Blood Pressure and the Brain
We have known for almost a century that regions of the brain are involved in the control of blood pressure.
Yet over the last three decades most of the emphasis in research into hypertension (high blood pressure) has focused on blood vessels, the heart and kidneys.
Now research from Bristol University in England has been published in this month’s issue of the journal Hypertension, and it may put the brain back into the center of research into the causes and treatment of high blood pressure.
Working with rats, the researchers isolated a protein called JAM-1 (junctional adhesion molecule-1), that is located in the walls of blood vessels in the brain. It appears to trap white blood cells causing obstruction of blood flow in some of the smallest blood vessels. This can cause inflammation and result in poor oxygen supply to the brain, which may in turn trigger events that raise blood pressure.
Though this work is in its early stages, this is exciting stuff: if confirmed, it might be possible to treat hypertension with drugs that reduce blood vessel inflammation and increase blood flow within the brain.
It also ties in with other recent research from Imperial College, London and Oxford University, in which a team of neurosurgeons and physiologists discovered changes in blood pressure while fitting brain electrodes to 15 patients for pain control.
Deep brain stimulation involves placing very thin electrodes on very exact locations in the brain and is already used to relieve pain and to help Parkinson’s disease patients with their movement.
The researchers found that they could make patients’ blood pressure increase or decrease by stimulating very specific regions of the brain with the electrodes. Regions that have been associated with blood pressure control in the past. If they stimulated an area deep down in the midbrain called the ventral periventricular/periaqueductal gray matter, blood pressure went down, and if they stimulated the dorsal periventricular/periaqueductal gray matter it went up.
Nobody is suggesting that we should start sticking electrodes in peoples’ brain, but this chance observation may have profound implications, particularly for people who drop their blood pressure too far when they are treated with standard medicines.
These two pieces of research may also help explain why a balanced inflammation–reducing diet and relaxation may both reduce blood pressure.
Mindfulness and Eating Disorders
There is a very interesting report about a study that is going on at Griffith University in Brisbane, Australia.
They are using a psychological technique called "mindfulness" that is firmly rooted in Buddhist philosophy, in which a person becomes intentionally aware of his or her thoughts and actions in the present moment, non-judgmentally. Mindfulness is applied to both bodily actions and the mind’s own thoughts and feelings.
The idea is to help them understand and deal with the emotions that trigger their binges. Unlike many other therapies used in the treatment of eating disorders, there is less focus on food and controlling eating and more on providing freedom from negative thoughts and emotions.
Psychologists Michelle Hanisch and Angela Morgan said that women who binged were often high-achievers and perfectionists and when they perceived that they didn’t measure up to self-imposed standards or were not in control of situations, they indulged in secretive eating binges.
It is well known that many women with eating disorders develop elaborate methods of hiding the evidence of their binges. Some feel so guilty afterwards they also induce vomiting, overuse laxatives or exercise excessively to counteract the effects of the binge.
The researchers say, "Binge eating is largely a distraction – a temporary escape from events and emotions that nevertheless can cause long-term physical problems including electrolyte imbalances. Instead, women need to learn how to react in a different way… Women who have been through the program report less dissatisfaction with their bodies, increased self-esteem and improved personal relationships," and "They learn that thoughts and emotions don’t have any power over us as they are just passing phenomena and aren’t permanent."
Mindfulness involves techniques and exercises that are very similar to meditation. They could help people live more in the moment, and develop a healthy acceptance of self and become aware of potentially destructive habitual responses.
There is quite a large literature on the use of mindfulness in a variety of clinical situations including substance abuse, oncology, chronic stress, reducing symptoms after organ transplantation, chronic headache and perhaps anxiety.
It will be interesting to see the final results of this study: I shall keep you informed about this and other studies on mindfulness, meditation and acceptance and committment therapy (ACT).
“Peace can be reached through meditation on the knowledge which dreams can give. Peace can also be reached through concentration upon that which is dearest to the heart.”
