SECTION I

The Psychobiology of
Mind-Body
Communication
1
The Placebo Response:
A Rejected Cornerstone of
Mind-Body Healing

OME interesting stories have been told over and over again because
they express truths that our thinking minds can understand in no other
way. This certainly is the case with the many folktales, both ancient and
modern, of how unexpected illness and "miracle cures" have taken place.
Modern science tends to reject these anecdotal accounts as unreliable or,
at best, as mere examples of the "placebo response": The person gets
better only because of a cultural belief or suggestion that deludes everyone
into thinking healing took place. The placebo response is rejected as a
"nuisance factor" that no one understands; it is unreliable and therefore
unreal. Let us begin this chapter by retelling a few of these healing tales—
the ones reported by highly regarded medical experts—to learn if we can
discern a common denominator in them. Perhaps it will turn out that the
placebo response has been, in fact, the rejected cornerstone of what could
become a practical approach to building a new understanding of mindbody
communication and healing.
T he L ikable M r . W right:
C ancer and the Immune S ystem

One of my earliest teachers in these mysteries of mind and body was

old Bruno Klopfer, a short, powerfully built gnome of a man who was so
short-sighted he had to hold a book right up to his nose in order to read
the print. His eyeglasses magnified his eyes to such a degree that I was
usually too stupified to say anything to him. Bruno was reputed to have
been a sort of minor genius with the Rorschach Inkblot test, and he had
written a standard three-volume work in the field. Yet his humble manner
3
4

The Psychobiology of Mind-Body Healing

gave no hint of his interpretive wizardry, which went well beyond what
he was able to write and teach.
Bruno's civility and perfect manners were a natural endowment from
his European background; he was always poised to listen fully when
anyone, particularly a student, was speaking. I would sometimes steal a
long, sideward glance at him during the fireside seminars he organized
for Jungian analysts in training on the California coast at Asilomar during
the early 1960s. Yet always, it seemed, behind his outward attention, there
was another part of him far, far away, communing with who-knows-what
levels of imagination and wisdom. If he caught you looking at him, he
would immediately "com e back" with only the slightest eyeblink and a
wan, collegial smile.
One of Bruno's well-documented feats was his ability to distinguish
between the Rorschach records of patients who had rapid versus slowly
progressing cancers. In his Presidential Address to the Society of Projective
Techniques in 1957, he tried to impart something of his skills in this
area by presenting his views on the psychological variables in human
cancer. As I said, he was a humble man, so instead of talking about his
successes, he chose to present a detailed case history of one of his failures.
This was the case of the likable Mr. Wright, who so intrigued Bruno that
he spoke of him often. I believe this case meant something important to
that wise part of Bruno that was so often far away. I will therefore present
it here, exactly as he published it. The original report on Mr. Wright was
written by one of his personal physicians, Dr. Philip West, a reliable observer who
played an important part in the story (Klopfer, 1957, pp.
337 339‫) ־‬.
Mr. Wright had a generalized far advanced malignancy involving
the lymph nodes, lymphosarcoma. Eventually the day came when
he developed resistance to all known palliative treatments. Also, his
increasing anemia precluded any intensive efforts with X-rays or
nitrogen mustard, which might otherwise have been attempted.
Huge tumor masses the size of oranges were in the neck, axillas,
groin, chest and abdomen. The spleen and liver were enormous. The
thoracic duct was obstructed, and between 1 and 2 liters of milky
fluid had to be drawn from his chest every other day. He was taking oxygen by mask
frequently, and our impression was that he was
in a terminal state, untreatable, other than to give sedatives to ease
him on his way.
In spite of all this, Mr. Wright was not without hope, even though
his doctors most certainly were. The reason for this was that the new
The Placebo Response

drug that he had expected to come along and save the day had
already been reported in the newspapers! Its name was "Krebiozen"
(subsequently shown to be a useless, inert preparation).
Then he heard in some way that our clinic was to be one of a hundred places chosen
by the Medical Association for evaluation of this
treatment. We were allotted supplies of the drug sufficient for treating 12
selected cases. Mr. Wright was not considered eligible, since
one stipulation was that the patient must not only be beyond the
point where standard therapies could benefit, but also must have a
life expectancy of at least three, and preferably six, months. He certainly didn't
qualify on the latter point, and to give him a prognosis
of more than two weeks seemed to be stretching things.
However, a few days later, the drug arrived, and we began setting up our testing
program which, of course, did not include Mr.
Wright. When he heard we were going to begin treatment with
Krebiozen, his enthusiasm knew no bounds, and as much as I tried
to dissuade him, he begged so hard for this "golden opportunity,"
that against my better judgment, and against the rules of the Krebiozen committee,
I decided I would have to include him.
Injections were to be given three times weekly, and I remember
he received his first one on a Friday. I didn't see him again until
Monday and thought as I came to the hospital he might be moribund
or dead by that time, and his supply of the drug could then be
transferred to another case.
What a surprise was in store for me! I had left him febrile, gasping for air,
completely bedridden. Now, here he was, walking around
the ward, chatting happily with the nurses, and spreading his message of good cheer
to any who would listen. Immediately I hastened
to see the others who had received their first injection at the same
time. No change, or change for the worse, was noted. Only in Mr.
Wright was there brilliant improvement. The tumor masses had
melted like snowballs on a hot stove, and in only these few days,
they were half their original size! This is, of course, far more rapid
regression than the most radio-sensitive tumor could display under
heavy X-ray given every day. And we already knew his tumor was
no longer sensitive to irradiation. Also, he had had no other treatment outside of
the single useless " s h o t."
This phenomenon demanded an explanation, but not only that,
it almost insisted that we open our minds to learn, rather than try
to explain. So, the injections were given three times weekly as
planned, much to the joy of the patient, but much to our bewilder-
The Psychobiology of Mind-Body Healing

ment. Within IO days [Mr. Wright] was able to be discharged from

his "death-bed," practically all signs of his disease having vanished
in this short time. Incredible as it sounds, this "term inal" patient,
gasping his last breath through an oxygen mask, was now not only
breathing normally, and fully active, he took off in his plane and flew
at 12,000 feet with no discomfort!
This unbelievable situation occurred at the beginning of the "Krebiozen"
evaluation, but within two months, conflicting reports began
to appear in the news, all of the testing clinics reporting no results.
At the same time, the originators of the treatment were still blindly
contradicting the discouraging facts that were beginning to emerge.
This disturbed our Mr. Wright considerably as the weeks wore on.
Although he had no special training, he was, at times, reasonably
logical and scientific in his thinking. He began to lose faith in his last
hope which so far had been life-saving and left nothing to be desired.
As the reported results became increasingly dismal, his faith waned,
and after two months of practically perfect health, he relapsed to his
original state, and became very gloomy and miserable.
But here I saw the opportunity to double-check the drug and maybe,
too, find out how the quacks can accomplish the results that they
claim (and many of their claims are well substantiated). Knowing
something of my patient's innate optimism by this time, I deliberately took
advantage of him. This was for purely scientific reasons, in
order to perform the perfect control experiment which could answer
all the perplexing questions he had brought up. Furthermore, this
scheme could not harm him in any way, I felt sure, and there was
nothing I knew anyway that could help him.
When Mr. Wright had all but given up in despair with the recrudescence of his
disease, in spite of the "wonder-drug" which had
worked so well at first, I decided to take the chance and play the
quack. So deliberately lying, I told him not to believe what he read
in the papers, the drug was really most promising after all. "W hat
th en ," he asked, "w as the reason for his relapse?" "Ju st because
the substance deteriorated on standing," I replied, " a new superrefined, double-
strength product is due to arrive tomorrow which
can more than reproduce the great benefits derived from the original
injections."
This news came as a great revelation to him, and Mr. Wright, as
ill as he was, became his optimistic self again, eager to start over.
By delaying a couple of days before the "shipm ent" arrived, his an
The Placebo Response

ticipation of salvation had reached a tremendous pitch. When I announced that the
new series of injections was about to begin, he was
almost ecstatic and his faith was very strong.
With much fanfare, and putting on quite an act (which I deemed
permissible under the circumstances), I administered the first injection of the
doubly potent, fresh preparation—consisting of fresh water
and nothing more. The results of this experiment were quite unbelievable to us at
the time, although we must have had some suspicion of the remotely possible outcome
to have even attempted it at
all.
Recovery from his second near-terminal state was even more dramatic than the first.
Tumor masses melted, chest fluid vanished, he
became ambulatory, and even went back to flying again. At this time
he was certainly the picture of health. The water injections were continued, since
they worked such wonders. He then remained symptom-free for over two months. At
this time the final AMA announcement appeared in the press—"nationwide tests show
Krebiozen to
be a worthless drug in treatment of cancer."
Within a few days of this report, Mr. Wright was readmitted to
the hospital in extremis. His faith was now gone, his last hope vanished, and he
succumbed in less than two days.
Bruno Klopfer's summary of Mr. Wright's personality as revealed in his
Rorschach record is as follows (Klopfer, 1957, p. 339):
Mr. W right's Rorschach record was obtained before his transformation from optimism
to pessimism took place. It reflects the picture of a personality with what I
called previously a "floating ego
organization." This is reflected in his actual behavior and the great
ease with which he followed first the suggestion of the drug advertisement and
later on the deliberate experimentally motivated suggestion of his doctor without
any sign of defensiveness or even
criticalness. His ego was simply floating along and therefore left all
available vital energy free to produce a response to the cancer treatment which
seemed nothing short of miraculous.
Unfortunately this situation could not last since it was not reinforced by any
deep-rooted personality center with a long-range point
of view which could have counteracted the catastrophic effect of his
disappointment about the drug. To use a symbolic analogy, while
he was floating along on the surface of the water under the influence
8

