Can our emotions damage our soul?

Body and mind: Body and soul - only strong together

Body and soul - only strong together - page 1

Today Walter Dell * doesn't even know what annoyed him. Probably nothing. But after that day, panic roused him from his sleep. He had chest pain. As he often did during the day when he harbored grudges. That night my chest hurt particularly badly. His first thought: The heart fails - again. Dell had already had a heart attack. Now the fear of death came over him again. His wife called the ambulance. However, the reported: false alarm. The 56-year-old went through two more such horror nights, twice the anger simmered in his heart, turning into pain.

It is common knowledge that heart and soul form a unit. How strongly they actually interact - that feelings can trigger physical pain and even heart attack symptoms - few know. For a long time, even medical professionals thought this was impossible. Ever since René Descartes postulated the separation of mind and body in the 17th century, doctors and scientists have long viewed and treated them as two separate spheres. But in recent years, studies have shown more and more clearly how closely the body and mind are connected.

Whether heart attack, back pain or virus infection - the psyche has an immensely large influence on the risk of illness and the course of healing. Doctors need to take this into account if they are to treat their patients well and save the healthcare system billions. It is still different: Although psychosomatics is finding its way into more and more medical disciplines, many patients are still wandering through the system because doctors only look for physical causes of their suffering and do not involve the soul.

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Conversely, and this comes as a surprise to many experts, the body has astonishing power over the psyche. Researchers are only just beginning to grasp the full extent. Biochemical processes in the organs can upset people emotionally in such a way that they become mentally ill. Some psychological ailments may even arise in the depths of the intestine, suspect representatives of a new field of research, neurogastroenterology. Experimental psychology has also discovered the body and has shown with amazing studies how even unconscious movements control our feelings and thoughts. The body may even be a key to new types of psychotherapy.

Sigmund Freud already assumed that psychological conflicts turn into physical complaints. However, it took decades for doctors to accept this. Today we know that mental illnesses, high pressure at work or conflicts in a partnership can affect everything from the scalp to the little toe.

The mental well-being of the pregnant woman already forms the immune system of her child in the womb. If she experiences a separation or other stressful situations, the body releases cortisol, which also reaches the fetus via the placenta and changes the immune system there. The affected children are then more likely to suffer from allergies or asthma as adults.

Later, your own stressful everyday life comes along, which weakens the immune system and makes the body more susceptible to viruses and bacteria. For example, carers of Alzheimer's patients who are mentally stressed are not only ill more often than people in other professions, as a study in the USA showed. In your body, protective immune cells also multiply less than usual. The nurses in the study also often produced fewer antibodies than necessary to be protected after a flu vaccination. Sometimes the effect of the psyche can even be observed directly, for example on wounds: they heal more slowly in stressful times. Otherwise, if the scab disappears after a week, it will take almost three days longer under exam stress. In the case of constantly arguing spouses, about four days are added.

Stressors and hormones

In extreme cases, the influence of the psyche can be life-threatening: Experts estimate that it was the decisive factor in four out of five heart attack patients. The risk increases, for example, if the job demands a lot from you, but is not sufficiently rewarded or does not leave any room for your own ideas. However, the heart often only blocks when conflicts, stress factors or strokes of fate accumulate.

When stressed, the body releases the hormones cortisol and adrenaline, and the heart pumps faster and with more pressure. The body is set up for action. In itself, that is not harmful. However, prolonged exposure can lead to chronic high blood pressure, which in turn can cause hardening of the arteries, which is closely linked to heart attacks. But the psyche is usually not the only cause. Improper diet, obesity and smoking are also risk factors.

Nevertheless, researchers even want to have identified a certain personality type that favors coronary heart disease. Accordingly, people with a "Type D" personality (D like distressed), who are often in a bad mood, fearful and depressed, are particularly at risk. Also suspected: personality type A. Such people are overly ambitious, downright dogged and therefore often hostile. "For me, perfectionism is actually the most important risk factor," says Jochen Jordan, head of the psychocardiology department at the Kerckhoff Clinic in Bad Nauheim.