–Patanjali (Indian Philosopher said to be the Compiler of the Yoga Sutras, Dates Unknown)
"Meditation is not to escape from society, but to come
back to ourselves and see what is going on. Once there is
seeing, there must be acting. With mindfulness, we know
what to do and what not to do to help.”
Thich Nhat Hanh (Vietnamese Buddhist Monk, 1926-)
“Generosity is another quality which, like patience, letting go, non-judging, and trust, provides a solid foundation for mindfulness practice. You might experiment with using the cultivation of generosity as a vehicle for deep self-observation and inquiry as well as an exercise in giving. A good place to start is with yourself. See if you can give yourself gifts that may be true blessings, such as self-acceptance, or some time each day with no purpose. Practice feeling deserving enough to accept these gifts without obligation — to simply receive from yourself, and from the universe.”
–Jon Kabat Zinn (American Mindfulness Meditation Teacher and Associate Professor of Medicine at the University of Massachusetts Medical School, 1944-)
Social Adversity and Schizophrenia
People who are interested in the interaction of genes, environment, brain and mental illness might be interested to look at a brief article posted over at the Psychiatric Resource Forum.
The article summarizes some very important new data on social adversity and the subsequent dvelopment of major mental illness. The research has been looking at a huge puzzle: why are serious mental illnesses so much more common in Afro-Caribbeans and Africans living in England and other parts of Western Europe? It was initially thought that it might all be due to over-diagnosis, but with deatialed work done in England, the Caribbean and Africa it has now become clear that that isn’t it.
There may be a contribution from vitamin D deficiency: dark skinned people who are recent immigrants cannot make as much in their skin as they need. But that is not a cause but a potential contrbutor. That being said I am going to have something more to say about causality in medicine in a post in the next day or two.
A second line of research has identified some key brain structures that if abnormal, dramatically increase the change that a "high risk" person will develop schizophrenia. By "high risk" we mean a significant family history of the illness.
This is important material and represents a major step forward in our understanding of major mental illness and a move away from the medical model that has dominated so much of psychiatry over the last 30 years.
Stress and the Skin
You have probably noticed how stress can have an impact on some people’s skin. Increasing stress can initiate or worsen skin disorders such as psoriasis and atopic dermatitis. There has also been a lot of discussion about whether stress can also exacerbate acne and cause cold sores to erupt.
A new study published in the December issue of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology sheds important light on this association.
It is well known that one of the physical effects of stress is to increase levels of a range of steroid hormones called glucocorticoids. The best known glucocorticoid is cortisol or hydrocortisone. So the question was whether the missing link between stress and skin problems might be one or other of the glucocorticoids.
Researchers from the Veterans Affairs Medical Center, San Francisco and the University of California at San Francisco and Yonsei University Wonju College of Medicine, Wonju, Korea decided to study this possible connection.
You may have heard that the skin is the largest organ in the body and provides the critical barrier between the environment and the internal organs. Its most important function is providing a permeability barrier that prevents us from drying out. When we are healthy we are approximately 65-70 percent water. We are able to survive and function in dry environments because the skin forms a permeability barrier that prevents the loss of water.
The physical location of the permeability barrier is in the outermost layer of the epidermis that is known as the stratum corneum. The stratum corneum is composed of dead cells surrounded by lipid membranes. The stratum corneum layer continuously sloughs off, and therefore has to be constantly regenerated. The epidermal cells in the lower epidermis are continuously proliferating to provide new cells, which then differentiate, move toward the surface and ultimately die, to form a new the stratum corneum. This process is going on in your skin right now, though it can be disrupted by damage such as sunburn. If the process becomes overactive, it can lead to the development of thick, hardened skin.
It was already known that psychological stress disturbs this elegantly balanced system by decreasing the proliferation of epidermal cells and inhibiting their differentiation. As a result the function of the permeability barrier is impaired.
To test the hypothesis that glucocorticoids would have adverse effects on skin function, they stressed some hairless mice by putting them in small cages in constant light and forcing them to listen to the radio for 48 hours.
