Positive Health Online

My original intention in writing this article was to explore Psychoneuroimmunology (PNI) and its recent developments. Considering the subject has lead me into other areas of thought, principally revolving around questions such as: "How can we really prove anything?", "What is really happening?" or ultimately "What is Truth?".

'Science and Art' conventional scientific approaches largely tend to overlook that biological entities
are ever changing and in life there is a ceaseless movement of energy.

Days of wonder

Let me try to explain. First, some personal history. As a child I was always fascinated with Science. In those days one had to make a choice, early on, between Science and Art. It seemed the two were mutually exclusive. So I chose Science and Art was consigned to the Outer Darkness till much later in my life. Well, back in the Fifties and early Sixties things seemed clear-cut. It seemed like every day some scientific marvel appeared – new wonder drugs, satellite communications, men on the moon, etcetera. If there was a problem, Science would soon come up with a technological fix. And still today the news media seem to harken back to those old days of "Breakthroughs". The myth of the technological fix, although believed by many, does not hold up on examination. It is a popular myth that infectious diseases are now well-controlled by antibiotics and immunisation. But the USA, surely the most advanced nation on Earth in terms of technological medicine, has seen the death rate from infectious disease rise by 58% in the years from 1982-92, rising from the fifth most common form of death in 1982 to third in 1992. (Journal of the American Medical Association (1996 275: 189-3). And the latest technological fix, Gene Therapy, despite enormous investment and 100 large clinical trials has yielded no effective treatment for any patient.

But at the time I swallowed the myth. I did a university degree in Biology, a postgraduate Fellowship in Immunology, and we were taught the dogma of the day. I worked in the Pharmaceutical Industry and then the NHS. At some point I must have thought "where is the Magic in this?". I guess it really dawned on me when I decided to do an MSc course to update my Immunology, and I found my favourite subject, the one Medical discipline that had the potential for a holistic approach had been reduced, in this course at least, to Molecular Biology – which I felt to be a "clockwork" reductionistic approach – had won out over the wider view of Immunology. I left the course.

As a child I thought the natural world magical (and I do again today!). I thought Science could be Magical. Take the magic out of Science and you are left with Technology. There is magic to be found in the DNA spirals, but somehow it got wrung out of them. Of course what happened in the Scientific and Medical worlds is a microcosm of what was going on in society itself, but with a lag phase. The Fifties and early Sixties where a time of grey materialism, with a few notable rebels (like the " Beat Generation"), then there was the explosion of consciousness that was the mid to late Sixties. I feel that mainstream Science is still in the Fifties with just a glimmer of the new consciousness from a few brave torchbearers. Conventional Medicine is, in consciousness terms, barely out of the 19th Century. Which brings me to the subject of Psychoneuroimmunology.

Psychoneuroimmunology

The science of PNI dates from the work of Robert Ader and colleagues who were looking at Pavlovian conditioning in rats. In the classic Pavlovian conditioning experiments, dogs were given food shortly after a bell was rung. One of the measurable biological effects of giving food to the dogs was salivation. The stimulus causing the biological effect is called the Unconditioned Stimulus and the neutral stimulus (ringing the bell) is called the Conditioned Stimulus. After a while, the dogs in this famous experiment would salivate when they heard the ringing of the bell, without presentation of food. What Robert Ader and Nicholas Cohen found is that immune responsiveness could be conditioned in the same way as behaviour.

In one of those happy "accidents" that sometimes occur in science they were using a drug called Cyclophosphamide, a stomach irritant, as their Unconditioned Stimulus, paired with flavoured water as the Conditioned Stimulus. As the story was related, they were quite surprised when many of their experimental rats died – they were not immunologists and did not realise that Cyclophosphamide was a a powerful suppressor of the Immune System (IS). Subsequently they subjected their rats to an antigenic challenge by injecting them with red blood cells from sheep, which would cause the rats to make antibodies against the foreign cells. When they measured the antibody response they found not only that those rats fed the Cyclophosphamide produced fewer antibodies, but that those fed only flavoured water (the Conditioned Stimulus) produced fewer antibodies too. The flavoured water alone could suppress the immune system because it had been associated with the drug in the past, just as Pavlov's dogs had been conditioned to salivate at the sound of the bell.

