Alive At The Edge:
Field Notes From An Endangered Species

Mechanisms for intervening and collaborating with our immune systems . . . unused and forgotten, they can restore the rhythm of life.

"Health can be viewed as the capacity of the organism to regulate its own behavior and physiology, and produce appropriate coordinated response patterns to a challenge. When an individual cannot regulate his/her own behavior and physiology, regulatory disturbances may take place that, in turn, may lead to disease under certain conditions."1 What does it mean, to regulate our behavior and physiology? We can look to the dance of the immune system to give us an image of biological self-regulation. The body functions within a certain normality, a homeostasis, a balance. When a threat in the form of a virus or bacteria intrudes, the body "amps up" with increased immune activity (cyotoxic cells, phagocytes, etc.) as a response. When the danger has passed, another "team" takes over to turn off this action and return us to organismic homeostasis.

We see a similar phenomena at work in the autonomic nervous system, which fluctuates between the sympathetic, or fight-or-flight, response and the parasympathetic, or relaxation, response. The trauma of HIV infection sets in motion an overactive immune response without cessation and the body is not capable of turning off the immune activation. This constant stimulation of the activating immune mechanisms without a corresponding resting phase wears out this function. And during this activation phase, the receptor sites on the lymphocytes are open, making them continually vulnerable to further HIV infection and destruction. Other auto-immune diseases, such as lupus and rheumatoid arthritis, are situations where the body is at war with itself as the organism cannot discriminate self from non-self, an essential state of inappropriate or confused identity. Looking at these conditions metaphorically, I am struck by existential human conditions being reflected on a biological level.

Vasquez, at the University of Texas, has indicated that the cellular and psychological responses to threat go through the same developmental stages: Recognition; Mobilization; Transformation; and Cessation. We can think of the biological trauma of HIV as being analogous to other forms of bodily and psychic trauma: abandonment, sexual abuse, betrayal. States of trauma create a dissociation, a certain shock, like the startle reflex, that temporarily inhibits the fluency and movement of the self. When the trauma/stressor is not adequately processed, transformed and resolved, the body/mind cannot return to optimal balance. And very often the shock of trauma backfires into a silence, a speechlessness, a lack of expression that "freezes" the organism and interferes with the full articulation of rhythmicity, potentially distorting the mechanisms of communication and self-regulation in the body.

"People who feel emotions but actively inhibit their expression (inhibitors) and people who report not feeling emotions but who, in fact, express them to others through non-verbal channels (repressive copers or those with illusory mental health) are the very people at greatest risk for illness and probably have the worst prognosis for healing."2 We live in a culture which is uncomfortable with the life of feeling and expression. We have neglected the education of what Daniel Goleman refers to as "emotional intelligence", and to neglect this capacity only furthers our estrangement from ourselves. As the soul is encapsulated in a body in this lifetime, it is our task to truly take birth by fire, to live and understand the feeling life of the self, in all its permutations and nuances. The chemistry and movement of feelings is vital for our cellular well-being as well as for tasting the depths of our experience.

"McCraty et al, (1995) in their research on the effects of emotions on heart rate variability, found that the elicitation of positive emotions (such as appreciation) are associated with increased parasympathetic activity, whereas the elicitation of negative emotions (such as anger), are associated with increased sympathetic activity."3

Very often this type of research is misconstrued as indicating that one should only have positive emotions, and supports people in the repression of uncomfortable feelings. Thus, it supports our wishful thinking to not suffer and only have happiness, love and light. Many Westerners have adopted Eastern spiritual paths as a way to avoid or transcend the navigation of difficult life experiences and the working through of painful memories. This abdication of present reality is also reflected in the Christian mythology of Heaven, a place of peace and no suffering. Thich Nhat Hanh speaks of the Buddhist notion of inter-being, that the garbage of our negative thoughts and experiences is the compost which grows roses, that both are necessary and that it is a matter of looking deeply into the garbage to see that the roses are already there.

