- Emotions and Immunity
Alison looked quite strained as she talked to me about the pain in her wrists and knuckles. She suffered from rheumatoid arthritis, which ran in her family, but had concluded that her pains were always worse when she felt stressed. That was why she was seeing me, to try and get her feelings of stress under control. She said later that it seemed to have worked. Her pain eased and disappeared a day or two later. It was some months later before she felt the need to see me again, and on this occasion also, increased feelings of stress seemed associated with a flare up of her problem.
Rheumatoid arthritis involves what some would call a malfunction of the immune response. In this case immune systems within the body attack the body itself. Alison's case suggests that there are times when psychological factors elicit this inappropriate response. Cancer and infectious diseases, which also involve the immune responses, may also be influenced by such psychological factors.
One mechanism for these effects is quite straightforward. To understand it we have to begin with the immune system itself. The immune system can be thought of as a surveillance process involving the continuous monitoring of bodily processes to ensure that there are no invading organisms and that normal bodily systems are operating. If invading cells such as viruses are detected, or if some cells begin proliferating abnormally, these will be detected and attacked.
Emotional stressors, such as the loss of a loved one, failures in social relationships, inability to express emotions and constant daily hassles can have widespread psychological and physiological effects. Psychological effects include feelings of anxiety, tension and mental exhaustion. Physical effects include stomach upsets, chest tightness, headaches and reduced effectiveness of the immune responses.
Emotional distress is associated with many changes in the immune response. For instance, emotions influence the neuroendocrine system, especially a group of chemicals called glucocorticoids. Cortisol, the most important of the glucocorticoids, is produced in greater quantities whenever there are feelings of stress. It has a role in balancing various bodily processes, including the numbers of immune cells. However, when there are chronic feelings of stress, cortisol is produced in excess repeatedly, as are other hormones. Among the bodily processes harmfully affected are the immune processes.
Recent research has shown that stressful experiences like the death, or even the protracted illness, of a spouse and even the demands of University examinations, can reduce both the numbers and the activity levels of various cells involved in immune responses. Furthermore these kinds of reductions in immune functioning have been linked to susceptibility to infections and to cancer. Sometimes the disruption in the immune response involves a failure to recognise the body's own cells, as in the case of autoimmune diseases such as rheumatoid arthritis.
A few years ago I was asked to assess a wonderful study that aimed to reduce seasonal cold and flu infections in school children. The researchers identified a large group of children who tended to become sick every flu season, averaging 40 days of illness and absence from school. Obviously kids like this are an extreme group, but for just this reason the researchers hoped to be able to be able to make measurable changes in them. One thing the researchers discovered was that all of these children were more distressed than average children about things that went wrong in their lives. If you like, they were more stressed.
A couple of months before the flu season the children were divided into 2 groups. Both groups met one-on-one, weekly with the researchers and talked about what was happening in their lives – a kind of talk therapy session. One group was given something extra. They were trained in a basic relaxation procedure given along with suggestions that they would feel more in control of things in their lives, and provided with an audio-tape to take home so that they could do the relaxation regularly, by themselves. The children were then monitored for the next few months.
The children who had only the talk therapy meetings with the researchers had the same days sick as usual, around 40 days. The children in the relaxation group had half the number of days with flu symptoms and half the number of days absent from school. Their parents reported that they were happier at home and at school and were more settled than they had ever been.
Findings like this provide support for an understanding of the final step in this argument about Psychological factors and the immune system, and that is the prospect of reversing depressed immune functioning by eliminating stress responses. If negative emotional responses can be normalised by deep relaxation (or meditation or self-hypnosis), then it is logical to expect that bodily processes such as the production of cortisol and immune processes will favourably affected.
Such research shows that specific functions of the immune response do change in response to psychological interventions, thus strengthening the notion that physical health can be more effectively managed when there is a greater understanding of individual psychology and when psychological factors are treated alongside physical ones.
This theory about how immunity works has been the basis of treatment offered to cancer patients by well-known clinics throughout the world. Some of these claim dramatically superior recovery rates and survival times. There are still many questions to be answered in this area, in particular the way that different people react to stress and to the management of their illnesses. An issue that has received strong experimental support is the idea that people who are determined to actively influence the course of chronic illness and make changes in their lives in order to do so tend to live longer.
More readings will be added to my blog from time to time. Have a quick look now to see the first posting on my blog PSYC1PLUS