Emotions, Stress and Health

Karen Mickleson, Ph.D.

June 2000

In my backstory, I make some pretty sweeping statements about depressives being more prone to cancer than anxious types; about how expansive emotions of joy, love, wonder, awe, are therapeutic, and I want to talk here about how this is so. The mind-body connection in health has been increasingly normalized in public discourse over the past thirty years or so, but it's rarely discussed in terms which connect the dots or which make much intuitive sense the average person can understand. My mission here is to make a dent in this void.

The other night Larry King had a panel of doctors discussing medical breakthroughs: Deepak Chopra, Andrew Weil, Nicholas Perricone, Michael Roizen and, Sanjay Gupta. After plowing through diabetes, Alzheimer's, cancer, and obesity, someone asks, "How significant are emotions, feelings and thoughts in creating disease?"

CHOPRA: Even in creating disease. Well, I'll say the lack of love, the lack of being cared for is associated with a three to five times higher incidence of death from all diseases. In many studies, it has been shown that it's a higher risk factor than smoking, than obesity, than lack of exercise and other habits.

KING: Really?

CHOPRA: Yes. Isolation, feeling isolated, feeling lonely, not having the experience of love. Because love causes the secretion of certain hormones that are immunomodulators.

KING: Dr. Roizen, you buy that?

ROIZEN: Absolutely. Stress, the opposite of love, is the greatest ager we have. Makes your real age up to 32 years older. And love and the other feelings and blocking stress actually can block 30 of those aging years. So it really is--that is the greatest ager we have. Much greater than even hypertension or diabetes.

KING: Wow. Dr. Perricone?

PERRICONE: Stress is at the basis of all the age-related diseases and accelerates the process. Stress is pro-inflammatory. Reduce stress and you'll reduce your incidence of disease and you'll live longer.

KING: So love. More you love, the less the stress. But love can bring stress.

CHOPRA: The intoxication of love is the most powerful healing force in the universe.

KING: Do you buy that?

GUPTA: I do buy it. I mean, we talk about the cortisol levels, the stress hormones in the body. You can directly measure this now scientifically in terms of its effect on the heart, in terms of its link to increased likelihood of developing heart disease or stroke, osteoporosis, cancers. So you know, if love is sort of the opposite of that, sure, I buy that.

(Transcripts, Larry King Show, 16 June 2000)

Their gist is that love heals and stress kills, but why? What does this mean?

If you can bear with me on a psycho-physiology detour, I'll summarize the basics: The autonomic nervous system in us manages all the contracting and expanding functions in our bodies--like the heartbeat tightening one second and then expanding as blood swooshes out the arteries; or like inhaling contracts our lungs and exhaling expands them.

The autonomic system divides the labor into two branches, the sympathetic and the parasympathetic. The sympathetic system works contraction, or tightening, while the parasympathetic works expansion or relaxing functions. There are all sorts of biological processes associated with each one, like secretion of particular hormones and such. Ideally, these systems have a nice homeostatic balance, which means an equilibrium where each system helps the other get back to the body's 'normal' when things get out of whack.

Unfortunately, that ideal is rare in the human condition.

In infancy we're all beset with intense emotional states we have no way to understand. In general they're lumped into two basic categories which arouse either relaxation or tightening. Love, wonder, and awe at mom's seemingly magic ability to make hunger go away and the joy it brings loosen us up. Tense rage at hunger pangs which feel like attacks inside our bodies, or the terror of feeling helpless and out of control over getting fed, or sorrow and despair when help isn't on the way, all make us contract our muscles. Watch a panicked baby and you'll see. These expanding and tightening functions are all deeply unconscious.

From early on, some of us grow more prone than others to tighten up our muscles against unpleasant feelings because we're scared of them. We are afraid that if we give in to sorrow, rage or despair, we'll fall into a pit of helplessness and lose control forever. On a bodily level this means a personality style evolves which unconsciously fires the sympathetic system so regularly that a tightly armored musculature comes to feel normal, or 'just the way I am'. People with this way of being tend to be more anxious, in general, than those at the other end of the continuum, who from early on tend to collapse in depressed despair against sorrow and rage rather than contract their muscles against to fight against it.

There's nothing intrinsically better or worse about being more or less a depressive type or more or less an anxious type--each has its gifts and challenges; it's a pick-your-poison kind of thing. Those of us at the depressive end of the continuum tend towards addictions, obesity and diabetes. Those with chronically contracted musculature inhabit a tight "body container" which promotes various unhealthy processes, for example, acid overproduction, which is associated with all manner of illness from ulcers to arthritis and GERD, to name but a few.

Because chronically tight musculature promotes an implosion of biological and emotional energy which gets highly concentrated down to the cellular level, feeding whatever disease processes are present. Cancer cells thrive in tightened emotional environments, happily running amok reproducing themselves.

