そして、身体の変化は心の変化をもたらし、心の変化は身体の変化につながるのです。医療や心理面談などで、身体の状態がよくなると気分もよくなるし、不安がやわらぐと身体もリラックスします。言葉では前後ができますが、心の変化と身体の変化は同時です。改めて David Bohm の比喩 はとてもよくできているといえましょう。
Psychosomatic Medicine is a medical science based on the basic concept of the relationship between mind and body. This relationship is very important in understanding psychosomatic medicine.
Mind-Body Correlation (Psychosomatic Correlation)
Human beings have a physical aspect (body) and a psychological aspect (mind). The body is the visible, material aspect of a person, and the mind is the invisible, immaterial aspect. No one knows what people are thinking in their minds. However, we try to get a glimpse of their mind through their words, actions, behaviors, and physical condition.
This “relationship between mind and body” is called “psychosomatic correlation”.
An example often used in psychosomatic medicine is the story of “lacquer (urushi) allergy. In a case where the patient was allergic to lacquer when passing under a lacquer tree, when the patient passed under a lacquer tree with the suggestion that the tree was not lacquer but another tree, the patient was not allergic even though the tree was not lacquer. However, when they passed under a non-varnish tree with the implication that it was a lacquer tree, they were allergic to lacquer even though it was not a lacquer tree (e.g., Ikemi, 1963).
The “placebo effect” of drugs is also well known today. In a review of 1082 placebo-controlled trials, the classic report found that 35% of placebo drugs actually had no effect (Beecher, JAMA, 1955).
In addition, neurogenic gastritis, which has long been common among the Japanese, is today referred to as functional dyspepsia. The stomach is one of the organs most susceptible to stress. When “stress” is combined with an increase in stomach acidity or a decrease in gastric motility, stomach acid stagnates, making gastritis and gastric ulcers more likely to occur.
Thus, the mind and body are more closely connected than we can imagine.
Mind and Body are One – David Bohm’s Parable
Our minds and bodies are always changing and are not fixed. To live is to change. Even if you were sad just a moment ago, you are already smiling. No state of mind lasts forever. The state of the body changes along with it.
The condition of the body is also changing from moment to moment. Yesterday’s physical condition is different from today’s, muscles tense and relax, the heart pounds faster and slows down, and the condition of the stomach and intestines changes rapidly. And when the body is in good condition, the mood also improves, and so on. Physical changes are accompanied by changes in the mind.
Human beings are a being whose mind and body are one, and this body (body) and mind (mind) cannot be separated. Since ancient times, it has been said “mind-body unity”.
David Bohm, an American physicist who also influenced philosophy and psychology, draws the following analogy between the mind-body relationship1).
“When a fish is swimming in a tank surrounded by four transparent walls, the reflection of the fish on the two sides at right angles to each other is the mind and body; the fish is the human entity.”
The shadows on the two walls are inseparable from each other: when one moves, the other moves. When the mind is tense, the muscles also tense, and when the mind is at ease, the body also relaxes. In this way, when the mind changes, the body changes, and when the body changes, the mind must also change.
Through this parable, Bohm states “Body and soul are not mutual influences, but rather unite to form a totality”.
Dealing with the mind and dealing with the body.
Medicine and medical science often deal with physical aspects, while psychology, as the name implies, deals with psychological aspects.
For example, if the medication improves the physical condition and reduces symptoms, psychological anxiety will decrease and become easier. Conversely, if the physical condition worsens and pain and other symptoms increase, psychological anxiety will increase and the patient may become fearful. This may lead to further worsening of symptoms.
Clinical psychology intervenes on the psychological level by providing psychological support. If psychological anxiety is reduced and ease is achieved, physical changes also occur, such as a slowing of the heartbeat and relaxation of muscle tension.
Thus, physical intervention will always result in psychological change, and psychological intervention will always result in physical change. In other words, “to treat the body is to treat the mind, and to treat the mind is to treat the body”. Therefore, it is important to approach the patient with the viewpoint that even if you are a psychological assistant who deals only with the mind, you are also (consequently) dealing with the body.
In psychosomatic medicine as well, we aim for an approach that does not separate the mind and the body, while keeping this perspective in mind. Even when using medicine, explaining the mechanism of action by saying, “This medicine has a … action,” will change the way it works. We treat this aspect therapeutically.
Looking at only one side of the mind and body can lead to an approach that drives only one wheel of the car, so a balanced perspective on both the mind and body is important.