Before being stressed one group of mice was treated with mifepristone, which you may know by its two other names, RU-486, or the “morning after” pill, which blocks the action of glucocorticoids. A second group was given a drug called antalarmin, which blocks glucocorticoid production. A third group was stressed but received neither drug and a fourth group remained unstressed in ordinary cages and without the continuous light and sound to which the other groups were exposed.
The mice that received mifepristone or antalarmin showed significantly better skin function compared to the stressed mice that did not receive either treatment.
The experiment demonstrated the important role that glucocorticoids play in inducing the skin abnormalities brought on by psychological stress. Although we hope that the study will lead to a way to treat people who suffer from these skin conditions, there is still a long way to go. It’s always difficult to extrapolate from mice to people. Second, there may be serious side effects of modulating glucocorticoid activity. Glucocorticoids are essential hormones that play many important roles. Blocking their action could have negative outcomes. This is one of the reasons why we are skeptical about advertisements that claim that some herbal concoction can “cure” cortisol-related obesity. If something could really modify the activity of cortisol or other glucocorticoids in the body, it would likely have many most undesirable effects.
The research team is now looking at the effect of psychological stress on the skin’s production of antimicrobial peptides, which play a role in defense against infection. It has long been thought that psychological stress might also reduce the ability of the skin to protect from infections.
I never like to leave a report involving animal experiments without also saying a heartfelt thank you to the animals that participated in the experiments.
This research is interesting and may have a number of spin offs. But I have another rather obvious question: since we already know that there is a link between stress and some skin problems, why not focus on stress management techniques, rather than trying to find new medicines to help counteract the biochemical effects of stress?
Hostility and Insulin Resistance
Insulin resistance – a reduction in the body’s ability to respond to insulin – is something that should interest and concern all of us. Not only are a third of Americans insulin resistant, with much higher rates in people of African and Indian heritage, but also insulin resistance is the major predictor of the development of type 2 diabetes and of coronary artery disease.
We already knew that stress and certain personality factors, including hostility can be associated with insulin resistance. Now new research from The Cleveland Clinic in Ohio has clarified the association.
The study involved 643 men with an average age of 63.1 years, and the findings are published in the current issue of Psychosomatic Medicine.
The researchers measured the subjects’ urine levels of norepinephrine. Norepinephrine is one of the objective indicators of stress. The researchers used standard rating scale – the Minnesota Multiphasic Personality Inventory and the Cook-Medley Hostility scale – to measure hostility. Insulin resistance was measured using some highly validated methods: the homeostatic model assessment index; 2-hour post-challenge glucose and insulin levels. The study had to be large because some many things can influence insulin resistance: nine other common variables had to be factored in to the analysis.
The study found that there was a statistical interaction between hostility and stress level in predicting insulin resistance. More hostile people do not always have worse insulin resistance, but they do when they are under stress, particularly if it is high level and sustained stress.
The team also found that not all components of hostility are related to insulin resistance. For instance, cynicism is a personality trait that is strongly related to insulin resistance.
We do not know if stress management techniques can reduce the risk of developing insulin resistance in these high-risk people, but it is likely that they will.
Yoga, tai chi ch’uan, meditation, psychotherapy may all be helpful. The best results of all have been to combine one or other of these with homeopathy, flower essences and spiritual counseling. We have little empirical research for these combined approaches, but a great deal of clinical experience that they may be beneficial.
If you notice that you or someone around you has a hostile, cynical way of handling stress, let them know that they are at high risk of developing a physical illness, but that there is a great deal that they can do for themselves before they fall off the cliff.
Hidden Harbingers of Weight: Salt Intake and Obesity
In Healing, Meaning and Purpose, I discuss some of the evidence for four previously little recognized causes of obesity:
- Stress
- Salt intake
- Pesticides
- Viruses
Each of these has been widely discussed in the professional literature, but little has percolated out into the general population except in advertisements for agents like Cortislim. I remain skeptical about these products. Tinkering with just one of the 260 hormones and neurotransmitters implicated in the control of weight is unlikely to be crowned with success. And their ingredients may also have the potential for causing problems. Recent advertisements have also mentioned that one of these products may elevate mood. Sad to say, in the last year we have seen two people who developed manic symptoms after taking one of the supplements. We are urging colleagues to see if there are any other cases, or whether these two were just coincidental.