It seemed that something in the rats' brain was causing this response. Subsequently they went on to show that conditioned responses had an important effect in their ability to resist disease. The science of PNI was born. At last it seemed here was scientific proof of the mind-body connection. That was in 1975 and the first book on the subject was the seminal 1981 volume "Psychoneuroimmunology" edited by Robert Ader.

Classical immunology

When I first learned about PNI I was excited. Immunological dogma taught that the IS was independent of the rest of the body, because its reactions could be shown to happen in the test-tube. This never made sense to me, I was interested in what happened in living organisms. Classically, the main function of the IS is to "Defend" the body against disease. To do this there needs to be a way that the IS can recognise a foreign molecule. Immunologists traditionally looked for ways in which, in the test-tube, a single cell of the IS could do this. By delving deep into molecular biology the "clockwork" of the mechanism of recognition could be worked out. But this reductionist approach takes us further and further from the whole organism; we fail to see the wood for the trees. To recognise something there is a need for communication between the cells of the IS and the rest of the body. There is a yawning gap between molecular biology and life as a whole. I believed that PNI might help span the gap and also begin to offer some explanation for how alternative therapies could influence health.

In the rationale of PNI, the mind-centred ideas, belief systems and feelings would trigger the nervous system which causes production of neurochemicals to affect the IS, producing health or disease. It hasn't turned out to be at all easy to prove and now more than 20 years since the birth of PNI the way in which mind changes affect the nervous system and disease processes is still unknown. Why is this?

The barriers to understanding

The processes we are dealing with here are very complex. Even before the advent of PNI it was realised that the interactions within the IS taken in isolation were complex. Intricate feedback mechanisms seemed to be needed just to explain the interaction of the IS with a foreign antigen. Weave into that interactions with the neuroendocrine system and there is a vast amount of complexity. The tendency within medicine over recent years has been towards ever more specialisation. The knowledge of the "clockwork" of biological functioning has become so vast that researchers have felt themselves forced to become experts in smaller and smaller bits of anatomy and physiology. For example, I recently saw a very large tome dedicated to the collateral ligaments of the knee. The science of PNI is interdisciplinary, and since the medical research is also generally organised into specialities this creates very real problems at basic levels such as funding the research, and communications between the disciplines which perhaps don't understand each other too well. Very little work has been done on PNI in the UK, mostly it has been done in the US.

I believe that the investigations run up against a barrier which is fundamental. We can never understand the whole by examining the parts. We need a paradigm shift in the way we look at biological systems. The challenge is to link the isolated mechanisms that have been determined with the complexity of the human condition. That leads us to our first problem: can we actually believe any data on any system studied in isolation? Much of medical knowledge has been derived from the non-living. Our anatomical knowledge comes in large part from cadavers. When we base our knowledge on dead tissue or tissue in isolation from the whole, we have lost the very life we try to understand. To give a basic example, most doctors will tell you the bones of the cranium don't move. The sutures between them ossify, and the cranium is effectively one solid bone. That may be true of cadavers, but I can feel those bones move in my clients as do thousands of Craniosacral therapists and Cranial Osteopaths. And the movements have been measured and I know those movements are vital for health, and a whole system of complementary therapy has grown around that, yet the dogma persists among most doctors and may take many years to change. And in PNI research it seems to be the same story. Looking through many research papers each one seems like a piece in a jigsaw. But even if the pieces fit together the result would probably not model reality very well. It would just be a static two-dimensional representation of something alive, dynamic and ever changing. Not even as good as studying cadavers and relating that to a live human being.

Co-operative networks

Is there then anything we can do to understand PNI? Well, there are certainly other models that can be used.

Part of the problem stems from the consideration of the nervous system and the IS being separate in the first place. This is possibly another problem thrown up by medical specialisation. At first glance the IS and the nervous system do not seem very similar. But both the IS and the nervous system relate the organism to the outside world, both have defense and adaptation roles, and both have memory. Nerve cells not only connect to the solid organs of the IS: thymus, spleen, lymph nodes, Peyer's patches and bone marrow but also seem to connect individual freely circulating cells of the IS. Molecules which communicate within the nervous system have been known for many years (e.g. endorphins, neurotransmitters) and also within the endocrine system (hormones) and the IS (cytokines). What has emerged more recently is the discovery that these peptide molecules are all one family of chemicals which mediate between these systems. Thus in fact they are one interconnected network. As Candace Pert, Director of Brain Biochemistry at the U.S. National Institute of Health, puts it: "I can no longer make a distinction between brain and body".

