Focusing and Health- some Psychobiological
Perspectives
By Bruce Nayowith MD
Overview:
I) Introduction
III) Stress and the creation of state-dependent memories,
learning and behavior
IV) Effects of State-dependent Processes
on Physical and Emotional Health
V) General Principles of working
with state-bound symptoms
VI) Guidelines
for accessing State Bound Memory, Learning, and Behavior for healing purposes
VII) Implications of psychobiology to Focusing
in particular
Introduction:
Until the last two decades, the field of psychobiology
was generally limited to studies showing associations between mental and
emotional conditions and physical health. Respect for the field was limited by
the lack of hard data regarding exactly how and why the mind was able to
influence the body in these ways. More recent research findings have clearly
articulated many of the cellular pathways of the mind-body link. These have
been quite brilliantly summarized and articulated by Ernest Rossi in his book, The
Psychobiology of Mind-Body Healing (W.W. Norton 1993). He elaborates on
what was once called “the mind-gene hypothesis” – the biochemical pathways
through which mental events influence the expression of certain genes on the
cellular level. Much of this hypothesis has been validated by further research.
In this article, I have elaborated
and revised my original post. Much of
the first part of this article is taken from Ernest Rossi’s work. (All quotes
and page numbers are from his book.) It is my hope that this information will
offer three things to the readers:
-
to
better understand, and explain to others, some of the cellular pathways that
generate stress-related mental and physical illnesses
-
some
of the particular strengths of Focusing from the perspective of psychobiology
-
a deeper
appreciation of the valuable work that Focusing practitioners are doing.
Some of the first studies into the effects of acute
stress and the body described the “fight or flight” response of massive
sympathetic nervous system discharge.
This is initially mediated by adrenaline and noradrenalin, and followed
by other hormones, such as cortisol. Activation of the nervous system and
release of hormones into the body act to increase heart rate, blood pressure,
muscle tension, increase alertness and memory, open the bronchioles in the
lungs, and constrict blood vessels in areas of the body not necessary to help
fight or run away (abdominal organs, skin), and increase blood clotting
ability. [For the body-feel of this
response, simply recall and experience of having been startled or very
anxious.]
Another reaction to intense
situations has been called the “possum” response. This is a massive
parasympathetic release, suppressing most of the body systems. Blood pressure
and heart rate drops, fainting may occur, muscles relax, stomach secretes more
acid…
The
key determinant as to which of these two pathways will be activated in response
to a major challenge depends on one’s (unconscious) interpretation of the situation. If it seems that fighting or running
away is possible, the fight or flight response will be elicited. If one feels
powerless to fight, escape, or alter the situation, then the possum response is
more likely to occur.
Because these “archetypal” responses to stress are
survival oriented, they tend to be quite powerful and intense. They do not come
without a price- a significant demand on many of the body’s cells and organs.
From an evolutionary standpoint, this is still a bargain. Most situations which
threaten the survival of animals last under 20 minutes. If the animal survives
the challenge, there usually follows a relaxation/ recovery period – damages
are minimal, and the body is able to renew itself.
Unfortunately for humans,
some form of inappropriate overactivity of the stress response may persist for
prolonged periods of time. Persistent states of fear and hostility
(sympathetic) or powerlessness and despair (parasympathetic) can lead to
imbalances in the endocrine, immune, or nervous systems, with resultant
physical and or psychological disturbances.
Then why is it that the negative effects of certain
stressors may continue long after the initial stressful situation has passed?
One key aspect of this is related to the dynamics of state-dependent learning.
Stress and the creation
of state-dependent memories, learning and behavior:
Our minds and bodies are linked
through a network of communication systems mediated by various messenger
molecules. These messenger molecules are produced and transmitted by the brain, peripheral nervous system, immune
system, endocrine system, and gastrointestinal tract. Many of these
molecules are conveyed through the blood stream. Others diffuse between or
within cells. They influence receptor sites on specific cells of the body, and
help regulate every function of the body- including behavior, learning,
metabolism, and growth. There
are many levels of information exchange and feedback loops to promote a stable
environment, which can respond quickly to challenges and changing conditions.
Cell
biology, habit patterns, and memory are in a state of continual growth and
flux. Processes of learning and adaptation are continuously occurring within
the cells of our bodies- this is how we learn and grow.