I recently mentioned some of the evidence for viruses as a cause of weight gain.
Now a new publication from the Universities of Helsinki and Kuopio is out in this month’s journal Progress in Cardiovascular Diseases, that provides powerful support for the salt hypothesis.
The researchers report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with an extraordinary 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.
As expected, reducing salt intake has a beneficial effect on blood pressure.
But in my view the most interesting finding of the study is the close link between salt intake and obesity.
As bartenders, pub landlords and tavern owners have known since the beginning of time, increasing a person’s intake of sodium produces a progressive increase in thirst. (You didn’t think that those peanuts on the bar were put there out of the goodness of the establishment’s heart did you??!)
The progressive increase in the average intake of salt explains the observed increase in the intake of sugar-containing beverages which, in turn, has caused a marked net increase in the intake of calories during the same period in the United States.
Here is an extraordinary statistic: Between 1977 and 2001, energy intake from sweetened beverages increased on the average by 135 % in the United States. During the same period, the energy intake from milk was reduced by 38 %. The net effect on energy intake was a 278 kcal increase per person a day. The American Heart Association has estimated that, to burn the average increase of 278 kcal a day and avoid the development or worsening of obesity, each American should now walk or vacuum 1 hour 10 minutes more every day than in 1977. As we all know, that has not happened.
In the decade from 1976-1980 to 1988-1994 the overall prevalence of obesity increased 61 % among men and 52 % among women. During 1999 to 2002, the prevalence of obesity was 120 % higher among men and 99 % higher among women as compared with the 1976 to 1980 figures. The increased intake of salt, through induction of thirst with increased intake of high-energy beverages has clearly made a significant contribution to the increase of obesity in the United States.
It is also of note that until 1983 the use of salt did not change or even showed a continuous decreasing trend in the United States. The prevalence of obesity was relatively low and remained essentially unchanged from early 1960s to early 1980s.
This new study suggests that a comprehensive reduction in salt intake, which would reduce the intake of high-energy beverages, would be a potentially powerful means in the so far failed attempts to combat obesity in industrialized societies.
There is now conclusive population-wide evidence that indicates that we could achieve powerful beneficial health effects simply by reducing our overall salt intake. These benefits include a decrease in obesity.
As an aside, the population-wide long-term experience from Finland indicated that a remarkable decrease in the salt intake has not caused any adverse effects.
A number of years ago we were engaged in some experiments in which we replaced regular table salt – sodium chloride – with potassium chloride. For the first three weeks food seemed rather tasteless. But then we all suddenly discovered a new universe of flavors that had previously been hidden under a thick coating of salt. So a dietary change does have a temporary effect on your taste buds.
Although the paper doesn’t say so, there is also some data that salt may itself increase cortisol release.
The bottom line?
We now have clear, empirical data to support three out of the four points that I made in Healing, Meaning and Purpose, and there is some less robust data for the fourth.
I urge you to try gradually to reduce your personal intake or salt, and to encourage your family and friends to do the same. I mentioned that food may initially seem a little less flavorful, but then things change rapidly and for the better.
And your body will love you for the change!
Alexithymia
There is an important psychological symptom that can cause a great deal of distress, particularly in relationships. It is called alexithymia.
The Harvard psychiatrist Peter Sifneos originally coined the term in 1972 to describe people who had extreme difficulty in emotional cognition. The word “alexithymia” literally means “no words for mood.” People with this problem lacked the ability to understanding, processing or describing their feelings verbally. As a result, most people who have the problem are largely unaware of their own feelings or what they signify. As a result they only rarely talk about their emotions or their emotional preferences, and they are largely unable to use their feelings or imagination to focus and fuel their drives and motivations.
