In my last article on Gluten and Grains, and whether they were digestible and tolerated by most people or not, I alluded to the concept of Psycho-Neuro-Endocrine-Immunology and the larger factors which determined whether someone’s digestive and immune systems were able to tolerate these more ‘challenging’ proteins.
The “Psycho” of this term refers to psychiatric: in essence, it is about neurotransmitters and the chemical impact of these throughout the body. It is certainly true that we can discuss serotonin and its relationship to gut function, we can also talk about gut permeability and the impact that the release of toxins (endotoxins, or Lipopolysaccharides) can have systemically, i.e. throughout the body – including in the brain.
But in today’s post I want to mention the reverse aetiology of immune conditions, and autoimmunity. I want to broach the subject of the relationship between the brain and the gut being bi-directional, i.e. the way we think can directly influence the environment of our digestive system.
***DISCLAIMER: Please read this in conjunction with other blogs of mine, most notably the previous post. In no way do I want to give the impression that psychoanalysis is the only thing necessary for healing, more that it is an often overlooked PART of a complete healing protocol.***
Perhaps the easiest thing to talk about with regard to psychology driving pathology is ‘stress’. In the true medical definition of the word, stress can mean anything that places excessive demands on the human body: from extremes of temperature, exercise, eating plant foods which have lectins or salicylates (designed as plant protection systems which are slightly toxic to the human body), to the stress of long-term sleeplessness, excessive hormone dysregulation or even really natural events like pregnancy and childbirth.
But stress also means everything that places demands on us from an emotional and lifestyle perspective: from the social and interactive, to familial demands, children, challenging colleagues or bosses etc.
And, from my perspective, stress is also something that we are extremely able to pile on ourselves.
You will likely have heard of the analogy of a bucket, which represents our capacity to cope with stress. Everything that is stressful contributes to the fullness level of that bucket. Excess stress is what causes that to overflow and symptoms result.
This can be seen within every physiological system. Built to withstand a certain amount of pressure, demands, toxicity and antagonising, our internal systems will fail when the load becomes too much to bear: whether in quantity, or also in duration – when the stresses have just gone on too long.
Stress in Immunity
But how does this relate back to tolerating gluten or not? Again, to be really clear, I am not discussing those with coeliac disease.
Gluten is a stress – for all the reasons I explained in my last post. And there are some people for whom gluten and the demand to digest grains has a disproportionate impact into their stress bucket – creating an overflow even without other stressors there.
However, there are others for whom stress is coming from all angles, and the inability of our digestive system to tolerate not only gluten, but a whole host of other foodstuffs, seems completely out of hand.
It is for these individuals where understanding our psychology, and having insight into how we are contributing to our own stress load with our thoughts, emotions, internal dialogue and increased anxiety, may have the ability to downregulate the stress response, improve the ‘general resilience’ of the body and the digestive system and increase the ability to ‘tolerate’ a broad spectrum of previously aggravating foodstuffs.
Before I go into detail on the three major areas of internal dialogue which I have noticed as a contributing theme in autoimmunity and immune oversensitivity, I want to be explicitly clear that the relationship between gut and brain is BI-DIRECTIONAL. It is also connected to every other physiological system. Nothing operates within a vacuum. Therefore, addressing these thought patterns and areas is not curative and universally applicable. Additionally, psychological distress is greatly contributed to by any issues within the GI tract.
Therefore, in my clinic, I work from a multidisciplinary approach, because I believe that it is more comprehensive and really tackles all factors which might ensure true healing when we have arrived at a place where autoimmunity (i.e. the immune system attacking the body’s own tissues) or immune hypersensitivity (i.e. an immune system which reacts to seemingly every external input) rule our lives.
Below are three of the key psychological areas I recognise as contributing to the picture of illness when immune issues are concerned. This is not an exhaustive list, but it touches on some of the thought processes which can contribute to an over-alert immune system.
But first, a word about the front line defence for autoimmunity and immune hypersensitivity in the Functional Medicine community: Elimination Diets.
