"For two month I’ve
had there spells," Fran wilson told the heart specialist. "I get
short of breath. My heart beats like a hammer and unevenly. I'm dizzy and i
tremble. My chest hurts. Twice I’ve fainted. My doctor says that my blood
pressure and electrocardiogram are abnormal,
"was there any upset
in your routine before the spells be-gan?" the specialist asked. "My
husband was transferred to Arizona," said Fran.
"I stayed behind to let the children
finish the school year. Since he left, I haven't slept well. Do you think fatigue
brought out my heart trouble?
"I suspect we'll
find," said the specialist, "that you don't have heart trouble at
all. I suspect that your illness is caused by emotion." Although the
doctor proved correct, Farn was not imagining her ailments. Nor was she
mentally ill in the usual sense of the phrase. Emotional stress can produce
real illness true changes in the body chemistry and structure of quite normal
people. And this phenomenon is amazingly common.
Many specialists agree that psychogenic (emotion-caused) disorders account for a large percentage of visits
to the doctor. Physicians have long known that the mind could make the body
ill. But they did not know how to differentiate between physically caused
illness and that caused by emotional stress.
Today, answers to this problem are beginning
to appear And many doctors are using
this new information as regularly as they employ their s stethoscopes and
tongue depressors.
Fran wilson's case illustrates one of the
easiest means of recognizing such ills: identifying characteristic
"clusters" of physical symptoms which often point to emotional
causes. Since Fran's spells resembled a common cluster called
"neu-rocirculatory asthenia," the heart specialist tried a simple
test. For two minutes he had her breathe deeply and rapidly. She grew dizzy.
Her heart sounded. She gasped that hid was having an attack.
When she had rested, the doctor explained:" those were some of the physical signs of great anxiety. Rapid deep breathing
produces many such signs in any person. When we are afraid or angry, a part of
the brain called the hypothalamus prepares the body for action. The heart speeds up
to rush blood to our muscles. We breathe hard to fill the blood with oxygen.
Hormones are released to
bring the nervous system to a pitch of a alarmed readiness. Sometimes our
conscious mind, seeing on reason to be angry or afraid, may block out our
awareness of anxiety. Yet all the while the hypothalamus continues the alarm.
Fran's emotional alarm had evidently been
triggered by the temporary separation from her husband.” I feel upset if anyone
close leaves me.” Fran admitted to the doctor.”When I was a child, my parents
left on a trip and were both killed in an accident. When Jim left the first
time in our marriage he’s been away more than overnight- I felt real panic. “I
pulled myself together, but I guess the dear was still there.” Fran was given
tranquilizers and saw the doctor three times to talk over her fears. The
symptoms vanished in two weeks.
Everyone knows that the of
mind evokes certain automatic responses from the body. Think about food and you
salivate. Words or thoughts can prepare sexual organs for function, and cause a
blush or goose-flesh. But more serious effects can be wrought by emotion. Take
the case of Ruth Chadwick.
Four times Ruth had conceived a child but
miscarried. On her fifth pregnancy, the obstetrician asked Ruth how she felt
about motherhood. He learned that, though she wanted a child, girlhood tales of
the rigors of labor had terrified her. The doctor decided to let Ruth talk out
her fears at each prenatal visit with no
other treatment, Ruth delivered a
healthy full-term baby.
Why? Researchers at the
university of Colorado have said that a woman fearful of pregnancy might, after
weeks or months of caring a baby, produce special hormones of a type normally produced
only at the end of pregnancy. they cause contractions, dilate the opening of
the cervix, and bring about birth . indeed many women like Ruth Chadwick, who habitually miscarry, may need
only a little office counseling to carry a child to term.
How can thought work such changes? There is a pathway between
the hypothalamus. The brain segment that controls primitive reactions to anger,
ear, hunger, and sex, and the pituitary gland. this mysterious gland, a lamp
the size of a known to secrete a growth hormone. but recent research has
uncovered a number of other hormones it produces.
The front lobe alone was found to create chemicals that
trigger the making of sex hormones and govern the thyroid, which in turn
controls the body’s metabolism. It yields yet another chemical that regulates
adrenal secretion.
The middle and back lobes of the particularly affect the
kidneys, contractions of the uterus , and blood pressure. “we have just opend
the door”, says one researcher, “and have had only a superficial look at this
gland. But we now know one way in which emotion can be translated into bodiy changes.
With such clues to very real mechanisms, many doctors have
begun to look for sign of emotional stress in patients as a matter of routine.
Written tesst have been designed to seek out the factors most commonly found
among people whose aliments have been proved to be caused by emotion.
One such patient was jean becker, whose low back pain had
grown steadily worse for a year, with no apparent cause. The symptoms seemed to
suggest a reptured spinal disc, which sometimes cant be seen on x ray. During
an office visit her asked, “have you been depressed lately?”
“ever since year ago, when my father died,” she said. “mother
died when I was small, and dad brought me up alone. Although my husband and
children give me plenty of family, without dad all the joy seems to have gone
out of things.”
The doctor gave her anti-depressant pills and told her to
come in for a chat every few days. Within a week jean’s back pain had
disappered. Moreever, the talks revelaed that she felt that her children had
little neede of her and that her husband was too occupied with his business to
give her much attention. On the her father had seemed to depend on her.
When the situation was explained to jean’s husband and
children, they quickly gave her the assurance of love she needed, and the pills could be
stopped. Had the back pain persisted once jean’s depression was gone, the
doctor would have felt it more likely that the cause was purely physical.
One test deviced by doctors at Duke university , Durham, N.C,
sought out unexplained fatigue, luck of sex interest, loss of weight ,
constipation, hopelessness, feelimgs of uselessness, difficulty in making
decisions and reslessness.
All of us sometimes have such feelings, ofcourse. The key to
the duke test is whether a number of such factors are present much of the time.
Sleep disturbance is one of the prime cluse: the person with a psychogenic
disorder is likely to wake early in the morning or during the night have a
chronic feeling of fatigue.
Sudden changes in life are often found to precede illness. In
one study of patients with a wide range of ailments, three out of four were
found to have recently suffered some major loss-loved once, jobs, homes.
Even apparently pleasant changes, such as a trip abroad, can
cause trouble. The tourist who complains about foreign food or water would
probably wiser to blame the tension of being in a strange place. More-over .
susceptibility to minor illnesses, such as colds, may be caused by small
emotional stresses.
Are doctors other than psychiatrists really handle such emotional problems? Numerous
expriences show that they are. And some medical schools now are offering short
courses in office psychiatry of there graduates. Most physicians can not devote
and hour to talk with a patient as psychiatrists do. But so long a time has
been found unnecessary in treating most patients with psychogenic illness. They
need ,primarily, re-assurance that there ills can be dealt with.
As doctors learn to incorporate the new knowledge of psychogenic illness in
to there work, some of the responsibility, as always , must rest with the
patient.he should make an effort to protect himself when he knows stress has
made him vulnerable. he can help the doctor by telling him when emotional
upheaval has preceded or accompanied an illness. He should be completely frank
about his angers and fears, his frustrations and losses.
The heroic view that “everything is just find” may be good
manners with a friends, but it is poor judgment when it is your doctor who
wants to know .
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