Mind-Body Research Matures

For years, mind-body research has been conducted at the perimeters of the scientific mainstream, but that marginalization appears to have ended, as the National Institutes of Health funnels money and personnel into interdisciplinary investigations of the relationship between mental states and physical health. Oddly, the way mind-body medicine has achieved this acceptance is by establishing the very molecular and cellular evidence of the role that the mind plays in bodily health that it once eschewed. During the 1920s in Germany and Austria, a movement arose to counteract laboratory-based medicine by emphasizing mental and behavioral aspects of disease treatment.1 That movement, dubbed psychosomatics and today often called mind-body medicine, experienced ebbs and flows of favor over succeeding decades. But under a $50 million initiative, NIH has established 10 centers around the country for mind-body research since 1999. Esther M. Sternberg, director of the National Institute of Mental Health's integrative neural immune program, which has spearheaded recent mind-body research collaborations throughout NIH, declares that "rigorous scientific evidence" has allowed the mainstream medical world "to welcome us with open arms." Acting NIH director Ruth Kirschstein affirms, "It is now accepted as fact that the brain and the immune system communicate." She adds that this communication plays a role in disease. The social sciences, psychology, neurobiology, neuroendocrinology, and immunology all have contributions to make, Kirschstein notes. "Every time I talk to Dr. Sternberg, I hear about another institute that wants to come on board and is excited," says Audrey Penn, acting director of the National Institute of Neurological Disorders and Stroke (NINDS). An immunologist and longtime proponent of mind-body research, Penn thinks the interdisciplinary style of the neural immune program can become a model for other integrative work across the NIH campus. During a March meeting in Bethesda, Md., on the science of mind-body interactions, plaudits were offered by many heads of the conference's 14 cosponsoring NIH institutes, centers, and offices. It was the first in a series of meetings to be organized by the integrative neural immune program. "Frequently, we were greeted with skepticism and sometimes scorn," a triumphant Sternberg reminisced to 500 attendees at the fully subscribed event in NIH's Masur Auditorium. "I think the packed house and the viewers on the Internet2 are indications of the interest in this field." The Virtual Body The study of human emotions and mind-body interactions is aided by realizing that, "Within our brain, we have a virtual body," suggests University of Iowa neurology department head Antonio R. Damasio. The author of two popular books on emotion and the body,3 Damasio proposes that the brain contains a complex set of maps in a Chinese box-like arrangement, "a very selective way of describing events that go on in the body." Emotions play a regulatory role, creating circumstances advantageous to the organism exhibiting them. "Emotions are collections of chemical and neural responses, fodrming a pattern." Accordingly, evidence of emotion can even be detected in the fruit fly, he argues. Arising from evolutionarily set ways of coping with energy intake needs, mating behavior, threats, and other environmental factors, emotions cause profound changes in body and brain states. The collection of these emotions constitutes the substrate for feelings, which occur in conscious organisms as part of a continuum that includes basic life regulation, emotion, feelings, and consciousness. He thinks that nature gave conscious beings the extra level of feelings to help in coping with a complex physical and social environment by sustaining emotions long enough to be useful in planning future behavior. It's therefore incorrect to regard consciousness and creativity as separate from more primitive regulatory functions. "I think it's much more interesting to see this as something happening earlier in the organism, earlier in the system, that has to do with homeostasis," he says. "The first concern for imagination, planning, and anticipation has to do with self-preservation." That hypothesis can be tested by examining brain structures, especially the "protoself" which is directed at the process of self-preservation. In a recent, "very preliminary" study, Damasio's group asked 41 individuals to conjure up the emotions of sadness, happiness, fear, and anger from autobiographical events. Subsequent positron emission tomography scans showed effects in brain regions involved in the mapping of internal states, such as the somatosensory cortices and the upper brainstem nuclei, lending support to the idea that the process of feeling emotions is partly grounded in dynamic neural maps.4 Damasio regards the paper as an early response to the notion that no one has any idea where emotions and feelings come from. Can stressful emotions affect health? The hypothesis of Michael Meaney, a developmental neuroendocrinologist at Montreal's McGill University, is that individuals reacting most to stress are at the highest risk for both medical and mental illnesses. The amount of licking and grooming by mother rats of their offspring varies, and Meaney's research shows that recipients of frequent or high licking display much more inhibition of the primary pathway for the fight-or-flight response to stress, the hypothalamic-pituitary-adrenal axis (HPA), than do offspring of low lickers.5 Grooming behavior appears to regulate this result through effects on forebrain noradrenergic systems. Moreover, individual differences in maternal care are transmitted