Psychoneuroimnunology: A New Facet of the Mind-Body Dialogue

Since ancient times, physicians have questioned whether the mind can affect health. Many anecdotal reports have claimed that patients overcame lifethreatening illnesses by their will to live. But we lacked hard evidence that would explain the relationships between attitudes and disease. Recently scientists have uncovered new data that demonstrate a bidirectional link between the immune and the nervous systems. We are now beginning to understand how these two systems can interact to either set the stage for disease or enhance the prospects for a healthy body. Various names have been applied to this field, including psychoimmunology and neuroimmunomodulation. In this essay, I will use the term psychoneuroimmunology. This term was coined by Robert Ader, Department of Psychiatry, University of Rochester Medical Center, New York, to describe the emerging field that studies an organism’s response to experience and the bodily system that operates to defend an organism against disease. I Some of the earliest research on the mind-body connection involved studies of stress. In 1914 physiologist Walter B. Cannon, Harvard Medical School, defined what he later termed the fight-orflight response. When the brain perceives stress, it signals the sympathetic branch of the autonomic nervous system, which regulates the “automatic” functions of the body, such as the heartbeat and the digestive processes. This results in an increased heart rate, faster breathing, and a rush of blood away from the skin, hands, and feet toward the deep muscle tissue. This action causes an increased supply of oxygen to flow to the muscles for use in either fighting or escaping the stressful situation. z As early as 1936, Hans Selye, director, Institute of Experimental Medicine and Surgery, Montreal, observed three morphological changes that occurred in response to noxious stimulations. These changes inchsded adrenal cortical enlargement, bleeding ulcers of the stomach and duodenal lining, and atrophy of the thymus and other lymphatic structures, a change that directly damages the immune systems Selye was a pioneer in stress research. He wrote about his 1946 paper “The general adaptation syndrome and the diseases of adaptation” in a Citation Classic.@ commentary in 1977.’1 In this classic paper, he defined the general adaptation syndrome as the sum of all nonspecific, systemic reactions of the body that occur upon continued exposure to stress. Selye proposed that the adaptation syndrome may be directly related to disease. I used the 1946 paper in my first experiments on citation indexing. s Many years later I met this remarkable man who was one of the pioneers in medical information science. In 1964 George F. Solomon, now of the Department of Psychiatry, University of California, Los Angeles, and Rudolph H. Moos, Department of Psychiatry, Stanford Univer.Jty School of Medi-