The Psychobiology of Mind-Body Healing

of his optimistic auto-suggestion or suggestion, he was transformed

into a heavy stone and sank to the bottom without any resistance
at the moment when the powers of this suggestion expired.
The case of Mr. Wright all too vividly illustrates the hope and failure
of our attempts at mind-body communication and healing as they currently exist. We
don't understand yet all the important factors in any
individual situation, and we have only the vaguest ideas about how to
facilitate mind-body healing in a reliable manner. Yet, we do know considerably
more about it today than 30 years ago when Mr. Wright showed
his doctors the power of optimism.
We know today, for example, that cancer growth can be controlled by
the person's immune system; if you can improve the immune system, it
can destroy the cancer. Obviously, Mr. Wright's immune system must
have been activated by his belief in a cure. The incredible rapidity of his
healing also suggests that his autonomic and endocrine systems must have
been responsive to suggestion, enabling him to mobilize his blood system
with such amazing efficiency to remove the toxic fluids and waste products
of the fast diminishing cancer. As we shall learn later in this book, we now
know a lot more about the "limbic-hypothalamic system " of the brain as
the major mind-body connector modulating the biological activity of the
autonomic, endocrine, and immune systems in response to mental suggestion and
beliefs. In summary, Mr. Wright's experience tells us that it
was his total belief in the efficacy of the worthless drug, Krebiozen, that
mobilized a healing placebo response by activating all these major systems
of mind-body communication and healing. But we are getting ahead of
ourselves. First, let me tell you a story about another one of my teachers.
F ranz A lexander's P ositive Interpretations:
C onsciousness, the H ypothalamus, and the E ndocrine S ystem

Franz Alexander, who was a world leader in psychosomatic medicine,

made pioneering efforts to relate psychoanalysis to the physiology of the
body (Alexander 1939/1984). He taught those of us who were lucky enough
to be his students that it wasn't enough to simply understand and analyze
patients. He had an inspired way of phrasing Freudian interpretations in
a positive manner in order to evoke confidence, belief, and the placebo
response as a natural form of mind-body healing.
Alexander was truly a master in his understanding of the relations between
personality, emotional conflict, and the endocrine system. Like
Klopfer, he was a gift to America, trained in the classical European intel-
The Placebo Response

lectual tradition. Alexander was a patrician type, with beautifully tailored

suits and well manicured fingernails. Those fingernails—they would occasionally
drum silently on the conference table while a colleague droned
on somewhere in the room. It didn't matter to Alexander; he also had the
gift of quietly slipping into his own inner vision quest while apparently
remaining with the rest of us who were stumbling about on the outside.
Alexander's recognition of the positive aspects of mind-body adaptations to even
the most difficult environmental stressors is indicated by the
following clinical examples of thyrotoxicosis (hyperthyroidism, or overactivity of
the thyroid gland). The thyroid is a part of the endocrine system
that produces hormones that regulate metabolism and growth. The brief
case histories he cites are suggestive of how early life stresses can overstimulate
the growth functions regulated by the thyroid, resulting in a
precocious though precarious sort of psychological maturity (Alexander,
1950, pp. 178-181):
Threat to security in childhood is a very common finding, both in
neurotics and in healthy individuals. Characteristic of patients with
thyrotoxicosis is their manner of handling this insecurity. Because
of the external circumstances described above, these patients cannot overcome their
anxiety by turning to their parents for help. Their
dependent needs are constantly frustrated by fate or by parental attitudes, by loss
of one or both parents, or by parental rejection, as
well as by conflicts of more complex nature which involve guilt.
Since they are frustrated in their dependent needs, they make a
desperate attempt to identify themselves prematurely with one of
the parents, usually the mother. (" If I cannot have her, I must
become like her, so that I can dispense with h e r.") This precocious
identification is beyond their physiological and psychological capacity and results
in a persistent struggle to master the anxiety and insecurity by a pseudo self-
reliance.
. . . Examples of premature need for self-sufficiency, manifested
in active participation in the support of the family or in taking care
of younger siblings, follow:
B.R., a 13-year-old white girl, is described by the mother as a "littie old lady"
because she is so prematurely grownup, obedient, and
reliable. She learned to cook when she was six and has cooked and
helped with the housework ever since. Whenever her mother became ill, she swept and
cleaned the house and took care of the whole
family. She acted as second mother to her younger brother.
H .D., a 35-year-old single man, the last of eight children, is the
IO

The Psychobiology of Mind-Body Healing

only surviving male. Two older brothers died at ages ten and three
respectively, and one brother died at home one week after birth
when the patient was two. His father was a puritanical man who
was harsh and impersonal to hide his own weakness and insecurity. He was apparently
demonstrative of affection and fondled his
children as long as they were helpless infants but demanded adult
behavior as soon as they were able to walk and talk. The mother was
depreciated by the father because she had had an illegitimate child
in her adolescence (patient's oldest sister) and was married "ou t of
pity" by the patient's father. She was unable to stand up to the
father and during the patient's infancy worked in the family store
for several years. The father prevented the mother as well as the
older sisters from giving the patient much attention. After the patient entered the
first grade, his father insisted that no one read him
the funny papers any more because he should learn to read for
himself. Constant pressure was brought to bear on him to behave
like an adult and yet he was constantly restricted in the active pursuit of his
interests.
E.B., a 24‫־‬year-old single colored woman, was a prodigy and progressed rapidly in
her school years. She was extremely conscientious, never truant. Her mother was a
teacher and "a very intelligent
and beautiful w om an." The patient was obviously competing with
her but never expressed her hostility openly. When her mother
became ill, the patient took over the responsibility for her two younger sisters
and assumed the function of mother toward them. She supported them financially even
during her college years. She has always been self-sufficient and extremely
ambitious and has controlled
or repressed most of her feminine desires in order to reach her intellectual goals.
Alexander recognized that mental stress somehow interacted with the
hypothalamus, which in turn stimulated the entire endocrine system via
the pituitary and thyroid. The hypothalamus was the bridge between
psyche and soma, and perhaps even the locus of consciousness itself. In
Alexander and French's edited volume, Grinker quotes with approval
Ingham's (1938) view of the situation (1948, p. 70):
The neurologic concept of consciousness is that it is a state of activity of the
entire nervous system, and in particular of the brain, which
varies quantitatively from the maximum degree of mental action to
complete inactivity, as in coma or general surgical anesthesia. Al
The Placebo Response

11

though all parts of the brain may contribute to the mental processes
during consciousness, mental activity of all kinds appears to depend
on the normal functioning of groups of neurons in the primitive
diencephalon [i.e., the hypothalamus]. The normal cycles of sleeping and waking are
evidences of the physiologic activity of this
mechanism. As it would appear that energy liberated in the diencephalon is
essential for the activation of all the rest of the nervous
system so far as psychologic phenomena are concerned, it may be
postulated that the "c e n te r" of consciousness is located in this region, and
much clinical and experimental evidence supports this
view. It is surely not accidental that other primitive functions of the
nervous system related to the vegetative processes, instincts, and
emotions have been found to be dependent on structures in the basal
region of the brain in close proximity to those postulated as the center
of consciousness. The application of this concept of consciousness
to psychiatry seems obvious, since quantitative variations of consciousness are
manifested in disturbances of behavior in terms of intelligence, emotions, and
instinctive action.
Although this view may sound a bit quaint to our modern ear, it can
be regarded as an early, psychobiological approach to the concept of mindbody
communication and consciousness. I will update this view in the
next chapter, in which I speak of consciousness as " a process of selfreflective
information transduction." Alexander had a high regard for the
work of the physiologist Walter Cannon, who did a great deal of pioneering research
in the area of psychosomatic medicine and, in particular, the
psychobiological basis of seemingly strange and bizarre occurrences, such
as voodoo death.
V oodoo D eath and L ife !
T he " G iving-up " C omplex and the A utonomic N ervous S ystem

Walter Cannon, who was regarded as one of the most creative and
authoritative medical physiologists of his day, tells the following stories
of voodoo death and recovery (1957, pp. 183-184):
Dr. S. M. Lambert of the Western Pacific Health Service of the
Rockefeller Foundation wrote to me that on several occasions he had
seen evidence of death from fear. In one case there was a startling
recovery. At a Mission at Mona Mona in North Queensland were
many native converts, but on the outskirts of the Mission was a
12

The Psychobiology of Mind-Body Healing

group of non-converts including one Nebo, a famous witch doctor.

