When the Body Says No: The Cost of Hidden Stress (14 page)

“‘Although I always knew she favoured my brother and sister, she was so full of love some of it slopped over onto me’ is also the perspective of an adult trying to distance herself from the emotional reality of the experience. The child’s perspective would be different. How did it actually feel?”

“I know I used to resent the attention paid to my little sister because she would hold her breath and turn blue. Later, she studied to be a nurse practitioner, to get a nursing degree, and she had four children. She was an addict and an alcoholic, and she died before she was fifty from an overdose. My parents tried with her … my mother tried desperately with her.”

“You’re so quick to jump to your parents’ defence.”

“That’s because I’m a parent.”

“I think it’s because you’re defending yourself against your own pain in your relationship with your parents. You had nightmares …”

“Everybody would have nightmares if they drank all the iced tea I did …”

“Nightmares are about our deepest anxieties. A kid is afraid of monsters under the bed. You turn the light on and you show him that there are no monsters, and the next minute he is afraid of the monster again. What is he actually afraid of? He’s afraid of not being protected, about not being connected enough. Maybe there’s something monster-ish in the parent … maybe the parent is angry, so the kid is really scared. The kid has all this fear, so his mind will create the image of a monster.”

“The nightmares I had were about my father. I detested him. Not too long ago, I was talking with my brother, who was very much browbeaten by my father. He became an aeronautical engineer in spite of all of it; although he himself has been a lifelong alcoholic, he’s a functional one, and actually excels in his field. Not long ago he said, ‘You know, Betty, I always admired you when we were kids because you weren’t afraid to stand up to Dad.’ That isn’t true—I was petrified of Daddy, but I would offer some resistance. To my brother, in his mind, I was a freedom fighter because he would never say a single word to my father. My father called him a sissy because he just studied all the time.”

“Another reason you had nightmares about him is that you couldn’t talk to your mom about any of these feelings.”

“What was I going to tell Mom—‘I hate Daddy and I don’t know what in the world you’re doing with him’?”

“No, just ‘Mom, I hate Daddy.’”

“It wouldn’t have washed. The Bible says you honour your mother and father.”

“I’m not blaming the mother because she is in this relationship—she has her own history. She can’t very well fight and upset the applecart. But for the child, the bigger wound is the experience with the mother. You come from a mother’s body and you relate to the mother. The mother is the universe for us. It’s the universe that lets us down. When the father comes along as an abusive, threatening figure, the universe protects us or the universe doesn’t protect us.

“Now, I’m not saying it’s the mother’s fault. It has to do with the position of women in society and the relationships people get into. I’m talking only about the child’s experience. The child doesn’t know it, since you can’t miss what you’re not familiar with, but the child is actually experiencing abandonment by the mom. When you say ‘that wouldn’t have washed,’ what you’re really saying is that your mother
had no way of hearing your root feelings. We don’t tend to think of that as wounding, but it is a deeper wound than anything else.

“There’s a wonderful feminist book by Dorothy Dinnerstein,
The Mermaid and the Minotaur
. It discusses how the exclusive role that women have in early childraising distorts child development. When the woman is married to an immature man, she is also a mother to her husband, so she hasn’t got the openness and the energy for her kids. So your real rival for your mother’s affection wasn’t your sister, it was your dad.”

“It’s so odd because all three of us before my sister died were talking one day about my father. The animosity that I feel for my father is nothing compared with what my sister and brother felt. They both hated my father so much. We were talking about my father, and my mother came into the room and she said, ‘You know, when you kids talk about your father, I’ve always felt angry with you, because your father was a good man.’ She also said, ‘I don’t think I paid enough attention to any of you. If I had it to do over again, I would pay more attention to all of you and less to Daddy.’”

“Perhaps. But she may not realize that he got the attention that he demanded. Had he had less, he would have made her suffer for it.”

