Brain Pickings Weekly - Book Review: The Balance Within: The Science Connecting Health and Emotions

Stress and the Social Self: How Relationships Affect Our Immune System

“We are all tethered to our social worlds by invisible but steel strong wires.”

BY MARIA POPOVA

Relationships, Adrienne Rich argued in her magnificent meditation on love, refine our truths. But they also, it turns out, refine our immune systems. That’s what pioneering immunologist Esther Sternberg examines in The Balance Within: The Science Connecting Health and Emotions (public library) — a revelatory inquiry into how emotional stress affects our susceptibility to burnout and disease.

As just about every socialized human being can attest, interpersonal relationships play a significant role in our experience of stress — either contributing to it and or alleviating it. And the way we connect — something psychologist Barbara Fredrickson has termed “positivity resonance” — is deeply patterned through our earliest experiences of bonding, which train our limbic pathways. Sternberg traces the cognitive origin of these formative patterns:

Somewhere in our brains we carry a map of our relationships. It is our mother’s lap, our best friend’s holding hand, our lover’s embrace — all these we carry within ourselves when we are alone. Just knowing that these are there to hold us if we fall gives us a sense of peace. “Cradled,” “rooted,” “connected” are words we use to describe the feeling that comes of this knowledge; social psychologists call this sense embeddedness. The opposite is perhaps a more familiar term — we call it loneliness.

Thus a person, sitting by herself in a room, may appear to others to be quite alone; but that person, if embedded, will have a world of relationships mapped inside her mind — a map that will lead to those who can be called on for nurture and support in time of need. But others, the Gatsbys among us, might be among a crowd of dozens and yet feel very much alone. Many pieces of great literature have in fact tapped into this sense of disconnectedness. Our sense that powerful forces beyond our bodies link us to others is so ingrained that we use phrases such as “times that bind,” “family dyes,” and “bonding,” to describe those intangible connections. And the emotions they evoke are among the greatest forces that affect our hormonal, our nerve chemical, and our immune responses — and through these, our health and our resistance to disease.

Illustration by Maurice Sendak for ‘Open House for Butterflies’ by Ruth Krauss. Click image for more.

We encode these emotions early and carry them forward through symbol and ritual, using physical experiences and objects as memory-anchors. Sternberg captures the enduring echoes of these primal patterns:

A very young child will carry a physical reminder of mother’s embrace: a security blanket, a favorite toy, something soaked with all the smells of home and love… The engagement ring and wedding band have the power in an ounce of gold to evoke the memory of the beloved… We are all tethered to our social worlds by invisible but steel strong wires.

And yet, however deeply engrained these patterns may be, relationships are also inherently alive — they grow, change, and invariably become what Leo “Dr. Love” Buscaglia memorably termed a process of “dynamic interaction.” In a passage that calls to mind David Whyte’s wisdom on endings and beginnings, Sternberg examines the often inevitable evolution — and sometimes revolution — of relationships:

A relationship is built of strings of moments that our mind has pulled out from where they were stored in memory, moments and memories that come with emotions attached. Memories, spliced together like this in a seamless thread, make a relationship seem continuous and whole. So, after not seeing a childhood friend for years, we can pick up where we left off, as if no time at all had intervened. In this way, too, relationships can be sustained in thought during long absences — parents away from adult children, long-distance lovers, commuting husbands and wives. But the same capacity of the brain to forge this chain of memory can lead to difficulties in a relationship if one member evolves past where the other’s memory left off. So, a child leaving home for college, who left still on the verge of adulthood and returns an independent adult, will encounter a parent’s resistance when the person who steps back into the parent’s memory is not the same as the one who left. It takes a period of adjustment on both sides to set the chain evolving back on a new course.

[…]

At times, one small corner of that map can swell and grow, reverberate and suddenly seem to take over our entire world: we fall in love; we are abandoned; we become envious; we hate. The persons who are the object of such feelings can take on gigantic proportions in our minds and dominate our whole social and emotional outlook, coloring every corner of our lives, until, through monumental effort, or simply through gradual erosion of time, they recede again to their rightful place and size.

Art by Andrea Dezsö for a special edition of the Brothers Grimm fairy tales. Click image for more.

These fluid social dynamics, Sternberg points out, permeate our culture well beyond our immediate individual experience:

The social world can activate the stress response, or it can tone it down. The effects of these personal connections can be more soothing than an hour of meditation. They can also be as stressful, and more long-lived, as running at top speed for twenty minutes on a treadmill. In fact, of all the sensory signals that impinge on us from moment to moment throughout the day, it is the ones connected in some way to another person that can trigger our emotions most intensely. If emotions are really meant to move us, it is these bonds toward which they push or from which they pull. Whole industries are based on the power of such social bonds: romance novels, movies, cosmetics, fashion, advertising, popular songs. In one way or another, the whole of our popular culture strives toward sealing or healing these social connections.

And heal we must, for the social self is central to our neurobiological experience of stress:

It seems that social conflict brings out an additional and unique hormonal response that is not stimulated by other forms of stress. This unique pattern of hormonal stress response predisposes socially stressed mice to herpes infection. The hormone that does this, which is secreted in saliva, is called nerve growth factor. Those who are prone to herpes virus “cold sores” will find this situation all too familiar. It is exactly when we are stressed — perhaps with lack of sleep and too much work, but especially with prolonged anxiety over personal or workplace situations — that we invariably get a cold sore.

Esther M. Sternberg M.D.: The Balance Within

From the Amazon listing:

The immune system was long believed to be autonomous -- unconnected to the brain; Sternberg, a neuroscientist at the National Institute of Mental Health, focuses here on research done over the last few decades that disproves this belief. 

She methodically details the history of this science -- describing, for example, the Nobel prize-winning work of three French scientists who, in 1958, discovered the "interleukins" (molecules that signal between cells), which led to further investigations into how immune cells communicate with the brain, and discussing the seminal but controversial work of Hans Selye, who in the 1950s explored the body's response to stress. 

Although Sternberg leavens her account with anecdotes and historical snapshots of early medical treatment, her litany of scientific experiments (mostly performed on rats) into the body-mind connection may overwhelm readers without any scientific background. 

Of greater interest are her reflections on the implications of this research for maintaining health and treating disease. 