The chief helper of the missionary was Rob, a native who had been
converted. When Dr. Lambert arrived at the Mission he learned that
Rob was in distress and that the missionary wanted him examined.
Dr. Lambert made the examination, and found no fever, no complaint of pain, no
symptoms or signs of disease. He was impressed,
however, by the obvious indications that Rob was seriously ill and
extremely weak. From the missionary he learned that Rob had had
a bone pointed at him by Nebo and was convinced that in consequence he must die.
Thereupon Dr. Lambert and the missionary
went for Nebo, threatened him sharply that his supply of food would
be shut off if anything happened to Rob and that he and his people
would be driven away from the Mission. At once Nebo agreed to
go with them to see Rob. He leaned over Rob's bed and told the sick
man that it was all a mistake, a mere joke—indeed, that he had not
pointed a bone at all. The relief, Dr. Lambert testifies, was almost
instantaneous; that evening Rob was back at work, quite happy
again and in full possession of his physical strength.
And a less fortunate outcome:
Dr. Lambert . . . wrote to me concerning the experience of Dr. P.
S. Clarke with Kanakas working on the sugar plantations of North
Queensland. One day a Kanaka came to his hospital and told him
he would die in a few days because a spell had been put upon him
and nothing could be done to counteract it. The man had been
known by Dr. Clarke for some time. He was given a very thorough
examination, including an examination of the stool and the urine.
All was found normal, but as he lay in bed he gradually grew weaker. Dr. Clarke
called upon the foreman of the Kanakas to come to
the hospital to give the man assurance, but on reaching the foot of
the bed, the foreman leaned over, looked at the patient, and then
turned to Dr. Clarke saying, "Y es, doctor, close up him he die" (i.e.,
he is nearly dead). The next day, at 11 o'clock in the morning, he
ceased to live.
Cannon (1942, 1963) concluded that voodoo death was due to a heightened and
prolonged exposure to the emotional stress of believing one was
under the witch doctor's spell. The actual physiological cause was an overactivated
sympathetic nervous system. Cannon believed that voodoo death
was possible only because of the "profound ignorance and insecurity"
The Placebo Response

23

of native populations who lived "in a haunted w orld." In a more recent

study in our own society of the problem of "sudden and rapid death
during psychological stress," Engel (1971) came to a similar conclusion
in ascribing death to "rapid shifts between sympathetic and parasympathetic
cardiovascular effects." Engel believed this "biological emergency
pattern" (1968) becomes fatal when the person feels unable to cope and
has lost all expectation that there will be any change or help from any other
source. The person dies because of an acute "giving-up-given-in" complex.
In a recent review of this area, Hahn (1985) describes the relation between
voodoo death, the autonomic nervous system, and the selection of native
healers as follows (p. 182):
Lex (1974) similarly explains the pathogenesis of voodoo death and
the therapy of curing rituals in terms of three stages of "tu n in g " of
the sympathetic and parasympathetic processes of the autonomic
nervous system. "Su g g estion " passes a lowered threshold of analytic judgment to
effect what is suggested. Lex also explains the common requirement of traditional
medical systems that healers have
suffered the conditions that they come to treat: Their prior illness
gives these healers first-hand acquaintance with and sensitivity to
the vagaries of the autonomic nervous system.
As we shall see in the successive chapters of this volume, the autonomic
nervous system with its two branches, the sympathetic (which activates
heart rate, respiration, blood pressure, tension, etc.) and the parasympathetic
(with generally relaxing effects opposite to the sympathetic system),
is, indeed, one of the major systems of mind-body communication and
the placebo response in illness or healing.
T he H ealing H eart and M ind:
N orman C ousins' P ositive E motions

Thus far in this chapter we have illustrated how negative life circumstances and
attitudes can lead to illness and death via the mind's modulaticn of the autonomic,
endocrine, and immune systems. Sensitive physicians have always known that the
reverse is true as well, and wise
observers in most cultures have recognized that a positive frame of mind
can have a salutary effect in healing the gravest illness.
No one has done more in current American culture to illustrate this truth
with well-documented and poignant examples from his own life than Norman Cousins in
his two books, Anatomy of an Illness and The Healing Heart.
14

The Psychobiology of Mind-Body Healing

Cousins' personal experience with mind-body healing began at the age

of ten when he was misdiagnosed and sent to a tuberculosis sanitarium
for six months. Left to their own devices, he and some of his fellow patients found
a way to a positive attitude and healing, which Cousins
describes as follows (1979, pp. 155--156):
What was most interesting to me about that early experience was
that patients divided themselves into two groups: those who were
confident they would beat back the disease and be able to resume
normal lives, and those who resigned themselves to a prolonged and
even fatal illness. Those of us who held to the optimistic view became
good friends, involved ourselves in creative activities, and had littie to do with
the patients who had resigned themselves to the worst.
When newcomers arrived at the hospital, we did our best to recruit
them before the bleak brigade went to work.
I couldn't help being impressed with the fact that the boys in my
group had a far higher percentage of "discharged as cured" outcomes than the kids
in the other group. Even at the age of ten, I was
being philosophically conditioned; I became aware of the power of
the mind in overcoming disease. The lessons I learned about hope
at that time played an important part in my complete recovery [as
an adult] and in the feelings I have had since about the preciousness
of life.
This early life experience with the therapeutic value of optimistic views
and creative activities led to a lifetime of accomplishment as the editor of
one of America's leading periodicals, The Saturday Review, and more recently as
Adjunct Professor at UCLA's School of Medicine. Cousins'
carefully documented recovery (1979) from a serious arthritic and rheumatoid-like
collagen disease of the connective tissues (diagnosed as ankylosing
spondylitis) by treating himself with generous, positive doses of good
humor (primarily in the form of old Marx Brothers movies and reruns of
Allen Funt's Candid Camera) is becoming part of a new folklore of healing.
His more recent recovery from a heart attack involving both myocardial
infarction and congestive heart failure (Cousins, 1983) has been discussed
by the four heart specialists and physicians most closely associated with
the case. Among the factors they described as significant in Cousins'
selftherapeutic attitude are:
1) The absence of panic in the face of the obviously grave symptoms
of his heart attack. (Such panic is part of the emotional syndrome
that kills victims of voodoo death.)
The Placebo Response

15

2) His unshakable confidence in his body's ability to utilize its own

wisdom in facilitating healing.
3) An irrepressible good humor and cheerfulness that created an auspicious, healing
environment for himself, as well as for the entire
hospital staff.
4) Taking a full share of responsibility for his recovery by establishing
a close "partner relationship" with his physicians.
5) His focus on creativity and meaningful goals, which made recovery
worth fighting for and life worth living.
Cousins summarized his experiences of personal healing by emphasizing that positive
attitudes and emotions can affect the biochemistry of the
body to facilitate rejuvenation and health. Positive attitudes and emotions
are the essence of well-being and the placebo response. As he aptly stated,
"T h e placebo is the doctor who resides w ithin" (Cousins, 1979, p. 69).
This statement reflects a profound change from the traditional view of the
placebo as a "nuisance factor."
Let us now take a closer look at what recent research on the placebo
response can tell us about mind-body healing.
T he 55% P lacebo C onnection

During the same time period when the anecdotal accounts of mind-body
healing described previously were being assembled by early leaders in the
field of psychosomatic medicine, more scientifically objective double-blind
studies of clinical pain were being conducted. (In double-blind studies,
neither doctors nor patients know who is getting real medication and who
is getting inert placebos.) Beecher's analysis and review (1959) of 15 double-blind
studies concluded that 35% of the patients with a wide variety
of postoperative pain found significant relief with placebos (inert medication or
"sugar pills"). In a more recent review (Evans, 1985), these conelusions were
confirmed with 11 more double-blind studies in which it
was found that 36% of the patients received at least 50% of pain relief from
placebos. The most carefully controlled clinical studies of placebos with
humans thus consistently find that about one-third of the patients receive
more than 50% relief. Under the right circumstances, the medically inert
placebo is somehow able to facilitate belief and expectation on the psychological
level. This accesses and activates very real mind-body healing
mechanisms that some now call the "placebo response."
The placebo response is not limited to pain relief. It has been found to
be a mind-body healing factor in all of the following illnesses (items 1
through 3), therapeutic procedures (items 4 through 6), and even in the
expectation of getting help (item 7).
16

The Psychobiology of Mind-Body Healing

1) Hypertension, stress, cardiac pain, blood cell counts, headaches,

pupillary dilation (implicating the autonomic nervous system);
2) Adrenal gland secretion, diabetes, ulcers, gastric secretion and motility,
colitis, oral contraceptives, menstrual pain, thyrotoxicosis (zmplicating the
endocrine system);
3) The common cold, fever, vaccines, asthma, multiple sclerosis, rheumatoid
arthritis, warts, cancer (implicating the immune system);
4) Surgical treatments (e.g., for angina pectoris or "heart pain");
5) Biofeedback instrumentation and medical devices of all sorts;
6) Psychological treatments such as conditioning (systematic desensitization) and
perhaps all forms of psychotherapy;
7) Making an appointment to see a doctor.
In a review of these studies, most investigators (White, Tursky, &
Schwartz, 1985) conclude that the placebo response, which has been
demonstrated across such a wide range of problems and treatment modalities, must be
a "tru e general ingredient in all clinical situations" (Wickramasekera, 1985). One
of the most informative of these recent studies
has been written by Fredrick Evans, a psychologist who has done a great
deal of original experimental work in this area. Evans has brought together
a mass of data to answer two basic questions about how the placebo
response functions in a variety of medical situations (1985, p. 215):
1) How powerful is the placebo response in terms of its clinical efficacy?
2) To what extent is the placebo response mediated by verbal and
nonverbal expectational factors?
To deal with the first question about the clinical efficacy of the placebo
response, Evans studied the data on double-blind studies of drug analgesia, since
these were the most numerous and carefully controlled examples of experimental
research. As is indicated in the accompanying box,
the efficacy of an unknown analgesic is determined by calculating an index
of drug efficiency. There is a remarkably consistent degree of placebo response,
averaging about 55% of the therapeutic effect for all the analgesic drugs studied.
Xhat is, while morphine obviously has more potent analgesic effects
than aspirin, about 55% of the potency of each is a placebo response. As
Evans describes it (1985, p. 223):
In other words, the effectiveness of a placebo compared to standard
doses of different analgesic drugs under double-blind circumstances
seems to be relatively constant. This is indeed a rather remarkable
The Placebo Response

bo x

17

1 Comparing Efficiency of Placebo and Analgesics

Illustration of Calculation of Index of Drug Efficiency for Evaluating

Placebo Efficiency Compared to Analgesic Drugs
Index of analgesic drug efficiency:

Reduction in pain with unknown drug

Reduction in pain with known analgesic (typically morphine)
Pain criterion:

Reduction in pain by 50% of initial level over drug level,

or
change in pain of 50% on rating scale (typically 10- or 5‫־‬point)
Index of placebo efficiency for morphine:

(averaged across six double-blind non-crossover-design studies)

Reduction in pain with placebo

Reduction in pain with morphine

Index of Placebo Efficiency Comparing Placebo with Morphine, Aspirin,

Darvon, and Zomax (Derived from Available Single-Trial Double-Blind
Published Studies)
Number of
double-blind studies

Placebo
efficiency for

6
9
2
2
3

Morphine
Aspirin
Darvon
Codeine
Zomax

56
54
54
56
55

Used by permission from Evans (1985).

and unique characteristic for any therapeutic agent! The effectiveness
of the placebo is proportional to the apparent effectiveness of the
active analgesic agent.
It is worth noting that this 56% effectiveness ratio is not limited
to comparing placebo with analgesic drugs. It is also found in doubleblind studies
of nonpharmacological insomnia treatment techniques
(58% from 13 studies) and psychotropic drugs for the treatment of
18

The Psychobiology of Mind-Body Healing

depression such as tricyclics (59% from 93 studies reviewed by Morris & Beck, 1974)
and lithium (62% from 13 studies reviewed in
Marini, Sheard, Bridges & Wagner, 1976). Thus, it appears that
placebo is about 55-60% as effective as active medications, irrespective of the
potency of these active medications.
The implication of these findings is that there may be a 55% placebo response
in many, if not all, healing procedures. Such a consistent degree of placebo
response also suggests there is a common, underlying mechanism or process
that accounts for mind-body communication and healing, regardless of the problem,
symptom, or disease.
This brings us to Evans' second question about the extent to which the
placebo response is mediated by verbal and nonverbal expectational factors. He
discusses three factors that have been found by investigators to
mediate the placebo response: (1) suggestion (or hypnosis); (2) anxiety
reduction; and (3) the expectancy aroused by cultural or medical belief
systems. It has been assumed in the past that placebo and suggestion were
essentially the same sort of phenomenon. The surprising conclusion from
a variety of well-controlled experimental studies comparing the placebo
response with hypnotic suggestion, however, is that there is no correlation
or relationship between them (Evans, 1977, 1981; McGlashan, Evans, &
Orne, 1969; Orne, 1974). During experimental conditions in the laboratory,
hypnotic suggestion and the placebo response appeared to operate by
different mechanisms or levels of response. One way of understanding
the difference is to say that hypnotic responsiveness is a specific, innate
ability and skill that involves the capacity to access or change one's own
patterns of mind-body communication by the use of psychological suggestion alone.
The placebo response, in contrast, is a more general, automatic mind-body
communication that utilizes physical treatment methods
to reduce anxiety and facilitate healing by marshalling powerful cultural
expectations and beliefs in the treatment method. Other researchers, to
be discussed in the next chapter, believe that while hypnotic and placebo
responses appear to be different in the way they are facilitated on a
socialcultural level, they are essentially similar modes of creative mentation on
the psychobiological level, where they are mediated by the patient's right
cerebral hemisphere.
The issues raised in this section are complex. However, we will assimilate their
implications for a general theory of mind-body communication and healing gradually,
as more understanding unfolds in each suecessive chapter of this book. For now, it
is enough to note that for at least
one-third of the population, a "55% placebo connection" is a consistent
The Placebo Response

29

healing factor operative with many different drugs, therapeutic procedures, and
psychophysiological symptoms and problems. The consistency of this healing response
across so many different conditions suggests that it is mediated by a common
mechanism or communication link
between mind and body. In the next two chapters, we will learn that the
“ limbic-hypothalamic system " of the brain is the most obvious anatomical
candidate for the role of connecting mind and body. Indeed, it is a unique
psychophysiological communication channel between the expectations
and creative processes of mind and the emotional physiology of the body.
It is the common denominator mediating the placebo response in such
apparently diverse circumstances as the naive belief of the likable Mr.
Wright, the negative expectations of voodoo victims, and the very real
healing possible via positive interpretations by Franz Alexander and positive
emotions by Norman Cousins.
2
Information Transduction
in Mind-Body Healing and Hypnosis

ransduction refers to the conversion or transformation of energy or

information from one form to another. A windmill transduces wind
energy into the mechanical energy of the turning blades. If the mechanical
energy of the turning blades is attached to a generator, it is transduced
into electrical energy, which can in turn be transduced into light energy
by an electric bulb. In the typical clinical application of biofeedback techniques,
the biological "e n e rg y " of the body's muscle tension can be
transduced into the visible "inform ation" of a measuring device that
enables the subject to alter his muscle tone. These examples, together with
the basic concepts of information, communication and cybernetic theories,
have led to a view of all biological life as a system of information transduction.
A history of the evolution of the concept of information transduction
as the basic problem of psychobiology and hypnosis is summarized in
Table 1. For the purposes of this book, it is convenient to begin our survey
with the views of Bernheim, who is generally recognized as being one of
the "fathers" of therapeutic hypnosis. In the following quotation, Bernheim
described his understanding of the essence of hypnotic suggestion as a
process of "transforming the idea received into an act" (Bernheim, 1886,
pp. 137-138):

The one thing certain is, that a peculiar aptitude for transforming the
idea received into an act exists in hypnotized subjects who are susceptible to
suggestion. In the normal condition, every formulated idea
is questioned by the mind. After being perceived by the cortical centres, the
impression extends to the cells of the adjacent convolutions;
their peculiar activity is excited; the diverse faculties generated by
the gray substance of the brain come into play; the impression is
20
Information Transduction
table

21

1 Evolution of the concept of information transduction as the

basic problem of psychobiology and mind-body healing

RESEARCHERS

Bernheim (1886)
Selye (1936, 1982)

Papez (1937)

Scharrer & Scharrer (1940)

Harris (1948)
Moruzzi & Magoun (1949)

Shannon & Weaver (1949)

Wiener (1948)
Meyers & Sperry (1953)
Sperry (1964)

Olds & Milner (1954)

Delgado, Roberts & Miller
(1954)
Jouvet (1973, 1975)

CONCEPT

Ideosensory and ideomotor reflex converts hypnotic suggestion into body processes.
Transduction of information via the "stress"
hormones of the hypothalamic-pituitary-adrenal axis
is the essential mechanism of psychosomatic
problems.
Mental experience is transduced into the psychophysiology of emotions by the
limbic-hypothalamic system and related structures.
Central nervous system controls endocrine's hormonal messengers via hypothalamus.
The ascending reticular activating system
(ARAS) of the brain stem projects to the limbichypothalamic system to stimulate
wakefulness.
Mathematical theory of communication.
Cybernetic view of life as systems of information
transduction.
Consciousness associated with left and right
hemispheres which function independently
when neural connections are severed between
them.
Discovery of reward and punishment centers in
the limbic-hypothalamic system.
"Paradoxical sleep" or dreaming as a process of
integrating behavior via cortical and limbic-

hypothalamic system.
Black (1963, 1969)
Nauta (1964)

Hypnosis can modulate psychophysiological

mechanisms of the immune system.
"Fronto-limbic" system integrates "planning"
functions of anterior frontal cortex with limbic-

hypothalamic system.
Delbruck (1970)
Weiner (1972, 1977)

Information transduction is the basic problem of

psychobiology.
Psychosomatic problems are a function of mindbody information transduction
involving limbichypothalamic-pituitary system.
(con tin u ed)
22

ta ble

The Psychobiology of Mind-Body Healing

1

Continued

RESEARCHERS

CONCEPT

Bowers (1977)

An informational approach to hypnosis involves

"the transduction of semantic information into a
form that is somatically encodable."
Psychoneuroimmunological research
demonstrates how the hypothalamus mediates
mind-body communication with immune system.
Sensory information is stored and integrated
with "cross-modal association" areas in the

Ader (1981)

Mishkin (1982)

limbic-hypothalamic system.

elaborated, registered, and analyzed, by means of a complex mental process, which

ends in its acceptation or neutralization; if there
is cause, the mind vetoes it. In the hypnotized subject, on the contrary, the
transformation of thought into action, sensation, movement, or vision is so quickly
and so actively accomplished, that the
intellectual inhibition has not time to act. When the mind interposes,
it is already an accomplished fact, which is often registered with surprise, and
which is confirmed by the fact that it proves to be real,
and no intervention can hamper it further. If I say to the hypnotized
subject, "Y our hand remains closed," the brain carries out the idea
as soon as it is formulated. A reflex is immediately transmitted from
the cortical centre, where this idea induced by the auditory nerve
is perceived, to the motor centre, corresponding to the central origin
of the nerves subserving flexion of the hand;—contracture occurs in
flexion. There is, then, exaltation of the ideo-motor reflex excitability,
which effects the unconscious transformation of the thought into movement,
unknown to the will.
The same thing occurs when I say to the hypnotized subject, "You
have a tickling sensation in your n o se." The thought induced
through hearing is reflected upon the centre of olfactory sensibility, where it
awakens the sensitive memory-image of the nasal itching, as former impressions have
created it and left it imprinted and
latent. This memory sensation thus resuscitated, may be intense
enough to cause the reflex act of sneezing. There is also, then, exaltation of the
ideo-sensorial reflex excitability, which effects the unconscious
transformation of the thought into sensation, or into a sensory image.
In the same way, the visual, acoustic, and gustatory images sueceed the suggested
idea.
Information Transduction