It was Barbara Ellen and her aunt who died of an overdose and her alcoholic uncle and her brave mother, Betty, and all Betty’s children who, to one degree or another, suffered for the demanding immaturity of Betty’s father and for the lack of true assertiveness by her mother. And these parents, too, were suffering and carrying the burden of generations. There is no one to blame, but there are generations on generations who had lived to bear a part in the genesis of Barbara Ellen’s breast cancer.

  T
HE LARGE MAJORITY OF LUNG CANCERS
are caused by carcinogens and tumour promoters ingested via cigarette smoking,” says the twelfth edition of
Harrison’s Principles of Internal Medicine
. The statement is scientifically incorrect, despite the truth it contains.

Smoking no more causes cancer of the lung than being thrown into deep water causes drowning. Fatal as immersion in deep water can be to the unprotected non-swimmer, for someone who swims well or is equipped with a life jacket, it poses little risk. A combination of factors is necessary to cause drowning. It is the same with lung cancer.

Smoking vastly increases the risk of cancer, not only of the lung but also of the bladder, the throat and other organs. But logic alone tells that us it cannot, by itself,
cause
any of these malignancies. If A causes B, then every time A is present, B should follow. If B does not follow A consistently, then A cannot, by itself, be the cause of B—even if, in most cases, it might be a major and perhaps necessary contributing factor. If smoking caused lung cancer, every smoker would develop the disease.

Several decades ago, David Kissen, a British chest surgeon, reported that patients with lung cancer were frequently characterized by a tendency to “bottle up” emotions.
¹
In a number of studies, Kissen supported his clinical impressions that people with lung cancer “have poor and restricted outlets for the expression of emotion, as compared with
non-malignancy lung patients and normal controls.”
²
The risk of lung cancer, Kissen found, was five times higher in men who lacked the ability to express emotion effectively. Especially intriguing was that
those lung cancer patients who smoked but did not inhale exhibited even greater repression of emotion than those who did
. Kissen’s observations implied that emotional repression works synergistically with smoking in the causation of lung cancer. The more severe the repression, the less the smoke damage required to result in cancer.

Kissen’s insights were confirmed in spectacular fashion by a prospective study German, Dutch and Serbian researchers conducted over a ten-year period in Cvrenka, in the former Yugoslavia. The purpose of the study was to investigate the relationship of psychosocial risk factors to mortality. Cvrenka, an industrial town of about fourteen thousand inhabitants, was chosen partly because it was known to have a high mortality rate and partly because its stable population base permitted easier follow-up.

Nearly 10 per cent of the town’s inhabitants were selected, about one thousand men and four hundred women. Each was interviewed in 1965–66, with a 109-item questionnaire that delineated such risk factors as adverse life events, a sense of long-lasting hopelessness and a hyper-rational, non-emotional coping style. Physical parameters like cholesterol levels, weight, blood pressure and smoking history were also recorded. People with already diagnosed disease were excluded from the research project.

By 1976, ten years later, over six hundred of the study participants had died of cancer, heart disease, stroke or other causes. The single greatest risk factor for death—and especially for cancer death—was what the researchers called rationality and anti-emotionality, or R/A. The eleven questions identifying R/A measured a single trait: the repression of anger. “Indeed
cancer incidence was some 40 times higher in those who answered positively to 10 or 11 of the questions for R/A than in the remaining subjects
, who answered positively to about 3 questions on average…. We found that smokers had no incidence of lung cancer unless they also had R/A scores of 10 or 11,
suggesting that any effect of smoking on the lung is essentially limited to a ‘susceptible minority.’”
³

These findings do not absolve tobacco products or cigarette manufacturers of responsibility in the prevalence of lung cancer—on the
contrary. All the thirty-eight people in the Cvrenka study who died of lung cancer had been smokers. The results indicated that for lung cancer to occur, tobacco alone is not enough: emotional repression must somehow potentiate the effects of smoke damage on the body. But how?

