Psycho-Somatic Medicine

This first post broadly introduces you to psycho-somatic medicine and gives a therapeutic context for yoga and other mindfulness based body practices

Welcome to my functional-body blog. The blog is intended as a reference for understanding how mind-body practices such as yoga, Tai-chi, Feldenkrais and all those others impact on your wellbeing, and as a resource for practical self-help exercises

This first post serves to introduce psycho-somatic medicine in the broadest possible terms, and to provide a therapeutic context for yoga and other practices. If you just can’t wait to try out the exercises skip to the next post now and come back here later

Mind-Body Medicine

The term psychosomatic, though having a precise scientific meaning, is often associated with negative beliefs such as: disease resulting from neurotic behaviour, or maybe an imagined ailment which exists only in your mind. This could not be further from the truth

The term embraces psycho (mind) and soma (body) and refers to the observation that there is an intimate relationship between mind-body where the condition of one is reflected in the other

Some “diseases” are considered especially prone to being aggravated by psychological stress: the skin disorder psoriasis, for instance, or irritable bowel syndrome and high blood pressure. Psychosomatic or “functional” disorders tend to be classified as such when medicine has not yet found a definitive physical cause. In fact all healthy and dysfunctional states co-exist in the psyche and soma in a bidirectional way, and all states of health and disease are in reality psycho-somatic

Body-Mind Connection

While it’s not difficult to understand how physical illness and pain can impact you emotionally you might ask “how does a mental state aggravate your gut or increase your blood pressure?” To answer this we need to look at how the body orchestrates the myriad activities that make up our physiology

The human body is regulated by three great interconnected and intercommunicating systems

  • The nervous system – processes data and regulates bodily functions on a moment to moment basis through electrical impulses travelling along nerves
  • The endocrine system – does this over days, weeks or months through circulating messengers we call hormones
  • Finally the immune system distinguishes between self from other to keep us safe from external and internal invaders, including bacteria, viruses and cells which have undergone malignant change

Stress and inflammation

Inflammation is one of the most basic activities carried out by the immune system to protect us from disease. While inflammation is protective it can, when excessive, prolonged (chronic) or inappropriate (eg auto-immunity) cause us harm

Harmful effects from inflammation include

  • Bronchospasm in asthma
  • Bowel inflammation with pain and impaired absorption
  • Arthritis with joint swelling with pain
  • Blood vessel damage with deposition of fibro-fatty plaques (atheroma) causing obstruction
  • A range of mental health issues including depression

For example, one recent literature review ( Viktoriya Maydych, 2019) concludes that current research supports a direct link between stress, inflammation and reduced emotional attention, the triad itself being a predictor of depression

Rest and Digest

The nervous system can be (artificially) divided into sub-systems. Of interest to psychosomatics is the division into

  • somatic (SNS) – associated with movement and sensation, and
  • autonomic (ANS) – associated with internal functions such as digestion, breathing, blood pressure and, crucially, inflammation

The ANS itself has two arms: the

  • Sympathetic system (SNS) – responding to danger by preparing the body for fight or flight

SNS activity is associated with stress and is pro-inflammatory. Though essential for our survival, persistent activation is associated with some of the harmful effects of stress and inflammation

  • Parasympathetic system (PSNS) – associated with two distinct responses:
    • freezing reactions (feigning death) to a situation perieved as a major threat to survival – this is the phylogenetically oldest response to threat, associated with overwhelm and thought to be the basis of post-traumatic stress
    • rest, digest and social interactivity in response to sensing safety – this is the phylogenetically most recent adaptation, unique to mammals.

Rest and digest responses are associated with feelings of safety and are anti-inflammatory, helping the body heal, repair and replenish its resouces. The vagus nerve is the main carrier of signals organizing visceral rest and digest responses, and I’ll have lots to say about the vagus and polyvagal theory in later posts


I hope you can now begin to see how, by nurturing a feeling of safety and relaxation, yoga and other mind-body disciplines can improve your overall wellbeing

Time now to put all this into practice with a particularly effective yoga technique for reducing stress: yoga nidra – the psychic sleep of the yogi. See you in the next article.


Reference

The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Viktoriya Maydych. Front Neurosci. 2019; 13: 384.

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