• Consider ongoing environmental input separately from your body’s responses.
• Understand the essence of illness/ disease is sustained exposure to real or perceived threats.
  • It creates an adverse chemical profile that increases metabolism (your rate of fuel consumption) and causes inflammation. Your tissues will be physically damaged over time.
• The core of the solution is discovering and learning methods to shift your physiology (body’s function) from threat (fight and flight) to safety (rest and digest).

All living creatures survive by mobilizing resources in their bodies to deal with threats and replenishing them when feeling safe. Both are necessary for life. However, sustained exposure to threats causes a shift in the chemical profile that breaks down your body causing mental and physical diseases. (1)

It is important to understand the nature of threats, the various ways they present, and the makeup of your body’s neurochemistry in a survival flight or fight mode. In other words, your body is collecting massive amount of data from multiple sensors in your body that is transmitted to the nervous system, which is translating it into action. The reaction causes changes in your physiology, stimulates physical actions, and creates behaviors that are appropriate to the situation.

Physiology

Physiology is the term that describes how the body functions. We stay alive because living creatures maintain an incredibly delicate balance of the body’s acid/ base balance, electrolytes, blood pressure, temperature, heart rate, and the list is long. It is a dynamic process that changes by the second in response to input from your surroundings.

The physiological changes cause sensations that we call emotions. But emotions are just words that describe what you are feeling when your body is in action. Your physiological state affects every organ system and translates into symptoms  Every physical and mental symptom you experience is explained by an inherited problem, an identifiable structural abnormality, or changes in your body’s physiology. There no such entity as unexplained symptoms.

Nature of threats

Any mental or physical threat, perceived or real, is going to be met with a defensive response from your body. Much of this mediated through the autonomic nervous system (ANS). It is called “autonomic” because all the effects are automatic in response to input. The stimulation/ survival aspect is a function of  the sympathetic nervous system (SNS), and the calming part is mediated through the parasympathetic nervous system (PNS). The vagus nerve is the main nerve that transmits these signals. It is the 10^th cranial nerve that originates in the midbrain just below the brain.

Physical threats include allergens, parasites, bacteria, viruses, lions, tigers, bears, and people we perceive as or are dangerous. Less obvious, but even more inflammatory, are mental threats, because we can’t physically escape our thoughts and emotions. Repressed ones are even  more problematic.

Mental threats are processed in a similar manner in the brain as physical ones and cause an inflammatory response that forms the basis for chronic mental and physical disease when sustained. Examples of mental threats are memories, negative thoughts, suppressions, repressions, insecurities (social, financial, health, etc.), cognitive distortions, and loss of life perspective and purpose.

Your body’s chemical makeup under threat

The survival response is the well-known flight, fight, freeze, and faint reaction. (2) We are all familiar with the physical manifestations of threat that includes an increased heart rate, sweating, muscle tension, and elevated blood pressure. But what you may not know is that the immune system also gets fired up and mobilizes many types of cells that fend off predators such as bacteria, viruses, and cancer cells. Cytokines are the signaling mechanism to mobilize or calm this response.

Cytokines are small proteins that serve as messengers throughout the body, transmitting higher-level signals and coordinating activities at the cellular level. They are central to modulating the immune system and inflammatory response. There are two kinds of cytokines: pro-inflammatory (Pro-I) and anti-inflammatory (Anti-I). While Pro-I cytokines protect us by warding off acute perils, Anti-I cytokines keep us safe by allowing us to regenerate, thrive, and prepare us for battle with environmental/ internal enemies.

When threats activate pro-inflammatory (Pro-I) cytokines, the resulting inflammation allows “warrior cells” to exit the blood stream through widened openings in the vessels to destroy the invaders (antigens). However, when they are chronically activated, inflammatory cells will destroy normal tissues. They are elevated in almost every chronic disease state. For example, researchers discovered that some types of depression are inflammatory responses of the central nervous system to chronic stress. (3)  Anxiety, bipolar, obsessive compulsive disorder (OCD), and schizophrenia also have elevated inflammatory markers. (4) Chronic stress also causes early mortality. (5)

Your body’s chemical profile when feeling Safe

 Anti-inflammatory (Anti-I) safety cytokines are the underpinnings of health and wellness. With the elevations of the Anti-I’s, we see the states of “breed and feed” and “digest and rest.” We are restorative, connected, bonded, sexual, reproductive, cognitive and creative. We also have high immunity.

There is a dramatic difference in your body’s neurochemical makeup when you feel safe compared to sensing danger. There is a deep sense of relaxation, contentment, sense of well-being. So, why do we not exist in this state most of the time? Generating a sense of safety is complicated for humans in that we have language and consciousness that is not present in any other species of life. You cannot outrun your mind.

The essence of healing

The essence of disease is sustained threat and the solution lies in connecting to your sense of safety using specific strategies.