Psychological influences make a decisive biological contribution to the onset of malignant disease through the interconnections linking the components of the body’s stress apparatus: the nerves, the hormonal glands, the immune system and the brain centres where emotions are perceived and processed.

Biologic and psychological activity are not independent; each represents the functioning of a super-system whose components can no longer be thought of as separate or autonomous mechanisms. The past quarter century of scientific inquiry has supplanted the traditional Western medical view of a split between body and mind with a truer, more unitary perspective. Candace Pert, a leading American researcher, has written that “the conceptual division between the sciences of immunology, endocrinology, and psychology/neuroscience is a historical artifact.”
⁴
Psychoneuroimmunology
—or, more comprehensively and accurately,
psychoneuroimmunoendocrinology
—is the name of the discipline that studies the interrelated functions of the organs and glands that regulate our behaviour and physiological balance.

The brain, nervous system, immune organs and immune cells and the endocrine glands are joined together through several pathways. As more research is done, more links are likely to be discovered. The combined task of this psychoneuroimmunoendocrine (PNI)
^*
system is to ensure the development, survival and reproduction of each organism. The interconnections among the components of the PNI system enable it to recognize potential threats from within or without, and to respond with behaviours and biochemical changes coordinated to maximize safety at minimal cost.

The various parts of the PNI super-system are wired together by nervous system connections, some of them only recently identified. For example, the immune centres—previously thought of as acted on only by
hormones—are extensively supplied with nerves. The so-called primary immune organs are the bone marrow and the thymus gland, located in the upper chest in front of the heart. Immune cells maturing in the bone marrow or in the thymus travel to the secondary lymph organs, including the spleen and the lymph glands. Fibres issuing from the central nervous system supply both primary and secondary lymph organs, allowing instant communication from the brain to the immune system. The hormone-producing endocrine glands are also directly wired to the central nervous system. Thus the brain can “talk” directly to the thyroid and adrenal glands, or to the testes and ovaries and other organs.

In turn, the hormones from the endocrine glands and substances produced by the immune cells directly affect brain activity. Chemicals from all these sources attach to receptors on the surfaces of brain cells, thereby influencing the organism’s behaviour. We have all had the experience described in medical language as “sickness behaviour,” which illustrates the action of immune products on the brain. A group of chemicals called cytokines, secreted by immune cells, can induce the feelings that prompt us to call in sick to our workplace—fever, loss of appetite, fatigue and increased need for sleep. Distressing as they are, such rapid adaptations are designed to conserve energy, helping us to overcome illness. Inappropriate secretion of the same substances, however, would interfere with normal functioning—for example, by causing excessive fatigue or chronic fatigue.

It is astonishing to learn that lymph cells and other white blood cells are capable of manufacturing nearly all the hormones and messenger substances produced in the brain and nervous system. Even endorphins, the body’s intrinsic morphine-like mood-altering chemicals and painkillers, can be secreted by lymphocytes. And these immune cells also have on their surfaces receptors for the hormones and other molecules originating in the brain.

In short, in addition to the unifying network of nerve fibres that wire together the various components of the PNI super-system, there is also constant biochemical cross-talk among them. The myriad products they can each send to or receive from the others enable them all to speak and understand the same molecular language and to respond, each in its own way, to the same signals. The PNI system is like a giant switchboard, always alight with coordinated messages coming in from
all directions and going out to all directions at the same time. It follows, too, that whatever short-term or chronic stimulus acts on any one part of the PNI system, it has the potential to affect the other parts as well.

What makes possible the versatile interactive functions of the PNI system? A microscopic look would reveal numerous receptor sites on the surface of each cell to which the common molecular messengers can bind. As Candace Pert reports, a typical nerve cell, or neuron, may have millions of receptors on its surface: “If you were to assign a different color to each of the receptors that scientists have identified, the average cell surface would appear as a multicolored mosaic of at least seventy different hues—50,000 of one type of receptor, 10,000 of another, 100,000 of a third, and so forth.”
⁵