(Kanbara K, LABs Psychosomatic Medicine, https://bodythinking.net/en/column/mindbody, July 2021)
References
Hayao Kawai, Psychotherapy and the Body, Iwanami Shoten, 2000.
Describes the autonomic nervous system, a relatively easy to understand and psychosomatic route connecting “mind and body” from the perspective of psychosomatic medicine.
Routes of Psychosomatic Correlations
Nervous system: pathway through the autonomic nervous system and other nervous systems.
Endocrine system: a hormone-mediated communication system in the body.
Immune system: One of the homeostatic mechanisms of the body that eliminates foreign substances that have entered the body.
Others: neuropeptides, cytokine networks, gut bacteria, etc.
What is the Autonomic Nervous System?
“Autonomic” means that the nervous system is not something that can be consciously activated, such as the motor nervous system, but is “automatically” regulated according to the condition.
There are two types of autonomic nerves systems: sympathetic and parasympathetic.
The sympathetic nervous system is the system that directs the body towards activity, tension, aggression, etc. and is more active when you feel like you have a sweaty hand.
The parasympathetic nervous system is the system that directs the body toward recovery in preparation for the next activity, which is to rest the body and improve the function of the internal organs.
Heart Rate and Autonomic Function
For example, one of the things regulated by the autonomic nervous system is the speed of the heartbeat. Normally, the heart rate is about 60-80 beats per minute, but it increases to about 100-150 beats per minute during exercise. When we get nervous in public, we say things like “I feel nervous,” and it is normal for our heart rate to be higher than when we are at rest.
At such times, the “sympathetic” tone is higher than the “parasympathetic” tone. During a good night’s sleep, conversely, the “parasympathetic” nervous system will be dominant and the heart rate will be at its slowest.
When you exercise, your “automatic” heart rate increases. It’s not increased consciously, as in “I’m going to exercise now, so I’m going to increase my heart rate”. In this way, the autonomic nervous system automatically works to bring the body into a more appropriate state without our conscious effort.
Disturbance of the Autonomic Nervous System
It is essentially a system that maintains homeostasis and keeps the body in proper condition, but when its function is disturbed, it can be involved in pathological conditions.
In a panic attack, for example, this “disturbance of the autonomic nervous system” occurs suddenly and without a trigger, and is linked to anxiety, leading to a negative spiral.
Also, in chronic pain, sympathetic tone becomes stronger, resulting in muscle contraction and decreased peripheral blood circulation, which amplifies and prolongs the pain. This leads to a vicious cycle of unnecessary sympathetic tone.
Since the autonomic nervous system cannot be consciously adjusted, as mentioned above, it is difficult to undo such a vicious cycle.
Autonomic Nervous System Regulation
There are various ways to regulate the function of such autonomic nerves.
These include Oriental medical methods such as qigong, yoga, aromatherapy, massage, acupuncture and moxibustion, mental and physical adjustment methods such as breathing and autonomous training methods, and regular lifestyle.
Among them, “biofeedback” is an attempt to “visualize” and connect the workings of the autonomic nervous system, which is originally automatically regulated and not consciously aware, to consciousness. Biofeedback is an attempt to “visualize” the function of the autonomic nervous system, which is not consciously aware of its own automatic regulation, and to connect it with consciousness in an attempt to self-regulate the autonomic nervous system.
Regulate your circadian rhythm = get some morning sun, be active during the day and rest at night. This has the effect of regulating the rhythm of the autonomic nervous system and the correct balance of hormones such as melatonin, which is linked to insomnia.
Breathing is also key to the various methods described above, and deep, slow breathing has the effect of rhythmically stimulating and activating the sympathetic and parasympathetic nervous systems.
It is important to restore the original function and balance of the autonomic nervous system in a way that suits you.
Modern Social Life and the Autonomic Nervous System
The autonomic nervous system, which is supposed to maintain proper physical and mental health, is thought to be the cause of various pathological conditions.
Originally, it was assumed that during the day, the sympathetic nervous system would activate the body to “fight or flight,” and at night the body would relax and prepare for the next day’s activities. However, today’s day-and-night lifestyle has exceeded such assumptions. Lights and displays are on until late at night, the boundary between on and off is lost, and both the sympathetic and parasympathetic nerves are activated in complex ways, making it difficult for the body and mind to properly regulate themselves.
This is one of the reasons why people are refreshed by being in an environment close to nature.
(Kanbara K, LABs Psychosomatic Medicine, https://bodythinking.net/en/column/ans/, Aug 2021