People with alexithymia seem unable to fantasize and many report multiple somatic symptoms. However, alexithymia is also associated with a number of other complaints, such as hypertension, irritable bowel syndrome, substance use disorders, and some anxiety disorders. Their speech is often concrete, mundane and closely tied to external events. So they will describe physical symptoms rather than emotions, and don’t understand that their bodily sensations are signals of emotional distress.
Alexithymia lies on spectrum: regular readers will remember some of our discussions about categorical and dimensional diagnoses. For some people it is little more than an inability to get in touch with their emotions. But at the other end of the spectrum are a number of illnesses in which alexithymia may occur, including schizoid personality disorder, posttraumatic stress disorder, anorexia nervosa or Asperger’s syndrome. It is also much more common in victims of trauma.
Much has been written about alexithymia: a literature search earlier today generated over 8,500 publications.
It is still not clear what causes alexithymia. But this much is clear: in some people, there is a strong inborn predisposition to developing it, while in others it can develop in response to life events such as being raised in a low socioeconomic group with little social stimulation, trauma or chronic stress. For this reason we often talk about primary and secondary alexithymia.
Some neuropsychological studies have indicated that alexithymia may be due to a disturbance to the right hemisphere of the brain, which usually plays a predominant role in processing emotions. Other studies show evidence that there may be a deficit in the transmission of information between the hemispheres of the brain, with emotional information from the right hemisphere not being properly transferred to the language regions in the left hemisphere. Other studies have suggested that alexithymia may be related to a dysfunction of the anterior cingulate cortex a region of the brain involved in the control of attention, empathy, emotion and the anticipation of rewards.
Alexithymia can have some serious consequences. Apart from making relationships very difficult, it is more common in people who have near-fatal asthma attacks or have poor diabetic control. People with a history of alcohol abuse who have alexithymia are more likely to relapse. Alexithymia may predispose people to developing the insulin resistance syndrome.
As you can see, alexithymia can be dangerous: we have to have words for our feelings, or the feelings will express themselves though our bodies. It can predispose us to just about every stress-related illness, and even some illnesses that we don’t normally think of as stress-related. Since alexithymia is all about an ability to express emotions, it can be thought of as a social or informational disease. If we cannot inform others about our wants and needs, and if our minds cannot send us signals to say that something is going wrong, there could be a catastrophe lying in wait for us.
People with extreme forms of alexithymia can be very difficult to help using conventional medicine.
However, many people have minor degrees of alexithymia, and these can be helped by therapies designed to help them express emotions:
- First is to become aware of the problem: I’ve had good success with asking people to keep an emotions “log book:” if they are having odd symptoms, how good are they about having appropriate emotions? I ask them to keep a note of their emotions in response to normal interactions with other people, or while watching television or a movie. If the person feels nothing while watching something really emotional, that can help him or her see that there is a problem. Simply learning to be more expressive can help mild cases: there are an array of forms of psychotherapy that can help.
- In mild cases, we have had some good results with flower essences. There’s not a shred of scientific proof that they help, but clinically they often do. The same goes for two other helpful approaches:
- Homeopathy: there are over a dozen remedies that may help
- Tapping therapies
Women, Asthma and the Brain
There’s been a longstanding puzzle in medicine. Well actually there are lots of them, but here’s one that may be a puzzle no more.
For many years now, it’s been known that asthma is more common in women, and also that psychological stress can cause flare ups of asthma.
Many women experience “menstrual flaring:” a worsening of asthma around the time of their menstrual period. There is also a strange paradox: some women with asthma wheeze less if they take an oral contraceptive, while some non-asthmatic women begin to wheeze when they take it. In some women pregnancy makes asthma worse, and in others it affords months of relief of symptoms. Women who are obese are more likely to get asthma, presumably because their intra-abdominal fat stores are churning out inflammatory mediators.
Researchers from the University of Wisconsin have shed some important light on this link between asthma and the brain. In research published in the Proceedings of the National Academy of Sciences. In the study, six patients with mild asthma were exposed to ragweed or dust-mite extracts. The subjects were shown three different categories of words: asthma-related (e.g., "wheeze"), non-asthma negative ("loneliness") or neutral ("curtains").
