INTRODUCTION
by Ida P. Rolf

The thesis which first came to our desk, the subject of this discussion, is the outstanding 262 page dissertation of Peter I ovine submitted to the University of California, Berkeley, as a contribution to physiology. It is titled “Accumulated Stress, Reserve Capacity, and Disease”. The word “stress” was rarely featured in scientific discussions twenty-five years ago. Its current emphasis marks the drastic change of thinking in present-day observation of human problems. Peter’s dissertation is an exhaustive review of the articles which have mile-posted this change of understanding.

Stress, according to Levine, may be defined as a process whereby a stimulus activates the autonomic nervous system to such a degree that return to the homeostatic balance can be interfered with. Stress therefore may be seen in terms of autonomic activation and accumulation. for example, a consequence of unresolved autonomic stress, or of improper use of the body musculature, as in had habits (Alexander) or by chronic immobilization of the myofascial network (Rolf), the probability of a given autonomic stress being resolved is diminished. The accumulation of stress, again, is expressed motorically as a further loss in this capacity by flexor rigidity and then concurrent agonist-antagonist “paralysis.”

Levine’s thesis is that stress and the chronic stress diseases are expressions of functional unbalance primarily within the autonomic nervous system, a disharmony in the relation of the sympathetic and parasympathetic systems. Whether or riot his assumption is correct, his unfolding of this point of view is a valuable contribution to those who try to alleviate the “human condition”, as well as to those who try to understand it.

Some of the stress-generated diseases enumerated are:

Central Nervous System: anxiety neurosis, obsessional neurosis, traumatic neurosis, epilepsy, migraine, shock, exhaustion

Endocrinural: primary and secondary thyrotoxicosis, diabetes mellitus, menopausal syndrome

Circulatory: hypertensions: essential hypertension, hypertensive heart disease, chronic nephritis and nephrosclerosis, malignant hypertension; rheumatic fever; coronary tensions: agina pectoris, coronary occlusion, coronary thrombosis; cerebral tensions: hypertensive encephalopathy, cerebral thromosis, cerebral hemorrhage; arterial tensions: Raynard’s disease, intermittent claudication.

Alimentorycaridospastic (esophageal); gastritis, gastric ulcer: duodenitis, duodenal ulcer; regional ileitis; colitis: pancreatitis

Genito-Urinary: menopause, leucorrhea, menstrual pain, ectopic pregnancy, impotence, cystitis.

Dematological: various rashes, psoriasis

Locomotor: torticollis (wry neck), lumbago, rheumatic fever, rheumatism, rheumatoid and atrophic arthritis, gout, tennis elbow.

In a work-a-day world, it is simple and convincing to see effort – mental as well as physical – as an expression of stimulation and over-stimulation of the sympathetic system. It is somewhat more difficult to envisage behavior appropriate to resolve the resulting accumulations. In his admirably understated and concise overview of therapeutic practices, Peter states: “Hence, in terms of the preceding models and arguments, one major avenue (and probably the most accessible one) to deal with (modify) the mechanisms of stress accumulation is directly at the muscular level, i.e., to affect the autonomic via its somatic connections.” In this connection, it is well to remember those teachers (Alexander and Rolf) who have stressed the direction of “let it” rather than “do it.” Such direction tends to de-emphasize the sympathetic component activity and allow the parasympathetic component to take on a more dominant role. We quote Peter’s abstract below. A copy of the entire thesis may be obtained from the Boulder office, at cost, which is about $17.50.

Accumulated Stress, Reserve, Capacity And Disease
by Peter Levine

OUTLINE

Part I – Accumulated Stress

Section A) Autonomic Stress – Introduction and Definitions

B) Catastrophe Theory

C) The model

D) Predictions of the Model

E) Model Applied to Hospitalized Population

Part II – Application of the Model

Section A) The treatment of accumulated stress ? Introduction

B) Holistic Approaches to Integrative Medicine

i. Acupuncture therapy ?Appendix
ii. Body Structure Approaches – Alexander and Rolf
iii. Respiratory Vegetotherapy (Reich)

