Psychosomatic illness as a Creative Process Part 5

There are many other psychosomatic diseases, and most, if not all, involve some reorganization of the immune system that drives it to attack normal tissue in an inadvertent effort to help the old brain carry out chronic, hard-to-satisfy instructions from a new brain that, like Alan’s, has lost control. In the case of these diseases, the immune system’s help is not only unneeded but disastrous. This attack on our own normal tissue by our immune system has caused medicine to label these diseases autoimmune, or self-induced.

Although in different diseases it may attack different tissues or organs, the immune system always seems to reorganize in a crazy way that causes it to misread normal tissue as foreign tissue and then attack and destroy it as if it were foreign. Why immune system creativity takes this form and why it attacks one tissue and not another are questions still unanswered. When this creative immunity attacks normal joints rheumatoid arthritis may be the diagnosis. When the spinal column is attacked, it may be called spondylitis; and when the gastrointestinal tract is attacked, the result may be ileitis or colitis. If it attacks the sheaths of the nerves, the diagnosis may be multiple sclerosis; the kidneys, glomerulonephritis; the skin, eczema.

There are many other, more obscure autoimmune diseases, but these are among the most common. What I believe is common to almost all of them is a life like Alan’s that is chronically out of control. Since there are multiple, self-generated, random creative possibilities the brain may even become stronger and healthier as a result of reorganization. Certainly there are many examples of people who live long and healthy lives under what seem to be markedly adverse circumstances. Because we tend to pay close attention only to sickness, these healthy people have not received much attention, but my belief is that they manage to keep their lives under good control despite their circumstances.

Even in sickness, however, there is always the possibility that the old brain will come up with a newly reorganized behavior that will reverse what seemed a hopeless disease process. There are many recorded cases of miracle cures of late-stage, hopeless cancer patients. It is likely that these cancer victims’ immune systems reorganized in such a beneficial way that they were able to act beyond their normal capabilities and eliminate the cancer. Reorganization can be miraculous, but it is not a miracle; it is a normal process in all living creatures. In the brief time that most doctors spend discussing how well or badly people are living their lives, it is not easy to discover what in the patient’s life is out of control.

Before and even after his heart attack, Alan never felt right in complaining to his busy doctor about his high-paying job, so he said nothing. And it would have taken a skilled counselor to get him to reveal his strangle-the-boss fantasies, which might have led the counselor to help him realize the danger of these thoughts and guide him to a better way to handle his life. In fact, it is quite characteristic of psychosomatic-disease sufferers that they tend to keep a stiff upper lip while they simmer inside with angering or some other controlling feeling behavior. If Alan had been a griper or complainer, he might have gained enough control through these feeling behaviors to protect his heart.

But even if he had wanted to complain, he was making so much money that he would have found it difficult to get people to take him seriously and sympathize. I have had some personal experience with severe arthritics who, in superficial conversation, claim that nothing is seriously wrong with their lives except for the disruption caused by their disease. They seem to accept the destruction going on in their joints with a kind of calm resignation as if there is little they can do—it is all up to the doctor. What Norman Cousins’ book Anatomy of an Illness showed was how little a doctor can do and how much an arthritic can do for him or herself.

I remember a talk I gave with Norman Cousins years ago, sponsored by UCLA, during which he spoke about his recovery from a serious form of arthritis. He described how he had checked himself out of the hospital and into a nice hotel room where he watched funny movies and laughed a lot. He also took mega doses of vitamin C. He took charge of his health and his pain. But if you understand choice theory, this is exactly what you expect. People like Alan do not deal with their frustrations with the usual psychological new-brain feeling behaviors like angering, depressing, or complaining. For reasons that they may not even be aware of, they have chosen not to attempt to regain or take charge of their lives in the way most of us do.

Instead, even with their disabling illnesses, they display such stoic cheer in their approach to the world that it is hard to suspect that there is probably something seriously wrong with their lives. While they appear to ignore their frustrations, their new brains are sending their old brain powerful help signals that lead to their diseases. But unaware of the turmoil in their old brains, they remain remarkably upbeat throughout their ordeals. Sometimes, after they become ill, they learn to use their illnesses to gain control over others. I do not believe that this was in their minds before they got sick, but it could account for their cheerfulness—they are getting some payoff from pain and disability.

This behavior not only tends to fool physicians but puzzles anyone who does not know choice theory. Physicians, especially, find it hard to believe that these seemingly mentally healthy, cheerful patients could have anything wrong psychologically. And the patients are almost always supportive of this stance. They hasten to agree with any doctor who treats them as unfortunate victims of a serious, completely physical disease. Keep in mind that these patients have major investments in not choosing a feeling behavior to deal with their frustrations, because they are trying, for reasons known only to them, not to become aware that their lives are out of control.

So, in a sense, physicians and patients join hands in denial of the cause of their illness and in doing so keep an important element, if not the most important element, of treatment—taking charge of their lives—out of the treatment picture. I am not claiming that good medical care is unnecessary, but medical care without better need-fulfilling behaviors will do little more than reduce the symptoms. Cancer As mysterious and frightening as cancer is to most of us, a great deal is already known about what causes a group of cells to reorganize and begin to follow its own genetic program. There is much medical speculation as to why this happens.

External agents such as toxins, radiation, and some viruses have all been incriminated, and there is some evidence that internal agents, such as a cancer-causing gene (an oncogene) may play an important part in this first step. It is important to me as a psychiatrist to affirm that there is no evidence that the cellular changes leading to cancer are in any way psychologically caused. It is a common observation in the medical community that some people, informed that they have cancer, seem to lose the will to live and die much more quickly than others with even more advanced disease. To the observer, it seems as if this new-brain knowledge causes some disruption in the immune system’s normal old-brain instructions to fight the cancerous foreign invader.

Even if we don’t know that we have cancer, the old brain will still fight, even if it is fighting a losing battle. When patients are told they have cancer, some may just give up and say, “This is too much for me to handle.” When cancer cells have multiplied to the extent that there is a discoverable disease, we now believe the immune system has failed to function. For as yet unknown reasons, it either did not find the cancer cells or, if it found them, did not destroy them. In contrast to normal cells, which will multiply only a given number of times and then stop, cancer cells seem to be programmed for rapid and unlimited multiplication. They grow quickly and wildly and feed on normal body tissue.

If unchecked, they will destroy the body with their overwhelming demands for sustenance. But we are rarely aware of this initial step, because we think that usually this growth is quickly and completely checked by our immune systems, which, if functioning normally, seek out and destroy these foreign cells before we are aware of their existence. Some of our modern cancer treatments are aimed at augmenting the immune system to get it to function normally or even better. This type of treatment is very interesting to me as a psychiatrist because of the connection between mind and body, an area as yet little understood.

Life is not a static process. In the normal give-and-take of living, the old brain is constantly looking for creative new ways to help us to become healthier and better able to deal with disease. Cancer is a disease for which we need all the physiological creativity we can muster, and where we need this most is in the immune system. With cancer, the immune system is already not functioning as well as it should, and when we reduce or turn off its ability to be creative by sending it give-up hormones, we have little chance against cancer. We need all the new-brain resistance to giving up that we can transmit to the old brain so it will keep our immune systems as active and creative as possible.