23

The mechanism of suggestion in general, may then be summed

up in the following formula: increase of the reflex ideo-motor, ideosensitive, and
ideo-excitability.
Although Bernheim's words now sound a bit antiquated, he aptly described
information transduction as the basic process of therapeutic hypnosis. Indeed,
virtually all modern approaches to mind-body communication attempt to facilitate
the process of converting words, images,
sensations, ideas, beliefs, and expectations into the healing, physiological
processes in the body.
After a period of abeyance, modern research in hypnosis was initiated
by Hull (1933), Erickson,* and Hilgard (1977), who stimulated a new generation of
researchers (Fromm & Shor, 1979; Sheehan & Perry, 1976).
These researchers developed methodologies for objective studies that led
to an informational approach to understanding hypnotherapeutic phenomena. For
example, in his pioneering volume, Mind and Body (1969),
Stephen Black used a very broad philosophical and experimental approach,
guided by information theory, in his investigations of how hypnosis could
modulate psychophysiological mechanisms of the immune system. Bowers
has summarized the informational view of hypnosis as follows (1977,
p. 231);
. . . The tendency to split etiological factors of disease into either
psychic or somatic components, though heuristic for many purposes,
nevertheless perpetuates, at least implicitly, a mind-body dualism
that has defied rational solution for centuries. Perhaps what we need
is a new formulation of this ancient problem, one that does not
presuppose a formidable gap between the separate "realities" of
mind and body.
One way of reformulating the question involves the concept of information. The
entire human body can be viewed as an interlocking network of informational systems
—genetic, immunological, hormonal, and so on. These systems each have their own
codes, and
the transmission of information between systems requires some sort
of transducer that allows the code of one system, genetic, say, to be
translated into the code of another system—for example, immunological.
Now, the mind, with its capacity for symbolizing in linguistic and
* See all four volumes of T h e C ollected P apers o f M ilton H. E rickson on H
ypn osis for a comprehensive presentation of Erickson's hypnosis research spanning
five decades (Erickson, 1980).
24

The Psychobiology of Mind-Body Healing

extra-linguistic forms, can also be regarded as a m eans for coding,
processing and transm itting inform ation both intra- and inter-personality. If
information processing and transm ission is com m on to
both psyche and soma, the mind-body problem might be reformulated as follows: How
is inform ation, received and processed at a
semantic level, transduced into information that can be received and
processed at a somatic level, and vice versa? That sounds like a question that can
be more sensibly addressed than the one it is m eant
to replace. And som e knowledgeable people are beginning to ask
it. For example, in a discussion section of the New York Academy
of Scien ce's Second Conference on Psychophysiological A spects of
Cancer, Jonas Salk com m ented on a stimulating paper by Shands
(1969) as follows: "H u m an language is a specialized form of communication. You
then jum ped to the molecular level, and I was glad
you did that, because there are parallels in that both express forms
of com m unication. The code needs to be translated . . . "
Unfortunately, we are a long way from being able to understand
the complex m echanism s that help to transduce inform ation from
a semantic to a somatic level, but som e such m echanism s surely exist, since, as
we have seen, the selective and specific impact of suggestion on body structure and
functioning seems very well supported indeed. And I would like to suggest that the
capacity for deep
hypnosis is an important variable in this transduction process. We
have already shown that the healing potential of suggestions seems
to be maximized in persons capable of deep hypnosis.

A great deal of progress has been made in the ten years since these
words were written. An approach to answering questions about how hypnosis can
facilitate the process of mind-body information transduction will
be surveyed in the following sections of this chapter. First we will review
evidence for the view that the limbic-hypothalamic system is the major
mind-body transducer. Then we will outline how many of the major
pathways of brain activity involved with memory, learning, and behavior
support the limbic-hypothalamic system in this process of mind-body information
transduction.
T he L imbic-H ypothalamic S ystem:
T he M ajor M ind-Body Information T ransducer

The most significant developm ent in mind-body research began when

the young Hans Selye broke through the prejudices of the medical establishm ent of
his day to introduce the psychological idea of stress as a factor
Information Transduction

25

worthy oi study (Selye, 1936, 1976). Selye's lifetime of ground-breaking

research culminated in a theory of how mental and/or physical stress is
transduced into "psychosomatic problems" by the hormones of the "h ypothalamic-
pituitary-adrenal axis" of the endocrine system. Selye called
this transduction process the "G eneral Adaptation Syndrom e." An overview of
Selye's General Adaptation Syndrome, updated to emphasize the
mind-modulating role of the limbic-hypothalamic system on the autonomic, endocrine,
and immune systems, is illustrated in Figure 1. (In addition, Figure 1 provides an
overview of the entire process of mind-body
information transduction that is presented in greater detail throughout
this volume.)
Selye's work was in agreement with the anatomical research of Papez
(1937), who demonstrated that mental experience was transduced into the
physiological responses characteristic of emotions in a circuit of brain
structures that constituted much of what is now called the limbic-hypothalamic
system. The Scharrers (1940) and Harris (1948) then initiated the exquisitely
detailed work which led to the discovery that "secretory cells
within the hypothalamus," could function as molecular information transducers by
converting the neural impulses that encoded "m in d " into the
hormonal messenger molecules of the endocrine system that regulated
"b o d y ." The conversion of these neuronal signals of mind into the messenger
molecules of body was called "neuroendocrinal transduction" by
Wurtman and Anton-Tay (1969).
The next major breakthrough in understanding the role of the limbichypothalamic
system in mediating and modulating mind-body communication and behavior came with
the discovery of pleasure (reward) centers
and pain (punishment) centers. When miniature electrodes are carefully inserted
into certain areas of the hypothalamus (particularly, the medial
forebrain bundle and the lateral and ventromedial nuclei*), experimental
animals will press a lever up to 15,000 times per hour to give themselves
a sense of reward (Olds, 1977; Olds & Milner, 1954). Indeed, the animals
would rather press the lever giving them the good feeling than eat! On
the other hand, placing the electrodes in closely adjacent areas such as
the periventricular structures of the hypothalamus and the thalamus,
among others, touches off the centers for pain and punishment (Delgado,
1969; Delgado, Roberts, & Miller, 1954). To demonstrate the potency of
the punishing and inhibiting centers of pain-controlling behavior, Delgado—with an
inimitable élan not seen previously in neurophysiologists—
actually stood alone in a bull ring with an aggressive fighting bull. At the
moment the bull was about to charge him, Delgado pushed the button
* See Figure 2 in Chapter 6.
26

The Psychobiology of Mind-Body Healing

STRESS

Blood pressure,
metabolism, etc.

1 Selye's General Adaptation Syndrome updated to emphasize the mindmodulating role

of the limbic-hypothalamic system on the autonomic, endocrine,
and immune systems. The state-dependent memory and learning theory of therapeutic
hypnosis is illustrated by the limbic system ' ‫׳‬filter" (square box) surrounding
the hypothalamus.

figure
Information Transduction

27

that fired an electrode implanted in the pain centers of the bull's brain.
The bull instantaneously stopped in his tracks, as the crowd roared its
approval of a most dramatic, public demonstration of mind-body science.
These demonstrations of the reward and punishment centers in the limbichypothalamic
system again suggest why it is the major center of mind-body
information transduction: Pleasure and pain are the great reinforcers of
learning, behavior, and how we experience and express ourselves.
Since it was known that the corticoid hormones from the adrenals could
suppress the immune system, it was supposed that this was the psychobiological
route by which the mental mechanisms of hypnosis could affect
the body's immune system. In a series of incisive studies, however, Black
(1963, 1969; Black & Friedman, 1965) was able to demonstrate that this
was not the case. Hypnosis was effective in modulating the immune systern,
particularly by inhibiting allergic skin reactions, but this therapeutic
response was mediated by an as yet unknown mind-body process. This
mystery is only now in the process of being resolved by psychoneuroimmunological
research (Ader, 1981), which is demonstrating how the
immune system can communicate directly with the hypothalamus via its
own "m essenger m olecules," called "im m unotransm itters."
By 1970 the physicist Delbruck was able to state that an understanding
of the mechanisms of information transduction was the central problem
of neurobiology. In his monumental survey of psychobiology and human
disease, Weiner (1972, 1977) took his inspiration from Delbruck and explored a
number of models of information transduction to determine
which were most appropriate for an understanding of psychosomatic problems. Weiner
recognized the value of therapeutic hypnosis in a variety
of the psychosomatic problems he studied, but concluded that we still do
not know enough about the specific biology of each disease to determine
the exact psychobiological routes of healing. In order to explore what these
routes might be, we will review those areas of the brain that funnel their
stimuli and information-processing activities into the limbic-hypothalamic
system in the next four sections.
T he R eticular A ctivating S ystem:
T he A wakened, N ovelty-Seeking, and D reaming M ind

Another line of significant research for understanding mind-body information

transduction began with the research of Moruzzi and Magoun
(1949). They discovered the ascending reticular activating system (ARAS)
in the brain stem, which projects its nerve connections to the limbic-hypothalamic
system, thalamus, and widely throughout the cortex to stimu
28