Part lIl – Organismic Effects of Accumulated Stress

Section A) Anatomic substrata – The hypothalamic hub

B) Autonomic endocrine relationships in accumulated stress

C) Hypothalamic excitation change in set point and adaptational capacity

D) Autonomic-somatic relationship.
i Autism

E) Mobilization (autonomic-somatic discharge)

Part IV – Stress Disease

Section A) Pre-symptomatic diagnosis and preventative medicine

B) The stress diseases: compendium and evidence for concommilant autonomic states (as predicted by model)-mech. Chill

Part V – The Servo Analysis of Cardiovascular Dynamics

Section A) Cardiovascular control
B) Cardiovascular systems simulation and isolation of sympalhetic /parasympathetic autonomic components

Part IV – Conclusion and Perspective

ABSTRACT

The underlying theme of this paper is that the accumulation of stress affects the reserve capacity of an organism, both in the maintenance of its functional integrity and in the resolution of subsequent exposures to stress. Stress is defined in terms of a reaction resulting from stimuli which sufficiently activate the autonomic nervous system (ANS) and is either resolved or accumulated depending on whether the pre-stimulus baseline is re-established or not. Accumulated stress profoundly influences the totality of organismic functioning. and is expressed essentially through three hi-polar effect or systems: In the realm of the autonomic, the effect or system is the sympathetic and parasympathetic visceral outflow.

For the somatic, it is paired movers, like extensor/flexors; and metabolically stress is expressed (though less distinctly) by, for example, catabolic/anabolic and inflammatory/anti-inflammatory endocrine reactions. The response to stress is defined as occurring sequentially in two phases. charge and discharge: When the charging (sympathetic) phase is followed by a parasympathetic discharge of equal magnitude, then pre-activation homeostasis is re-established and the stress is said to be resolved. On the other hand, it is shown that under certain physiologic conditions (and behaviorally where mobilization – i.e., somatic response to stress – is blocked) the charge phase is no longer balanced by rebound. In these cases activation is not resolved and the stress becomes incorporated within the organism, as a diminished adaptational capacity.

The basic physiologic relations of the autonomic, sympathetic and parasympathetic, can be represented by a simple mechanical analogy (the “Zeeman Machine”) which exhibits properties described by a relatively new branch of mathematical topology, Catastrophe theory. The visualization gained by this re-presentation offers new insights into the nature and mechanisms by which stress accumulates. It also suggests ‘paradigms’ by which stress, once it has already become internalized, may be successively resolved towards reestablishing a fuller adaptational range/reserve capacity.

In this regard, various holistic systems of healing are seen to focus their efforts towards detecting and treating these accumulation imbalances and reduced capacities even before they become symptomatic and pathologic. It is the view of this work that a wide range of “stress diseases” with varied symptoms and obscure aetiologies are the final – pathologic – expression of this loss in resiliency. That the accumulation of stress is the underlying stratum in certain disease syndromes is tested by measuring autonomic levels underlying certain blood pressure responses of a hospitalized population. It is not possible, however, to measure the sympathetic and parasympathetic components directly (since they are expressed as a single output vector, blood pressure).

For this reason a systems analysis of the cardio-vascular system, based on well known experimental parameters, but with variable set point and gain levels, is constructed. A set of blood pressure response curves is generated and compared with the hospitalized population. the fit of these with the experimental data is surprisingly good. In addition, the prognosis for five groups in the hospitalized population is predicted accurately by the model, whereas no such predictions could be made on the basis of the raw data. The accumulation of stress, defined in terms of the autonomic nervous system, influences many, if not all, other systems.

The concept of an autonomic hypothalamic “huff” around which behavior is organized and executed is illustrated to clarify some of these extended relationships. Specifically, the hypothalamic links between autonomic-endocrine, as well as somatic mobilizing systems, are examined in this context. In addition, examples illustrating the potential for the wide and varied symptomatologies of their “fink-integration” (autonomic-endocrine-somatic) in the stress diseases are presented. Some possibilities for pre-symptomatic diagnosis, whereby stress accumulation is detected before the development of debilitating symptoms and tissue pathologies, are investigated as well.

These stress diseases are shown, in a selected set of examples to have underlying patterns of unresolved stress that can be understood in terms of their tofxrlogic configurations in catastrophe space.

EXCERPT of Part II.

