretty relevant within the heart muscle itself. There is a clear overlap of MSIMI (mental stress induced myocardial ischemia) with microvascular dysfunction [Meadows et al., 2020].
=> Here too, the mind – mainly at the subconceptual level – can be seen as one element in a whirlpool of different factors. Information from the brain and heart flows back and forth much more, of course, than we are consciously aware of [Bremner et al., 2018; Moazzami et al., 2020; Shah et al., 2019; Vaccarino et al., 2021]. Even so, a large part of this information is meaningful, one way or another. As a result, the INTERHEART study, with over 16.000 participants from 52 countries, showed that mental stress is responsible for at least 30% of known acute myocardial infarction risk [Das, 2006]. This is one of many studies showing the same consequence from different viewpoints in the lab and real life.
There are more examples like this.
For instance, I more than suspect stomach ulcers to be one of them. Yet, an ulcer may stop if you take the ‘causal bacterium’ out (of the whirlpool). If you put it back in, it may start again. Scientific studies show that in many cases – probably those without whirlpool – just taking the bacterium out or into the stomach doesn’t do anything. Much research pointed to influences of stress until a 2005 Nobel Prize (“cause = bacterium”) stopped this research ― including mine. It’s a pity. We could have used it in COVID times. Should we not urgently restart the stress-ulcer research? I’m ready, theoretically, but lack the resources.
It may still not seem straightforward to many that the mind might be a factor within the same whirlpool as a micro-organism.
Well, it is the aim of science to keep thinking,
then to practically investigate.
However, as far as the subconceptual domain (~psycho-somatics) is concerned in medicine:
- The drive to investigate is small.
- The methods to investigate are not readily straightforward, being developed for the conceptual domain. In my view, this is one of the primary reasons for many people losing faith in science altogether ― very unfortunate! A.I. means may finally bring a thorough change pretty soon.
“To measure is to know” stays relevant, in my view, even more than ever. We don’t need less science, but more, especially concerning a passing event where the means can be – and partially already are – developed to bring substantial change for the better. If this could solve half of the problem in a utopian world where everybody would suddenly do the right thing, then in this Valley of Hinnom, it may be ‘only’ 10%.
Not good enough? What if it would be a pill? Where is the excuse?
There is much work to do.
Meanwhile, I keep wondering, why is the WHOLE domain of medical science/scientists reluctant?
I guess it needs some Kuhnian tipping point.
Very difficult and culturally challenging ― so what are we waiting for?
References
[Bremner et al., 2018] Bremner JD, Campanella C, Khan Z, Shah M, Hammadah M, Wilmot K, Al Mheid I, Lima BB, Garcia EV, Nye J, Ward L, Kutner MH, Raggi P, Pearce BD, Shah AJ, Quyyumi AA, Vaccarino V. Brain Correlates of Mental Stress-Induced Myocardial Ischemia. Psychosom Med. 2018 Jul/Aug;80(6):515-525.
[Das, 2006] Das S, O’Keefe JH. Behavioral cardiology: recognizing and addressing the profound impact of psychosocial stress on cardiovascular health. Curr Atheroscler Rep. 2006;8:111–118
[Meadows et al., 2020] Meadows JL, Shah S, Burg MM, Pfau S, Soufer R. Cardiovascular Imaging of Biology and Emotion: Considerations Toward a New Paradigm. Circ Cardiovasc Imaging. 2020 Aug;13(8):e011054.
[Moazzami et al., 2020] Moazzami K, Wittbrodt MT, Lima BB, Nye JA, Mehta PK, Pearce BD, Almuwaqqat Z, Hammadah M, Levantsevych O, Sun YV, Raggi P, Garcia EV, Goetz M, Quyyumi AA, Bremner JD, Vaccarino V, Shah AJ. Higher Activation of the Rostromedial Prefrontal Cortex During Mental Stress Predicts Major Cardiovascular Disease Events in Individuals With Coronary Artery Disease. Circulation. 2020 Aug 4;142(5):455-465.
[Ong et al., 2012] Ong P, Athanasiadis A, Borgulya G, Mahrholdt H, Kaski JC, Sechtem U. High prevalence of a pathological response to acetylcholine testing in patients with stable angina pectoris and unobstructed coronary arteries. The ACOVA Study (Abnormal COronary VAsomotion in patients with stable angina and unobstructed coronary arteries). J Am Coll Cardiol. 2012;59:655–662
[Shah et al., 2019] Shah A, Chen C, Campanella C, Kasher N, Evans S, Reiff C, Mishra S, Hammadah M, Lima BB, Wilmot K, Al Mheid I, Alkhoder A, Isakadze N, Levantsevych O, Pimple PM, Garcia EV, Wittbrodt M, Nye J, Ward L, Lewis TT, Kutner M, Raggi P, Quyyumi A, Vaccarino V, Bremner JD. Brain correlates of stress-induced peripheral vasoconstriction in patients with cardiovascular disease. Psychophysiology. 2019 Feb;56(2):e13291.
[Shah et al. 2020] Shah SM, Meadows JL, Burg MM, Pfau S, Soufer R. Effects of Psychological Stress on Vascular Physiology: Beyond the Current Imaging Signal. Curr Cardiol Rep. 2020 Oct 9;22(12):156.
[Vaccarino et al., 2021] Vaccarino V, Shah AJ, Mehta PK, Pearce B, Raggi P, Bremner JD, Quyyumi AA. Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient. Atherosclerosis. 2021 Jul;328:74-82.
[Vlastelica, 2008] Vlastelica M. Emotional stress as a trigger in sudden cardiac death. Psychiatr Danub. 2008;20:411–414