Discovery and acknowledgement of all our threats–whether real, imagined, anticipated, or repressed–is the first step towards addressing them. The second is choosing an adaptive rather than maladaptive escapes to safety, whether the threat be physical or spiritual. We are better at physical escapes to safety than we are at spiritual ones.

If you have a choice of solving an unpleasant situation, that is clearly the first choice. But the stresses that have the greatest impact on your health are the ones that are not solvable. Being trapped by anything or anyone really fires up your defenses. But since you can’t escape your consciousness, what can you do?

There are multiple ways of dealing with threat while creating safety.

It is the reason that The DOC Journey is a specific sequence. The anger from being trapped by pain is intense and unpleasant but also powerful and protective. The antithesis of anger is being vulnerable, which living creatures are not naturally programmed to allow. You must build a foundation and learn safety at a doable level. Then it is important to proceed at your own pace to tolerate being vulnerable and still feel safe. If you dive in too quickly without a solid base, you will react in a way that makes your defenses stronger. As you deliberately progress through the healing journey, you will learn to trust your skills and discover ways to find safety regardless of the circumstances. You have regained control of your life.

Recap

The cause of chronic disease is sustained exposure to threats. The solution lies in learning ways to find safety. Although you cannot control your thoughts and most of your external stresses, you do have control of shifting your body’s physiology. They are simple tools that become automatic with repetition. Acquiring these skills will allow you to live your life on your own terms – and feel safe.

What about the need to tolerate vulnerability? There are no rewards in nature for being vulnerable. You won’t survive and that includes humans. Yet being vulnerable is the core of human relationships. But what if you were abused and don’t inherently trust people – and why would you?

We have a dilemma

• The essence of chronic disease is sustained exposure to threat (feeling vulnerable).
• Yet allowing yourself to be vulnerable is at the core of human relationships.
  • You must be able to trust someone before that can happen.
  • If you had a chaotic, even abusive upbringing, how do you know who to trust?
• What happens if you don’t have the tools to deal with rejection or being hurt?
• How can you feel safe while allowing vulnerability?
  • Every relationship requires taking risks.

This is one of the reasons you must learn in a sequence, steps, and at a comfortable level. It is not a straight-line path, nor will it ever be. You do have to care for yourself and learn to “fail.” Every person has their own way of learning to feel safe and live life on his or her own terms.

References:

1. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013);7/4:217-227. 10.1111/spc3.12020
2. Porges Stephen. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. Norton and Co, New York, NY, 2017.
3. deHeer, EW, et al. The association of depression and anxiety with pain: A study from NESDA. PLOSone (2014); 9:1-11. e106907.
4. Shields SS, et al. Psychosocial interventions and immune system function. JAMA Psychiatry(2020); doi:1001/jamapsychiatry.2020.0431
5. Torrance N, et al. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain (2010);14:380-386.

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The nature of illness

All physical and mental symptoms are the result of you gathering data from your surroundings from different sensors, your brain interpreting the sum total as safe, neutral, or threatening, and then you automatically responding in a manner to ensure survival. You may or may not be aware of the reactions. They can be dictated by signals from chemicals, small proteins (cytokines) produced from your cells, signalers from the nervous system (neurotransmitters), or signalers from our glands running through our blood (hormones).

The term, “mind body” is not a useful term in that it implies that there is a separation between them. There is actually just you; one system that responds as a unit. Your nervous system, including your brain, is simply one of the many ways your cells communicate to coordinate your functions. The mind and the body are inaccurate constructs and distractions to understanding illness and disease compared to wellness and health.

Safety

With cues of safety from your environment, including your mind, your response will be signalers such as safety cytokines (anti inflammation and pr- anabolism), GABA (calm), acetylcholine (restoration), serotonin (contentment), dopamine (rewards), oxytocin (connection and bonding), growth hormone and growth factors (regeneration). The immune response will be strong yet inflammation low when stimulated by safety cytokines. Clinically the result is feeling less inflamed, less painful, relaxed, composed, present with a slower heart rate, blood pressure and breathing. The more time that can be spent in this regenerative state the better for health and wellness.

Your body’s goal is to survive. Defeating or dissipating threats and discord and maintaining safety and harmony to keep your range of behaviors and chemistry in a stable restorative and regenerative zone is key to thriving. The nociceptive (pain) and the emotion systems, both with and without awareness, guide you to take actions to avoid harm. When you experience an uncomfortable or unpleasant feelings from any source, it is simply signaling danger and then you can take appropriate steps to find safety.

Threat

Environmental cues of threat or internally generated ones are met with a defensive response including stimulation of your immune system with elevations of inflammation, elevated metabolism to provide fuel for defense, and increases in multiple stress signalers including the threat cytokines (IL1, IL6, IL17, TNF), inflammatory chemicals, (histamine, prostaglandins), mobilizing neurotransmitters (glutamate, dopamine, noradrenaline), and stress hormones (adrenaline, cortisol, aldosterone, vasopressin and endorphins).