Applications of the Model

A crucial question is why changes in body posture and use should have such a great effect on internal conditions, such as cardiovascular, many gastrointestinal disorders, various gynecologic conditions, sexual failures, migraines. depressions etc, if, as Tinbergen says, “There can be no doubt that it often does have profound and beneficial effects … both in the mental and somatic sphere.”

Towards formulating this question it need be realized that posture, while connoting a static state, is more accurately an ‘equipoise,” i.e., and equilibrium position from which action is initiated and returns within a potential field of movement. From this standpoint we now look at the effects of autonomic stress on “posture.” It is well known that autonomic sympathetic effects are associated with flexor reflexes in the legs and rigid contraction of the abdominal muscles, both in man and animals: 2 Eble (1960), McPherson (1961), and Youmans (1961).

Further, it will be shown later that maintained levels of central excitation lead also to simultaneous (non-reciprocal) activation of agonist-antagonist (e.g., flexor-extensor) pairs. The consequence of this is, as previously discussed, that autonomic discharge is blocked, assuring a further feedback of high frequency volleys, which in the absence of mobilization would lead to further accumulation of autonomic stress, making the probability of subsequent resolution even less likely. The skeletal pattern to stress is made graphic in the? startle response in whit h contraction of the abdominal and leg flexors, along with a shortening of the neck muscles and curvature of the spine thrusts the head forward and rotates the pelvic girdle so that the lumbar spine becomes excessively anterior. If this attitude, for whatever reason, becomes chronic, such as lithe autonomic stress is not resolved, then an additional factor, gravity, compounds the situation for the vertical biped.

Dr. Ida Roll (1973) points out, in her system of manipulative work that a progressive strain pattern becomes fixed within the mfyofascial systems of the person experiencing stress. The basic tenets of her theory are deceptively simple. The “ideal body” is seen as made up of segments: head, thorax, abdomen. pelvis, thighs, and legs, which are balanced one upon the other and organized about a gravitational vertical an imaginary plumb line passing through ear lobe, shoulder, hip joint, and anklebone. Any chronic deviation from this optimal state is seen to spread stress over the entire body by an infinite sequence of compensation until none of the segments are in proper balance. I his situation is progressive. It can do nothing but further distort the imbalance.

Muscles must now be constantly lightened with a wasteful expenditure of energy to maintain this unstable configuration. The individual is in a constant stress situation, fatiguing more rapidly. Tired, the person lets his or her head drop even further forward, causing the lower back to arch in compensation and the abdomen to protrude outward. The segments, now further out of alignment, require more muscular energy to keep the body from collapsing. Thus, the effect snowballs into excessive inefficiency and fatigue. (As an example, imagine carrying for even a clay a fifteen pound weight – the weight of the head a few inches in front of one.)Some consequences of these distortions, as well as their treatment by ‘structural integration” (So, are summarized by Dr. Rolf 11973):Stresses, aches, and pains are the body’s language to express the strained imbalance between the field of gravity and the body integrals weight masses of head, thorax, pelvis, legs. Such a body is unbalanced: we call it random.

Return to balance is possible. Manipulation to reposition the soft tissue will give greater freedom to the Muscles. This can be combined with a patterning of freer movement to achieve more appropriate balance. The mechanism for achieving improved function is perfectly logical. Within the body as a whole, the relation of individual structural units (head, thorax, pelvis, legs) is brought toward a vertical line in a position of standing rest. Logically, vertical alignment of units must give a structure capable of retaining its form within the disorganizing pulls of gravity on individual segmental units. Structural integration has shown that it is possible to create such an alignment. The result is a man of different mechanical and psychological qualities.

Strain between body segments alters patterns of movement. In a random body, any given movement evokes response not only from the muscle primarily concerned land its antagonist). but from a chorus of other units as well. Some of this accompanying group may interfere with, or limit, the movement, rather than support it. The resulting aberrated flow may, in fact, be an inversion of the movement demanded. It is a jangle of response, altering or even inverting the movement intended. Originally, these compensatory restrictions may well have been an effort at support on the part of the body, an attempt at ‘splinting’ or ‘relieving’ an injured part. But at the present time, they are barriers to movement; circumventing their restriction demands exhausting outpourings of energy.