According to Sternberg, physical and psychological stresses -- such as prolonged lack of sleep, divorce or social isolation -- can make people sick by adversely affecting their immune and hormonal responses. 

Conversely, a strong belief in healing rituals and prayer may help make them well (via the placebo effect). All in all, Sternberg is optimistic about the idea of bridging disciplines to develop new treatments for disease.

The director of the Molecular, Cellular, & Behavioral Interactive Neuroscience Program at the National Institutes of Health gives us one of the best recent books on emotions and health. 

Sternberg effectively draws on her ample research and clinical experience to provide detailed descriptions of the interrelationships of the immune, nervous, and endocrine systems and how they in turn relate to emotions and the body. 

Into her clear scientific exposition, she folds the lives and works of such fascinating researchers as Wilder Penfield and Hans Selye. She has the personal touch, as when she stresses the importance of face-to-face communication and contrasts it to the impersonal aspects of Internet communication. 

She has a feeling for place and vividly depicts Montreal and other settings. Finally, in her citation of medical cases, she enlightens and stimulates, as, for example, when in recalling a classic case of alert perception, she reveals the importance of total-body tattoos in the study of the lymphatic system. 

Maintain Your Equilibrium in the Face of Stress

By Jan Bruce

You can think of living your life and chasing your ambitions as stressful, or you can think of it as thrilling. 

When you think of it as thrilling, you are doing what psychologists call "reframing" -- and it's critical to shifting your experience of stress. 

After all, a life without thrill is a boring life indeed. It may be safe, but offers you no opportunity for growth. Facing your fears isn't easy -- but your ability to reframe it as a positive is key. 

But while you want to be thrilled, you also want to feel sane. This is where the rubber meets the road. Maintaining sanity while chasing these lofty ambitions, though, is anything but easy. Growing a career, finding and maintaining love, raising children, building financial security and nurturing a passion are just a few of the enormous undertakings that make up your life's work, and trying to do it all can be overwhelming. 

The question then, is how we turn a situation of constant pressure into one of productivity and -- more importantly -- pleasure.

I teach people the tools and techniques for confronting life's challenges in a responsive, not reactive way -- by identifying the thoughts and emotions that derail your attention and energy. 

By looking below the surface of your own conscious thought process, you can unearth unseen motivations and beliefs that are driving your behavior and limiting your growth. By helping you become an expert on your own thoughts, actions, behaviors, you can stop trouble before it starts, and keep stress under your control.

Your goal isn't to change what's "out there" so you don't feel stressed. It's to build your resilience so that you can stay strong in the face of anything. 

That means not just replacing negative thought patterns and behaviors with positive, supportive ones, but shifting your perspective so that you feel connected to something bigger than your to-do list. 

All of your physical, mental and emotional behaviors together create who you are and how you'll fare in the face of stress. So let's make that version of you the best it can be.

Here are the key strategies for maintaining equilibrium so that you're not entirely thrown off by your efforts, nor mired in anxiety or indecision:

Try to manage your stress, not eliminate it. When I talk about maintaining balance, I mean maintaining the ability to find your balance on shifting ground. 

The goal isn't to eliminate stress from your life, but rather, to make sure that you have tools to handle whatever comes your way so that stress doesn't get the best of you.

Recognize that it's hard work. Though there us an approach that offers an easy, accessible framework for addressing stress and thinking traps, the work can be daunting. 

Making time to exercise or summoning the will to eat correctly, not to mention having the humility to ask for help when you need it, are no small tasks. 

If you can approach your challenges with respect for the difficulty of the task at hand, you might find that you're more accepting with yourself as you try to meet these challenges and more proud of yourself when you succeed.

Consider it practice. There's no final competition, event or performance with this work, no final test of whether you "beat: stress or not. 

Instead, it's something you'll come up against every day. If you view every day as an opportunity to revisit and improve this approach, however, you'll find that you accumulate lots of victories.

Now that you have these tools and perspectives, get to it -- there's no better time than now to start.

In the News: Effects of Stress On Brain Cells Offer Clues to New Anti-Depressant Drugs

Structure of protein SGK1.Based on PyMOL rendering of PDB 2R5T.

May 6, 2013 in Neuroscience

Research from King's College London reveals the detailed mechanism behind how stress hormones reduce the number of new brain cells - a process considered to be linked to depression. The researchers identified a key protein responsible for the long-term detrimental effect of stress on cells, and importantly, successfully used a drug compound to block this effect, offering a potential new avenue for drug discovery.

The study, published in Proceedings of the National Academy of Sciences (PNAS) was co-funded by the National Institute for Health Research Biomedical Research Centre (NIHR BRC) for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London.

Depression affects approximately 1 in 5 people in the UK at some point in their lives. The World Health Organisation estimate that by 2030, depression will be the leading cause of the global burden of disease. Treatment for depression involves either medication or talking therapy, or usually a combination of both.

Current antidepressant medication is successful in treating depression in about 50-65% of cases, highlighting the need for new, more effective treatments.

Depression and successful antidepressant treatment are associated with changes in a process called "neurogenesis"- the ability of the adult brain to continue to produce new brain cells. At a molecular level, stress is known to increase levels of cortisol (a stress hormone) which in turn acts on a receptor called the glucocorticoid receptor (GR). However, the exact mechanism explaining how the GR decreases neurogenesis in the brain has remained unclear.

Professor Carmine Pariante, from King's College London's Institute of Psychiatry and lead author of the paper, says: "With as much as half of all depressed patients failing to improve with currently available medications, developing new, more effective antidepressants is an important priority. In order to do this, we need to understand the abnormal mechanisms that we can target. Our study shows the importance of conducting research on cellular models, animal models and clinical samples, all under one roof in order to better facilitate the translation of laboratory findings to patient benefit."

In this study, the multidisciplinary team of researchers studied cellular and animal models before confirming their findings in human blood samples. First, the researchers studied human hippocampal stem cells, which are the source of new cells in the human brain. They gave the cells cortisol to measure the effect on neurogenesis and found that a protein called SGK1 was important in mediating the effects of stress hormones on neurogenesis and on the activity of the GR.

By measuring the effect of cortisol over time, they found that increased levels of SGK1 prolong the detrimental effects of stress hormones on neurogenesis. Specifically, SGK1 enhances and maintains the long-term effect of stress hormones, by keeping the GR active even after cortisol had been washed out of the cells.

