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Psycho-neuro-immunology (PNI) – exploring the link between mind and body

By Jo Morgan MA, UKCP, MBACP (reg)
Integrative Psychotherapist and Yoga Therapist

If the body system’s capacity to maintain stability is undermined during stress, and what is known as the allostatic load is reached, the system will begin to break down, which is what occurs in stress-related diseases. Sapolsky (1994) writes: “We have come to recognize the vastly complex intertwining of our biology and our emotions, the endless ways in which our personalities, feelings and thoughts both reflect and influence the events in our bodies.” He goes on to say that recognizing this demonstrates an “understanding that extreme emotional disturbances can adversely affect us”.  The current explanation for the relationship between stress, well-being and disease, where clinicians differentiate between things that enable us to grow, and things that undermine us, is know as Allostasis. Allostasis is the term used to describe the body’s ability to maintain stability through stress or change.

Psychoneuroimmunology looks at the interactions between the immune, psychological, endocrine, and autonomic systems in the body; in other words how what we feel emotionally can affect our whole body system and how this in turn can influence our thoughts.

Research suggests that the body’s response to stress is significant. The part of the brain called the hypothalamus initiates the body’s stress response by releasing Corticotrophin (CRH) which triggers the pituitary gland to release the adrenocorticotrophic hormone (ACTH). After ACTH is released into the bloodstream it reaches the adrenal gland and triggers the release of glucocorticoids, and in particular the stress hormone, Cortisol. This takes over the role of epinephrine and acts on the liver to release glucose into the blood for immediate use by the body.

Cortisol is a steroid and steroids can enter the nucleus of cells and effect DNA, possibly suppressing genes that would produce more immune bodies. The hormone Melatonin is produced at night and helps us to sleep soundly. It is also involved in inhibiting tumour growth and regulates the immune system by activating certain cytokines. Cortisol can suppress the production of Melatonin which will present short and long term problems within the body, therefore we are at greater risk of becoming ill and possibly more susceptible to developing cancer especially if we are predisposed to it genetically.

Every time we are faced with a stressor, real or perceived, our body thinks it is under attack and we activate the stress response. If we continue to activate this mechanism our immune system may become disregulated and our ability to fight off infection becomes weakened.

The Nervous System

The principle function of the ANS autonomic nervous system is described as ‘homeostasis’ – the tendency to maintain internal equilibrium by adjusting physiological processes. There are two aspects of the ANS: the parasympathetic nervous system (PNS), and the sympathetic nervous system (SNS). They are always active but one has to be dominant at all times and this is dependent upon the individual’s external and internal environments.

The sympathetic nervous system acts to excite the nervous system and its effects are most apparent under stress or exercise. This is often referred to as the ‘fight or flight’ response. The SNS is a catabolic system, which means that it breaks down energy in the body. The neurotransmitters, epinephrine and norepinephrine, are released in high doses during the sympathetic response damaging lymphatic tissue and inhibiting production of t-cells – a white blood cell that plays a central role in immune function.

The PNS parasympathetic nervous system is anabolic in nature, rebuilding the body’s resources. The main nerve that sends the parasympathetic information between the body and the brain is the ‘vagus’ nerve. The vagus nerve contains both motor and sensory fibres and its passage through the neck, thorax and abdomen enables its wide distribution within the body. The vagus influences respiration, heart rate and digestion. The main neurotransmitter of the parasympathetic nervous system is acetylcholine, which induces relaxation and inhibition. Acetylcholine is released from a well toned vagus.

Heart Rate Variability (HRV) is an important measure of autonomic response between the PNS and SNS. High levels of variation reflect a resilient autonomic response whilst low levels indicate challenges with either mobilizing or calming the system.

The Role of Yoga

The concept of using theKoshas (layers of the self) in our work as yoga therapists is that the focus is on nourishment for the mind and body as a whole. The Koshas enable us to work with the awareness of the senses, refining annamayakosha, heightening balance in body and brain. Through working with the koshas we improve breath awareness and develop mindfulness practice, which will help bring the system into rest and relaxation mode. Controlled slow breathing are important factors in increasing and retraining ANS resiliency. Engaging in practices that support a parasympathetic response means lower levels of cortisol, which in turn means that the body can produce healthy levels of immune cells.


References:  Sapolsky. R (1994), Why Zebras Don’t Get Ulcers, New York: W H Freeman.


Mind-Body Connection

We often talk about the mind and body as though they are completely separate – but they aren’t. The mind can’t function unless your body is working properly – but it also works the other way. The state of your mind affects your body. If you feel low, you tend to do less and be less active, which makes you feel worse – you can become more tired, feel more depressed and tense, plus you miss out on things you enjoy. So it can easily become a vicious cycle.

The Study of Psycho-Neuro-Immunology

This is the established scientific study of how the mind and body communicate, and how stress can affect our immune system and susceptibility to disease.

It is only since the advent of modern medicine in the 19th and 20th centuries that we seemed to lose the ancient wisdom of how illness and wellbeing are connected to the mind, society, morality and spirituality. However, in recent years the study of PNI reminds us that psychological states like chronic stress, depression, anxiety, fear produce profound effects on the body. Most of us will have our own experiences of how headaches or digestive problems can result from stress. But PNI has extended that to include the way in which genes express themselves in genetic illnesses like rheumatoid arthritis and multiple sclerosis. Over time, mental and emotional states take a heavy toll on the body and are a significant risk for illness.