Fascia ensheaths muscles and organs. Control of the position of the weight blocks in space is through these fascial sheaths. The one appropriate, but now outmoded, response reflects interference in the smooth sliding adjustment of fascial planes necessary to free, economical movement. Compensatory mechanisms originate in. and operate under, the laws of mechanics. Accident, habitual posture, or the dramatization of an emotional attitude can distort the vertical alignment of weight blocks, Then it is the total enwrapping envelope of the superficial fascia which must adjust to keep the weight blocks from literally falling apart. There is, of course, always a point of originating localized fascia) strain. But to make acute restrictions subjectively more tolerable, the body adjusts by spreading the strain to more distant points through the medium of the network of fascial planes.

Often, reinforcement is through thinkening of the fascia; this thickening usually becomes permanent, and the restriction is then chronic. In doing this, the body has adjusted throughout. In the fascia, particularly the superficial fascia, this thickening and displacement is visible in the contours of the body. But such visual cues are usually ignored because their significance is not understood. There are many patterns of disintegration. Fascial shortening may cause a slight displacement of body parts. Or fascial envelopes may attar h to neighboring myofascial unit, consolidating several of these elastic sheaths into a single unit of less resilient, less mobile tissue.

Or the problem may focus on restricted movement at the joints, where tendons shorten or become displaced. Once started, patterns of disintegration are automatically progressive. As shortening and thickening of fascia proceeds, body cavities become smaller and distorted; visceral crowding ensues. Subjectively and objectively, the picture is one of consistently lowered energy and lessened vital well-being. The point is that as a consequence of unresolved autonomic stress. or of improper use of the body musculature, as in porn habits (Alexander) or by chronic immobilization of the myofascial network (Roll), the probability of a given autonomic stress being resolved is diminished. The accumulation of stress, again, is expressed i otorically as a lurlher loss in this capan it by flexor rigidity and then concurrent agonist-antagonist “paralysis.” tern , in terms of the preceding models and arguments, one major avenue (and probably the most accessible one) to deal with (modify) the mechanisms of stress accumulation is directly at the muscular level, i.e., to affect the autonomic via its somatic connections.

The effect of this should he able to be monitored both at the muscular and autonomic effect or outputs. This has been done, to an extent, with the technique of Structural Integration developed by Dr. Rolf. Dr. V. Hunt, in the studies outlined in section III, C, has shown that, as a consequence of ”processing’ by this method (SI), the pattern of agonist-antagonist firing Wring) tends toward a more efficient “undulating” one. thus it seems possible that a restructuring and patterning’ of the functional elements which determine the’This work involves. in addition to myo-fascial manipulation. the evocation of specific movement patterns while certain goups of tissue are prevented from motion. The idea here is to demand “appropriate and enefication of smaller, more specific groups” in lieu of more general or “gross” movements.

The study (it these patterns has also teen greatly extended and advanced by Judith Aston, M.A., in a system called “Structural I’allerning.’ upright relation to gravity can tunclamenlally reorganize the capacity for disc barge of accumulated stress. That autonomic variables are simultaneously affected is suggested by some preliminary observations of Levine and Jackson & Levine. Thermographic measurements’ were made on body segments before, after and during each of the ten processing hours. Most usually profound thermic changes ex ocurred not only in local regions which were I’ing manipulated (as might be expected from the pos(-isc hems hyperemia induced b y deep pressure), but in distant situ as well.

The digits of the hands, for example, which reflect autonomic state particularly well, routinely change 4.12 degrees as a result of the processing series. In addition, many of the local and general changes ocuurred specificially and only after movement considered appropriate” for that the particular segment session was evoked. Thus it seemed that the autonomic changes occurred simultaneously with the reestablishment of reciprocal movement patterns. In addition, blood pressure measurements were taken in a few subjects before and after processing and were found generally in normalize towards 120170 as well as to become more balanced on the right and left sides of the body.