But
there is something different about the learning that occurs in intense
emotional/ physical states. The learning and encoding of memories and
behaviors associated with these episodes may be state-bound.
State-dependent memories are dependent on and
limited to the psychophysiologic state in which they were acquired. One can remember or access this type of
learning and memories only when in a certain state, or when linked with a
symbol or association to that state. Many
studies have demonstrated that if something is learned while relaxed, one
recalls it more fully while relaxed - if learned on mind-altering substances,
then better recalled when on the same drugs. State-bound learning also occurs
during intense physical and emotional states – it is more difficult to access
the memories, learning and behavior once back in normal operating modes.
Here are Rossi’s words (p.
57):
“A psychological or
physiological shock/stress can lead simultaneously to:
immediate
state-dependent encoding of strong classical Pavlovian associations to
traumatic events due to stress
release of adrenal hormones
impaired ability to
do something about it (as is typical
of learned helplessness) due to
the inhibition of instrumental learning under the same conditions.”
A simple example
of how certain symbols or associations can access memories (for those of us old
enough to remember) is how the question: "Where were you when JFK
died?" may release a flood of memories.
Those words are able to access the state-bound memories that were encoded
during the stress-induced (the shock of hearing about the assassination)
altered cell metabolism.
On a more serious
level, certain stimuli associated with a trauma (sights, sounds, words,…) may suddenly evoke intense physical and emotional
responses, often without any understanding or memory as to why this is
occurring. If memories are evoked in this process, one may feel powerless to
stop the flood of memories, sensations, and emotions from flooding into
consciousness and running its course.
Stanislav Grof
has called this set of physical, emotional, mental and symbolic experiences all
linked together through state-bound learning a COEX-a system of COndensed
EXperience [similar to what are called
“engrams” in Dianetics.]
I would like to set forth a very abbreviated summary of the cell biology of this process
of encoding for state-dependent memories, learning, and behavior:
Certain intense states and situations trigger
the release of messenger molecules such as steroids, adrenaline, and various
neuropeptides. Some of these messenger molecules have the ability to pass
through the membranes of body cells and gain direct (or indirect) access to the
cell nucleus. Once in the nucleus, they can modulate the expression of certain
genes. It is almost as if these messenger molecules uncover and activate certain
genes that were previously quiescent; they stimulate the cellular DNA to
produce certain proteins and new messenger molecules. These proteins are the
biochemical equivalent of memories, associations, habitual behaviors, and emotions.
After the crisis has passed, the initial stress hormones and other
messenger molecules are no longer secreted in such high quantities. These
previously-released substances are rapidly metabolized and removed from
proximity to the cells. The cellular environment again approaches a more normal
state, and the aspects of the genes that were “uncovered” by these substances
are “covered back up again”.
Adrenaline
for example, not only activates the fight-or-flight response, but also modulates
the retention of memory. This is one reason that stress- related memories
and events are so deeply “learned” or ingrained into one’s being. It also
explains why one’s memories of a very agitated situation may begin to become
fuzzy soon after the event. As the cellular milieu returns towards normal,
one’s ability to access the memories becomes more difficult.
The more intense
(or repetitive, which accumulates intensity) the event/ stimulus, the deeper
the state-dependent patterns may become ‘imbedded’ into one’s
cellularity.
How State-dependent Processes Affect Physical and
Emotional Health:
Even though one’s ability
to access the encoded material is state-dependent, protein synthesis
for these emotions and patterns of behavior may continue even after one has
returned to a more normal emotional and physical state. Cells may be continuing to generate
neuropeptides that code for patterns of distress- patterns of tightening,
fear, or withdrawal. When the initial
stress has abated, the extracellular hormone environment returns to normal, and
it is not possible to access or unlearn these behaviors from normal
consciousness and emotionality. What has been called repression may
actually be a form of state-bound memories – truly inaccessible from normal
awareness without some way to access them (more on this later).
The familiar sense of: “I don’t know why I feel ------, but I do…”
is often a manifestation of this state-dependent amnesia. The pattern
generating the feeling is not accessible to ordinary memory access.
To offer an
analogy, intense situations (because of the physiological alterations created
during the stress response,) “open the flap to the control panel” that controls
access to some of the genes in the cells. Once “open”, new programs
are written and activated (for certain new learning, memory, and behaviors.