The Psychobiology of Mind-Body Healing

late the brain into wakefulness. The reticular formation has been described
as ‫ ״‬a state-level structure within the pons and brain stem " (Bloom, Lazerson, &
Hofstadter, 1985) that plays an important role in body-mind information
transduction: It receives sensory information from all of the
body's neural pathways and acts as a "filter," passing on to the brain only
the information that is novel or persistent.
It is the brain's ability to wake up, to become alert and attentive to novel
patterns of sensory stimuli and information, that enables it to focus its
activity on new learning and creativity. The mind's ability to attend to the
new has its psychobiological basis in the activity of a cluster of norepinephrine-
containing neurons in the locus coeruleus of the pons area of
the brain stem. When novel stimuli are received by the locus coeruleus,
its neural connections stimulate the onset of brief states of heightened
responsiveness in the higher cortical areas of the brain, and in the
limbichypothalamic center that integrates memory and houses the reward or
pleasure mechanisms. In other words, the locus coeruleus transduces
novel stimuli into a heightened psychobiological state. Dull, repetitive
situations, on the other hand, decrease the activity of the locus coeruleus
and lead to relaxation, drowsiness, and sleep. The fact that what is novel
and fascinating actually heightens brain activity is a very important, though
still generally unappreciated, precondition for all forms of creatively-oriented
psychotherapy and mind-body healing experiences. It is one of the
fundamental principles used in the language of human facilitation that
we will explore in Chapter 5.
The relation between activity in the locus coeruleus and dreaming was
discovered by Jouvet (1975). When he destroyed the part of the nucleus
locus coeruleus that normally inhibits motor activity during dreaming, he
found that cats would act out their dreams in the form of what he called
"pseudohallucinatory" behavior. From these observations, he developed
an interesting theory of dreaming as a process of integrating genetic or
innate behavior (Jouvet, 1973,1975) that has become the psychobiological
basis for more recent theories of dreaming as an experimental theater
wherein many patterns of mind-body communication and healing can be
explored (Dement, 1965, 1972; LaBerge, 1985; Mindell, 1985a, b; Rossi,
1972/1985).
What is the difference between the activity of the dreaming and the
awake mind? One answer to this question is in the voluntary, overall
organization of mental activity. There may be creative, very revealing
bursts of metaphorical imagery in the dream, but they are not usually
under voluntary control. LaBerge (1985) has recently described experiments in which
specially trained (and talented) subjects apparently could
Information Transduction

29

control the content of some of their dream states, as well as their access
to some of their own psychophysiological functions (e.g., sexual arousal,
respiration). This relatively rare ability, called lucid dreaming, however, may
be the exception that proves the rule. The successful lucid dreamer is the
individual who can use a certain degree of conscious planning and voluntary control
to transduce mind into physiological responses. Let us now
turn our attention to the major areas of the brain that are involved in this
planning and voluntary control process.
T he F rontal C erebral C ortex: T he O rganizing and P lanning M ind

The frontal (or prefrontal) cerebral cortex, with its specialized planning
functions, has been described as the most recently developed area of the
human brain. Proportionately larger than that of any other animal, it
occupies one-quarter of the total mass of the cerebral hemisphere and does
not attain maturity until the child is about seven years old. The frontal
cortex has rich connections with both the reticular formation (ARAS) and
the limbic-hypothalamic systems, which we reviewed in the two previous
sections. The integration of information transduced in these two areas by
the organizing activity of the frontal cortex is the main subject of this
section.
The awakening and attention-getting novel stimuli transduced into the
brain by the reticular formation and its specialized nuclei (e.g., the locus
coeruleus) are organized and expressed as normal human responsiveness
by the planning and sequencing functions of the frontal cortex. The frontal
cortex also has such rich connections with the limbic-hypothalamic system
that some investigators have considered it as a single "fronto-limbic system”
(Nauta, 1964,1972; Nauta & Domesick, 1980; Nauta & Feirtag, 1979).
Luria has summarized the overall planning and organizing function of the
frontal cortex as follows (1966, p. 233):
. . . The fact that the frontal region is closely connected with the
underlying structures of the limbic lobe, and through them with
other nervous apparatuses concerned with interoception, gives reason to suppose
that it receives signals of the various changes taking
place in the organism and that it is intimately involved in the regulation o f body
states. Evidently, changes in body state occur not merely
because of the appearance of new stimuli, evoking arousal reactions,
but also because of the body's response activity. It may be postulated
that these changing states may lead to corresponding further changes
in the activity of the body. There are, therefore, important grounds
30

The Psychobiology of Mind-Body Healing

for believing that the frontal lobes synthesize the information about the
outside world received through the exteroceptors and the information about
the internal states of the body and that they are the means whereby the
behavior of the organism is regulated in conformity with the effect produced
by its actions.
The organization and synthesis of external and internal information for
the "regulation o f body states" are important for our developing understanding of
mind-body communication and healing. This regulation of
body states takes place when the organized stimuli of the external and
internal worlds are funneled through the limbic-hypothalamic system.
Psychophysiologists such as Achterberg (1985; Achterberg & Lawlis, 1980,
1984) have assembled evidence for the view that mind-body communication and healing
are mediated by the "body im age." The body image is
an organization of visual imagery that apparently is constructed in the
fronto-limbic system, particularly with the help of the right cerebral hemisphere.
To approach an understanding of this idea, we will now overview
the process of information transduction by the right and left cerebral
hemispheres and their contributions to the facilitation of mind-body communication.
T he C erebral H emispheres: T he L ogical and M etaphorical M inds

A great area of discovery about information transduction in the brain

during the 1950s and 1960s was initiated by Meyers and Sperry (1953),
who discovered that when the nerve connections (the corpus callosum)
between the left and right cerebral hemispheres in the cat were severed,
each hemisphere apparently functioned in part independently. Since this
operation did not seem to impair mental faculties, Sperry (1964) and his
colleagues resorted to this surgical procedure with carefully selected human
subjects who had very severe and uncontrollable grand mal epileptic seizures. If
the source of the epilepsy was located in one cerebral hemisphere,
they reasoned, the operation would at least prevent the seizure activity
from spreading to the other half of the brain. The operation was remarkably
successful in relieving the epilepsy. When psychologists carefully examined these
"split-brain" patients, however, they encountered a series
of fascinating discoveries about the intrinsic differences in the way information
was transduced or processed in left and right hemispheres (Gazzaniga, 1967,1985).
For the purposes of our study of mind-body communication and healing, it is most
important to note that the left hemisphere
is specialized in the verbal-linguistic transduction of speech and analytical
Information Transduction

32

thinking, while the right plays a more predominant role in the holistic,
analogical-metaphorical information transduction characteristic of emotions,
imagery, and particularly, the body image (Achterberg, 1985). The
basic hypothesis that has emerged is that the right hemisphere's modes
of information transduction are more closely associated with the limbichypothalamic
system and mind-body communication in the placebo response and therapeutic
hypnosis. Ian Wickramasekera has recently summarized this idea as follows (1985,
pp. 274-275):

. . . Good placebo responders, like good hypnotic subjects, inhibit

the critical, analytic mode of information processing that is characteristic of the
dominant verbal hemisphere. Good placebo responders will tend to be individuals who
are prone to see conceptual or
other relationships between events that seem randomly distributed
to others. They will inhibit the interfering signals of doubt and skepticism, which
are consequences of the more analytic mode of information processing typical of the
dominant (left) hemisphere. Like
good hypnotic subjects, good placebo responders are likely to embroider or
elaborate on the given stimulus properties of a drug potentiating it, out of their
own rich subjective repertoires. Alternatively,
they may negate or attenuate the effects of a . . . drug through
negative attributions.
Shapiro (1971) describes placebo nonresponders as "rigid and
stereotypic and not psychologically m inded" (p. 445). There is a
striking similarity between this description and that of a poorly hypnotizable
subject. There is increasing evidence (Bakan, 1969; Graham
& Pernicano, 1976; Gur & Gur, 1974; Lachman & Goode, 1976) that
hypnotizability or suggestibility is predominantly a right-hemisphere
(nondominant or minor-hemisphere) function for right-handed peopie. Minor-
hemisphere functions include holistic and imaginative
mentation with diffuse, relational, and simultaneous processing of
information (Ornstein, 1973; Sperry, 1964); the tendency to " s e e "
some relationship or "m ean in g " in data, however randomly generated (e.g., a
Rorschach inkblot), would appear to be an aspect of
creative mentation that is posited to be a property of the nondominant hemisphere.
This explanation can account for the common features of good placebo responders and
good hypnotic subjects.
The intense interest of psychotherapists of all persuasions in learning
to facilitate the creative mind-body healing potentials of the right hemi
32