Next, the researchers used a pharmacological compound (GSK650394) known to inhibit SGK1, and found they were able to block the detrimental effects of stress hormones and ultimately increase the number of new brain cells.

Finally, the research team were able to confirm these findings by studying levels of SGK1 in animal models and human blood samples of 25 drug-free depressed patients.

Dr. Christoph Anacker, from King's College London's Institute of Psychiatry and first author of the paper, says: "Because a reduction of neurogenesis is considered part of the process leading to depression, targeting the molecular pathways that regulate this process may be a promising therapeutic strategy. This novel mechanism may be particularly important for the effects of chronic stress on mood, and ultimately depressive symptoms. Pharmacological interventions aimed at reducing the levels of SGK1 in depressed patients may therefore be a potential strategy for future antidepressant treatments."

More information: Anacker, C. et al. 'A role for the kinase SGK1 in stress, depression and glucocorticoid effects on hippocampal neurogenesis' Proceedings of the National Academy of Sciences (PNAS) (May 2013) www.pnas.org/cgi/d… s.1300886110

Wiki on SGK1:

http://en.wikipedia.org/wiki/SGK

Adrenaline, Cortisol, Norepinephrine: The Three Major Stress Hormones, Explained

by Sarah Klein

Thanks to the work of our sympathetic nervous system, the "fight or flight" system that takes over when we're stressed, when you see your boss's name in your inbox late at night, your body reacts like there's a lion on the loose.

Behind the wide range of both physical and mental reactions to stress are a number of hormones that are in charge of adding fuel to the fire.

Adrenaline

What It Is: Commonly known as the fight or flight hormone, it is produced by the adrenal glands after receiving a message from the brain that a stressful situation has presented itself.

What It Does: Adrenaline, along with norepinephrine (more on that below), is largely responsible for the immediate reactions we feel when stressed. Imagine you're trying to change lanes in your car, says Amit Sood, M.D., director of research at the Complementary and Integrative Medicine and chair of Mayo Mind Body Initiative at Mayo Clinic.

Suddenly, from your blind spot, comes a car racing at 100 miles per hour. You return to your original lane and your heart is pounding. Your muscles are tense, you're breathing faster, you may start sweating. That's adrenaline.

Along with the increase in heart rate, adrenaline also gives you a surge of energy -- which you might need to run away from a dangerous situation -- and also focuses your attention.

Norepinephrine

What It Is: A hormone similar to adrenaline, released from the adrenal glands and also from the brain, says Sood.

What It Does: The primary role of norepinephrine, like adrenaline, is arousal, says Sood. "When you are stressed, you become more aware, awake, focused," he says. "You are just generally more responsive." It also helps to shift blood flow away from areas where it might not be so crucial, like the skin, and toward more essential areas at the time, like the muscles, so you can flee the stressful scene.

Although norepinephrine might seem redundant given adrenaline (which is also sometimes called epinephrine), Sood imagines we have both hormones as a type of backup system. "Say your adrenal glands are not working well," he says. "I still want something to save me from acute catastrophe."

Depending on the long-term impact of whatever's stressing you out -- and how you personally handle stress -- it could take anywhere from half an hour to a couple of days to return to your normal resting state, says Sood.

Cortisol

What It Is: A steroid hormone, commonly known as the stress hormone, produced by the adrenal glands.

What It Does: It takes a little more time -- minutes, rather than seconds -- for you to feel the effects of cortisol in the face of stress, says Sood, because the release of this hormone takes a multi-step process involving two additional minor hormones.

First, the part of the brain called the amygdala has to recognize a threat. It then sends a message to the part of the brain called the hypothalamus, which releases corticotropin-releasing hormone (CRH). CRH then tells the pituitary gland to release adrenocorticotropic hormone (ACTH), which tells the adrenal glands to produce cortisol. Whew!

In survival mode, the optimal amounts of cortisol can be life saving. It helps to maintain fluid balance and blood pressure, says Sood, while regulating some body functions that aren't crucial in the moment, like reproductive drive, immunity, digestion and growth.

But when you stew on a problem, the body continuously releases cortisol, and chronic elevated levels can lead to serious issues. Too much cortisol can suppress the immune system, increase blood pressure and sugar, decrease libido, produce acne, contribute to obesity and more.

"Ducks walk out of a lake, flap their wings and they fly off," says Sood. "When you face something stressful, particularly if it's not likely to repeat or doesn't have a huge long-term impact, you want to be able to shake it off and move on with life."

Of course, he adds, estrogen and testosterone are also hormones that affect how we react to stress, as are the neurotransmitters dopamine and serotonin. But the classic fight-or-flight reaction is mostly due to the three major players mentioned above.

Samuel J. Mann, M. D. Blogs: Is There a Mind/Body Connection in Hypertension?

The mind/body connection in health and illness has been the subject of a tremendous amount of research and public interest. Studies and articles receive considerable attention in the medical, psychology and lay press because of the popular belief in such a connection, and in mind/body interventions as a means to prevent or cure conditions such as hypertension.

Over decades, thousands of studies funded by hundreds of millions of National Institutes of Health dollars have been performed. It is long past time to ask: What has this enormous body of research taught us regarding the understanding or treatment of hypertension? Should further money be poured into mind/body research in hypertension? In this two-part blog, I will address these questions, based on what research tells us, and based on my own research and clinical experience.

Part I:

http://www.huffingtonpost.com/samuel-j-mann-md/stress-and-hypertension_b_2517600.html

Part II:

http://www.huffingtonpost.com/samuel-j-mann-md/hypertension_b_2738014.html?utm_hp_ref=health-news&ir=Health%20News

Wray Herbert Blog: Feeling Anxious? Think Again

by Wray Herbert. author of 'On Second Thought: Outsmarting Your Mind's Hard-Wired Habits'

The number one fear is public speaking, hands down. Pollsters have reported time and again that the average person dreads public speaking more than disease or even death. These polls merely confirm what our sweaty palms and elevated heart beat make undeniable: Standing up and addressing an audience brings out our worst fears about performance and failure and the judgment of others.