Incorporated into these programs are associations as well as the emotional and
physical tone of that state.) This ‘control
panel access door’ then closes after the body has moved away from these states,
and is no longer possible to gain access (through normal waking consciousness
and body state) to stop these programs from running. The body’s natural healing
mechanisms can correct the dysfunctional programs only by first “re-opening the
panel” to gain access to the control mechanisms.
Some of these
programs are inactive until a trigger (association to the situation) is
encountered. (These triggers may be visual, auditory, kinesthetic, mental or
emotional cues directly involved in the initial stressful situation, or a
symbol, (which later becomes associated to one of these cues, and
thereby becomes a part of the COEX.) Exposure to these triggers automatically “runs
the program”, and elicits the state–dependent feelings, memories, and body
responses- a Pavlovian type response. Phobias
and triggered flashbacks are good examples of this.
Other programs may be continuously
producing inappropriate physical, mental or emotional responses.
The generalized, continuous unease and tension experienced by many with
post-traumatic stress disorder is an example of this.
Describing this without the
biochemistry, it is as though certain stresses (especially those that
induce some form of trance or dissociation) can cause ‘something inside of
us’ to open, into which the psychological/ emotional tone of that moment
is ‘injected’ into some of the cells, along with other accompanying
associations.
If there are
sufficiently intense components of fear, abuse, hatred, loneliness, etc., they
may literally become part of one’s body chemistry. After the intense experience has passed, many
aspects of one’s life may feel more normal, but something inside may not seem
normal, not right…
While this is
part of the body on one hand, it may feel foreign to one’s normal sense of
self. It may be experienced as: “something inside me that has a life of its
own”, and, in a way, it is.
Its effects are experienced by normal waking consciousness,
but the “core” of the state-bound system is not accessible. We can further carry this idea of how
negativity can become incorporated into one’s body cells and self-image.
If certain
statements were expressed during intense states (like “you are no !*$@@! good!” or “don’t you ever…..!”
), they may become associated into the state-dependent COEX.
Those statements
may even come to feel as if they are an integral part of one’s identity or
being – a felt conviction that “THAT (negative judgment) is who I really am”.
Likewise, one
would expect that experiences of warmth, kindness, and connectedness could also
become incorporated into the body.
(The limited ability
for “positive self-talk” and affirmations repeated in alert waking consciousness
to unlearn or reprogram state-bound material will be explained in a later
section.)
Even if one feels relatively stable
emotionally in the present, it is possible for these patterns, learned in the
past, to be contributing to suboptimal health. The following are a few examples
of physical conditions that can be related to stressors:
Chronic
muscle tension from persistent patterns of muscle guarding
Chronic
oversecretion of hormones
cortisol –
diabetes, decreased immune response
regulators
of stomach acid – ulcers, gastritis, reflux
Adrenaline
and noradrenaline – elevated blood pressure and strain on heart
sex
hormones – altered menstruation, ovulation, endometriosis
Alterations
in immune system functioning
increased
susceptibility to infections
Increased
allergic responses (food allergies, hay fever, asthma…)
autoimmune
diseases (lupus, rheumatoid arthritis,…)
increased
risk and/or progression of cancer
Altered
contraction of smooth muscle in body
asthma
irritable
bowel syndrome
spastic
bladder
Chronic
constriction of blood flow to an area
recurrent
infections
poor
healing from wounds or fractures
In some people,
the above symptoms may be linked directly to state-bound material, and may
become unlearned (healed) during a felt shift.
A personal example was my experience with recurrent sore throat and
fever that developed whenever I was under stress and lost some sleep (see personal
account in earlier pages of this Folio).
This state-bound system
encoded a pattern of chronic constriction of blood vessels and/or immune
suppression in the area of my throat. This resulted in an increased
susceptibility to infections which persisted until a felt shift (with
emotional, physical, biographical and dream components) occurred while
Focusing.
Another example
was that of my first wife. After many months of good health, symptoms of
endometriosis (which in previous years had led to a hospitalization and several
operations) developed rapidly after an experience that had symbolic association
to a very distressing past experience. Healing occurred in association with a
felt shift later on.