Mental illnesses are even more dangerous than stress or certain personality types. "Depression stresses the heart as much as smoking," says Christoph Herrmann-Lingen from the Center for Psychosocial Medicine at the University of Göttingen. You double the risk of heart disease. Even subliminal depression is comparable to the damage that passive smoking causes. The mental illness alone cannot lead to a heart attack, says Herrmann-Lingen. "But it can accelerate his occurrence." In depressed people, the blood coagulates more quickly, the frequency of the heartbeat is no longer as variable, and inflammation occurs more frequently, for example in the blood vessels - circumstances that favor heart attacks. In addition, depressed people tend to unhealthy behavior such as chain smoking or frustration eating.

Heart disease and sadness are a dangerous couple. The chances of survival for people with depression after a heart attack are significantly lower than for those whose souls are not suffering. This is problematic because people who survive a heart attack often develop psychological problems later. Many suffer from anxiety, some even from post-traumatic stress disorder. It is all the more important that doctors keep an eye on the emotional well-being of heart disease or risk patients. This awareness is growing in specialist circles. More and more clinics have psychocardiological wards that focus on the interplay between heart and soul.

Walter Dell also spent six weeks on such a ward at the University Hospital in Göttingen. At first he was skeptical: "I found it hard to believe that my head was fooling me into another heart attack, that anger was a burden on my heart." In the meantime he is grateful: "I came here as a pile of misery. Today I can make people laugh again." Psychotherapy alone and in a group, relaxation exercises and art therapy have nurtured him. In art therapy, he painted his current self: an egg. His heart is where Yolk swims. It is safe there, because all the stress and anger that shot him in the chest before ricochet off the shell.

So it seems as if the medical professionals recognized the close interplay between body and soul and finally drew the necessary conclusions. The majority of psychiatric clinics, for example, now have the psychosomatic label in their name. The number of hospital beds for psychosomatic patients has also doubled. In reality, however, many doctors still only resort to medication. The psyche is still seen as rather unimportant.

The picture of a purely physical illness often still dominates among general practitioners. "We are trained incorrectly," says the Rostock family doctor Thomas Maibaum, who is responsible for advanced training in the Mecklenburg-Western Pomerania family doctor association. During their studies, young doctors learned too little about the psyche, and in practice they are trained to initially only look for physical reasons for an illness. Every fifth patient in a family doctor's practice has physical complaints for which there is no organic cause. On average, it takes up to six years for these patients to receive psychosomatic treatment. Many then have a true odyssey behind them.

For those affected, this means additional stress, they are often given the wrong medication and should have to undergo unnecessary examinations. And the health system is burdened with considerable additional costs - Experts estimate that billions of dollars could be saved if doctors took more account of the mental health and social circumstances of their patients.

This becomes clear with the example of back pain. They are one of the most expensive diseases in this country. Four out of five Germans have had back problems at least once in their lives. In more than 80 percent of these, there is no physical cause. But even if the doctor diagnoses a herniated disc, it doesn't have to be causing the pain. Often the psyche plays an important role. It determines how strongly people feel a stinging or pulling. Depressed people, for example, often feel a slight pike as unpleasant pain. Stress and conflict can also make pain worse.

Psychotherapy for back pain patients

In every third back pain patient, the head is the reason why short-term complaints turn into years of suffering. Because back pain becomes a problem above all if you overestimate it, see a doctor every time you pinch or even stay in bed. Anyone who withdraws from everyday activities for fear of pain at the first prick and spares themselves too much does not achieve relief, but the opposite: The back muscles atrophy and ultimately hurt even more when moving. A vicious circle sets in. Sometimes patients stray for decades from family doctor to orthopedic surgeon to physiotherapy to osteopathy - without success. According to a report by the health insurance company DAK, this costs the health system 25 billion euros every year. A quarter of this could be saved if doctors made more use of modern therapy methods such as psychological training.