Clinically, you are on “high alert” and there are numerous bodily responses to threat. The basic ones include an increased heart rate, rapid breathing, increased speed of nerve conduction (increases pain), elevated blood pressure, sweating, muscle tension, and a sense of danger that we call anxiety. There also numerous symptoms created by this physiological state. They include tension and migraine headaches, neck and low back pain, skin rashes, stomach cramps, depression, bipolar, burning sensations in various parts of your body, and there over 30 different responses. Although the chemical environment encompasses your whole body, each organ and organ system will manifest its unique response.

Symptoms, illness, and disease

 When the threat is transient or resolvable, there will be different physiology that will quickly abate the symptoms. When the threat is more prolonged, people will develop illnesses and diseases that, also, are reversible with appropriate treatment including the removal of threats and restoration of safety. When threat is sustained people can develop serious illness and diseases that may cause permanent tissue damage and create physical, mental and social havoc.

 What causes disease? There are two aspects consider.

• Your nervous system/ body
  • Your inherent coping skills
  • Your current state of reactivity influenced by diet, exercise, sleep, meds, etc.
• Your environment or perception of it
  • The magnitude and duration of threat – the inability to find safety

So, it is the interaction of the surrounding stressors with the human organism that determines the manifestation of physical and mental symptoms; illness and disease versus wellness and health.

The current state of “mainstream” medicine

Modern medicine has nullified these aspects of care in that we are not given the time nor are we encouraged to talk to our patients. From the beginning, we are not providing cues of safety. Then, we don’t know our patients and their coping capacity and really don’t know much about their environment. We are given only the time to treat symptoms. We are ignoring the root cause of the problem–total threat load. It is similar to putting out a major fire with a garden hose. It can’t and doesn’t work. Indeed, there is an ongoing and growing epidemic of chronic disease – both mental and physical, social and spiritual.

Solving our medical care crisis

Our medical care crisis could be solved with one simple move – significantly increase the reimbursement for talking to patients. This would allow a sense of safety, allow providers to assess both the patient and his or her surroundings, and direct them to resources to reduce the threats in their lives, improve safety,  coping and connection skills and provide tools to more effectively process their stresses.

The other half of the equation is to quit paying as much for procedures and also not reimburse for interventions that have been proven to be ineffective or damaging.

Addressing  root causes

A basic concept in extinguishing a fire is to deprive it of its fuel. Forest fires are the classic example. Fire breaks eliminate fuel and are only ineffective if the fire is so powerful as to jump over them. Fire retardants cover wood in a manner that it cannot be consumed. If water is used, it may be delivered in a mist, which helps lower the oxygen available. Water also removes heat. A carbon dioxide fire extinguisher displaces oxygen and suffocates it. The bottom line is that to fight a fire you have to address one of the root causes of it – oxygen, heat, or fuel.

Treating only symptoms is not only ineffective, the “fire” will continue to burn causing ongoing tissue damage. Successfully minimizing the impact of chronic illness requires minimizing the multitude of threats and maximizing access and opportunities for safety. coping and connection while also improving skills to better process toxic environmental inputs.

Summary

Every mental and physical symptom is created by the interaction between your surroundings and your body. Your body contains trillions of sensors that collect data that is sent to and processed by your central nervous system. Unpleasant sensations compel you to take action signaled by your brain and local tissues to resolve threat. Pleasant input causes you to take actions that are restful and regenerative.

The two factors creating symptoms and disease are you (and you coping capacity) and your surroundings (stressors). When you stresses overwhelm your coping capacity, you’ll experience symptoms, maybe become ill, or develop a serious disease. The solution lies in 1) increasing your coping capacity and 2) teaching you skills to more effectively process stress so it has less of an impact on your body, health, and sense of well-being. As you learn to regulate your body’s neurochemistry, you’ll have control, a sense of safety, and thrive. The DOC (Direct your Own Care) Journey presents a well-traveled sequence of lessons that will allow you to master these skills.

References

1. O’Neill Hayes, Tara and Serena Gillian. Chronic disease in the United States: A worsening health and economic crisis. Americanactionforum.org; September 10th, 2020.

Plan A–Thrive and Survive COVID-19, 2nd edition; Loving Life Lengthens It

The post Essence of Illness first appeared on Back in Control.

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What would be the outcome of a scenario where a stranger or acquaintance walked up to you and began to call you names and shove you. Maybe they even hit you? What would you do? You would call the authorities and the perpetrator would be charged with assault. If it was a first offense, there might be a light penalty and stern warning. However, if it was repeated, he or she would incur a much stronger penalty–maybe even prison.

