C H A P T E R
5
Stress and the Body: the Mind-Body Dialogue

SCHEMATIC DRAWING OF THE BRAIN AND THE CONNECTIONS WITH THE GENERAL ADAPTATION RESPONSE

      The key idea behind [PNI] is that the immune system, the body's army of defenses against invading organisms, and the brain are in constant two-way communication.  Electrical signals sent by the neurological system, including the brain, are turned into chemical signals in the immune system, and vice versa.

      The two systems "talk" to each other in a process of ongoing translation between these two languages. In fact, it is believed that this translation takes place in the region of the brain known as the limbic system. This is also the part of the brain where emotions are "processed."

      One example of this communication would be the relationship between the lymph system and the brain. The lymph system is part of the body's armament. We have all felt our glands, or lymph nodes, swell when we have been sick-they are collecting stations for invading attackers, collecting and eradicating the enemy organisms. Another part of the lymph system, the thymus, is the production factory for some of our most important immune "weapons"-the T-Cell lymphocytes. The T-Cell has become much more famous in recent years because of ADDS research. The T-Cell is the type of white blood cell most acutely and dramatically affected by HTV (human immunodeficiency virus).

      How does this knowledge fit in with our discussion of stress and stress management? As we've seen, part of the body's way of responding to stress is to put out a variety of stress hormones, such as ACTH, epinephrine, norepinephrine, and the glucocorticoids (a type of steroid). These hormones, directed by a part of the brain, suppress the immune system. When this happens, the body cannot fight disease as effectively. In particular, the T-cells, which are critical to the body's ability to fight many types of infections, decline in times of extreme stress. They also decline in times of loss or bereavement, which is possibly one of the reasons why surviving spouses often become ill within a short period following the death of their loved one.

      (Please see the schematic diagram of the mind-body dialogue and how the different systems communicate.)

      Of course, not all individuals react to stress in the same way. It is interesting that if a person feels in control of his life, then the immunel system will be suppressed less dramatically than if he feels powerless! This fact has implications for health care workers, and emphasizes ill a scientific way, the importance of involving patients and clients in the! planning of their own care. [Margaret Hamilton Birneyl ''Psychoneuroimmunology: A Holistic Framework for the study on stress and illness," Holistic Nursing Practice 1991; 5(4): 32-38]. ] 

      John and Jane Dixon emphasize the importance of the person's I perception of the lack of control: "Stress tends to lead to illness primarily under conditions in which the stressful circumstance is seen as interfering with the possibility of leading life as people feel they would like to or ought to." [John P. Dixon, Jane K. Dixon, and Janet I Spinner, "Perceptions of life-pattern disintegrity as a link in the relationship between stress and illness," Advanced Nursing Science I 1989; 11(2-3)]

Systems Theory
      Systems theory is another way to understand the mind-body/stress illness link. Human beings, like other living things, are open systems | in which all facets of the systems are in constant feedback with each other.

      The mind, the emotions, and the body's biochemical production sites all "talk" to each other; translating back and forth between their individual languages. It is impossible to study the effects of stress on one body system without looking at the overall picture.

      Each of us has seen examples of the psychoneuroimmunological connection in our own lives. Think of the times when you had "caught 

a cold," during particularly stressful times at work. Or the times your back had "given out," when you were feeling overwhelmed with the demands placed upon you. Your body was giving you a signal that you and your life were out of balance. Did you listen?

      Our bodies are important. Our body is a unified, fluid, organic environment. It is our means for experiencing our world. One of the key points to stress management, and achieving a higher level of wellness, is to learn to listen to our body. Be aware of the clues which it is giving you.

      Chest pain is a clue. Tension headaches are clues that you are out of balance in some way. These clues provide you with a tremendous opportunity to learn about who you are and how your body 'Works."

      Before we begin our discussion of how stress impacts the major organ systems, it is important to take some time to assess your body-to increase your awareness of how stress affects you. You may want to pull out the Self-Assessment from page five and refer to your answers at this time.

      This "check-in" will serve two purposes. First, it will help you to understand yourself better-to improve your "listening" skills. Secondly, if you are a health care professional, going through this process will help you think of ways to in corporate it into your practice. Do you currently have some clients who would benefit from such an exploration? Think about this question as you do the work.

      As with all the self-assessment tools in the book, what you write or draw is for your eyes only. Give yourself permission to get as much out of the experience as possible-let your ideas flow. Just go with the process; don't let your critical mind censor your ideas.  As with any learning process, it may feel strange at first, but the results will be very beneficial.

Mind-Body Awareness Exercise
      Draw a picture of a person. Don't worry about artistic skills; a stick figure will work just fine for this exercise. Draw whatever image feels right to you

      Now that you have made your drawing, let it represent your body. Mark on the drawing the areas of your body where you feel tension, the parts of your body that "feel" the stress which you encounter each day.

      Take as much time as you need to get in touch with yourself. 
      Good job! Now explore the answers you have drawn a bit further. Pick one area of your body that feels tense and try to draw it with as much detail as you can. Feel free to try crayons or pencils of different colors if this helps to describe what you feel. Does the sensation have a particular color? Is it hot? Cold? Sharp? Dull? Explore it as fully as you can.

      What part of your body did you focus on? Which was the most important, or the most of a challenge for you to deal with? Think of the last time you experienced the symptom or feeling which you described, what were you doing at the time? Who were you with? How did you feel?

      Take some time to summarize what you have just learned about your body' s reaction to stress: combining the words with the drawing is a powerful way to increase  your awareness of your own body, and your thoughts about the mind-body-stress connection.

      Now that you have learned a way to increase your awareness of your own body, it is time to read about the effects of stress on the major systems of the body. 

The Cardiovascular System
      It is a well-known fact that cardiovascular disease is the number 1 killer in America. The reasons behind this are very complex and not B fully understood. Diet, lack of  exercise, smoking, obesity, and heredity can all contribute to the development of a variety of conditions* affecting the heart and the blood vessels. Some researchers believe that there is a link between the emotions and cardiovascular disease. W« have already seen that an increased heart rate and blood pressure are! two of the components of the body's reaction to stress. Any health care I worker knows that one of the goals of treatment for a person who has! sustained a heart attack is to minimize stress as much as possible; any! human living in modern society has heard the warnings about excessive stress contributing to high blood pressure. Why?

      Biochemical substances secreted by the pituitary and other glands I such as the adrenals have a major impact on how the heart and vessels I function. These substances are triggered by sudden appearances of I tigers and grumpy employers, or worries about paying bills, etc.

      The cardiovascular system also works in partnership with the respiratory system. You will notice that part of the stress reaction is an increase in both the heart and respiratory rates. A change in one usually leads to a similar change in the other. If you breathe faster, your heartbeat will probably quicken. More importantly for stress manage­ment purposes, if you learn to breathe slowly and calmly, you can use your breath as a tool to "slow" yourself down and relax as we shall see later in the book.

      Human communication also affects the cardiovascular system. | When you talk fast, your heart rate and blood pressure will rise. Sometimes when listening to other people, you may notice your heart beating faster, especially if they are discussing some emotionally-charged topic. As you can see, the mind and the cardiovascular system do not function in separate galaxies; they work as part of an interwoven system.