The field of PNI has documented different physiological responses to stress. Various forms of stress management have been found to be helpful in modifying the body’s stress response. These include:

  • mindfulness meditation

  • yoga

  • counselling & psychotherapy

  • exercise

  • volunteering in the community

  • stream-of-consciousness writing

  • humour

  • music

  • nutrition, acupuncture and other complementary therapies

  • touch/massage

  • sunlight and nature

  • social connectedness.

Exercise  Until the last 100 years or so, you had to be quite active to just live your everyday life. Now, in modern Western societies, so much of what we used to do is done by machines.

Exercise doesn’t have to be about running around a track or working out in a gym. It can just be about being more active each day, and may include things like washing the car, gardening, strolling around the block etc. It is however, important to do something quickly enough so that you raise your heart rate (aerobic exercise), as it is then that the “happy” chemicals called endorphins are released into our body and make us feel good.

 If you keep active, you are:

  • less likely to be depressed, anxious or tense

  • more likely to feel good about yourself

  • more likely to concentrate and focus better

  • more likely to sleep better

  • more likely to cope with cravings and withdrawal symptoms if you try to give up a habit such as smoking or alcohol

  • more likely to be able to keep mobile and independent as you get older

  • possibly less likely to have problems with memory and dementia.

Tips on getting started:

  • It is vital to pick an activity that you ENJOY

  • any exercise is better than none.

  • BUT a moderate level of exercise seems to work best.

  • This is roughly equivalent to walking fast, but being able to talk to someone at the same time.

  • Don’t start suddenly – build more physical activity into your life gradually, in small steps.

How well does exercise work for depression?

For mild depression, physical activity can act as a natural anti-depressant, and be as (or more) effective for some people than medication. In some areas in the UK, GPs (family doctors) can prescribe exercise.

Doing 30 minutes or more of exercise a day for three to five days a week can significantly improve depression symptoms. But smaller amounts of activity — as little as 10 to 15 minutes at a time — can make a difference. It may take less time exercising to improve your mood when you do more-vigorous activities, such as running or bicycling. (Ref: Royal College of Psychiatrists).

The mental health benefits of exercise may last only if you stick with it over the long term — another good reason to focus on finding activities you enjoy.

Why does exercise work?

  • It helps to release feel-good brain chemicals (neurotransmitters and endorphins) into the brain, which can ease depression. Brain cells use these chemicals to communicate with each other, so they affect your mood and thinking.

  • Exercise can stimulate other chemicals in the brain called “brain derived neurotrophic factors” (BDNF). These help new brain cells to grow and develop. Moderate exercise seems to work better than vigorous exercise. BDNF seems to reduce harmful changes in the brain caused by extreme stress.

  • Harder exercise (perhaps needed to fight or flight from danger) can help to dispel the physical effects of a trauma, loss, shock or crises as it helps reduce adrenalin and produces endorphins. Animals in the wild naturally do this by fleeing from or fighting danger.

  • Exercise can also reduce risks of high blood pressure, diabetes, arthritis and cancer.

Exercise can also help you:

  • Gain confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence and help you to feel more in control.

  • Take your mind off worries. Exercise is a distraction that can get you away from the cycle of negative thoughts that feed anxiety and depression.

  • Get more social interaction. Exercise may give you the chance to meet or socialize with others.

  • Cope in a healthy way. Doing something positive to manage anxiety or depression is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how badly you feel, or hoping anxiety or depression will go away on its own can lead to worsening symptoms.

How do I get started — and stay motivated?

Starting and sticking with an exercise routine can be a challenge. Here are some steps that can help. Check with your doctor before starting a new exercise program to make sure it’s safe for you.

  • Identify what you enjoy doing. Figure out what type of physical activities you’re most likely to do, and think about when and how you’d be most likely to follow through. Do what you enjoy to help you stick with it.

  • Get your mental health provider’s support. Talk to your doctor or other mental health provider for guidance and support.

  • Set reasonable goals. Your mission doesn’t have to be walking for an hour five days a week. Think realistically about what you may be able to do. Tailor your plan to your own needs and abilities rather than trying to meet unrealistic guidelines that you’re unlikely to meet.

  • Don’t think of exercise as a chore. If exercise is just another “should” in your life that you don’t think you’re living up to, you’ll associate it with failure. Rather, look at your exercise schedule the same way you look at your therapy sessions or medication — as one of the tools to help you get better.

  • Address your barriers. Figure out what’s stopping you from exercising. If you feel self-conscious, for instance, you may want to exercise at home. If you stick to goals better with a partner, find a friend to work out with. If you don’t have money to spend on exercise gear, do something that’s virtually cost-free, such as walking. If you think about what’s stopping you from exercising, you can probably find an alternative solution.

  • Prepare for setbacks and obstacles. Give yourself credit for every step in the right direction, no matter how small. If you skip exercise one day, that doesn’t mean you can’t maintain an exercise routine and may as well quit. Just try again the next day.