That the method affects central nervous end endocrine changes as well, has been demonstrated in an extensive series of computer evoked potential microbioassays by Dr. Julian Silverman et al.. 1197’ii.It could be argued that the autonomic system changes were caused directly by the nature of the deep and sometimes painful manipulation of the method Infeed, this point cannot be dismissed. It undoubtedly affects the results. bill the thermograhic dada indicates that the evocation of appropriate movement seems lo he primary. Furthermore. the rnanipulalions used in the Alexander work are by and large extemely gentle and involve neither pain nor deep muscle pressure: “It consists in essence of no more than a very gentle, first exploratory, and then corrective manipulation of the entire muscular system.” In additions, Tinhergen observes that “Whenever a gentle pressure is used to make a slight change in leg posture- the neck muscles react.

Conversely, when the therapist helps one to release the neck muscles it is amazing to sex quite pronounced movement for instance of the loos. even when one is lying on the couch.-‘These phenomena. demonstrating “that the innumerable muscles of the body are continuously operating as an intricately linked web,” seem also to be an underlying theme in the variously somatic ally oriented holistic approaches.’ Thus, there is a basis for arguing that the autonomic changes do By using calibrated sheets of liquid crystal.-Thee tests include various chig which Serman argues. are associated will, an enhanced tolerance of Ram elictutg sympathetic, while deep pressures are uphmropic cumuli: e.g., we Cellhurn (1967 ), pp. 6.

Stroke rather classic observations or Weber 1941 bear an interesting relation to this. He found that it a tingle muscle (5ay. the left biceps) is contracted it leads to a of the right arm and both . After general fatigue such as from vigorous running or swimming the test control Kuun causes at MOnfrit In addition if only the single biceps muscle no extrac fatigue, then the ‘ante reversal reaction occur, in it extremilies in reepre to contraction the fatigued muscle. The normal vauxlilalur response. however, is retained ii another datigud muscle is conscur when this “web” is appropriately altered towards more balanced functioning. It would be most useful to measure autonomic changes concurrent with these manipulations, particularly during and after somatic discharge, e.g., the spontaneous, often rhythmic, subtle movements in one area resulting from the release of another, or from an increase in overall charge. In another form of therapy, to be described next, Dr. Gerald Frank has made a striking color motion picture of body surface temperatures by means of a Barnes thermographic apparatus (personal communication) during charge/discharge cycles.

One can observe propagated patterns of autonomic (vasomotor) change which can be predicted from the therapist’s assessment of the chronic muscular sets and tensions. (Unfortunately, again, in this case, concurrent somatic changes were not recorded electromyographically, which would have been useful, both to objectify the diagnosis as well as to compare their dynamics with those of the autonomic measurements.)iii. Respiratory Vegeto-Therapy: Wilhelm Reich, M.D. The German physician Wilhelm Reich, independently, though slightly later than Alexander, noticed also that Many difficulties, both “physical” and “psychological” (indeed, the neurosis itself, he contended) were directly linked to chronic muscular tension patterns and spasticities.

He made the discovery that many of these tensions had their roots, not so much in the habitual improper use of the expression of certain instinctive drives.’ He found that after a certain degree of loosening these muscular rigidities, which he graphically called armor, spontaneous movement and feelings of “well being” began to occur.’ along with a free, spontaneous function of respiration.’ Reich came to realize that these involuntary convulsive discharges served to maintain or to regulate the “energy economy” (his term) of the organism and were one of the principal biological functions of a full (and deeply meaningful), uninhibited sexual union (which he found lacking in all of his patients).’In terms of the ideas here, the great interest in Reich’s work is his explicit formulation of the relation of the charge/discharge function and chronic musuacted, even if the record is taken from the fatigued arm.)

Further, Gellhorn & Lewin (1913) had shown that “menial fatigue” produced a similar reversal reaction. Thus, gross physical and mental exertion as well as local muscular fatigue have the effect of profoundly influencing global autonomic behavior, a fact that is taken for granted and applied by holistic avenues in a practical way.’ Both his work and life are summarized in Wilhelm Reich – His Life and Work by David Boadella (19731.’These feelings, he found, usually heralded an improvement of the patient’s symptoms to the point where they neither recurred nor were replaced by others.’ This he called the “breakthrough into the vegetative” to underscore its non-volitional autonomic nature.4. This capacity was always absent in the patients when they entered treatment with him, even if their reported “performance” was adequate. (there has been much dispute over the primacy he attached to the orgasm, as well as its causal relation to impre psychosomatic function. These issues are entirely outside the scope of this work. rigidities w the regulation of “bio-energy” (his terms), i.e., in the regulation of accumulated stress. As a consequence of this understanding, Reich and some of his later followers (e.g., Dr. Phillip Curcuruto) found that specialized techniques of continuous work on a person’s respiratory pattern, employing certain aspects of “hyperventilation.”‘ could be utilized in order to build up an appropriately controlled sympathetic charge concomitant with intensification of the “somatic armor.