from mother to daughter, providing a mechanism for the transmission across generations of behavioral reactions to stress. "You start to understand the representation in the brain of the maternal rat," he muses. Separation and Stress Early separation of a mother and offspring is a stressor being studied by University of Minnesota developmental psychologist Charles A. Nelson and his colleagues at the MacArthur Foundation/McDonnell Foundation research network on early experience and brain development. Led by University of Pittsburgh neuroscientist Judith L. Cameron, the team separated groups of rhesus monkeys from their mothers at one week, one month, three months, and six months of age. The two oldest groups displayed almost normal behavior. The one month-old group stopped eating and had to be taught to feed, then formed extreme attachments to an elder. The one week-old cohort displayed no interest in social contact. When placed in a novel room and mildly stressed by the arrival of a strange animal, the one-week-old monkeys vocalized but showed little vigilance, while the month-old group was vocal and hugely vigilant. Seven months later, this self-directed behavior of the younger animals and anxiety of the older ones remained the same. By then, the younger monkeys were prematurely engaging in sex, but it was not followed by the usual social grooming. In an attempt to remedy this behavior, the researchers separated animals at one week, then paired them three weeks later with extremely maternal "supermom" monkeys. "So far, one or two of the one-week-old separated animals have actually gone through several supermoms, and it's not taking," Nelson reports. The team's long-term goal is to determine whether the timing of the separation influences the plasticity of these effects. Their results to date are being prepared for publication. In human society, epidemiological studies have established a clear relationship between social isolation and disease, although the mechanisms remain unknown, says University of Chicago psychology professor John T. Cacioppo. Isolation is comparable to smoking and obesity as a health risk, he adds. Cacioppo's group conducted the largest-ever study of loneliness, assessing 2,632 undergraduates.6 He recalls that the team began with a hypothesis they hoped wasn't true: "People are lonely because they bring less social capital to the table. They're ugly, they're stupid, and they're poor." This proved to be inaccurate. The lonely spent as much time with other people as the nonlonely, but the former group did have higher levels of stress, especially in the morning, and they also had elevated mean salivary cortisol levels across the course of the day, suggesting activation of the HPA axis. The lonely tried to adopt healthy behaviors, but they were not as successful as the nonlonely. The only genetics study published on humans and loneliness suggests that heritability could be a factor.7 "Lonely individuals view the world as a more threatening place than embedded individuals," Cacioppo concludes. "Social behavior does not appear to be like a bank, where you draw down on it. Instead, it appears to be like a gym, where you gain strength by exercising it." Courtesy of David Kindler, DTKindler CommunicationsGerald Fischbach Amidst the optimism about the potential for these sorts of mind-body discoveries to help reconfigure science's view of emotions and health, notes of warning are also being sounded. Gerald D. Fischbach, Columbia University dean of medicine and a former NINDS director, cautions against oversimplifying human emotional life and behavior. Asserting that the human brain is the world's most complicated organ because of its interaction with the environment, he observes, "There's a real danger in biologizing very complex phenomena." Robert M. Rose, a psychiatrist and director of the Research Network on Mind-Body Interactions at the John D. and Catherine T. MacArthur Foundation, which co-organized the conference at NIH, worries about "the pervasive sound of the popularizers." Gurus who don't claim proof but promote spurious powers of the mind to heal the body are a continuing threat that must be combated by science, he says. The study of integrative mechanisms that link the social world to the brain and body--which he thinks could be called "social neuroscience"--deserves "skeptical enthusiasm." Rose remarks with a smile, "Historically, work in this field has been somewhat mindful, but also somewhat brainless." Steve Bunk (sbunk@uswest.net) is a contributing editor for The Scientist. References 1. E.D. Wittkower, in Z.J. Lipowski et al., eds., Psychosomatic Medicine, New York: Oxford University Press, 1977, pages 3-13. 2. To view conference videotapes, see http://videocast.nih.gov/PastEvents.asp?c=1 3. A.R. Damasio, Descartes' Error: Emotion, Reason and the Human Brain, New York: Putnam, 1994, and The Feeling of What Happens: Body, Emotion and the Making of Consciousness, New York: Harcourt Brace, 1999. 4. A.R. Damasio et al., "Subcortical and cortical brain activity during the feeling of self-generated emotions," Nature Neuroscience, 3:1049-56, October 2000. 5. C. Caldji et al., "Variations in maternal care in infancy regulate the development of stress reactivity," Biological Psychiatry, 48:1164-74, Dec. 15, 2000. 6. J.T. Cacioppo et al., "Lonely traits and concomitant physiological processes: the MacArthur social neuroscience studies," International Journal of Psychophysiology, 35:143-54, 2000. 7. S. McGuire, J. Clifford, "Genetic and environmental contributions to loneliness in children," Psychological Science, 11:487-91, November 2000.

Mind-Body Research Matures

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