FOR HEALTH CARE PROVIDERS
What are Psychophysiologic Disorders? PPD’s go by many names – psychosomatic disorders, neural circuit disorders, neuroplastic pain disorders, primary chronic pain, stress illness, mind-body conditions, conversion disorders, functional disorders and many others.
They occur when our minds, under severe emotional stress, create real pain in our bodies through learned neural pathways in the brain.
What is our challenge? While medical practitioners have been aware of this process for thousands of years, in the past few decades, we have set aside this knowledge and instead, focused on research and treatments which prioritize the amazing pharmaceuticals and procedures which the Cartesian model of scientific study has brought us. These discoveries have been truly amazing – antibiotics, transplant surgery, imaging studies that have allowed us to see inside the body and medications that can heal. We are fortunate to live in this time of life-saving discoveries.
However, in our well-intentioned efforts to view all illness as being caused by tissue damage or physiologic processes gone awry, we have overlooked the power of our own mind to affect our health outcomes. We have forgotten that internal stress can actually cause dis-ease. There are a few conditions for which we readily acknowledge this interplay between thoughts and emotions and the body. For example, Takotsubo’s Cardiomyopathy and Conversion Disorder are widely accepted as being caused by emotional processes.
In the meantime, we have an estimated 100-200 million Americans suffering in chronic pain and 1.5 billion globally. We have not understood the cause of these conditions and our treatments aren’t working. This situation has been a factor in the opioid epidemic, rising healthcare costs and disability rates. The currently accepted medical ethos for chronic pain is, “It never goes to zero. You can’t eliminate chronic pain.” and, “The primary goal is improving function, not eliminating pain.”
What is the solution? During this time, some physicians, such as the late John Sarno MD, Howard Schubiner MD, David E. Clarke MD, David Hanscom MD, and David Schecter MD, have been able to successfully treat patients who have unexplained and treatment-resistant medical conditions such as chronic back and neck pain, fibromyalgia, migraine headaches and irritable bowel syndrome by using a mind-body approach to healing. Such an approach addresses the role of unresolved stressors, both past and present, in the creation of dis-ease.
We have all had a psychophysiologic response to internal stress at some point in our lives – the time your face turned red when you felt embarrassed? Or, the time you experienced “butterflies” in your stomach before that lecture or performance? This physiologic reaction is a result of stress-inducing thoughts and emotions in our mind activating neural pathways in our brain which cause physical symptoms in our body. This human experience is universal.
Sometimes, this universal human response to stress can become severe enough to cause debilitating pain that interferes with one’s ability to fully live one’s life – so we seek help from our doctors and therapists, hoping for a diagnosis and a cure. These patients often received diagnoses such as primary chronic pain, chronic neck and back pain, failed back syndrome, irritable bowel syndrome, fibromyalgia, migraine headache, pelvic pain syndrome, phantom limb syndrome and many others…
What causes Psychophysiologic Disorders ? Early childhood trauma, recurrent adult traumas and/or current stressors trigger a danger response in the brain’s amygdala. This activates various neural circuits in our brain such as the sympathetic nervous system (SNS), the parasympathetic nervous system (PSNS) and others. This activation triggers a cascade of neurotransmitters in our brain and stress hormones in our body which prepare us to defend ourselves from the danger. If the SNS is activated, we develop shortness of breath, a fast heart rate, a high blood pressure, sweating, tremor and muscle tension. Other neural pathways can create other effects on all the physiologic systems of our body. This system works perfectly for acute, time-limited dangers like being attacked by a tiger, but when these traumas are ongoing or occur repeatedly over the course of one’s life, chronic ANS activation can cause health problems. There can be other factors at play as well which serve to keep the brain on “high alert”, such as specific personality traits (e.g. perfectionism, people-pleasing behaviors and chronic fear thoughts), and “conditioned responses” – like Pavlov’s Dogs, we can learn pain in response to innocuous stimuli. The chronic pain leads to fear which causes heightened attention, and a vicious cycle ensues of more pain, more fear, more attention, more pain, etc. The original traumas are often associated with unresolved emotions which we would prefer not to feel – in fact, we will avoid feeling these feelings of anger, sadness, guilt or shame at all cost. But, the emotions are still there, in our subconscious, signaling danger and activating the ANS. Many of these thoughts and emotions are occurring at a subconscious level and we have no more control over it than we do our dreams.
A mind-body treatment approach to pain views chronic, non-malignant pain as a dynamic, neuroplastic process which can be unlearned. With appropriate treatment, we learn that our bodies are not broken which breaks the fear response, we unlearn our conditioned responses to the pain, we learn to respond to life’s stressors in healthier ways and we learn to attend to our internal states in ways that promote well-being. A different message is then sent to our brain – that we are safe and not in danger. We are now in control of how stressors affect us – allowing our ANS to turn off.
Treating neural pathway pain as if it were the result of tissue damage typically will not work and often can create more pain via complications of treatment and increased fear from the patient receiving direct and indirect messages that their bodies are broken and can’t be fixed. The pain of PPD is not due to damaged tissue or damaged nerves, but occurs in normal nerves conducting normal pain responses. The problem is that our mind is sending the wrong message to our brain. When we can change the messaging, we can change the response and heal the pain.
Some of the health conditions which have been responsive to this treatment include chronic neck and back pain, migraine headaches, fibromyalgia, irritable bowel syndrome, gastroesophageal reflux disease, interstitial cystitis, pelvic pain, hyperacusis, as well as many conditions viewed as “pain equivalents” such as dizziness, chronic fatigue, tinnitus, insomnia, anxiety and depression. There are many more. In fact, our minds have the capacity to create any type of pain which can be imagined.
What are the benefits of a mind-body approach to healing? That’s easy. Patients get better, medical providers are happier and medical costs go down. Everyone wins !
If you would like to learn more about the effects of unresolved stress on health or refer someone for treatment, contact Dr Batson.
Please note that it is critical to first rule out life-threatening and other serious health conditions through appropriate testing by a qualified health provider before considering a psychophysiologic disorder and before referral for treatment.