The paradigm of a typical session in vegetative therapy- as practiced by Dr. Phillip Curcuruto,’ is gradually, by means of various specialized respiratory patterns and responses, the build a sympathetic charge’ to the point where a discharge either occurs spontaneously or can be provoked by appropriately manipulating certain muscles so as to evoke, centrally, a mobilization reactor), triggering the disc barge phase.’ One of the reasons for utilizing the respiratory Junction, and not just stimulating by manipulating the must lei, is that a goal of the process is to build a capacity for the a ?containment” of charge so that the discharge phase begins to occur spontaneously as a consequence of the excitatory buildup.

The sessions can be looked upon, in a sense, as an “autonomic learning” situation whereby the process of building charge into discharge is repeated, the client becoming less anxious” and more at horn.’ after each successive cycle; the fear of being stuck diminishes as they are able, biologically, to resolve that buildup and even begin to experience it pleasurably. This capacity, which they bring, involuntarily, according to Dr. Curcuruto, into their hit: situations, increases (heir ability to tolerate and to resolve ongoing stresses spontaneously, as they occur, One cannot help but he struck by the correspondence of this work to the topologic re-presentation of the previous sections. The progressive building of charge and, in particular, the need initially for mobilization followed by charge/discharge cycles is what is predicted for the resolution of accumulated stress.- See figures IX and VIII (pages 49 and 411, which show the need for mobilization in low motility cusp regions as well as a progressively decreased resolvability.

Contrast Reich’s therapy to the effect of the global “neurologic assault” of electroshock treatment; the resolution of accumulated stress is not simply a matter of introducing a “random” excitation?, but a re negotiator” process which involves a critically timed buildup of excitation and appropriate trigger into discharges. Otherwise, the level of accumulated stress could. See appendix. This could be interpreted as a consequence of the hvper ventilation, but, as mentioned in appendix ii, these effects disappear as the blocks become dissolved, which cannot he explained by the strict medical model. Personal Communication . See appendix ii, on hyperventilation. These manipulatives probably have similar autonomic effects to those of acupuncture stimulations. The process, at least initially, can be quite anxiety producing. It is, recall, the “lire or death” emergency response which is being evoked. This depends no the developmental and life history: the course of sessions is to Wine degree unique for each individual well become “hooked” at a higher autonomic level, with lower probability of subsequent resolution. In the actual work it is the ability of the teacher/therapist to assess the range and limitation of that person, at any given time, and to work appropriately within it. that gradually expands their perimeters.

EPILOGUE AND CONCLUSION

It has been the scope of this dissertation to define and discuss the accumulation of stress and its consequences upon organismic function and reserve capacity. When an organism incorporates stress, the result is pervasive, appearng in physical, emotional, mental and behavioral processes. Human beings whose life expression has been reshaped by stress are continually observed by physicians and therapist/teachers. Yet while all these re-educators, healers, medical persons, etc., know that they are all, in some way, dealing with the effects of stress, there would probably be very little agreement among them as to what stress actually is and how to deal with it for any given individual.

The medical solution to symptoms, for example, is all too frequently the management of the various somatic expressions of stress by the use of drugs (e.g., psychoactives – tranquilizers and “mood elevators, blue king agents, smooth muscle stimulants and relaxants, analgesics, antacids, etc.), and sometimes counseling for social and readjustment problems. George Engle (1960), one of the founders of modern psychosomatic medicine, points out that this implicit assumption, that “disease is a thing in itself,” severely limits the search towards understanding of the total organization of the body. In a definition of the health process along these lines, Romano (1950) proposes: Health and disease are not static entities, but are phases of life, dependent at any time on the balance maintained by devices, genetically and experientially determined, intent on fulfilling needs and adapting to and mastering stresses as they may arise from within the organism or from without.