In her book, Imagery
In Healing, Jeanne Achterberg recounts the story
of a woman with chronic pelvic infections for over 10 years. During a
self-healing exercise, she had a spontaneous episode of imagery in which she
saw (and physically experienced herself as) a Native American woman being
abused by members of another tribe. This experience was associated with intense
warmth in her pelvis and an immediate and permanent disappearance of her pain
and infections. The physical mechanism for this (and in many experiences of
“faith healing”) was postulated to be the sudden releasing of a ongoing long-standing pattern of excessive constriction of
the blood supply to her pelvic organs. Decreased blood flow had impaired her
body’s ability to protect against infection and heal.
In the above
examples, we could say that the Focusing and imagery approaches were able to
gain sufficient access to the state-dependent pattern to allow them to unlock
and end their dysfunctional physiological patterns. All were associated with
cathartic felt shifts.
Some general principles of working with
state-bound symptoms:
Attempting to
heal state-bound material is challenging on several fronts-
1) There is amnesia (no memory) of the event from normal
consciousness, so one may not even be able to make a connection between present
symptoms and the initiating or sustaining events.
2) There is no direct way (while remaining in ordinary waking
consciousness) through an act of will to access, unlearn, or “heal” them.
3) The idiosyncratic nature of these state-bound patterns means
that every person (and each state-bound memory in the same person) has a
different composition and pattern. The
determinants and incorporation of components and “meaning” into the state-bound
complex occur more by an associative process rather than by a logical,
predictable one
4) Recent brain research suggests that prolonged chronic
stress may cause permanent damage to the hippocampus in the brain, which
is involved in short term memory and learning. This leaves less capacity for
problem solving and resolution.
The following are several
guidelines for working with state-bound memories, learning and behavior:
1)
One way to become
free from the effects of state-dependent dysfunction is to gain access to the
original (or a similar) physiological state and allow other resources of the
body (conscious awareness, other self-healing processes) to enter in and
restore the system to a healthier state. Re-accessing the original state “gains
access to the control panel” and allows different learning, memories and
processes of regulation to take place.
2) It may be possible to access state-dependent
encoded information from any modality of mind-body communication that was
incorporated into the COEX.
Rossi (p 93) mentions the following avenues for
accessing state-dependent material:
Imagery Behavior
Symbols
Sensation (perceptions) Awareness (cognition)
Emotion
Identity
Tending to a felt sense was not mentioned by Rossi specifically.
It seems to include, but be more than the simple sum of, several of these
modalities simultaneously.
[In addition, some approaches that involve acupuncture
meridians have been reported to be helpful, though these do not directly access
the emotionality or symbols.]
3) One
very effective way into a state-bound system is by attending to the symptoms
themselves.
The
symptoms are seen as a gateway to healing. (analogous
to Gendlin’s philosophy of the life-forward direction implicit in each felt
sense)
Rossi contrasts many
behavioral medicine and psychoanalytic approaches, which see symptoms as
problems to get rid of, with psychobiologically-oriented approaches, which see
symptoms as:
“maladaptive forms of
information transduction that can become
important signals for creative personal development. (p 292):
“Behavioral and
psychoanalytic approaches both throw away valuable information by placing themselves in opposition to
the problem network. Our psychobiological approach uses the data
by accessing the state-dependent system that encodes the problem, and reframing them into creative functions…
“…Many types of chronic pain
and recurrent physical symptoms …actually amplify the (minimal) stress signals
of mind and body.”
4)
The act of consciously attending to modalities associated with state-bound
material facilitates healing by changing its state-bound nature.
Rossi
(p 91) “A basic
premise here is that every access is a reframe. Every time we access the
state-dependent memory, learning and behavior processes that encode a problem,
we have an opportunity to re-access and reorganize (reframe) the problem in a
manner that resolves it….
…(recent research into memory learning and cognition
shows that) memory does NOT operate like a tape recorder in which we simply
play back exactly what we have learned.
Memory is always a
constructive process whereby we actually synthesize a new subjective experience
every time we recall an event.”
Rossi (p111-112):
“to tend to a symptom is actually the most direct source to accessing its
psychobiological sources encoded in the state-bound processes…
…research into the
neurobiology of memory and learning indicates that the process of accessing and
recall is not simply that- accessing and recall are actually a synthetic
process of reconstruction. Therefore, prescribing the symptom (voluntarily
tending to it) is actually a process of reconstructing it. When we ask a
person to experience a symptom voluntarily rather than resisting it, we are
drastically altering the internal dynamics and state-dependent memory and
learning systems that allow the symptom to flourish. We have changed it from
a dissociated and involuntary action to a voluntary action; we are undoing its
state-bound character.”
