Dr. Kelly Brogan
Holistic Psychiatrist & Author Of A Mind Of Your Own
February 4, 2020
Nine months after the birth of my first daughter, I felt off. Flatness, forgetfulness, cold, and tired. If I hadn’t discovered my formal diagnosis of an autoimmune thyroid condition, I could easily have been offered an antidepressant. Instead, I delved into the complex physiology of the immune system and its relationship to seemingly unrelated areas like the gut and brain. I learned pathways and the role of nutrients in their optimization. I changed my lifestyle, and my life changed as a result. What if this diagnosis wasn’t just a result of chemical exposure, lack of sleep, and a horrendous diet? What if it meant something, specific, to me, for me, and about me?
• • •
Psychoneuroimmunology: Gut-Brain Science
According to my credentials, I have fellowship-level expertise in Psychosomatic Medicine. What does that phrase mean to you? Undoubtedly, it conjures notions of hysteria and attention-seeking illness fabrication. Almost in an effort to escape these implications, this advanced medical training has, at some sites, been rebranded as Consultation-Liaison Psychiatry, to invoke the seemingly more legitimate study of psychiatric symptoms emerging in medical and surgical patients.
Psychiatry has been seeking to scientifically substantiate itself for the better part of a century, and we have all fallen prey to the allure of the biological explanation, the organic cause, the mechanistic descriptor for a given pathology. Many a patient has felt relief at being told that they have a “chemical imbalance.” A chemical imbalance is, by definition not your fault. In fact, there’s nothing you can do about it, except, of course to fill your prescription and take it forever, like a good patient.
The Physical Origins of Mental Illness
Even with my left turn from conventional psychiatry, I have spent a decade steeped in vanguard biomedical models of depression, bipolar, and schizophrenia. Models that explore the contributions of various systems including endocrine, immune, and neurochemical. I have even been criticized by other psychiatry-dissenters as simply substituting one physiologic illusion for another that continues to pathologize what is appropriate human angst and response to trauma. These critics say, it’s all mind, not body.
What if there is a new conversation happening in the medical literature – one that encompasses the whole person, all at once?
Entitled Symbolic Diseases and “Mindbody” Co-Emergence. A Challenge for Psychoneuroimmunology, Broom et al take the progressive field of Psychoneuroimmunology to task and demand an even more nuanced and sophisticated approach to the human experience.
Gut-Brain: Just The Beginning
On many levels, psychoneuroimmunology is an exciting revelation simply because it decimates false boundaries between different systems and allows more cohesive assessments to be made. No longer are there many blind men feeling parts of the elephant describing a rope and a tree trunk. We begin to understand that the immune and endocrine systems appear to be mediating a dialogue – bidirectional – between the gut and the brain.
In this model, the gut influences the brain and the brain influences the gut but they are still two separate entities communicating through biochemical signals. Where are YOU in this relationship? Where are the elements of the human experience that reflect your deeply held beliefs, thoughts, and relationships? What about your history and experience of yourself up until this point? Are we still just reducing humanity to bubbles of substances?
Gut-Brain-Mind: Adding Another Dimension
The mind is invited into gut-brain physiologic conversation in the form of stress. Stress has been used as a cause-all vector of bodily illness, a perspective that still reigns in the literature including data that demonstrates that perceived stress mobilizes inflammatory immune cells in the bone marrow. But the mind is more than stress, isn’t it? Is the personal meaning of the stress relevant?
Dr. Candace Pert has confirmed as much through her discovery of the bodily opiate receptor and research on neuropeptides demonstrating that that emotions are literally encoded throughout organs and tissues. Her perspective seems to elucidate why and how one person could weep after 8 minutes of raised arms in a kundalini yoga class and another might barely find it challenging. We get closer to a more personal experience of the physical body that blurs the boundaries between mental and physical.
In fact, the interpretation of the physical by the mind can actually then lead to changes and shifts in the physical – this is called the placebo effect. An emergent phenomenon, the placebo effect is physical and mental and both in the context of your personal beliefs, history, and expectations. It is not a mental factor. It is not a physical factor. It is a totality of you brought to the experience of healing.