We all experience some measure of social anxiety, but some people suffer much more than others, and not just with public speaking. Dates, job interviews, even idle cocktail chatter -- any kind of social encounter can be a source of unbearable dread for people with a social anxiety disorder, or SAD.

Millions are debilitated by the emotional and physical arousal associated with this most common of mental disorders.

Despite the prevalence of SAD, however, a lot remains unknown about the disorder. While the negative emotions are a hallmark of clinical anxiety disorder, there is conflicting evidence about the physiological symptoms. Do sufferers really have maladaptive bodily responses to social stress, or do they just perceive it that way? An answer to this basic question would be helpful in guiding clinical intervention.

A team of psychological scientists has been exploring the interplay of thinking, attention and physiology in SAD. Jeremy Jamieson of the University of Rochester, Matthew Nock of Harvard and Wendy Berry Mendes of UC -- San Francisco designed two studies to sort out these aspects of the disorder and, beyond that, to test a simple intervention that might diminish the unpleasant symptoms of social anxiety.

Here's the background that sparked the scientists' inquiry. It's a popular belief that stressful arousal -- heightened blood pressure, heart rate and so forth -- accumulates over time, leading to poor health and disease down the road. But this is not entirely true. Stress can indeed be deleterious to people's health, but only if they see the stressful situation as a threat -- something they lack the inner resources to cope with. By contrast, if people see a stressful situation as a challenge to meet, their physiological response is different -- and not as harmful to the body.

In the first study, the scientists wanted to see if they could clarify the psychological and physiological aspects of SAD. They recruited volunteers, some of whom met the clinical definition of SAD, and deliberately confronted them with their worst fear -- speaking in front of judgmental strangers. They used a well-established social stress test, in which volunteers are required to prepare a short speech about their personal strengths and weaknesses, deliver it to an audience of two judges, and then recover from the experience. The judges were trained to give subtle but negative non-verbal feedback during the speech; they didn't smile or nod or otherwise indicate any kind of affirmation of the speaker's performance. Half of the volunteers -- both with SAD and without -- went through this stressful experience, while the remaining volunteers, the controls, gave their speech in private, without a judgmental audience.

During this experiment, all the volunteers were hooked up to monitors, which recorded their physiological reactivity. The scientists also measured the volunteers' vigilance for signs of threat, their negative feelings, and their appraisal of their own stress -- whether they saw it as a challenge or a threat.

Then they crunched all the data together.

The most surprising finding was that there was no significant difference between SAD sufferers and healthy controls on measures of arousal. That is, when required to speak before a judgmental audience, both showed high vigilance and the harmful kind physical arousal, compared to those who did not have to speak in public. Those with SAD reported more subjective anxiety and negative feelings, but on objective measures they were no worse off than healthy people in a highly stressful social situation.

Since this finding was unexpected, the scientists wanted to double-check it, but they also wanted to capitalize on it. If SAD sufferers' biological arousal is indeed disconnected from subjective feelings of anxiety, would it be possible to ameliorate the disorder simply by thinking about physical symptoms constructively? Perhaps they could be thought of as a resource that enhances performance, rather than a liability. This is what the scientists explored in a second experiment.

It was basically the same experiment, except that this time some of the volunteers were urged to reappraise their symptoms in a more positive way. Specifically, they were told this just prior to the speaking task: "In stressful situations, like public speaking, our bodies react in very specific ways. The increase in arousal you may feel during stress is not harmful. Instead, these responses evolved to help our ancestors survive by delivering oxygen to where it is needed in the body." They were explicitly encouraged to reinterpret their arousal as an adaptive response. The idea was that changing perceptions of arousal might mitigate anxiety.

And that's just what they found, and detail in a forthcoming article in the journal Clinical Psychological Science. Both socially anxious and healthy volunteers, when encouraged to see their bodily arousal as functional, improved on a number of measures. They still saw public speaking as stressful and personally demanding, but they saw themselves as more resourceful -- better able to cope with the social stress of speaking. What's more, their physiological response actually improved as well; it came to resemble the more adaptive, healthier kind of arousal. Finally, they were not so preoccupied with threatening cues in the world. This shift in attention, away from negativity, could be protective, diminishing the likelihood of reacting to new social threats in the future.

Wray Herbert's blogs -- "Full Frontal Psychology" and "We're Only Human" -- appear regularly in The Huffington Post.

Meredith Melnick Blog: Healthy Love: The Perfect Antidote To Stress



Girls' Love Stories #7, DC, September 1950.



The Huffington Post 

Falling in love sure sounds stressful: the quickened pulse, the fixation, the anxiety that feelings won't be returned. But while the sight of your beloved might send your heart racing (thanks to a kick of adrenaline), the act of being in love may have a protective effect on your health.

Indeed, the moments of first love involve some stress. One small study of those who were newly in love found that levels of cortisol -- a stress hormone -- were higher in recent lovebirds than in those who were single or in long-term relationships. What's interesting is that when the group was tested again 12 and 24 months later, their cortisol levels had returned to normal. It suggests that the stress of falling in love is fleeting, but the benefits of being in love remain -- including some other hormonal changes that may have a stress-protective effect.
"
What happens in the brain when you love someone is that there's more activity in the 'reward' system," explains Dr. Helen Fisher, a physical anthropologist who studies the neurohormonal phenomena of love and is a research professor at Rutgers University. "Your brain floods with dopamine, which gives you focus, energy and optimism and those things can all be good to counter stress."

As Fisher explains, romantic love can provide something of a loop: as you fall in love, your dopamine levels surge, which in turn contributes to testosterone production. More testosterone is linked to increased sex drive. And sexual release has a particularly healthful effect, Fisher says, delivering oxygen to the brain and other organs.

"Sex with the right person has a lot of health benefits," she says, listing a battery of stress-reducing health benefits. "It lowers blood pressure, enhances mood by releasing endorphins. It's a sedative, helps you sleep, soothes aches and pains. It even gives you healthier skin and even emotional confidence."

While many of those side benefits of the physical acts of love can contribute to reduced stress, you don't need to have sex to achieve calm: kissing, holding hands or even just looking at your beloved can release the "love hormone" oxytocin in the blood stream, Fisher told Healthy Living. And oxytocin can actually work to inhibit cortisol production and stress response. Some research finds that just feeling the emotional support of a partner was enough to amp up levels of the feel-good hormone coursing through one's veins.