Using functional magnetic resonance imaging, they showed that activity in two regions, known as the anterior cingulate cortex and the insula showed increased activity when the asthma-related words were heard compared with the other types. What is more, this enhanced activity was specifically linked to physiologic signals from the ragweed and dust-mite extracts. So being exposed to asthma-relevant emotional stimuli is associated with markers of inflammation and airway obstruction in asthmatic people exposed to an asthma-producing antigen.
In people with asthma and other stress-related conditions, these brain regions may be hyper-responsive to disease-specific emotional and physiologic signals. Taken together, these could contribute to problems that worsen the asthma, such as inflammation.
And one of the ways of making these regions of the brain hyper-responsive? Bathe them in estrogen.
That still does not explain why pregnancy and the oral contraceptive makes some women’s asthma better, and does the opposite in others. But it may just have to do with the “set point” of the cells in these regions of the brain. In the same way that we might set the thermostat in out house. An already hyper-responsive brain might be normalized and an under-active one stimulated to be over-active.
We need to do some more experiments, but these are a great start.
If you ever wheeze, have a look to see if there are stressors or hormonal events that trigger you. Whether you are being treated with homeopathy, herbals or conventional therapy, knowing when to expect trouble gives you the power to adapt you treatment when you are entering a risky time in your life.
Banquo’s Ghost
“Chess is the game which reflects most honor on human wit.” — Voltaire (a.k.a. François-Marie Arouet, French Writer and Philosopher, 1694-1778)
For anyone with even a passing interest in chess, a re-unification match for the World Championship is currently taking place in Elista, the capital city of Kalmykia, a small region of the Russian Federation that is Europe’s only Buddhist country. Though I’m sure that some would quibble about whether it should be in Europe or Asia.
The beginning of the match between two of the world’s top Grandmasters – the aggressive Bulgarian gambler Veselin Topalov and the conservative Russian, Vladimir Kramnik – has led to and 2-0 score in favor of the Russian.
So why am I mentioning this is a blog dedicated to Personal Growth, Healing and Wellness? Because the current one-sided score line has a lot to do with each of these topics. This match is not just about chess playing ability: it is also about psychological and emotional strength, character and resilience.
There was a time when chess masters were unfit, often over-weight and the majority smoked. When I first started playing in tournaments in England, it was quite normal to have ashtrays beside most of the boards.
Oh how things have changed!
Now the players prepare physically, psychologically and some even spiritually with prayer and meditation:
- Very few players smoke, not just because of long-term health risk, but because the deleterious effects of lowered oxygen levels on cognition outweigh the short-term improvement in attention caused by nicotine.
- Aerobic exercise is essential to ensure that the brain is perfused with oxygen, and if you are physically unfit you cannot expect to survive a number of games that may each last for five or six hours.
- Strength training is also essential to overall fitness and physical and the maintenance of psychological resilience. Topalov is going to need that now.
- Posture is extremely important. According to Chinese and Ayurvedic physicians and chiropractors, bad posture results in a restriction in the flow of Qi, Prana, or blood. Whether or not you believe in the flow of Qi in the body, it is easy to demonstrate that bad posture has bad effects on cognition.
- Flexibility is also an essential part of physical wellness that affects you psychologically as well as physically. Daily stretching should be part of everyone’s life.
- Relaxation and meditation: one or other or both are essential tools for maintaining your balance while under stress, and for building resilience.
- Diet: a carefully balanced nutritious diet rich in omega-3 fatty acids (without any added mercury!) and fiber is essential for optimum mental functioning.
- Fluid intake: the current recommendations are for a healthy person to drink between 80 and 120 fluid ounces of pure water each day.
- Avoid alcohol: A former World Champion – Alexander Alekhine – lost his title after turning up drunk on a number of occasions during a match to defend his title.
Looking at the pictures from the match, in both games Topalov looked intense and Kramnik far more relaxed. It could have been an illusion: I would need to be in proximity to be sure. In the first game Topalov took a needless risk in a dead level position. In the second, he had an absolutely won game. I’m no grandmaster, but even I spotted a win in three moves. How could he have failed to find it and then lost?