5)
The process and nature of state-bound learning and associations is highly
individualistic.
Each
person has a unique pattern of state-dependent (stress-induced) symptoms. A directive approach, where the
therapist or guide tells the client what the experts say is needed to improve, will not be as effective as a more
exploratory, problem focused approach, where the problem tells the client and
therapist “ what it needs” at each (often illogical and
idiosyncratic) step of its expression and healing.
Approaches to healing state-bound problems:
There are three general
levels at which most therapies influence this process:
1)
Learn and
practice newer, healthier patterns, in an attempt to override or overpower the
state-dependent patterns.
A “natural” response to
feeling bad is to do or tell oneself things to try to make oneself
feel better. (Positive affirmations, willpower, self-talk…) While some find
these helpful to a point, they do not affect the process of continuing to code
for these stress-induced patterns. Some may find that “trying to feel better”
actually intensifies a sense of inner conflict. Sometimes these dysfunctional
state-bound patterns are interpreted and labeled as an intentional “ self-destructive tendency,” rather than recognized for
what they are.
This may be a good opportunity
to mention some of the suffering that can be caused by misguided applications
of these insights.
The use of willpower,
affirmations, etc, is of some value in creating healthy patterns, but is unable
to reverse the earlier “cellular brainwashing” (especially if these
affirmations, etc. are done while in a state of normal waking awareness.)
Yes, the dysfunctional
patterns were “learned”, but they are not consciously accessible. They were not
‘chosen’.
And it may be extremely
difficult and distressing to access these state-dependent memories associated
with intense states. These misinterpretations often lead to “blaming the patient for their
illness.” Now that we are aware of how state-dependent patterns are formed,
let’s not contribute to adding additional guilt and suffering to people in
these situations by repeating such unenlightened slogans such as: “You choose
your illness”, or “The reason that you are not getting better is because you do
not want to enough.”
2) “Derail” the
associators, or triggers, that stimulate the manifestation of state-bound
responses in the cells.
Modalities such as Neurolinguistic Programming
(NLP) are often
employed to change the associations triggering the symptoms. For example,
someone with a spider phobia can learn to disconnect the “spider” from the
panic reaction. This will eliminate the spider as a trigger to symptoms, which
is adequate for many people and situations. This has had remarkable success in
phobia cures, for example.
If there is also
a more generalized pattern of anxiety as well, it may not be as effective, unless these
modalities are used as a vehicle into accessing the state-dependent material
rather than mere symptom removal. Otherwise, they would not unlock or unlearn
the remainder of the initial negative pattern itself – the “cellular memory.”
3) Attempt
to recode for the present dysfunctional programs in the cells at the cellular
level.
Present theory
suggests that one very effective way to end this process at its roots is by re-accessing
the initial chemical/ hormonal (usually with similar emotional and feel-quality
associations) milieu under which the original learning took place.
This allows
access to the genes that are still coding for proteins since they were turned
on by an earlier stress response (and have been shielded from being turned off
since). It also offers the opportunity
for this earlier program to be replaced with a different one, to code for
different proteins and patterns of bodily response.
There are several
ways to re-access the state-dependent encoding process:
a)
attempt
to re-create similar emotional conditions (and assuming the biochemistry will
follow suit,)
b)
change the quality and field of attentional
focus on some aspect of the distress,
c)
and/or
attempt to reaccess this state through one of its associations. (tight area in the body, anxious feelings, dreams,
memories…)
Visualizations,
Dianetics (using sentences), certain bodywork approaches, hypnosis, talking
therapies (when the client focuses - connects with some physically felt quality
associated with the situation!) are just a few of the possible methods that
have been effective. Often there is some large cathartic emotional release and
often-‘repressed’ memories that flood out during the healing process.
Healing in these states can
be a very delicate matter. It is important not only for the client to open
up into that emotional/biochemical condition, but also that these
experiences by met with openness, kindness, acceptance, and respect…
Ideally, we would desire that a new learning take place in which the stress and
its associated triggers are held in an “attentional embrace of kindness and
care”, so that the whole experience can become associated with “proteins and
memories of kindness” rather than ‘adding another dose’ of reinforcing
tightness, distress, and dis-ease into an already distressed client and their
cellular milieu.