This behavior is unacceptable at every level in the adult world, although there seems to be an increasingly common trend called “mobbing.” In this situation, co-workers or colleagues with gang up against a fellow worker and harass them.

Why is any level of this behavior tolerated in childhood? Any of it? I don’t have to give examples because every one of us has either witnessed bullying, been a part of it, or been a target. What is remarkable, is that the attacks are often emotionally intense and can involve physical contact. Usually, it is repetitive and can last for years. Make no mistake, the scars are permanent and there is a medical case that bullying should be treated as criminal assault right from the beginning, regardless of what age it begins. This does not necessarily mean severe consequences at the beginning but a clear pathway of consequences needs to be laid out.

Early on, it is the parent’s responsibility. Where are the kids learning this behavior? Who are they imitating? Are they being bullied at home? Remember, the basic role of a parent is to provide a safe, nurturing, and secure environment where everyone can thrive.

The consequences of being bullied

The core issue driving chronic disease, whether it is mental or physical is the body’s survival response to chronic threat. The solution lies in creating safety. Some of the consequences of remaining in a survival state are elevations of:

• Inflammatory cytokines (signaling proteins) that drive inflammation,
• Adrenaline and noradrenaline that increase heart rate, muscle tension, rate of breathing, and sweating.
• Histamines that fire up the immune response
• Cortisol, which drives a heightened metabolic state that destroys tissue in an effort to maintain a fuel supply for fight or flight.

The data

A 2014 paper out of Britain obtained 50–year follow up data on 7,771 participants whose parents reported bullying exposure between ages 7 and 11. Here is a partial list of the consequences and they were more severe if the bullying was frequent vs. occasional. (1)

One of the stark facts is that 28% of children had been exposed to occasional bullying and 15% had been frequently bullying. That is high percent. Life isn’t fair and the kids who were bullied were more likely to suffer from the following problems.

• Parents in manual occupations
• Low parental involvement
• Placed in foster care
• An ACE score of two or more (Adverse Childhood Experiences) indicating various forms of abuse
• They had lower IQ scores
• Difficulty in processing stress – either internalized or externalized it

Consequences

• Increased anxiety, depression, suicidality
• Poorer self-rated general health
• Lower cognitive functioning
• Alcohol dependence
• Lower educational level by midlife
• Higher unemployment rate
• Being single or without a partner
• Less social
• Poor social support
• Lower quality of life
• Lower satisfaction with life

Another paper by the same author looking at the same group of people who had been bullied showed that women who had been bullied showed elevated inflammatory markers and a higher chance of obesity, which leads to a host of other medical problems. It is becoming increasingly clear that persistently elevated inflammatory markers is associated with almost every chronic disease state­–both mental and physical. (2)

Over 40% of the population was exposed to some level of being bullied in this study and there are numerous other studies documenting the often devastating mental, physical, and social consequences. Why do so many people bully others? I could never figure out why someone would treat another person in a way that they would not like to be treated themselves. There are several reasons with the wounded chicken in the coop being one example. Animals of all species instinctively weed out the weaker members of the group.

Not thinking clearly

But humans have consciousness and have the capacity to override that impulse. But another problem is that when you are angry, the blood supply shifts away from the thinking centers of the brain and you cannot think clearly. You revert to non-human animal behavior and it is destructive. Anger is only about self-preservation and is temporary insanity.

The rewards of power

There is also a physiological reward for being bullied. One study showed that children who had been bullied had higher levels of  inflammation as measure by a blood test called C reactive protein (CRP) than children who had not been bullied. (3) As noted above, these levels can be sustained well into adulthood. What is more disturbing is that the bullies had significantly lower levels of CRP than students who were left alone. My assessment of this situation is the answer for anxiety is control, so as to take evasive action to survive. Anxiety is an inflammatory process. So, the more power you possess, the more control you have. What we call “socialization” in school is an early and ongoing power struggle. It is not subtle how this behavior carries into adulthood.

Kids will be kids

This is deadly phrase. It covers up a multitude of wrongs that have lasting consequences. Multiple studies have documented the issues. Many efforts have been made to clamp down on bullying but we all know how pervasive it is.

I am not going to list all the possible solutions and certainly many efforts had a lot of success. But they don’t go deep enough and don’t have the necessary reach. Why?

Parents hate bullying. They feel helpless. Teachers hate it. They can only do so much and unfortunately bullies love it when people try to stop them. They now have a lot of attention and control. Just policies and light penalties are no match for them.

It is a crime

I am not a fan of our criminal justice system. Teaching life skills to those in prison is critical and it is not widely being done. So, these comments are made with this in mind – rehab first. However, in addition to the “zero-tolerance” approach that has been attempted for over a decade, bullying is a crime and should be treated as such. It is the logical starting point.

References

The post Bullying is Assault and Should be treated as Such first appeared on Back in Control.

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