So if it’s not just a broken body, why do we get sick?
Since the dawn of the microbiome, exosomes, and placebo research, no longer can we hold onto the cold comfort of our genes. We weren’t simply “born with” our illnesses and struggles. They have been co-created by us in our environment. But are they meaningful beyond that? Purposeful, even? Teleology is the study of purpose as a driving force of nature. It flies in the face of the mechanistic, reductionist perspective that life is random, nature is meaningless, and that force, effort, and exactitude dictate all outcomes.
The attunement of the organism to the world is reciprocated by the action of the world on us. The world or environment is not something inert, passive, something waiting to be acted upon. – Maurita Harney
Far from being new age woo, this field is supported by burgeoning disciplines such as quantum physics and biosemiotics, non-linear exploration of top-down informational exchange in web-like matrices. The one gene-one pill-one ill model of random bad luck is a skin this snake has shed.
The Meaning of Your Illness Matters
I firmly believe that there is a personal invitation in every diagnosis, and even every symptom. It is an invitation to examine everything and anything from diet to spiritual beliefs, but could illness carry personal symbolism and meaning? Broom et al, the authors of the previous paper, suggest that:
“Some persons will represent their meanings and “stories” clearly in language, some in behavior, some in the body, and some (maybe most) in multiple ways.”
To appreciate the relevance of symbolism, the whole person must be assessed in a global view with sensitivity to the meaning for a given individual of their symptoms. They pull cases from the literature including;
“A woman developed the precancerous condition oral leukoplakia (and, later, oral cancer requiring seven surgical interventions/reconstructions) at age 33. After 22 years of disease she entered therapy, and, in the first session, it emerged that her dentist father had died by suicide when the patient was age 6 and when he was 33. At age 12, the patient had been told by her alcoholic mother that she, the daughter, had caused the father’s death because she had refused to sit on his knee! There was a profound shame at having “caused” his death. Brief therapy led to a rapid and, thus far, 15-year remission.”
This made me wonder if my postpartum thyroiditis symptoms of cloudiness and fatigue so many years ago were representative of my feeling suppressed and oppressed by my unexpressed self. Perhaps I developed exactly what it is that I needed to become more myself in this life, and that healing it rather than fighting it was the integration that rendered me one with my very personal process.
Broom et al might say yes. They propose a co-emergent framework. This is one in which mind and body are not causing effects in one another but are a part of an unbroken continuity of internal body processes and external interpersonal meanings and influences. In other words, it is a model that takes into account the person, their story, and their environment as all a part of a web that includes the body and its systems.
More Than the Sum of Our Parts
How can we can enter on all of these levels at once – body, mind, and meaning? With the launch of my course, Vital Mind Reset, I have witnessed that self-healing is possible when we escape the reductionist magic pill/magic bullet model and honor our weblike complexity. Medical meditation, examination of beliefs, engagement in community, detox, and nutritional medicine all synergize to bring about results that might not have otherwise been possible. In fact, Bloom states:
“It appears that a co-emergent framework commonly allows recovery from chronic illnesses unresponsive to biomedical treatments.”
When we use this multi-signal, personalized (by you, for you) approach, participants marvel at the simplicity of the interventions yet the robustness of the shift:
In fact, we don’t even need to know why this multilevel approach to healing works, or how. We can move beyond the chemical theories, the complex analysis, and simply be in the process of sending the bodymind a signal of safety. Safety looks like ease. Trust. Curiosity. And even surrender. It’s not a fight. It’s not a battle. It’s a cooperative exchange and an exploration. It’s becoming more of our whole selves because we are becoming less fragmented and self-evasive. We stop hiding parts of our personhood from our awareness. We embrace it all in order to heal.
I now look for the story in any physical symptoms that arise in me, and in the physiologic specifics of my patient’s conditions. Exploring these stories often reveals the key to true wellness.