HeaIth, in a positive sense, consists in the capacity of the organism to maintain a balance in which it may be reasonably tree of undue pain, discomfort, disability or limitation of action, including social capacity. Such a definition, though helpful because it attempts not to dichotomize the process of health and sickness, is too general to be of much concrete use. Such terms as “reasonably free” “failures,” “disturbances,” “mastering stress” are much closer to value judgments than to definitions. Yet it is important in that it focuses attention away from simple factor theories, such as the cellular concept of disease.

Engle’s and Romano’s views are echoed by ,Mason (1970), in his presidential address to the Society of Psychosomatic Medicine, he states: Psychosomatic medicine really represents a subdivision of a broader field which might be integrative medicine. While most of medicine pursues a course o1 viewing, disease as a local or regional or unit phenomenon, we pursue a course of viewing disease as a disorder of integration: i.e., a disorder of somehow fallible integrative machinery.

Beyond the concept that foreign agents such as bacteria, viruses or toxins can enter the body, disrupt its machinery and produce disease, we still have remarkably little else in the way of fundamental concepts of how disease develops. In particular, medicine has came up with very little else In the way of fundamental concepts of how disease develops. In particular, medicine hasgone up wish very little so far on the question, ‘I low can the machinery of the body itself go wrongs’ What is the Achilles’ heel of so excellent an organism which has emerged from so long a course of evolution? (my italics)

Tracing the history of biology, as Mason does, the road goes from body systems to organs; then to tissues, cells, cytoplasm and most recently to molecules (the place where the physical sciences were only a few decades ago). This approach, isolating and making islands, breaks down the organism into smaller and smaller components in an attempt to understand the basic principles of its operation. An important exception in modern biology, as Mason points out, was the work or the 19th Century phsyologist Claude Bernard. Bernard’s vision was to recognize that to understand biologic al function, it was necessary to discover principles by which the parts or the organism interrelated to produce an integrated whole response.

For him it was the coordination necessary to maintain an internal consistency in the face of a changing environment. Mason i19.”01 points out that against the general analytic trend in biology the “psychosomatic” field (i.e., the broad concept of stress) represents one of the few movements in the direction of the integrative approach sine c Bernard. He further points to the theoretical and philosophical importance of viewing the “psycho-somatic” field in this perspective: “A basic science of integrative physiology should be a prerequisite for the field of psycho-somatic medicine, rather than an afterthought of its existence.” He adds: No major new discipline has yet emerged to take over the great task of developing this biologic field. So tar, research contributions have come mostly from tragniended efforts within endocrinology, neurophysiologv, physiology, psychologv and psychiatry, more or less as side .lions. It is certainly a striking paradox in modern biology that we do not vet have a well organized, ful fiedged science of integrative physiology devoted to a Geld of such profound theoretic importance. (Itialics in original)

The efforts of this dissertation are, hopefully, in this direction and can be restated in terms or Mason’s question. “What is the Achilles’ heel of so excellent an organism which has emerged front so long a course of evolution?” The kernel of this explanation is that this Achillean limitation is inherent within the cyclic pattern of charge and discharge. This rhythm is the basis of a highly tuned and responsive emergency system, with its obvious survival benefits, but which simultaneously predisposes the organism to the loss of reserve capacity, if that cycle is prevented from completion. This maladaptive consequence is seen to occur primarily in situations where the nervous system becomes activated to emergency, but where response can not or does not occur.

Obviously, in the context of modern society, this is a very deep and complex issue. The effects of accumulated stress leave their widespread scars, not only in disease but In the deforming of human potential, occurring in. their most crippling form as early, perhaps, as birth and even in intrauterine existence, A truly holistic approach to these problems can never be complete. It is by its very nature a searching process, involving every form and expression of “life energy” and its negation, no matter how seeming small and inconsequential. The understanding 0f the physiological mechanisms by which stress accumulates, its prophylaxis, containment and social expression as well as treatment are central component, in this search. To quote Tinhergen (1994) once again: “It is stress in its widest sense, the inadequacy of our adjustability, that will become perhaps the? most important disruptive influentin our society.” And its resolution. one might add, possibly one of its most creative forces.