This is the underlying reasoning for holistic adjunctive treatments for cancer and other illness which focus on relaxation, "stress reduction", meditation, and the like. These are efforts to decrease the unconscious firing of the sympathetic nervous system, and teach a person to grow conscious of "letting go" of anxiety by experiencing the expansive, non-contracting states of the parasympathetic system--exemplified in feelings of love, joy, laughter, surrender, spirituality and such. The reason so many have trouble staying with relaxing states is that in an odd way, "letting go" of anxiety or tightness feels scary, as if you might fall into an abyss and lose control over emotions and never climb out again. It somehow feels safer to stay "tight" and "in control" than to risk tumbling headlong into a sadness one worries will have no bottom.

The personality implications of all this are intuitively familiar to us. Not always, but often, cancer patients are very nice people who rarely express anger, negativity or open disagreement unless it's in a pent up explosion or outburst. They have a hard time saying no directly, suffer from guilt, and tend to favor optimistic views over realistic assessments of unpleasant realities. Again, no judgement here, just that emotions are natural biological processes seeking expression, not unlike taking a poop. They aren't good or bad, they just are. And when they're kept inside, or only expressed in all-or-nothing explosions, their energy feeds whatever is going on inside one's muscular container, whether cancer cells, arthritis, or gastritis.

In my case, although I live over on the depressive end of the continuum, I had been in an emotional vise at work for several years which required me to suppress massive amounts of pent up anger. And on top of that, I was ingesting substances which created lots of excess acid.

The subject of carcinogens and carcinogenic lifestyles is too broad for this discussion. But essentially, if you take a hundred random people with personality styles fitting all along the depressive-anxious continuum, and expose them all to the exact same carcinogens, in the end, you'll find a higher percentage who get cancer over on the anxious personality end than on the depressive end. In other words, being a more muscularly armored, anxious person who blocks out unpleasant emotions doesn't cause cancer, but may put one at greater risk for contracting it, other things being more or less equal

WHAT ABOUT STRESS?

You may have noticed I didn't use the word 'stress' once in my little epistle above. I dislike the concept of stress. It emerged back in the sixties at some point, I think in reference to our 'stressful society' or something like that. Soon it became a garbage pail term to describe unpleasant states of being, like, "Man, I'm all stressed out". As it gained attention in the medical world to describe the condition of feeling pressured in our stressful society, terms like 'stressors' or 'stress events' were used to describe happenings in our lives like divorce or job loss which caused us to feel, you guessed it, 'stressed'. God forbid we should normalize use of the term 'emotion' in public health parlance.

Stress is emotion. Emotion we feel in response to events in our workaday world or interpersonal lives. Stress is another word for anxiety. Or fear. Or sadness, or anger or impatience or grief or hopelessness or helplessness. Stress describes what happens physically in our bodies when we experience these emotions.

But the term 'stress' is used in the public vernacular to separate our body experience of emotions from their meaning to us. I don't have to think of myself as anxious if I call myself 'stressed'. I don't have to ask myself, "Gee, what am I so scared of?" I don't have to cry in grief if I've lost a close friend when I tell myself I'm 'stressed out by recent events'. I don't have to verbalize my fear of failing to myself when I miss my sales goal if I tell myself or my wife, "Man, work is just stressful".

Even the physicians in the exchange above were at a loss to replace the word 'stress' with 'fear', or 'pain', or 'despair'. They didn't have the emotional vocabulary to say "Love promotes health whereas the effects of anxiety and rage on the body promote illness". The best they could offer was refer to stress as the 'opposite' of love. What a fine how-do-you-do.

The stress concept lets us pretend that what ails us is 'out there' in the world, and not in our feelings ABOUT what happens to us. It's more comforting to see ourselves as victims besieged by all these terrible stressors 'out there' coming at us like invisible bugs from space--whether a nasty boss, a traffic jam, a complaining spouse, a raise in rent, or any of the endless array of events which make up the stuff of life. We prefer to think of ourselves as stressed, than to name our specific discomfort, like "I hate my boss" or "I'm furious this traffic will make me late" or "I'm afraid I'll miss out on something" or "I feel so humiliated and criticized by my wife" or "I'm so scared over how I'll pay the rent". Somehow to acknowledge these emotions makes us feel weak or failed or afraid we'll lose control.

Over years of work with people, the most satisfying experience for me and my patients was their gradual learning over time they did not "go crazy" if they gave in to tears, did not become permanent raving lunatics if they sobbed themselves into a ranting rage, and that ultimately, they felt much more at peace in their own skins once they accepted pain and fury as just "part of me", but not "controlling me".

So the moral of this story is that physical health is helped along by emotional health, by learning words for our feelings and using them when we can. It is also enhanced by making life choices which lead us towards expansive feelings of joy and love and wonder, and away from those which make us tight and anxious. It was in this spirit that I named my six month trip through Europe the of Joy in Beauty tour.