So this Valentine's Day, as you're thanking your beloved for the happiness they bring you, don't forget to include the calm they provide as well.

Girls' Love Stories #4, DC, March 1950

Wikipedia: Dr. Stephen Porges' Polyvagal Theory

The Polyvagal Theory (gr. 'polus', “‘many’” + 'vagal', "'Vagus Nerve'") was proposed and developed by Dr. Stephen Porges, Director of the Brain-Body Center at the University of Illinois at Chicago.

The theory specifies two functionally distinct branches of the vagus, or tenth cranial nerve. The branches of the vagal nerve serve different evolutionary stress responses in mammals: the more primitive branch elicits immobilization behaviors (e.g., feigning death), whereas the more evolved branch is linked to social communication and self-soothing behaviors.

These functions follow a phylogenetic hierarchy, where the most primitive systems are activated only when the more evolved structures fail. These neural pathways regulate autonomic state and the expression of emotional and social behavior.

Thus, according to this theory, physiological state dictates the range of behavior and psychological experience. Polyvagal theory has many implications for the study of stress, emotion, and social behavior, which has traditionally utilized more peripheral indices of arousal, such as heart rate and cortisol level.

The measurement of vagal tone in humans has become a novel index of stress vulnerability and reactivity in many studies of populations with affective disorders, such as children with conduct problems and those suffering from borderline personality disorder.

Phylogenetic Subsystems/Stages

The vagus nerve is a primary component of the autonomic nervous system. Polyvagal theory outlines the structure and function of the two distinct branches of the vagus, both of which originate in the medulla.

More specifically, each branch is associated with a different adaptive behavioral strategy, both of which are inhibitory in nature via the parasympathetic nervous system (PNS).

The vagal system is in opposition to the sympathetic-adrenal system, which is involved in mobilization behaviors. According to polyvagal theory, these opposing systems are phylogenetically arranged.

The Dorsal Vagal Complex

The dorsal branch of the vagus originates in the dorsal motor nucleus and is considered the phylogenetically older branch. This branch is unmyelinated and exists in most vertebrates. This branch is also known as the “vegetative vagus” because it is associated with primal survival strategies of primitive vertebrates, reptiles, and amphibians. Under great stress, these animals freeze when threatened, conserving their metabolic resources.

The DVC provides primary control of subdiaphragmatic visceral organs, such as the digestive tract. Under normal conditions, the DVC maintains regulation of these digestive processes. However, prolonged disinhibition can be lethal for mammals, as it results in apnea and bradycardia.

The Ventral Vagal Complex

With increased neural complexity seen in mammals (due to phylogenetic development) evolved a more sophisticated system to enrich behavioral and affective responses to an increasingly complex environment.

The ventral branch of the vagus originates in the nucleus ambiguus and is myelinated to provide more control and speed in responding. This branch is also known as the “smart vagus” because it is associated with the regulation of sympathetic “fight or flight” behaviors in the service of social affiliative behaviors.

These behaviors include social communication and self-soothing and calming. In other words, this branch of the vagus can inhibit or disinhibit defensive limbic circuits, depending on the situation.

The VVC provides primary control of supradiaphragmatic visceral organs, such as the esophagus, bronchi, pharynx, and larynx. The VVC also exerts important influence on the heart.

When vagal tone to the heart’s pacemaker is high, a baseline or resting heart rate is produced. In other words, the vagus acts as a restraint, or brake, limiting heart rate. However, when vagal tone is removed, there is little inhibition to the pacemaker, and so rapid mobilization (“fight/flight”) can be activated in times of stress, but without having to engage the sympathetic-adrenal system, as activation comes at a severe biological cost.

Vagal Tone: A Physiological Marker of Stress

In order to maintain homeostasis, the central nervous system responds constantly, via neural feedback, to environmental cues.

Stressful events disrupt the rhythmic structure of autonomic states, and subsequently, behaviors. Since the vagus plays such an integral role in the PNS via regulation of heart rate, it follows that the amplitude of respiratory sinus arrhythmia (RSA) is a good index of PNS activity via the cardiac vagus.That is, RSA is a measurable, noninvasive way to see how the vagus modulates heart rate activity in response to stress. This method is useful to measure individual differences in stress reactivity.

RSA is the widely used measure of the amplitude of heart rate rhythm associated with rate of spontaneous breathing. Research has shown that amplitude of RSA is an accurate indicator of the efferent influence of the vagus on the heart. Since inhibitory effects of the VVC branch of the vagus allow for a wide range of adaptive, prosocial behaviors, it has been theorized that individuals with greater vagal tone are able to exhibit a greater range of such behaviors.

On the other hand, decreased vagal tone is associated with illnesses and medical complications that compromise the CNS. These complications may reduce one's capacity to respond to stress appropriately.

Clinical Applications of Polyvagal Theory and Vagal Tone

Vagal tone has been used in medical and psychological research to better understand the physiological underpinnings of various disorders.

For example, healthy human fetuses have a high variability in heart rate, which is mediated by the vagus. On the other hand, heart rate decelerations, which are also mediated by the vagus, are a sign of fetal distress.

More specifically, prolonged withdrawal of vagal influence on the heart creates a physiological vulnerability to the influence of the DVC, which in turn produces clinically relevant bradycardia. However, the onset of this deceleration is commonly preceded by transitory tachycardia, which is reflective of the immediate effects of VVC withdrawal.

For more:

"How your nervous system sabotages your ability to relate" an interview with Stephen Porges about his polyvagal theory by Ravi Dykema

http://www.nexuspub.com/articles_2006/interview_porges_06_ma.php

Luminita Daniela Saviuc Blog: Seven Ways To Release Negative Emotions

Do you get easily angered, stressed, frustrated? How often do you get caught up in other people's drama or your own drama? Are there any toxic emotions present in your body right now?

Whether there is any negativity in your life right now or not, it is wise to know what would be the best way to release the toxic emotions from your life when they arise, because in the end we are all human and we will all experience negative emotions at one point or another.

1. Awareness

Firstly, we need to understand that the first person who will get hurt by holding on to the toxic emotions is us and not so much the person, event or situation who triggered the toxic emotions in us.