...tissue in isolation from the whole, we have lost the very life we are trying to understand.

And why should we? The idea that the "unruly body" needs to be commanded by a central authority (the brain and Central Nervous System) is perhaps more a reflection of an hierarchical Judeo-Christian world-view than actual biology. One can turn to Buddhist doctrine of Dependent Co-Arising for an alternate view, which would support the idea of interdependent networks. In this doctrine, reality is described as a dynamically interdependent process, with all factors both mental and physical existing in a web of mutual causal interaction. No one element is autonomous or unchangeable. This idea of interdependence can also be found in Systems Theory and Deep Ecology. The concept of process is also very important. Conventional scientific approaches largely tend to overlook that biological entities are ever changing, and in life there is a ceaseless movement of energy. It can be a little like trying to understand the plot of a movie from one still picture. As Arnold Mindell, the process-oriented psychotherapist, comments: "Process is related to the occurrence of events and not to any one of their particular qualitative or quantitative characteristics. The concept of process and information thus bridges modern terms such as matter, psyche, life and energy". When we come to recognise the interdependence of all things as necessary for our very survival on this planet our view of human biological systems will change.

When this day comes we will also cease to think of disease as invasion, of medicine as war, and health as victory over the invaders. As the patterns of disease shift, as the old germs are vanquished, we see new diseases emerging which cannot fit into the war doctrine so easily. Autoimmune diseases, where the body seems to attack itself with its own IS are on the rise (We have seen the enemy and he is us!). A whole host of degenerative disease is upon us. Illness has not declined with Modern Medicine, it just changes its nature.

The organising force

"Is the whole greater than the sum of its parts?" – Is there an organising force or field, such as the Morphogenetic Field proposed by Rupert Sheldrake, or some "God-like" force? Or is the organisation an internal property of biological systems themselves? This latter idea is eloquently explored in Fritjof Capra's latest book "The Web of Life".

Perhaps I'm a romantic, but my "gut feeling" leads me to the external organising "God-like" force. (Remember in the gut are the Peyer's Patches, areas of peptide-rich lymphoid tissue, part of the IS and therefore in intimate connection with the nervous system – so just as important as "thinking"!).

I believe we have to abandon the mechanistic concept that the whole is just the sum of the parts. The Newtonian idea – the universe is made up of "building blocks" and we just need to find them all to understand it – fell apart with the quantum revolution in Physics in the 1920s. Unfortunately that has yet to percolate down to mainstream medicine! For example, in molecular biology genes specify the base sequence of DNA and RNA and hence code amino acids to make proteins. But where is the instruction for form, for an organism's morphology? There is no gene for thought or intelligence. Form also happens in the inorganic world e.g. snowflakes are all said to have different forms, they are not specified by genes. I feel that a possible answer may lie in the concept of resonance – the transfer of energy and information between things vibrating at similar frequencies. Many subtle energetic therapies rely on this principle.

Resonance transcends space and time – there is a connection between all matter – we are truly connected with all that has ever lived. To quote the biologist Dr. Mae Wan Ho "Living systems are by their very nature neither subjects alone nor isolated objects, but both subject and object in a mutually communicating universe. Each living being is implicated in every other. Each suffering impoverishes us. Each joyous, creative act enriches us. The capacity to evolve depends on communication."

The field of resonance is vast and well beyond the scope of this article to discuss in detail, but I offer some comments and examples. All matter is vibratory in nature. Quantum Field theory predicts that all elementary particles (and therefore everything else) arise from energy fluctuations (i.e. vibrations) within a sea of potentiality known as the Quantum Vacuum. Couple this with the concept of Entrainment and Resonance can be seen as a powerful organising force in any system. (Entrainment is the process by which harmony (and disharmony) can spread within a system e.g. Pendulums fixed to the same ceiling and set rocking randomly will come to swing harmoniously; women living together will harmonise their menstrual cycle).