To be really clear, an Elimination Diet is designed to calm the reactivity of the immune system by removing inflammatory foods and anything that can possibly cause symptoms. The severity of restriction (and quantity of foods eliminated) is determined by the degree of suffering and illness in the patient. An Elimination phase can also include changing cookware, household cleaners, personal care products and even water supply. In severe cases, recommendations can be made to move home (typically in toxicity overload or mould exposure).
The limitation of Elimination Diets, in my perspective, is that they should never be seen as a longterm strategy. The idea of staying on an Autoimmune Paleo diet for life is OK, but in my eyes it is shortsighted and imperfect as a ‘cure’. I believe that dialling down the immune, inflammation and stress buckets down should enable people to open up from restrictive elimination protocols, allowing far more back into their lives. This may never, ever include an ability to digest gluten and grains properly.
But for those for whom their diet consists of just a handful of ‘safe’ foods, where everything they eat or drink, everywhere they go and every action they take is filled with the fear of exposure:
I truly believe that working through the following psychological areas, with the support of someone who has experience in dealing with the psychology of autoimmunity, may provide the infrastructure which allows for freedom from the restrictiveness of elimination dieting, which is actually just a sticking plaster over a hypersensitive immune system.
Immune Psychology 1 – How You Think and Feel About Food
When the way we think about food itself is filled with negative associations, the nervous system and immune system will automatically be on high alert whenever food is brought towards the body. The whole process of eating and ingesting food then becomes fraught with anxiety.
Heightened anxiety creates a sympathetic dominance, i.e. our body’s nervous system moves into a state of “fight or flight”. This switch to sympathetic nervous system is AWAY from the parasympathetic nervous system. It is the parasympathetic nervous system which controls “rest and digest”, in other words providing the peristalsis movement of the GI tract, stimulating the release of acid and enzymes for digestion and opening and shutting the sphincters which regulate the flow of ingested foods.
When “fight or flight” is activated because our brain has sent fear-messages at the very thought of ingesting food, we are literally not in the right emotional, mental or physical space to eat.
Blood is diverted away from the digestive organs to the limbs and your body is cued by your psychological perspective to either face an enemy or run away. When the enemy in question is food this is, in no way, conducive to digestion.
When insufficient acid and enzymes are produced, motility is disturbed and the right environment isn’t there because of improper nerve impulses, effective digestion becomes impossible and symptoms result: the very symptoms that were feared (indigestibility and immune attacks of improperly broken-down proteins). Our brains are wired to note cause and effect, so when it looks as if the food itself caused the symptoms our fears are reinforced.
It does not take many occasions of this happening for us to begin mentally associating eating itself with pain, discomfort and fear. In reality, our anxiety has primed our digestive system to react.
Psychologically fearing food, independent of its impact on the digestive juices and GI tract, will also prime our immune system to react. Our immune system responds to the messages of impending threat that emanate from a psyche trained to fear food. As we (mentally) send alarm bells to our immune system because we are frightened, our immune system does what it is designed to do: it goes on high alert and becomes a little too trigger-happy, ready to fight anything and everything. So it fights, even when the food molecules themselves don’t actually pose a threat.
The immune system will always respond to threats, whether real or imagined, and it is this situation which gives rise to multiple intolerances. When, for whatever reason, we become frightened of anything and everything our immune system will respond by fighting anything and everything.
In a state of high stress, inflammatory molecules are being sent everywhere at all times. Add to this the consumption of something that you are deeply afraid of, your immune system merely responds as it is prepared to do. Symptoms are the result – and again, we have a catch-22 situation. You perceive that food itself has given rise to symptoms, whereas in truth it is your priming of the immune system to defend which has caused the attack.
In order to calm such responsiveness it is not enough to eliminate everything from your diet (and life) which causes reactions (even if it were possible). Instead, it must be recognised that psychologically mediating the way we perceive food, reframing it in our brains and transforming our relationship to it, is essential.
Feeling frightened of food and eating is perhaps a natural response when we have experienced digestive issues in our lives. However, the association of fear and threat with food and eating can persist and contribute to the manifestation of symptoms.