Let us not look back in anger, nor forward in fear, but around in awareness. -- James Thurber

2. Take Responsibility

Even though it may not always be easy, it is very important to stop blaming others for how we feel and to take 100 percent responsibly for our own thoughts, emotions, action or inaction, to take 100 percent responsibility for our life, and by doing so we will claim back our own power.
When you blame some outside forces for whatever you are feeling, you give away any power you may have to change the negative situation and your feelings about it, and you allow yourself to be the victim.

Take your life in your own hands, and what happens? A terrible thing: no one to blame. -- Erica Jong

3. Don't Believe Everything You Think

The next wise thing to do is question your own thoughts. Don't believe everything you think, especially if your thoughts are creating even more stress, anxiety, frustration, anger and all kind of other negative emotions in your life.

The world we have created is a product of our thinking; it cannot be changed without changing our thinking. -- Albert Einstein

4. Acceptance vs. Resistance

Don't resist the pain these toxic emotions are causing you, for resistance would only make things even worse. What you want to do is to act as if whatever you are feeling right now is there because you chose to. Accept it and allow the pain to just be and by doing so you will help release and heal the pain.

Acceptance of what has happened is the first step to overcoming the consequences of any misfortune. -- William James

5. Let Go

Let go of the need to blame others for your anger, let go of the need to put yourself down for feeling the way you are feeling and let go of all the toxic emotions you are holding on to. It is as easy as holding tightly a rotten apple -- toxic emotions -- and then letting that apple go. It's that simple.

Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned. -- Buddha

6. Shift From Negative To Positive

If you focus too much on what seems to be wrong, you will not be able to release the negative emotions. Shift your focus from negative to positive, focus on the things you want to attract in your life and the feelings you want to feel and not on what you don't want -- very important! By doing so, you will allow the dark clouds to pass and the sun to shine through.

I can feel guilty about the past, apprehensive about the future, but only in the present can I act. The ability to be in the present moment is a major component of mental wellness. -- Abraham Harold Maslow

7. Show Gratitude

Now that you released all the toxicity from your body, why not express your gratitude for all the amazing things you have learned along the way? Express your gratitude toward all those people/events that triggered all kind of negative emotions in you, and thank them for helping you become a happier, wiser and confident person.

I have learned silence from the talkative, toleration from the intolerant, and kindness from the unkind; yet, strangely, I am ungrateful to those teachers. -- Khalil Gibran

Hermona Soreq Blog: Stress Reactions: Acetylcholine

by Hermona Soreq, Professor of Molecular Neuroscience, The Hebrew University’s Edmond and Lily Safra Center for Brain Sciences

Do the Stress Reactions of Our Brain Control the Immune System -- Or Is It the Other Way Around?

In the well-known 17th-century text Le Malade Imaginaire, Molière (Jean-Baptiste Poquelin) wrote, "the mind has great influence over the body, and maladies have their origin there."

Since Molière, we now know that a diseased body and malfunctioning immune system also affect the mind.

Inflammation of the nervous system has been increasingly recognized as an important factor in multiple conditions, including Alzheimer's and Parkinson's disease. New technologies in genetic engineering and drug development are rapidly progressing to implement this knowledge for early diagnosis and creative treatment strategies that take into consideration both the brain and the body.

One area that has benefited considerably from these developments is the study of anxiety.

Historically, human stress reactions enabled our ancestors to survive attacks and protect the body from injury. But even though these reactions aren't necessities like they were for our ancestors, the same response patterns have continued to the present. An unpleasant discussion at work rarely leads to physical attacks, but our body nevertheless prepares for such attacks; it elevates the blood pressure to prepare for running, and produces more white blood cells as protection from anticipated injury.

While such reactions are useful for immediate protection -- since alertness can assist us in reacting to stressful experiences faster and more efficiently -- the consequences of stress responses may also entail long-term damages spanning muscle and nerve cells malfunctions, neurodegenerative diseases like Alzheimer's and Parkinson's, and inflammatory diseases.

The long-term and disease-provoking consequences of stress responses may take years to develop. This was not a concern for early humans, whose life span was shorter than ours (by the time stress could take its toll, they were no longer alive). But today, humans live much longer, and as a result, stress-associated diseases -- especially in the elderly -- have become a major social and financial burden.
*** Over the past two decades, I, along with my colleagues at the Edmond and Lily Safra Center for Brain Sciences (ELSC) at The Hebrew University of Jerusalem, have pioneered and developed innovative strategies for investigating the consequences of traumatic experiences and designed new strategies to combat neurodegenerative diseases.

Our work has proven that in both brain neurons and blood cells, the genetic information that processes events are vulnerable to changes under stress. Moreover, we've discovered that both inherited and acquired defects in neurons, as well as traumatic experiences or exposure to a contaminated environment, contribute to delayed susceptibilities to stress-associated diseases.

The consequences may be seriously harmful, affect seemingly unrelated functions (e.g. learning and memory, the day-and-night cycle, muscle fatigue, inflammation), and last over the life spans of individuals and communities.

A good portion of our research has been devoted to a small chemical called acetylcholine, the first known neurotransmitter (a small chemical compound which is capable of activating neurons to send electrical signals) and the primary communicator between the body and the brain.

Discovered 100 years ago by the Nobel laureate Otto Loewi, acetylcholine comes from the brain through the vagus nerve and is responsible for muscle twitching. We've discovered that acetylcholine signals produced in the brain affect psychological stress responses, inflammation, aging, and the recovery from acute ischemic stroke.

As part of our research, we isolated the genes controlling acetylcholine degradation in humans and identified stress-induced changes in their expression in brain neurons and blood cells alike.

To pinpoint the physiological role of these genes, we engineered mice with excess or deficient amounts of the genes' protein products and watched their learning, muscle functioning and behavior. We learned three basic things:

1) Either too much or too rapid degradation of acetylcholine may cause cognitive deterioration, which intensifies anxiety reactions and can also intensify them, creating a vicious cycle;

2) The mice with excess breakdown of acetylcholine suffer constant inflammation, demonstrating the power of brain-to-body communication for our immune system and showing that individuals who carry inherited small changes in these genes are at increased risks for Parkinson's and Alzheimer's disease;

3) Different products of these genes may either enhance the progression of brain pathology in Alzheimer's and Parkinson's disease or help protect against them, and they also determine one's prospects to survive and recover from ischemic stroke. Measuring such changes by a simple blood test can hence predict one's prospects for recovery and the risks for post-traumatic stress disorder.