Resonant systems are common in biology. In cells there are found microtubules with a resonant frequency about that of ultraviolet light. It is proposed by Fritz Popp and others that this might be a cell communication system based on coherent light (like laser light). Most molecules are dipolar (they have a positive electrical charge at one end and a negative at the other) and vibrate at microwave frequencies, another possible communication system. These ideas are actively being explored by those on the cutting edge of physics and biology.

Work with the Body/Mind interface that PNI represents could take us deep into the nature of Quantum reality. Indeed the Body/Mind relationship rather resembles the wave/particle duality of Quantum Physics. I can only mention in this short article other areas that would merit investigation. The Quantum model of consciousness proposed by Danah Zohar and supported by the work of Herbert Frohlich (see The Quantum Self by Danah Zohar) seems entirely relevant to PNI research, also the possible "quantum computer" in the brain supported by the work of Brian Josephson. Modern Immune Network ideas have come from Francisco Varela and Antonio Coutinho. There are many other names that could be mentioned but often their work is held in scant regard by the mainstream conservative scientists. Unfortunately controversial work does not attract funds.

I am suggesting that the researchers of PNI and other fields in Biology should look at some of these ideas and break away from the mechanistic tunnel vision that currently afflicts them.

Is there value in clinical trials?

Perhaps one of the examples in the tunnel vision approach to medicine is an over-reliance on clinical trials. Should Alternative and Complementary Therapists seek to prove the effectiveness of their Therapies using double-blind placebo-controlled trials? Such therapists are often berated by the medical establishment for lack of "scientific" evidence to back up our work, relying mostly on "anecdotal" evidence. In actual fact much of modern medicine hasn't been subjected to such trials itself, but let's let that go for the moment. Such trials presume the ability to control all factors except those under investigation – in the simplest possible case, a single drug versus a placebo. The trial is "blinded" – no-one knows who is getting the drug and who is getting the placebo. All the other variables are simply forgotten about, which is plainly an absurdity. I'm not saying this approach is totally worthless, but we must recognise its shortcomings. It is possible to control more variables with laboratory animals, by creating uniform environments, using genetically identical animals and so on, but clearly this cannot be done with people! And in many therapies, the treatment is very complex – as in bodywork – and this approach is ridiculous.

The reason for my focus on this is that I have seen some very badly designed clinical trials, both when I was an Information Officer in a Pharmaceutical Company years ago, and more recently in the literature on PNI. In PNI there are also very many variables, too many for the kind of simplistic, mechanistic approach that has been applied to much research. I am not the only person to have noticed the problem. Byron Waksman, Professor of Pathology at New York University, looking at PNI research in Multiple Sclerosis, comments: "If you do not recognise the complexity of neuroimmunological interaction, it is impossible to do satisfactory research. This is perhaps particularly true of behavioural scientists trying to understand psychological phenomena in immunological terms" (Advances 10,4 16-22 1994). He goes on to observe that neurologists all agree that exacerbations of MS are all triggered by stress – but no one has been able to prove this objectively. This is similar to the situation many alternative therapists are in – we know it works, but we can't "objectively" prove it. Despite this, our clients continue to come to us, and get healed.

To summarise, I feel the example of Psychoneuroimmunology and its investigation is but one example of the need for a paradigm shift in medicine and science. In certain areas of science, notably physics, there are signs that this is happening, but there is little evidence of this in medicine. I feel there is a need for a holistic view, the end of narrow specialisms, and medicine and science should embrace the spiritual, embrace the magic of life. As Alternative and Complementary therapists we must ask ourselves the question – should we continue to seek approval of the medical establishment, in a secondary role, or are we brave enough to endure the death struggle of a dying paradigm and move onward?

"I am not a mechanism, an assembly of various sections
And it is not because the mechanism is working wrongly, that I am ill.
I am ill because of wounds to the soul, to the deep emotional self
And the wounds to the soul take a long, long, time, only time can help.
And patience, and a certain difficult repentance, realisation of life's mistake, and the freeing oneself
From the endless repetition of the mistake
Which mankind at large has chosen to sanctify."
D.H. Lawrence