This has been taken into account at the Berlin Back Center for years. In addition to sports and physiotherapy as well as medical treatment, the patients here also take part in psychotherapy. In doing so, they learn, for example, to consciously relax again and again, especially when everyday life is stressful. Because those who have a lot to do at work or do mentally stressful things often automatically tense up. The back muscles are then permanently activated and start to hurt. In many cases, relaxation exercises can prevent pain from occurring in the first place. If the symptoms are already chronic, attention training can help.

Psychotherapy can help even if there is a physical cause of the symptoms. It was a blessing for Katrin Wagner's * back. The 46-year-old had suffered several herniated discs. She ignored warning signs from her back for a long time and sometimes worked 80 hours a week, even though she only had a part-time job. Until one day it slammed in her back. She made it to the train home. She could only crawl out and lay motionless on the platform. Two days before the annual vacation. And because her family was more important to her than work, she drove with pain - in the motorhome towards Tuscany. Back in Berlin, the right half of her body was paralyzed. Just a few more days and it would have stayed that way forever.

But she got back on her feet - and carried on as before. Again and again her back struggled, made her freeze. For example, while strolling on Kurfürstendamm, when a police officer had to maneuver the cars around the immobile woman on the street. One day, when it banged in her spine again, the health insurance company sent her to the back center in Berlin. In psychotherapy, Wagner now learns to relax her muscles and change her way of thinking - she learns that she doesn't always have to do everything. If it pulls in her loin now, she knows: "This is a cry for help from my back."

Patients benefit from the fact that body and soul grow together in research and practice. To consider only the influence of the psyche would again be too short-sighted. Conversely, the body also has power. Physical illnesses, in turn, can cause psychological distress. It is understandable that people despair when they have to endure constant pain or have to change their lives after being diagnosed with diabetes, when they fear another heart attack or the return of a tumor. However, there are indications that physical processes often also work in secret, which strike the soul.

In the case of diabetes, researchers are tracking down such connections. Not only is diabetes a possible consequence of depression, but it also doubles the risk of becoming depressed. Researchers suspect that diabetics not only suffer from the stress of the disease, but that their bodies also have processes that make them more prone to depression. On the one hand, diabetics often feel exhausted when they have poor blood sugar control, are unable to concentrate and lack drive. "That can affect the mood and favor depressive symptoms," says the psychology professor Frank Petrak from the LWL University Hospital in Bochum, who has been studying the psyche of diabetics for years. On the other hand, the disease can possibly also lead to changes in the brain.

This is indicated by the fact that some diabetics have a reduced plasma concentration of the growth factor BDNF (brain-derived neutrophic factor) to have. This protein plays an important role in the growth of nerve cells. Animal experiments also showed that diabetes in mice impaired the formation of nerve cells in the hippocampus. And human imaging studies indicate a reduced brain volume in some diabetics in certain areas such as the amygdala and the hippocampus. So far, these are only isolated findings, but they suggest one thing: "Assuming that nerve growth in the hippocampus is disturbed in some diabetics, this may hinder the ability to learn," says Petrak. "Perhaps then they can learn less well how to cope with difficult situations." That could lead to depression. So far, that's speculation. But it is undisputed that physical processes can produce psychological symptoms. In some cases, the latter point to a physical problem first.

As with Tina Scholl *. She was treated by psychiatrists for many years. Sometimes one suspected a depression, sometimes a borderline disorder or schizophrenia. In fact, Scholl had severe symptoms, and at times she felt pursued and watched. But no matter what the therapists gave her, it only got worse. Because responsible was not a mental illness, but a hereditary metabolic disorder called porphyria. It disrupts the build-up of the red blood pigment hemoglobin, so that precursors accumulate in the organs. The body reacts with extreme physical and mental symptoms. After doctors found and treated the real cause of Scholl's problems, she suddenly felt better.

Physical causes of mental disorders

Erich Kasten describes this story as an extreme example of a misinterpretation. He's seen cases like this before. The psychologist is a professor at the University of Göttingen, but also treats patients in his practice in Travemünde. It happens that people seek his help in whom he cannot detect a mental disorder. "They had a happy childhood, have an intact marriage, have healthy children and a great job, but they can no longer pull themselves together," says Kasten. He sends her back to the family doctor for a blood count - he often finds something.