New discoveries in stress-related pathologies are occurring at a quickening pace. Just recently, we've developed a synthetic DNA-based drug for treating patients with inflammatory bowel disease.

With the help of a $5 million grant approved by the Leona M. and Harry B. Helmsley Charitable Trust, we hope that such developments will bring us closer to finding more permanent treatments for neurodegenerative and other diseases that have, unfortunately, become all too common.

Steven M. Southwick M. D. :The Science of Resilience

For nearly twenty years my colleagues and I studied post-traumatic stress disorder and the profound negative psychological, social, and neurobiological impact of traumas such as child abuse, natural disasters, physical and sexual abuse, and combat. We often wondered why some survivors succeeded in overcoming adversity, bouncing back, and continuing on with purposeful lives, while others didn't. Some individuals were clearly more resilient than others.

The American Psychological Association defines resilience as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." To answer our question, we turned to three groups of highly resilience individuals: former Vietnam prisoners of war, Special Forces instructors, and civilian men and women who had endured and even thrived after surviving harrowing traumas.

In our book, Resilience: The Science of Mastering Life's Greatest Challenges, Dennis Charney M. D. and I systematically address the topic of resilience. Because resilience is the complex product of genetic, psychological, biological, social and spiritual factors, we investigate resilience from multiple scientific perspectives. We synthesize the latest scientific and popular literature on the topic, describe our own psychological and neurobiological research on resilience, and quote from our in-depth interviews with a large number of highly resilient people.

When we began our study, we assumed that resilience was rare and resilient people were somehow special, perhaps genetically gifted. It turns out, we were wrong. Resilience is common and can be witnessed all around us. Even better, we learned that everyone can learn and train to be more resilient. The key involves knowing how to harness stress and use it to our advantage. After all, stress is necessary for growth. Without it the mind and body weaken and atrophy.

Let's take a quick look at some genetic and biological factors that have been associated with resilience. While no one gene or gene variation explains resilience, genetic factors do play an important role in determining how an individual responds to stress and trauma. For example, DNA studies have found that polymorphisms (i.e., variations) of genes that regulate the sympathetic nervous system, the hypothalamic-pituitary-adrenal axis, and the serotonin system partially determine whether our biological response to stress is too robust, too muted, or within a range that is optimal for adaptive functioning. In addition, studies of identical twins, where one twin has been exposed to a traumatic stressor such as combat but the other twin has not, have estimated an overall heritability of posttraumatic stress disorder ranging from 32-38%. This means that genes are important but that they are only part of the story.

A host of neurobiological factors and systems have been associated with resilience including a sympathetic nervous system (i.e., epinephrine and norepinephrine) and a hypothalamic-pituitary-adrenal axis (i.e., cortisol) that respond rapidly to stress and danger but that are well regulated and shut off once the danger has passed; a dopamine reward system that continues to fuel positive emotions even during periods of chronic stress; intact hippocampi that allow us to form new memories, to differentiate between dangerous and safe environments, and help to regulate our stress response; and a highly developed prefrontal cortex that can regulate emotional and behavioral reactivity to stress by inhibiting the amygdala, which plays a central role in processing and triggering raw emotions related to the fight-flight response.

Emerging scientific research has begun to show that neurobiological systems associated with resilience can be strengthened to respond more adaptively to stress. For example, research using EEG and fMRI technology has shown that mindfulness meditation and training in cognitive reappraisal can increase activation of the left prefrontal cortex. This is important because people with greater activation of the left prefrontal cortex recover more rapidly from negative emotions such as anger, disgust, and fear. University of Wisconsin researcher Richard Davidson has proposed that resilience is largely related to activation of the left prefrontal cortex and the strength of neural connections between the prefrontal cortex and the amygdala. Robust activation of the PFC inhibits the amygdala, quiets associated anxiety and fear-based emotions, and allows the PFC to facilitate rational planning and behavior.

As a second example, the hippocampus is another brain region that is critically involved in resilience and how we respond to stress. It is well known that unremitting stress with prolonged elevation of cortisol can damage neurons in the hippocampus. Because the hippocampus helps to regulate the hypothalamic-pituitary-adrenal axis, damage to its neurons can decrease their ability to dampen the stress response. The result may be even greater damage to hippocampal neurons. Fortunately, recent research has found that nerve growth factors, like brain-derived neurotrophic factor, enhance the growth of brain cells, prolong cell survival, and repair damaged nerve cells. In animal studies, vigorous voluntary aerobic exercise increases levels of nerve growth factor and appears to protect against some of the negative effects of stress. This may also be true in humans where research has shown that aerobic exercise can increase hippocampal volume, raise serum levels of BDNF, and improve spatial memory, and that physically active subjects show lower cortisol and SNS responses to psychological laboratory stress compared to less physically active subjects.

As scientists learn more about the complex interplay of genetics, development, cognition, environment, and neurobiology, it will be possible to develop behavioral, social and pharmacological interventions and training programs to enhance resilience to stress.

Steven M. Southwick, MD, a recognized expert on the psychological and neurobiological effects of extreme psychological trauma, is the co-author of Resilience: The Science of Mastering Life's Greatest Challenges (Cambridge University Press 2012). Dr. Southwick is the inaugural Greenberg Professor of Psychiatry, Post-Traumatic Stress Disorder, and Resilience at the Yale Medical School and the Yale Child Study Center, adjunct professor of psychiatry at the Mt. Sinai School of Medicine, and medical director of the Clinical Neurosciences Division of the National Center for Posttraumatic Stress Disorder.

In the News: Work Stress 'Raises Heart Risk'

Is this really news? It seems pretty well known and obvious to me.

Work stress 'raises heart risk'

By James Gallagher Health and science reporter, BBC News

Having a highly demanding job, but little control over it, could be a deadly combination, UK researchers say.

They analysed 13 existing European studies covering nearly 200,000 people and found "job strain" was linked to a 23% increased risk of heart attacks and deaths from coronary heart disease.

The risk to the heart was much smaller than for smoking or not exercising, the Lancet medical journal report said.

The British Heart Foundation said how people reacted to work stress was key.