The Psychobiology of Mind-Body Healing

sphere has led to many controversial efforts to find observable facial or

body language cues about the process. Eye m ovem ents associated with
characteristic styles of thought or reflection were independently described
by Teitlebaum (1954) and Day (1964). Bakan first suggested that right or
left cerebral hem ispheric dom inance or activity could be the basis of the
tendency for eyes to move to the right or left, respectively, when involved
with the transduction of logical versus analogical information.
In more recent reviews of the many research studies in this area, Bakan
(1980) concluded that the right hem isphere does, in fact, have a primary
role in the production of raw im ag ery . This raw imagery tends to be facilitated
during sleep, dreaming, muscular relaxation, free association, mind
wandering, and under the effects of certain drugs that block interhemispheric
communication. W hen the cerebral hemispheres are in good communication, however,
the raw imagery of the right hemisphere is "co ok ed "
or transduced by the left hem isphere. This has led to the "p arad o xical"
finding that subjects who do well in structured tests of imagery and spatial
relations tend to move their eyes to the right, indicating a heightened lefthem
ispheric involvement. Observations of eye m ovem ents as a clue to
which hem isphere is most activated must therefore take into account the
degree to which the imagery is transduced by a primary process (raw) or
secondary process (cooked).
This difference betw een the cerebral transduction of raw and cooked
imagery may be characteristic of all the other sensory modalities. It is
found, for example, that the right cerebral hem isphere is activated by
music in the untrained listener who is simply enjoying it, while the professional m
usician's left hemisphere is activated while he is analyzing the
same music (Mazziotta, Phelps, Carson, & Kuhl, 1982). These differences
in inform ation transduction by the left and right cerebral hem ispheres
(Rossi, 1977) is the basis of many of the approaches to the facilitation of
mind-body com m unication that we will explore in later chapters.
M emory and L earning, M ind and C onsciousness

The direction of recent psychobiological research in memory and learning is confirm

ing the im portance of mind-body information transduction
in the limbic-hypothalamic area of the brain for understanding how sensation and
perception are integrated with thought and behavior. In this
section we will cover only the two areas that are of greatest significance
for our them e. These concern (1) the role of horm ones in memory and
learning; and (2) the m anner in which sensation and perception are integrated with
memory and learning in the limbic-hypothalamic system.
Information Transduction

33

McGaugh, a physiological psychologist, has summarized the role of hormones in

memory and learning as follows (1983, pp. 163-164):
It is well known that sensory stimulation activates nonspecific
brain systems [via the ARAS system, as we have seen above]. Sensory stimulation
also results in the release of hormones, including
ACTH, epinephrine, vasopressin, and the opioid peptides, enkephalin and endorphin.
A great deal of recent research has shown that
learning and memory are affected by these hormones. . . . These
findings raise two important questions. First, is the release of these
stress-related hormones part of the normal . . . processes involved
in the endogenous modulation of memory storage? Second, do the
effects of treatments known to produce retrograde amnesia and
retrograde enhancement of memory involve influences of hormones?
If the answer to these questions is yes, as much recent research suggests, then the
major question to be addressed is the basis of the effects of endogenous hormones
on brain activity underlying memory
storage. . . . Our findings, as well as those of other laboratories, suggest that
retention is influenced by epinephrine released from the
adrenal medulla (McGaugh et al., 1982). We have for several years
also studied the effects on memory of post-training electrical stimulation of the
brain. Our recent findings . . . indicate that the effects
of amygdala [a part of the limbic system] stimulation on memory may
involve the release of peripheral epinephrine. The convergence of
these two lines of research has provided evidence strongly supporting the view that
hormones released by experience act to modulate the
strength of the memory of the experience and suggest that central modulating
influences on memory [in the limbic-hypothalamic system] interact with influences o
f peripheral hormones. (Italics added)
M cGaugh's research provides us with what may become the basis of
many therapeutically useful methods of facilitating mind-body communication and
healing. Although our understanding of the incredible intricacies
of these processes is still at an elementary level, it is nonetheless sufficient
to suggest an important integration of the work of Hans Selye and Milton
Erickson in the field of psychosomatic medicine, as we shall see in Chapter 4.
The work of Mortimer Mishkin and his colleagues at the National Institute of Mental
Health is tracing the route by which the sensory information in the visual area of
the cortex is transmitted to the limbic system
where it is stored and integrated with processes of memory and learning.
The limbic system (particularly its component structures, the amgydala
34

The Psychobiology of Mind-Body Healing

and hippocampus) is the area where information stored by many different

sensory systems can be combined and integrated. This type of "crossmodal
association'' makes sensory-perceptual information available to the
hypothalamus for flexible patterns of information transduction into the
body's psychophysiological responses (Murry & Mishkin, 1985).
We may regard this research on cross-modal association as the latest
formulation of Bernheim's original concept of the ideodynamic as the
psychophysiological basis of therapeutic hypnosis. Mishkin's work is thus
a new research base for the investigation of mind-body communication
and healing in hypnotherapy. His research into the relation between the
visual modality and the limbic system must be extended to all other sensory
modalities.
In an earlier work (Rossi, 1972/1985), I concluded from a study of the
phenomenological content and processes of dreams that inter-modal shifts
between sensations, perceptions, emotion, imagery, cognition, identity,
and behavior were characteristic of the process of psychological growth
and change. Mishkin's work is providing the experimental foundation for
such psychological studies of creative development and for the renaissance
of new methodologies that are currently being developed in psychotherapy
to facilitate these processes (Mills & Crowley, 1986). We will continue the
study of these processes of information transduction in the "language of
human facilitation" presented in Chapter 5.
Mishkin's work is clarifying the great debate between the behaviorist and
cognitive approaches to understanding how memory and learning take
place and the role of thinking, awareness, and consciousness in the process.
Mishkin (Mishkin, Malamut, & Bachevalier, 1984; Mishkin & Petri,
1984) has developed a two-level psychobiological theory that has a place
for both behaviorist and cognitive frameworks. Habits, which have been
described by behaviorists as automatic stimulus-response connections that
take place whenever there is an adequate reward, are designated by
Mishkin as the more basic process that operates at all levels of life, from
the most primitive one-celled organisms to man. A cognitive process of
self-reflection and thinking is not required for the formation of such habits.
The acquisition of information, knowledge, and a self-conscious and selfdriven
memory system, as described by the cognitive learning theorists,
requires the evolution of a "cortico-limbic-thalamic" pathway that is
characteristic of all the more advanced life forms, such as mammals and man.
From the broad perspective developed in this chapter, we could define
consciousness or mind as a process of self-reflective information transduction.
This
definition may not be satisfying for philosophers, but it is sufficient as a
practical guide for our thinking about mind-body communication and how
Information Transduction

35

we may go about creating new approaches to mind-body healing. The

major processes and pathways of self-reflective information transduction
described in this chapter are beginning to emerge as the psychobiological
basis of self-driven consciousness and mind-body communication. All of
these pathways focus on the limbic-hypothalamic system* as the major
center of mind-body information transduction.
If we were more advanced in our understanding of psychobiology, we
would know which specific mind methods would facilitate each of these
major pathways to mind-body communication. What type of procedure,
for example, would most effectively stimulate the ARAS to create a heightened state
of cortical activity to facilitate new learning in a particular individual? How
shall we help a patient access memory and habit systems
with visual imagery via the occipital, temporal, limbic-hypothalamic route?
What questions about planning what aspects of life experience would most
usefully engage the fronto-limbic system of a teenager in quandary about
life goals? What combination of logical-verbal and analogical-metaphorical
modes of information transduction would optimize left and right cerebral
hemispheric integration for creative problem-solving in any specific situation?
Although we are far, indeed, from being able to answer these questions,
the very act of posing them is a step in the direction of resolving them.
Current experimental techniques, such as the PET Scan (Positron Emission
Transaxial Tomography) and Magnetic Resonance Imaging, moreover, are
making available means for testing whatever ideas and hypotheses we
develop in this area. In the later chapters of this book we will explore a
number of ways and means of accessing and facilitating each of these
major pathways of mind-body communication and healing.

* For the reader sophisticated in anatomical studies, it may be well to point out
that we
are using the term ' ‫ ׳‬limbic-hypothalamic system " in this book in the broadest
sense
to include the following: amygdala, hippocampus, cingulate gyrus, fornix, septum,
and certain nuclei of the thalamus and the Papez circuit.
3
State-Dependent Learning in
Mind-Body Healing and Hypnosis

n order to fully appreciate the scope of the state-dependent theory of

mind-body healing and hypnosis, it is necessary to review its evolution
over 200 years (outlined in Table 2). In Chapter 1 we saw how Bernheim
originated the concept of information transduction in mind-body healing
and hypnosis. In this chapter, we begin with the words of James Braid
(1795-1860), who originated the concept of the altered state or statedependent
theory of mind-body healing and hypnosis. Braid recommended
that hypnosis be defined as follows (quoted in Tinterow, 1970, pp. 370-372):

Let the term hypnotism be restricted to those cases alone in which

. . . the subject has no remembrance on awakening of what occurred
during his sleep, but of which he shall have the most perfect recollection on
passing into a similar stage of hypnotism thereafter. In this
mode, hypnotism will comprise those cases only in which w hat has hitherto
been called the double-conscious state occurs.

