Published in the Journal of Holistic Medicine – Spring 2005
This paper is based on my presentation at the annual conference of the British Holistic Medical Association, Autumn 2004
A short introduction to the Endorphin Effect concepts and approach.
Most holistic practitioners are aware of the mind-body relationship but, in my experience, very few realise just how visceral that relationship is. Also in my experience, very few apply to it themselves as a method of self-healing or of early diagnosis.
So when I teach practical applied PNI, I begin by illustrating just how direct and impacting the psychoneuroimmunological system is. I first ask students what their favourite food is. Let me ask you, the reader, the same question. Whether it is chocolate, brown rice, fish fingers or a lettuce leaf, if you were to spend a short while imagining that food in your mouth â€“ its texture, its aroma, its taste â€“ then almost immediately you would trigger your digestive juices into production.
No need for any training with Pavlovâ€™s bell. Each of us can ring the synapses in our mind-brain and the endocrine system will respond. The unconscious processes of the neuro-endocrine system do not care whether the trigger is imagined or real. There is no food! But despite that, the body responds as if there were. Think of chocolate â€“ or your favourite culinary delight â€“ and your mouth salivates.
We can illustrate the immediacy of this effect with other examples. Spend a little while contemplating your favourite erotic image and you will also feel the stirring of certain endocrinal juices. Think of fearful and horrible things, and your body will begin to produce the hormones of anxiety and tension. Contemplate that which you enjoy and the natural opiates will be stimulated into production.
The point I want to emphasise here is how flesh and blood, how gutsy, juicy and visceral this all is. It is not subtle. The events in the mind directly impinge on the bodyâ€™s chemical environment. The results are physiologically obvious and also have a huge effect on the mood and psychology of the individual.
I visited a holistic ophthalmologist a decade ago. He asked me to look at the bottom rows on the usual eye test chart. He then began to say very unpleasant, evocative words such as, â€˜Auschwitz. Children being tortured. The killing fields.â€™ Within a few seconds the bottom lines blurred as the unpleasant associations triggered the hormones of anxiety, which tensed up some muscles, which pulled my eye lens askew. He then uttered some pleasant words, â€˜Children playing on a friendly beach. Kittens. Fluffy lambs. Happy times.â€™ And my eye muscles relaxed back into better focus.
Of course, the way in which the mind works is obviously effected by previous conditioning, emotional history and personal preferences. But the crucial issue is to realise the full implications of this. At the most fundamental level, whether our body chemistry is a brewing stew of anxiety and tension (the cause of 80% of middle age and post-middle age illness according to NHS statistics) or a more comfortable, open and flowing system, can to a substantial degree be effected by the ongoing state of our mind and mood.
At the core, then, of practical applied PNI is the idea that we can consciously choose to manage the signals that our psyches send into our bodies. The thoughts and feelings of our mind-brain, and also of our mind-heart(1), are far too important to be left uncontrolled and outside our conscious awareness.
The current popular wave of neuroscience substantially legitimates our focus on mind-body medicine, but it is best to be clear that neuroscience is a young methodology and, in my opinion, has thus far only mapped out ten per cent of the territory. Like much science, however, it is imperialistic and many of its proponents are very assertive and confident. For certain, neuroscientists are pioneering a methodologically rigorous analysis of mind-brain electro-chemical mechanics, but they have little understanding as yet of its practical and immediate consequences.
Traditional holistic healthcare, however, particularly the Taoist and Ayurvedic schools, has a well-tried and thoroughly practiced approach to mind-body medicine (2). My own expertise in the area does not come from my formal academic background as a psychologist or amateur neuroscientist, but as a student and teacher of meditation. In fact, I was first taught how my mind could support my physical health and work with specific healing in a Kabbalistic meditation group. In this tradition, as in many others, a tree of life is visualised and kinaesthetically felt as being in the physical body. The mind then sends messages and moods through the tree into the biological system.