What is the explanation? Chess players have to play a certain number of moves in a specified time, so not only are they playing their opponent, they are also playing against the clock. The biggest prize in the game is on the line, for which both players have been preparing since childhood. And there are hundreds of thousands of people who are watching and analyzing their every move.
I know from personal experience that it can be hard enough to be interviewed on a television show being watched by millions of people, where any false statement would haunt me forever. Imagine having a battle of wits with one of the finest chess players in the world in the knowledge that every move will be analyzed for the next century, and computers are already analyzing every permutation of every move that the two players have made.
The stress on the players is unbelievable. Both have prepared for it, but it is also a matter of who has prepared best: that is a mixture of temperament and training. Just today I read an article talking about ways of avoiding stress. This is silly: stress is part of life and it can provide the motor in motivation. The trick is how we learn to respond to stress.
There is also another stressor that has only been felt by world championship contenders on two or three previous occasions. This match is being played in the shadow of the retirement of Garry Kasparov, who, in the opinion of most people, is the strongest player who ever lived, with the possible exception of Bobby Fischer. The difference is that Bobby became World Champion all by himself, with little help and by inventing a new approach to chess. It is a great tragedy that his life has apparently been blighted by mental illness, and that he has played only a few recorded games in the last 34 years.
By contrast, Garry was the strongest player in the world for twenty years, and in the opinion of most experts would probably still beat both of the current contenders. So whoever wins wants to prove himself a worthy champion. Garry’s specter remains like the ghost of Banquo in the Scottish play.
The final essential is that both players have to detach from the results of the first two games. Kramnik will obviously have his tail up now, but he is too smart and too experienced to give in to complacency. Topalov has to completely forget about the first two games and focus on what lies ahead: I’m sure that he has someone on his team working on simple techniques to stop the past from populating his psychological present.
Whatever lies ahead for these two men in the next few weeks, we shall see that chess is a microcosm of life in general.
“What is needed, rather than running away or controlling or suppressing or any other resistance, is understanding fear; that means, watch it, learn about it, come directly into contact with it. We are to learn about fear, not how to escape from it.”
–Jiddu Krishnamurti (Indian Spiritual Teacher, 1895-1986)
Fibromyalgia and Childhood Abuse
There is a small and growing literature about a link between fibromyalgia and a history of abuse, primarily in childhood or early adolescence.
A new study has shown that people with fibromyalgia who had experienced physical abuse in childhood did not have the normal daily fluctuations in the stress hormone cortisol. They also had sudden surges in the hormone as soon as they were woken up, which can be a good stressor. People who had been sexually abused also had this odd cortisol response on being awakened. These findings suggest that severe traumatic experiences in childhood may be a factor in causing hormonal disturbances in people suffering from fibromyalgia. This adds to the growing body of evidence that in women having pain early in the day, there is a high likelihood that the entire stress hormone system does not function normally.
Colleagues from the Department of Psychiatry, UMDNJ-New Jersey Medical School in Newark, New Jersey have reported that women who have been raped are ten times more likely to experience chronic pelvic pain as well as generalized pain.
Another study has found close correlations between childhood abuse and the subsequent development of chronic pain. The link between rape and the subsequent development of fibromyalgia seems to be mediated by chronic stress, in the form of posttraumatic stress disorder.
What this means is that professionals need to consider this:
- It is important careful to inquire about any history of past or present abuse or other severe trauma
- That empathy and constructive validation of disease and suffering can be very helpful
- That dysfunctional pain behaviors and personality traits may be a consequence of abuse together with a lack of resilience
- That multidisciplinary treatments including psychotherapy may be the best approach to helping people. Using the methods of Integrated Medicine is often far better than reliance on potentially habit-forming medications.
If we remember that there is more and more evidence of inflammation and other physical problems in fibromyalgia, and that stress and maltreatment in early life can alter the structure and function of specific regions of the brain, what this all shows us is that abuse in childhood can have a long term impact on the way in which both the body and the brain functions.