Job strain is a type of stress. The research team at University College London said working in any profession could lead to strain, but it was more common in lower skilled workers.

Doctors who have a lot of decision-making in their jobs would be less likely to have job strain than someone working on a busy factory production line.

Freedom

There has previously been conflicting evidence on the effect of job strain on the heart.

In this paper, the researchers analysed combined data from 13 studies.

At the beginning of each of the studies, people were asked whether they had excessive workloads or insufficient time to do their job as well as questions around how much freedom they had to make decisions.

They were then sorted into people with job strain or not and followed for an average of seven and a half years.

One of the researchers, Prof Mika Kivimaki, from University College London, said: "Our findings indicate that job strain is associated with a small but consistent increased risk of experiencing a first coronary heart disease event, such as a heart attack."

The researchers said eliminating job strain would prevent 3.4% of those cases, whereas there would be a 36% reduction if everyone stopped smoking.

'Unable to change'

Prof Kivimaki said the evidence of a direct effect of job strain on the heart was mixed.

He told the BBC job strain was linked to other lifestyle choices that were bad for the heart: "We know smokers with job strain are more likely to smoke a bit more, active people with job strain are more likely to become inactive and there is a link with obesity.

"If one has high stress at work you can still reduce risk by keeping a healthy lifestyle."
Prof Peter Weissberg, medical director at the British Heart Foundation, said: "We know that being under stress at work, and being unable to change the situation, could increase your risk of developing heart disease.

"This large study confirms this, but also shows that the negative effect of workplace strain is much smaller than, for example, the damage caused by smoking or lack of exercise.

"Though stresses at work may be unavoidable, how you deal with these pressures is important, and lighting up a cigarette is bad news for your heart. Eating a balanced diet, taking regular exercise and quitting smoking will more than offset any risk associated with your job."

Dr Bo Netterstrom, from Bispebjerg Hospital in Denmark, said other stresses at work such as job insecurity "are likely to be of major importance".

He said job strain was "a measure of only part of a psychosocially damaging work environment".

Wray Herbert: Having Heart Can We Rethink Life's Stresses?

Eustress is the "good stress."

From Wray Herbert's blog
Author, 'On Second Thought: Outsmarting Your Mind's Hard-Wired Habits'

Imagine that you are at the top of a ski slope, about to make a run. It's a challenging slope, black diamond--steep and narrow, lots of trees. Plus it's windy, and there's that treacherous drop-off on the right. You're an inexperienced skier, not a novice but not at all confident that you belong in such extreme terrain. Your heart is pounding and your gut is tight.

Now imagine that you're on top of the very same slope, but you are a skilled downhill racer, an Olympic contender. You're sure you know how to attack this slope--you've done it many times before--but even so, your heart is pounding and butterflies are fluttering in your gut.

Both of these hypothetical skiers are under stress, and feeling the arousal that comes with stress. But one is experiencing good stress, the other bad stress. They are both looking at the same slope, but one sees it as a threat, the other as a challenge. The expert knows that his skills are more than sufficient for the situation. The nervous learner has no such confidence.

Psychological scientists are interested in this contrast, as are health professionals. We tend to think of stress as negative, and arousal as harmful, and indeed we spend lots of time and money--on vacations, fitness clubs, bar tabs--trying to minimize stress. But is it possible that stress is not all that bad, that in fact it may be tonic at times?

The key is how we think about stress and arousal. Those two skiers are in fact experiencing different bodily changes. Though both are feeling activation of the sympathetic nervous system, the fearful skier is feeling constriction of the vessels, which makes the heart work harder. The expert is actually experiencing more sympathetic arousal as he contemplates the challenge ahead, but the blood vessels are dilating, increasing cardiac efficiency. But they don't know or care what's going on inside them. They both simply feel edgy and aroused.

What if the learner's fear could be construed as a positive challenge? What a skier--or anyone--could be made to believe that the pounding and fluttering were actually a resource, tools for enhanced performance? That's the question that University of Rochester scientist Jeremy Jamieson wanted to explore in the laboratory. Working with UCSF's Wendy Berry Mendes and Harvard's Matthew Nock, he has run a series of experiments to see if bad stress can be transformed into good stress in the mind.

Here's an example. The researchers took physiological measurements on a group of volunteers, who were told that they would have to make a public speech--a stressful prospect for most people. Just prior to this event, some were instructed about the value of human stress response in high-level performance. They were encouraged to interpret any signs of arousal as a positive thing, a tool that would aid them in making a confident speech. The others were told to ignore their stress arousal, or they were told nothing at all.

The findings were clear. During the speech, those instructed in reappraisal were much more like the Olympian skier, showing what Jamieson calls "physiological toughness": They experienced less blood vessel constriction and more cardiac output, as if they were attacking the slope. What's more, immediately after the speech, these volunteers were less vigilant. In other words, they felt confident, not threatened.

Think about this. It wasn't an elaborate intervention. They were merely encouraged to reappraise their gut feelings. The scientists decided to test this simple idea again, in the context a high-stress real-life event: a high-stakes examination. They recruited students who were already preparing to take the Graduate Record Examination (GRE), guaranteeing that their performance was genuinely important to them. The students came into the lab to take a practice version of the exam. As before, only some were told that their nervous stomachs and pumping hearts were known to improve, not worsen, performance. Right before the test, all the students gave saliva samples for analysis.

Those who were taught to reappraise their arousal--to see it as a benefit--had higher levels of alpha amylase, an indicator of nervous system arousal, and they performed better on the practice GRE. But here's the really interesting part: One to three months later, when they took the actual GRE under regular testing conditions, these students had higher math scores than the controls. And they also reported that their test-day arousal had helped them with the exam. This brief and simple intervention had sustained effects on both stress appraisal and test performance.

These are just a couple examples on ongoing research that the Jamieson and his colleagues will describe in a forthcoming issue of the journal Current Directions in Psychological Science. The findings may change the way that clinicians think about acute, everyday stress and a variety of ills. Much valuable work has shown that we can regulate our emotions and mitigate our stress arousal--through mindfulness mediation, for example. But there are many times when it's impossible, or inadvisable, to dampen the body's arousal signals. Reappraisal may offer an additional tool to cope with bodily stress in an adaptive way.