Appendix

by Ida P. Rolf, Ph.D.

We append hereto a digest of a discussion of the physiological significance of autonomic nerves from

The Autonomic Nervous System
By Joseph Pick, M.D.
J.B. Lippincott & Co. . Philadelphia, 1970) pp.31-33

The autonomic nervous system can he classified into parasympathetic and sympathetic components on anatomical grounds and also on account of the different responses which these two types can evoke even in one and the same organ. In anatomical terms these two systems may be distinguished a, follows: preganglionic parasympathetic neurons have long fibers and terminate with tow collaterals, in contrast, preganglionic sympathetic neurons have short fibers which terminate with many collaterals at post-ganglionic cell bodies.

In functional terms the two may he distinguished as follow,: Parasympathetic nerves promote the secretion of the posterior lobe of the pituitary. shade the eve by causing the pupil a’ sphincter to contract, accomodate the ocular lens to near objects through the ciliary muscle and protect the cornea from drying, by lacrymal secretion. The parasympathetic component furthers the activity of the digestive system by inducing secretion of the salivary glands of the mouth, the pancreas and [tie liver, and by increasing the peristaltic movements of the intestine. Cardiac and pulmonary functions are inhibited by parasympathetic vagal fibers because they decrease the rate and force of the heart beat and produce contraction of the small bronchiole in the lung.

To sum up, the significance of the parasympathetic or craniosacral component of the autonomic system is essentially anabolic, because it is directed toward the preservation, accumulation and storage of energies in the body. Sympathetic nerves widen the pupil through the contraction of the pupillary dilator; they inhibit the peristalsis of the alimentary canal except for the contractions of the intestinal sphincters: but they accelerate the rate and force of the heart beat, elevate the blood pressure by vasoconstriction of wide areas in the body, and promote the secretion of the adrenal medulla and the exchange of gases in the pulmonary circulation by dilating the bronchiole of the lung.

The general effect of a sympathetic discharge, then, is katabolic, because it causes the expenditure of bodily energies and inhibits the intake and assimilation of nutrient matter. It appears therefore that the parasympathetic and the sympathetic components of the autonomic nervous system are in apposition to each other. What then, is the significance of this antagonism?

Dr. Pick quotes the great American physiologist Cannon as follows: The coordinated physiological processes which maintain most of the steady states in the organism are so complex and so peculiar to living beings – involving as they may, the brain and nerves, the heart, lungs, kidneys and spleen, all working cooperatively – that I have suggested a special designation for these states. I Homeostasis. The word does not imply something set and immobile, a stagnation. It means a condition which may vary, but which is relatively constant. In rapidly adjusting the internal organization for efficiency in meeting sudden external demands on the body the sympathetic system has its significance.

As soon as the emergency is over, the energies which were dissipated during moments of stress must be restored and further reserves gradually built up for the next emergency. Herein lick, the significance of the parasympathetic, the other grand division of the autonomic nervous system. There must be also proper homeostatic balance between the activity of the parasympathetic, the accumulator of reserves, and that of the sympathetic, the spender of energies. If the body spends too much, it goes bankrupt. If it is too thrifty, incapable or afraid to spend, it will be overwhelmed by some enemv, he it another organism, extremes of temperature, or an excess of material retained in the body, whether sill or sugar. Adequate spending, therefore, helps to free the body from the restrictions of environment and upholds the constancy of the rnillieu inierieur of the body. Pick goes on to say: This is the well-known story of the autonomic nervous system through which we have attained great control over the challenges of our physical surroundings, and which has subsequently become one of the mediators of our emotions of “anger,” “rage” and “fear.”

References

J. Pick, M.D
Autonomic Nervous System
J. B. Lippincott & Co., Philadelphia, (1970)
pp.293, 294, 295, 296, 297, 298, 301, 306, 308, 310, 311, 314, 316, 318, 328, 336, 337, 338, 345, 346, 385, 386, 409, 410, 411, 413, 414, 415, 423, 424, 425, 430

1 A term suggested by Dr. Julian Silverman-personaI communication.

2. As well, of course, its primary effect is on the functioning of the internal organs via the smooth musculature.Accumulated Stress, Reserve, Capacity and Disease