"Don't wish for, don't wait for, don't expect happiness: just be it in the present moment. We need to know how to make peace and joy out of suffering as the quest for no-suffering is illusion, and creates more suffering: if you abandon suffering, you abandon happiness. The material of our suffering is the same as the material of our happiness. And the practice of mindfulness, the attention to the breath, the satisfaction with ourselves, allows us to heal this duality."4

What is crucial is that we can experience and express the full spectrum of feelings, recognizing that each state of being has valuable information for the organism. When we begin to judge and differentiate feelings, sensations and thoughts as good or bad, we limit input into consciousness and diminish our choices and adaptability. There is speculation at this point that each feeling state and its expression reflects a natural pharmacoepia within the body that regulates its functioning. So we have within us one of the natural mechanisms of healing, that of the chemistry of expression. Sympathetic activity generates arousal and stimulates the production of the hormones of fear and excitement. These hormones of fear/distress have been shown by research studies to impair aspects of cellular immunity in vitro. Yet as Fritz Perls pointed out so eloquently, "Fear is excitement without the breath." And the exhale, the expression of feelings in action/words, can change a potentially unhealthy chemistry into a life-affirming one.

"Primary emotions like anger, fear and sadness do not have any harmful effects on our bodies. They alter our physiology, but so does every biological function. It's only when we habitually block feelings that they become the "toxic" states associated with weakened immunity: anger becomes resentment or chronic depression; fear turns into panic; sadness yields to hopelessness."5

Because the chemistry of the autonomic nervous system interacts so intimately with our perception and cognition, one triggering the other, it is important to know the mechanisms by which we can intervene and collaborate with our immune systems. Whereas it is virtually impossible to intervene directly with our immune systems and its biochemistry, we do have the power to change our insight and our responses, which alters our chemistry of feeling and perception. Very often this cognitive reframing happens through the meaning we give to our life experiences and the contexts for meaning, such as philosophical and spiritual teachings, that guide our perspective.

Psychological research on long-term survivors of AIDS has indicated the correlation between enhanced immunity and healthy self-care; maintaining connectedness; having a sense of meaning or purpose in life; and maintaining perspective.6 Each of these criteria overlaps and informs the other. By focusing on why we want to live, there is the potential for a corresponding shift in the how of life. This translation of intention into behavior is the greatest challenge for humans, yet it is also the greatest transformation. We can be reborn in this life by reincarnating ourselves through insight and action, through reorganizing ourselves somatically and psychologically.

This restoring of rythmicity to ourselves is a somatic task as well as a psychological one, something that very often is neglected in our thinking.

For feelings are not just psychic constructs but something we feel as the tissue of our being, various sensations, a substantial presence in our guts.

In fact, the inhibition of feelings is also the inhibition of movement, and vice-versa, which we can observe in incongruence between words and facial expressions, for example, or the steadfast refusal in some people to cry. And yet the movement of feelings very often is the motivation for movement in life.

"When we are angry, we're moved to correct an unfair or threatening situation. When we're sad, we're moved to find comfort and contact. When we're afraid, we're moved to deal with or escape the source of danger.

"Emotions are the bridge between mind and body, stimulus and action. When we chronically deny, split off, or repress emotions, we're destroying this bridge."7

Bringing our attention back to movement and the life of the biological self without the interference of the conditioned mind assists in the cultivation of our aliveness, and our connection to other life forms. The self-identification and proprioceptive feedback of movement expression can create a base of support internally for experiencing and exploring our feelings, relating to them not as the monsters we may have imagined them to be, but as bodily experiences of life.