Even an underactive thyroid can trigger symptoms similar to depression. Overfunction, on the other hand, sometimes causes mood swings that mess up the lives of those affected. Even a root inflammation can lead to psychological symptoms, says Kasten.If an inflammation goes undetected or persists for a long time, it can throw people emotionally off track that doctors classify them as mentally ill. Messenger substances of the immune system trigger the typical feeling of illness in the brain, which forces infected people to withdraw from society, making them more introverted and lacking drive. It actually makes sense, after all, sick people belong in bed. But in the long run it can endanger the psychological balance.

There are numerous such physical causes of mental disorders, including vitamin deficiencies or oversupply. "Ultimately, all mental processes are based on a physical basis. So it is not surprising that many organic disorders are also noticeable mentally," says Kasten. But not everyone knows that.

Just as doctors often neglected to consider psychological causes for physical problems, psychotherapists mostly did not suspect that physical causes could be behind psychological symptoms, says Kasten. They lack medical training. "What they learn is not enough to really understand what is going on in the body." It is therefore not enough to train doctors in psychosomatic medicine. On the other hand, psychologists should understand the body better.

It is possible that the cause of a mental disorder sometimes lies in a region of the body that hardly anyone would suspect: the intestines. "For a long time it was only assumed that psychosomatic disorders can lead to stomach and intestinal diseases. However, for some years now there have been increasing indications that it could also be the other way round," says Peter Holzer, Professor of Experimental Neurogastroenterology at the Medical University of Graz.

The representatives of the still young discipline of neurogastroenterology regard the intestine as a kind of second brain because of its millions of nerve cells. It not only receives signals from the first brain, but vice versa also sends information there. In addition to the nerve cells, immune messenger substances, intestinal hormones and bacteria also influence the brain - and possibly control emotions.

Animal experiments have shown, for example, that laboratory mice behave more anxiously when their intestines are inflamed. Other mice became depressed when researchers genetically manipulated certain gut hormones to disable them. It makes sense that these messenger substances control behavior, says Peter Holzer. Ghrelin, for example, is released when you are hungry and reduces anxiety and depression. "Both would be more of a hindrance when searching for food."

The findings on the intestinal flora are even more astonishing. "It is now assumed that intestinal bacteria produce substances that reach the brain via the blood and can change emotional processes there," says Holzer. When scientists from Canada paralyzed the intestinal flora of mice with antibiotics, the animals were much more eager to explore than before - an indication of reduced fear. Holzer's team came to similar results, but they also observed that the mice also had memory problems. A study from Ireland in which researchers treated mice with a probiotic caused a stir. They reported that after four weeks of lactobacillus diet, the mice were less anxious and depressed and were also able to cope better with stress. Corresponding changes in the brain could even be detected.

Of course, such experiments suggest that one can specifically influence one's mood through diet. "After all, we know that the nutritional quality has a major influence on the composition of the intestinal flora," says neurogastroenterologist Holzer. However, it is still unclear whether and how psychological parameters can be controlled via it. To what extent one can infer the complex psychopathology in humans from the rather simple animal experiments is questionable. Holzer believes that initial studies on humans are only of limited relevance. Researchers claim that a probiotic milk drink improves the mood of some healthy test subjects over a longer period of time. "However, the number of participants was very small," says Holzer. A yogurt drink for depression would be almost too good to be true - and big business for the food industry.

Yet scientists believe that eating a healthy diet promotes mental health. This is indicated by a growing number of large-scale studies. For example, a prospective study of around 3,000 adolescents in Australia showed that participants who switched to healthy diets over the years also improved their mental well-being. In adolescents whose nutritional quality decreased, however, the psychological well-being also decreased. Other studies indicate that Mediterranean food in particular is good for the soul.

Your own body is also a key to mental happiness. Even his movements contribute to it. It has long been known that physical exercise is good for the psyche. It is not without reason that depressed people are advised to move as much as possible. Sport increases the release of endorphins. But psychologists have discovered even more intriguing mechanisms.