I worked with these methods of healthcare and healing on a daily basis for over twenty years before first hearing about psychoneuroimmunology and endorphins. Because of my experiential background in the field, like other meditators, I was immediately familiar with a territory that the scientific researchers were â€˜discoveringâ€™. In particular, there was a focus on the importance of endorphins, the bodyâ€™s natural opiates. These hormones or neuropeptides (the nomenclature of these â€˜molecules of emotionâ€™(3) is still not rigorously defined) are implicated in all physical sensations of pleasure and relaxation. In full flood, endorphins â€“ â€˜endoâ€™ = made inside the body; â€˜orphinâ€™= morphine â€“ can render natural childbirth pain free and pleasurable, and for example open up the whole body to floods of pleasure in full orgasm. They are also responsible for the minor localised sensations of pleasure or relaxation. There are several types of endorphin â€“ also known as enkephelons â€“ and they are produced not only in the brain but also in every cell of the body. This explains why there are localised sensations of pleasure, which seem to exclude any mental perception.
One of the cutting edges of PNI is to map the feedback systems involved in their production, but research in this field is slow because of its costliness. This lack of a coherent â€˜scientificâ€™ map does not, however, detract from the rigour of the mind-body strategies whose effect is to release tissue tension, relieve pain, open up tissue and create feelings of pleasure. In fact, their rigour can be found in their repeatability â€“ over millennia! â€“ and the innumerable personal descriptions of their effect. They also provide a foundation, as I have said, of many traditional medical systems and we are, I hope, beginning to trust the wisdom of these traditions even while contemporary science is as yet unable to describe their internal logic within a western intellectual framework.
Over the last ten years I have attempted to clarify and simplify the basic strategies of a practical mind-body approach for inhibiting the production of adrenaline and cortisol, and for triggering the flow of the bodyâ€™s endorphins. These techniques have been taught in innumerable workshops and are being increasingly used by holistic practitioners.
Although they are very simple, they do require one super-human effort â€“ I now write sardonically â€“ which is that of pausing and monitoring actual physical sensations in the body. I write sardonically, but affectionately, because I keep meeting holistic medical doctors who, for instance, understand the importance of the mind-body connection, but who do not themselves monitor and self-manage their own mental state, moods, physical symptoms and sensations. One medical friend, for example, self-admittedly could have avoided heart surgery if he had given careful awareness to symptoms which presented themselves twelve months ahead of the actual crisis. What we are discussing here is the simple strategy of pausing and turning oneâ€™s focus inwards to oneâ€™s own body, scanning and giving careful attention to all the internal sensations.(4) Not only does this monitor oneâ€™s state of health, it also sends reassuring messages through the neuroendocrinal network.
What holistic medical traditions and applied PNI demand is that individuals take responsibility for their own healthcare and begin with this simple daily monitoring exercise. In essence this is no different from the mainstream preventative suggestion that men and women regularly self-examine to catch early indications of impending illness.
I will now briefly list the five core exercises, which are described more fully in my book The Endorphin Effect.(5) The first technique includes the self-monitoring exercise. All these techniques work to relieve physical sensations of anxiety and engender tissue relaxation and a sense of wellbeing. This opening of the tissue is, of course, a key issue in the maintenance of healthy and free-flowing circulatory systems. From a more holistic or eastern perspective it also engenders harmony with the flow of nature and cosmos.
Exercise 1 â€“ The Inner Smile
In a comfortable position, you allow your chest and stomach to sink and relax. You lower your chin slightly and turn your eyes down as if looking down into the body. You then guide your attitude so that you have an open-hearted and kind-minded mood towards your own body. Like a parent looking after an infant, you look into your body with warm, intelligent eyes and you send reassuring and friendly messages into your physical system. If there is any region that is tense or in pain, you particularly focus down into that region sending it messages of affection and acceptance. You â€˜holdâ€™ and â€˜cradleâ€™ any pain or discomfort. You demonstrate an excellent bedside manner toward your own physicality.