The ability to emotional and psychology work with our thoughts and emotions around food can have a dramatic impact on this situation. By taking steps to switch on the parasympathetic nervous system and consciously calm down prior to eating you can change this experience. But by working to reduce the mental stress-response to food you will also directly quell the immune response.
This won’t work for things which you are truly intolerant, allergic or sensitive to. But I have learned that sensitivity can work on a spectrum and is deeply affected by our mental state. It has been demonstrated that you can modify the immune system’s reactions through meditation, and the work of Wim Hof has shown how inflammatory responses can be mediated by brain training techniques.
Therefore, if your mind and psychology are “anti-food”, or indeed meritocratic about it – thinking of it as “good” and “bad”, “clean” and “naughty”, or, most perniciously, constantly referring to foods as “safe” or not, “compliant” or not (common in Elimination Diet circles) then it could well be that working through these thoughts and mental perspectives with somebody may allow you to actively temper your reactivity and change your ability to digest, absorb – and ENJOY – a broader spectrum of foods.
Immune Psychology 2 – How You Think and Feel About Your Body and Yourself
Chronic illness is draining and life-altering. It changes one’s relationship to one’s body and oneself.
One of the biggest challenges in chronic illness is to find a way to love oneself through it.
That may sound ‘soft’ or esoteric, but when your body starts to suffer, for any reason, there are a whole host of psychological shifts that accompany that suffering. These thoughts and feelings can be as impactful as the illness itself – particularly if we fall into the trap of feeling as if we’re letting people down, being a burden or start ruminating about all of the things we are not doing because of our illness.
Additionally, when our brain views illness through the lens of our ‘stupid’ body having ‘failed’ us, this negative self-talk also has a direct impact on every part of our being. Psychological self-defeatism directly influences our physiological wellbeing, and also our capacity for healing.
We have all heard of the power of gratitude, or the importance of positive thoughts and attitude. The reality is that all thoughts are powerful – be they positive or negative. Pessimism has just as much power as positivity, and never is this more true than when faced with the adversity of a symptomatic body.
Perception is key when it comes to immunity as mentioned above when framing food as a threat. The internal tendency to demean and talk ‘down’ to our own bodies will alter the responses of our immune system.
Autoimmunity is a state in which the immune system is attacking our own tissues. If you think about it, this is the immunological equivalent of attacking ourselves mentally with negative self talk. If we hate ourselves for any reason – even just for being ill – we continue to send ‘attack’ messages towards ourself. Our immune system will continue to do as directed and mount attacks against our own body.
I must stress that I am in no way accusing people of creating autoimmunity by a negative attitude towards themselves. However, the tendency for psychological self-attack seems to manifest concomitantly with autoimmunity – i.e. people who have genetic susceptibility to autoimmunity tend to also have a psychological tendency to a negative self perspective.
Put simply – the two conditions regularly coexist. I strongly believe that if autoimmunity is to truly go into remission it requires quieting any self-hatred from the mind. We cannot be attacking ourselves with our own thoughts, hating our body, and expect our immune system to sit still and not attack us too. Anything that we point our attack towards, our immune system is likely to follow – and this includes if we are permanently and persistently negative about our ‘failing and stupid’ bodies, and/or who we are as people.
This is complicated to unravel when sitting in a body that is symptomatic and suffering. I work hard with clients on this point, because there are often layers of historic self-doubt and insecurities upon which the feelings around illness have been constructed.
And yet life really can change through altering perception and interpretation. Viewing illness or autoimmunity as either a physical or personal failure builds a picture of our bodies as enemies (so we attack them) or as having let us down. However, I don’t personally believe that it’s helpful or effective to tell people just to stop thinking like that.
Instead, I work on allowing my clients to build a different relationship with their body. The precise routes to do this will vary with each person - but the main sensation I am trying to build within my clients, always, is TRUST.
Without trust, being inside our body is a very scary and sorrowful place to be. Whether treating bugs and bacteria, hormones, neurotransmitters, weight gain/loss etc. etc. or autoimmunity and immune hypersensitivity – I am always focusing on showing my clients reasons and ways to allow them to trust in their bodies and themselves again.