The healing process itself
may not be without its own traumas. The client is in vulnerable to many
influences in these states (they are again open to new state-dependent
learning!), and can be inadvertently retraumatized or re-programmed with
less-than–healthy associations. There
are at least two stages in the healing process in which this can occur.
1)
Trauma can be inflicted during attempts to return the client to a state
analogous to the original traumatic one in order to begin the healing. For
example, methods based on “reliving the original experience” run the risk of
reinforcing the pathology or of introducing new pathology depending on what
is employed in encouraging the client to relive it. - certain
stresses may be added to the mind and body by either client or healer in the
attempt. This is especially true with more aggressive, directive approaches
(attacking ‘the adult without’ in an attempt to help ‘the child within”). The more gentle and accepting the approach, the less likely it
is to re-injure.
2)
Traumas may be inadvertently incurred while actually IN the altered cellular
state during the ‘healing’ experience. Some intense methods of “opening someone
up and re-programming ” (the early days of Erhart Seminar Training,
certain marathon encounter groups….) may have the negative effect of
“re-inoculating” one’s tender places with a different type of harshness - limiting
or negating the desired healing.
A Perspective on what Focusing offers here:
Focusing offers one powerful
way to approach these difficult and tender places. By attending to the felt
sense and letting it develop, one begins to access the state-bound learning on
its own timing. Staying with a felt sense generates the conditions similar to
those that created the initial stressful cellular environment. As the felt
sense unfolds along its own uniquely encoded path in each individual, the
affected cells are given the opportunity to release their original feelings,
beliefs and dysfunctional patterns, and be replaced with the more positive
“learning programs”- the emotions, attitudes and beliefs present during the
healing moment.
The Focusing
approach is a very “organic” and non-manipulative processes.
The depth and speed of “going into the problem” is regulated by the client,
the felt sense itself, and the other felt senses in the body (the places
that wants to go slower or are scared of another place inside are also honored
rather than ”pushing through resistance”). This honors
the whole body system, not just the one aspect that is pushing for healing but
may be doing so at the possible expense of another part.
Besides
tending to the felt sense, a physical sense “of the whole thing”, Focusing
makes space for all of the modalities able to access state-bound material –
imagery, sensation, emotion, identity, behavior, language, and symbols (a
handle). Including the interaction between these modalities and the cognitive
mind within an environment of a relaxed, open attentional field further frees
the problems from its state-boundedness.
Even
when felt shifts do not occur in a session, as “every access is (an opportunity
for) a reframe”, simply taking the time to consciously attend to felt senses
begins to decrease their state-dependent nature, facilitating healing.
Tending to the life of the felt sense, and
asking it what it needs, allows the encoded problems to unfold at their own
healing pace and in their own way. No
forcible attempts to “recreate the situation” need be brought into the client’s
body during a Focusing session. In fact, “nothing extra or unnecessary is
added”.
Tender, distressed areas are
allowed to open at their own speed. There is no attempt to push or force them
to open prematurely, (e.g. “If you don’t deal with this now, you will never get
better!”) which is another subtle form of violence that could otherwise be
introjected into one’s cells and psyche. This extreme safety also allows very
tender places to drop the protective layer and let themselves be accessed – and
subsequently healed.
Focusing not only allows for
effective access and healing of state-bound material, but it also cultivates
the development of an friendly, accepting, curious attitude and orientation
towards more and more of life experience in the remainder of the focuser’s
awareness.
In addition, the qualities of allowing,
respect, acknowledging the positive intention, and loving attention offered by
the listener are among the most life-promoting and protecting environments one
can offer to these injured and stressed places. Even when a profound physical
healing does not occur, Focusing often offers the client a cellular
experience of kindness, presence and mercy. This cultivates an experiential
base which can be accessed and offered to oneself and to others in their times
of distress.
On a biochemical level, the proteins and
learning encoded in the cells of the body in times of stress moves more and
more away from patterns of distress, tightness, other armoring and withdrawal,
and toward a release of kindness, empathy, compassion, and safety – both in the
body and in the mind.
In this way, Love extends itself
from one through others, offering healing to an ever-expanding realm of
experience.