Studies show: Our thinking apparatus in no way works like a computer, isolated from the environment in a rigid housing. The feelings and thoughts that arise in the head depend on the body on which it is sitting. Even thoughtless movements or postures guide our sensations and judgments. This makes it easier for people to remember positive events in experiments when they raise their arms from the bottom up or when they smile and sit up straight. On the other hand, if you sit in a hunched position for a while, you give up faster on frustrating tasks and are less proud of successes.

Muscles and feelings

The subjects in such studies are usually not even aware that they are performing a certain movement or adopting a certain posture. You are made to do this with subtle tricks. In a famous experiment by the social psychologist Fritz Strack, for example, test subjects found a cartoon much funnier when they held a pencil between their teeth that automatically activated their smile muscles. Other subjects who were asked to turn the pen upside down with their lips and therefore could not smile were far less amused.

It seems as if the facial expressions are not only an expression of feelings, but also reinforce them or evoke them in the first place. Psychologists have found plenty of evidence that activating muscles can put people in certain moods and influence their judgments. The social psychologist Jens Förster was able to show that people become more receptive to positive words if you get them to nod their heads. On the other hand, if you let them shake their head, they tend to store negative information. In another study, Strack and Förster showed that people who bend their arms because they are supposed to press against a table top from below remember more pleasant things than people who press the table from above and thus stretch their arms.

According to the thesis, certain movements are linked in the course of life to those positive or negative stimuli with which they occur together. For example, bending the arm is associated with things that you pull towards yourself because you want them, or with people you hug. On the other hand, the arm is often straightened when we push something undesirable away from us.

"Memories are stored on different levels," says Johannes Michalak, professor of psychology from the University of Hildesheim. "Emotional information is linked to physical representations. Thus, certain movements or postures are associated with emotional states." Michalak speaks of a memory network. "If a node in this network is activated, for example through body posture, the other nodes are also automatically activated, such as the emotional information."

This distorts the awareness of new information. Michalak has shown that people can remember positive terms better when they sit upright or walk with a swing. On the other hand, if they slump or shuffle to themselves, their attention to negative words is increased. "The physical change means that our information processing system is configured differently," says Michalak. "If I adopt a positive attitude, the system is more likely to be configured to process positive information."

As strange as the experiments may seem, they are far more than entertaining basic research. Approaches for new therapies can emerge from the researchers' findings. Johannes Michalak wants to investigate whether special movement training might help against depression or prevent relapses. He found that depressed people walk more slowly and more stooped than mentally healthy people. The problem: "If you go depressed, then more negative emotional states are activated," says Michalak. Another reason that depressed people may find it so difficult to break out of their negative world is that their movement patterns keep them trapped in it.

Michalak found that even people who have overcome depression still display a depressive gait pattern to some extent. He fears that this will encourage relapses. Patients therefore not only have to change their way of thinking, but also learn to move differently again. Studies have already shown that mindfulness-based psychotherapies, which also train body awareness, reduce the risk of relapse in depressed people. "So far, however, it is unclear what role increased body awareness plays in this," says Michalak. He wants to close this gap and research the effect of walking training for depressed people.

As part of her habilitation at Heidelberg University, the psychologist Sabine Koch showed that targeted movements briefly lift the mood of depressed people. Koch researched the effect of dancing on mental disorders and found that an Israeli circle dance with pronounced jumping movements could temporarily alleviate depressive symptoms in patients. "Because vertical movements are so limited in depressed people, we wanted to get them to move more up and down," says Koch, who is now professor for dance therapy at the SRH University in Heidelberg.

In her series of experiments, she varied the sequence of movements and found out that jumping actually triggered the positive feelings. Koch also tried out various dance styles with anxious patients. With them, cradle rhythms in particular had an anxiety-reducing effect. "Moving from side to side, preferably in three-quarter time, eased the anxiety best," says Koch. She suggests integrating dance exercises into psychotherapy, for example at the beginning or end of the sessions.

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