Immune Psychology 3 – How You Think and Feel About the Development of Your Illness
All of which brings me to what I have found to be the most fundamental part which begins the unwinding of the above psychological minefields and starts to foster trust and self-respect, diminishing the fear-based relationships we have with our bodies and eating.
Everything about immunity is dependent upon sensing a level of safety or threat. If your food and your body are threatening you cannot calm your immune system. But if we are to trust in food, and trust in our body and our ability to heal, we need reasons and justification for doing so. Blind faith is often not enough.
Here is where I think that the Functional Medicine approach provides vital assistance in the healing process. It is why I work from a multidisciplinary perspective, incorporating both the physical AND the psychological into my work with clients.
You cannot forgive, accept and learn to understand and work with your body if you are still confused as to what happened, where your illness came from and why you are suffering.
The best way that I ever found, personally, to make peace with symptoms and to learn to trust my own body again, was to understand the genesis of my illness, the truth behind my symptoms and suffering and really learn why my ill health manifested in the way it did. Knowing ‘why’, and forgiving myself, was one of the greatest tools to healing.
In Functional Medicine we map the trajectory of a client’s symptoms onto a personalised timeline. This is a key clinical tool because it helps the practitioner trace the progression of disease. However, it is also a liberating tool for patients because it has the powerful effect of allowing them to let go of a major trigger and negative reinforcer of illness: guilt.
When we can see illness mapped onto a timeline of life experiences – genetics, birth issues, early life, childhood trauma, infections, travel bugs, stressful life events and other influences – a natural unwinding occurs. Seeing ourselves as the end result of a whole host of lifelong inputs, it becomes clear that illness is a, perhaps natural, conclusion to a lifetime of insults and complications.
Understanding the trajectory and the storyline of ill health decreases the sense of personal responsibility and blame that often accompanies chronic illness. This is not about facilitating victimhood or a ‘poor-me’ mentality. Instead, it is about recognising ill health as a consequence of life, rather than as a personal flaw, failing or ineptitude.
This is where working with someone who understands both the way physiology works, along with comprehending the intricate machinations and motivations of the psyche, is a real asset to any recovery. Addressing the body’s trauma whilst simultaneously discussing the psychological trauma that goes alongside suffering with chronic illness is an invaluable tool to finding real freedom from the illnesses which have interrupted our lives.
All of this may seem very, very far away from whether gluten and grains are healthy or not, which is where I began last week. However, in truth, my big point with both of these posts is that everything challenging in life is something we must cope with – whether gluten protein, other foodstuffs, our work colleagues or familial relationships.
How well we cope is dependent on so many factors – from genetics, to toxin exposure, to digestive integrity, to the fullness of our stress bucket.
A large contributor to coping is perspective, psychology and how we interpret what comes towards us in life. I have witnessed that transforming our relationships with food, ourselves, our bodies and the lives we live can profoundly alter our coping capacity at every given moment. In a state of calm, immune responsiveness – to gluten or to anything – diminishes.
My work with clients is on both physiology and psychology. I ensure that we establish foundations of health within digestion, hormones, lifestyle measures and nutritional sufficiency. But I also know that to heal I must help my clients reduce their stressors in all areas. One of the most profound, in terms of impact on both illness and healing potential, is the stress we place on ourselves from our internal dialogue. Allowing my clients to trust, embrace, forgive and accept themselves is possibly the most valuable work that I can do.
If you or anyone you know needs my support in the areas of autoimmunity or immune hypersensitivity, particularly if you feel some emotional and psychological support to tackle your condition, I offer Digestive Wellness Coaching – with Initial Consultations followed by Support Packages and you can contact me for support at any time (text/email/phone) and we can work together through your stresses and internal dialogues.
Please do get in touch if you would like my support. And don’t forget to sign up to follow my updates (top right of this page) – I plan to write more about the role of our psyche in healing for future posts. And if you’re still unsure as to whether this is a route for you to go with your healthcare, do Sign Up to receive my Completely Free PDF on whether you could benefit from working with a Functional Medicine Coach.