Exercise 2 â€“ Curled Deer
This name comes from the classic Taoist exercise. It is done concurrently with Exercise 1 Its core feature is to allow and guide the body so that it sinks into the sensation of having a rest or sleep. You see many commuters instinctively going into this strategy, preparing for or recovering from a day at work. The essence of this strategy is to bring your focus fully home into you own body, particularly allowing your awareness to sink down into the area of your lower stomach (tan tien or hara). The trick here is to cut off from external stimuli and disappear down into your own body. You also guide your breath into the regular rhythm of sleep and, like an actor, play-act feeling sleepy until the sensation becomes authentic.
Exercise 3 â€“ Positive Triggers
In this strategy you focus on any thought, memory or activity that gives you pleasure. If you pause and give awareness to the physical sensations that accompany enjoyable thoughts and activities, then you will notice that somewhere in your body there is a pleasurable feeling. You turn your contemplative focus towards this sensation, no matter how small it may be, and then allow, guide and sense it sinking more deeply into the body. You â€˜stretchâ€™ and absorb the sensation of wellbeing allowing it to anchor deep in your bones, spinal cord and brain, embedding the enjoyable sensations at a cellular level.
Exercise 4 â€“ Biophilia
The human body is, it seems, hard-wired to respond positively to the natural world in general, including the sky, stars and what may be called the spiritual dimension of life â€“ God, the Tao, the great mystery of existence. So in this exercise you pause and allow yourself to remember that wherever you are and whatever your situation, nature and the cosmos are always there. It is just a matter of allowing your cellular make-up to remember the presence of nature. The sequence that I teach is to allow yourself first to be aware of the Earth. Then Nature. Then the Sun. Then the whole Cosmos and the great wonder of existence. Again, you then notice the pleasurable sensation that goes with this awareness and you allow the feeling to sink more deeply into the body.
Exercise 5 â€“ Exercise
Finally, of course, there is exercise. Sustained movement of at least twenty minutes almost always stimulates the production of endorphins and is responsible, for example, for the â€˜runnerâ€™s highâ€™. So when you want to lift your mood and nothing else works, move your body. Then, after a while, when the pleasurable feelings start, focus on the enjoyable sensations and allow them to sink into your body and circulate more fully.
Students and practitioners of holistic healthcare will not be surprised by any of the above exercises. In one form or another they repeatedly appear in integrative approaches to healing and health maintenance. They also help to build a general psychological confidence as people who use them become accustomed to effecting and managing their own chemistry.
Over the coming years I expect medical science to map more precisely how these systems work mechanically and I look forward to their insights and stimulation. Growth in wisdom, in mindfulness and in awareness of nature and cosmos, will not however come from laboratories. How to practice applied PNI will, as it ever was, be a journey of personal experience.
* * * *
The important strategic lesson here is that the development of self-awareness, coupled with self-responsibility, is the key to self-managed healthcare.
This needs, in my opinion, to begin with the education of children following the example of their parents, teachers and healthcare practitioners. This is already beginning in British primary and secondary schools with the development of the curricula of emotional literacy and personal and social healthcare. We can begin to see the development of a healthcare culture focused on building and maintaining good health through sustained preventative monitoring, practical PNI, diet, exercise and ameliorating social conditions â€“ a holistic approach in which PNI and the endorphin effect are key elements.
(1) Doc Childre and Howard Martin, The HeartMath Soulution, Piatkus, 1999.
(2) Daniel Goleman Healing Emotions: Conversations with the Dalai Lama on Mindfulness, Emotions and Health, Redwing Books, 1997.
(3) Candace Pert, Molecules of Emotion, Simon & Schuster, 1999.
(4) Eugene Gendlin, Focusing, Bantam, 1982.
(5) William Bloom, Feeling Safe, Piatkus Books, Piatkus Books, 2003; William Bloom, The Endorphin Effect, Piatkus Books, 2001.