"Feelings are energies which are given to the body and then consciously experienced. They are not ours any more than the air we breathe is ours. We cannot control them. We can only say yes...feelings are part of the rhythmic flow, the stream of life. We don't make demands on our feelings. We simply give them the space they need. We attend, allow and respect. Turning the attention to the body is the beginning of the process of compassionate self-care."8

Our abilities to care for ourselves through reflection, action/expression, connection, and involvement can be seen as valuable ingredients in health care -- perhaps even the most important. One could make an analogy between the cessation response/the parasympathetic activity with the ability to psychologically surrender to our own inner movement. At a certain point, we all need to believe that the war is over, that we can let down our guard and trust the spaciousness of being which includes the full range of feelings.

And yet to trust is not a simple task as we make ourselves vulnerable to betrayal.

The "betrayal" of balance is one of the strongest dramas of human existence.

When we've been betrayed, especially by someone we are very close to, it feels crazy making, like can we even trust that the sun will rise tomorrow?

When we are diagnosed with a disease, the shock of the body's betrayal very often drives us further away from our own center. This realization that security, life, love are not guaranteed traumatizes the innocent self and can have devastating consequences. The inherent dangers of betrayal are responding with the dark side of human behavior: denial, revenge, cynicism, paranoia and self-betrayal.

I wonder how the "somatic betrayal" of illness affects the implicit will to live -- as it is easy to imagine ourselves as the perpetrator, the saboteur of our own lives, accumulating all the wounds of a lifetime and projecting them onto this cellular act. Either this profound wound can deflate us into a certain state of hopelessness, or into a state of openness and reformation.

James Hillman, the Jungian psychologist, has referred to betrayal in mythological terms as the end of innocence, the expulsion from the Garden of Eden, the mortification of Christ on the cross. This "sacred wound" has within it the inherent gift of spiritual growth.

"It may well be that betrayal has no other positive outcome but forgiveness, and that experience of forgiveness is only possible if one has been betrayed.

Such forgiveness is a forgiving which is not a forgetting, but the remembrance of wrong transformed within a wider context, or as Jung has put it, the salt of bitterness transformed into the salt of wisdom...Just as trust has within it the seed of betrayal, so betrayal has within it the seed of forgiveness. Neither trust nor forgiveness could be fully realized without betrayal."9

Our personal engagement with our own process on many levels is at the heart of efforts to restore balance in the traumatized organism that we refer to as self, this movement towards self-regulation and organismic integrity. At a certain point, we are called upon to forgive our betrayers . . . the virus or tumor, our parents, abandoning lovers, society, even God. And in this forgiveness is the seed of mature love which permeates our entire being, energetically, psychologically, and perhaps even biologically. As Buddha said, "You could look the whole world over and not find another being more deserving of love than yourself." We can turn the spotlight of compassion, awareness, and caring onto our own being and act from that orientation. And perhaps this lesson of self-love is the greatest opportunity we are given in living with a life-threatening disease.

1 Kemeny, M., Solomon,G. et al, Psychoneuroimmunology

2 Davison, K. and Pennebaker, J., Emotions, Thoughts and Healing: After Dafter in Advances, Vol. 12, No. 2 (1996) (This issue of Advances is devoted to "Why Negative Emotions can sometimes be Positive", a fascinating discussion on current research and considerations.)

3 Ironson, G., Solomon, G., Cruess, D., Barroso, J., and Stivers, M., Psychosocial Factors Related to Long-Term Survival with HIV/AIDS in Clinical Psychology and Psychotherapy, Vol. 2, No. 4 (1995)

4 Thich Nhat Hanh, Dharma Talk, Plum Village, France, January 25, 1997

5 Temoshok, Lydia and Dreher, Henry, The Type C connection: The Mind-Body Link to Cancer and your Health (New York: Random House, 1992) pg. 265

6 Ironson, G. et al (1995)

7 Temoshok, L. and Dreher, H. (1992) pg. 266

8 Schwartz, Stephen, Compassionate Self-Care, in The Sun

9 Hillman, James, Betrayal, in A Blue Fire: Selected Writings (New York: Harper Collins, 1989)

Next Article