And, finally, as a generic term, comprising the whole of these

phenomena which result from the reciprocal actions of mind and
matter upon each other, I think no term could be more appropriate
than psychophysiology.
In the first part of this quotation, Braid defines hypnotism as a process
of dissociation or reversible amnesia giving rise to the "double-conscious
state." Modern researchers would call this a process of "state-dependent
memory and learning": What is learned and remembered is dependent
on one's psychophysiological state at the time of the experience. Memories
acquired during the state of hypnosis are forgotten in the awake state but
are available once more when hypnosis is reinduced. Since memory is
36
State-Dependent Learning
table

37

2 Evolution of the state-dependent memory, learning, and

behavior therapy of mind-body healing and therapeutic
hypnosis

RESEARCHERS

CONCEPT

Braid (1855)

Double-conscious state manifest as "reversible

amnesia" is the "psychophysiological" basis of
hypnosis.
Dissociation manifest as a block or reversible
amnesia between the conscious and unconscious
is the source of psychopathology that can be accessed and healed by hypnosis.
The root of psychoanalysis: Emotional trauma
leads to dissociation, repression, complexes,
and amnesia as the basis of neurosis and functional psychosis.
Demonstrated how traumatic amnesias and psychosomatic symptoms are psycho-neuro-
physiological dissociations that can be resolved with
"inner resynthesis" in hypnotherapy.
Hypnosis occurs spontaneously at times of stress,
suggesting that this phenomenon is a statedependent condition.
Reviewed 40-year literature establishing statedependent memory and learning as a
valid experimental basis of dissociation in many paradigms of drug and
psychophysiological research.
State-bound information and behavior are conceptualized as the psychophysiological
basis of
"altered states," dissociations, mood, multiple
personality, dreams, trance, religious, psychotic,
creative, artistic, and narcoanalytic phenomena.
Psychological shocks and creative moments occur when habitual patterns of state-
dependent
memories and associations are interrupted.
Research in state-dependent learning lends experimental support to the general view
of all
amnesias and psychological experiences as statebound.
Formulated the neodissociation theory of hypnosis,
which implies that state-dependent memory and
learning are the same class of psychophysiological phenomena as hypnotic
dissociation.

Janet (1889, 1907)

Freud (1896)
Jung (1910)
Rank (1924)
Erickson (1932, 1943a, b,
c, d, 1948)

Cheek (publications from

1957 to 1981)
Overton (1968, 1972, 1973)
Fischer (1971a, b, c)

Rossi (1972, 1973)

Erickson & Rossi (1974)

Hilgard & Hilgard (1975)

Hilgard (1977)

(1
c o n tin u ed )
38
table

The Psychobiology of Mind-Body Healing

2

Continued

RESEARCHERS

Rossi (1981, 1982)

Werntz (1981)
Werntz et al. (1981)

Benson (1983a, b)

Zornetzer (1978)
McGaugh (1983)
Izquierdo (1984)

CONCEPT

Formulated ultradian theory of hypnotherapeutic

healing: (1) The source of psychosomatic problems is stress-induced distortions of
state-dependent ultradian psychobiological rhythms in
the suprachiasmatic nucleus of the hypothalamus; (2) Erickson's "utilization"
hypnotherapy
normalizes these ultradian rhythms with autonomic system balance.
Correlation of ultradian rhythms in nasal and
cerebral hemispheric dominance is centrally controlled by hypothalamus mediating
autonomic
system balance.
The "relaxation response" in yoga and meditation has its psychosomatic healing
source in "an
integrated hypothalamic response resulting in
generalized decreased sympathetic nervous systern activity."
The endogenous state dependency hypothesis of
memory formation; "peripheral hormones" of
the adrenals modulate memory and learning in
the limbic-hypothalamic system.

dependent upon and limited to the state in which it was acquired, we say
it is "state-bound inform ation."
In the second part of the quotation, Braid invented the generic term
psychophysiological to denote all the phenomena of "th e reciprocal actions
of mind and matter upon each oth er." This early use of the term
psychophysiological was his way of conceptualizing the process of information
transduction between mind and body in healing and hypnosis.
Pierre Janet (18591947‫ ) ־‬was the next major figure in the history of hypnosis to
use the phenomenon of reversible amnesia as the basis for building a "dissociation
theory" of mind-body problems. A dissociation or
"block" between the conscious and unconscious minds was conceptualized
as the source of psychopathology that could be accessed and healed by
hypnosis. Freud adopted this view and used "free association" rather
than the formal induction of hypnosis to access the dissociated or repressed
memories that had become the basis of psychological and psychosomatic problems.
State-Dependent Learning

39

The earliest roots of psychoanalysis were concerned with investigating

the necessary and sufficient conditions for such reversible amnesias and
dissociations. In his pioneering paper on "T h e Aetiology of H ysteria,"
Freud (1896) discussed the role of trauma as follows (cited in Freud, 1956,
p. 186):
For let us be quite clear that tracing an hysterical symptom back
to a traumatic scene assists our understanding only if the scene in
question fulfills two conditions—if it possesses the required determining quality
and if we can credit it with the necessary traumatic power.
Life circumstances that had the requisite "determining quality" and "traumatic pow
er" led to the formation of complexes. The effects of such complexes on memory and
behavior were investigated experimentally by C.
G. Jung in his association experiments and described as follows (Jung,
1910, p. 363):
At the end of the [association] experiment, the subject is questioned as to whether
he correctly recalls the reaction he gave previously to each single stimulus word;
it then becomes apparent that
forgetting normally takes place at or immediately after disturbances
caused by a complex. We are in fact dealing with a kind of "Freudian
forgetting" [that is, repression]. This procedure provides us with
complex indicators which have proven to be of practical value.
Otto Rank (1924/1952) later pushed the possible source of complexes and
neurosis back to the original trauma of birth. Thus the entire edifice of
psychoanalysis could be said to rest upon this effort to explain how trauma
gave rise to emotional complexes by initiating dissociation, repressions,
and amnesias.
Milton H. Erickson (1902-1980) then demonstrated how amnesias caused
by psychological shocks and traumatic events are psycho-neuro-physiological
dissociations that can be resolved by "inner resynthesis" in hypnotherapy
(Erickson, 1948/1980). One of Erickson's early students, David
Cheek, M .D., systematized an ideomotor signaling approach for investigating
emotional trauma, stress, and psychosomatic symptoms. Over a
25-year period, Cheek's clinical case studies led him to formulate the
theory that severe stress invariably causes an altered state, identifiable as
a form of spontaneous hypnosis which encodes state-bound problems and
symptoms. He recently expressed his view as follows (Cheek, 1981, p. 88):
Hypnosis occurs spontaneously at times of stress (Cheek, 1960),
suggesting that this phenomenon is a state-dependent condition
40

The Psychobiology of Mind-Body Healing

mobilizing inform ation previously conditioned by earlier similar
stress (Cheek, 1962b).
At such times, the individual tends to revert in memory and physiological behavior
to an earlier m om ent of great stress. The formal
induction of hypnosis may suddenly release disturbing memories
of experiences associated with spontaneous hypnoidal states. This
can be helpful in the search for factors responsible for maladaptive
behavior but can embarrass an inexperienced hypnotist who may
find his subject identifying him with some evil person in past experience. This
flashback phenom enon is nonspecific. The trigger
m echanism may evoke a totally inappropriate response, as I have
frequently found in evaluating anesthesia experiences.

C heek's many clinical publications comprise the most extensive documentation of

the psychobiological approach to mind-body communication
and healing currently available in the literature on therapeutic hypnosis.
His approach will be described and illustrated in more detail in Chapter 5.
W hen Erickson and I updated the history of therapeutic hypnosis with
basic theory and research in modern psychology, we built upon Fischer's
view of the relation betw een state-dependent learning and am nesia as
follows (Erickson & Rossi, 1974/1980, pp. 71-90):
Taken together these clinical and naturalistic investigations strongly suggest that
hypnotic trance is an altered state of consciousness
and am nesia, in particular, is a natural consequence of this altered
state. Recent research in "state-d ep end en t learn in g" lends experimental
support to the general view of all am nesias as being "sta teb o u n d ." We can
now understand hypnotic am nesia as only one of
a general class of verifiable phenom enon rather than a special case.
Fischer (1971c) has recently summarized the relation betw een statedependent
learning and am nesia as follows:
Inasm uch as experience arises from the binding or coupling of
a particular state or level of arousal with a particular symbolic interpretation of
that arousal, experience is state-bound; thus, it can
be evoked either by inducing the particular level of arousal, or by
presenting som e symbol of its interpretation, such as an image,
melody, or taste.
Recently, some researchers had 48 subjects memorize nonsense
syllables while drunk. W hen sober, these volunteers had difficulty
State-Dependent Learning

42

recalling what they had learned, but they could recall significantly
better when they were drunk again. Another scientist also observed amphetamine-
induced excitatory, and amobarbital-induced,
"inhibitory," state-dependent recall of geometric configurations.
His volunteers both memorized and later recalled the configurations under one of
the two drugs. However, while remembering
from one state to another is usually called "state-dependent learnin g," extended
practice, learning, or conditioning is not necessary
for producing "state-boundness." On the contrary, a single experience may be
sufficient to establish state-boundness.
Déjà vu experiences and the so-called LSD flashbacks are special
cases of the general phenomenon of state-boundness. Note that
neither focal lesions nor molecules of a hallucinogenic drug are necessary for the
induction of a flashback—a symbol evoking a past
drug experience may be sufficient to produce an LSD flashback.
It follows from the state-bound nature of experience, and from
the fact that amnesia exists between the state of normal daily experience and all
other states of hyper- and hypoarousal, that what
is called the "subconscious" is but another name for this amnesia.
Therefore, instead of postulating one subconscious, I recognize as
many layers of self-awareness as there are levels of arousal and
corresponding symbolic interpretations in the individual's interpretive repertoire.
This is how multiple existences become possible: by living from one waking state to
another waking state; from
one dream to the next; from LSD to LSD; from one creative, artistic, religious, or
psychotic inspiration or possession to another;
from trance to trance; and from reverie to reverie (p. 904).
We would submit that hypnotic trance itself can be most usefully
conceptualized as but one vivid example of the fu n dam en tal nature o f
all phenom enological experience as " state-bound . " The apparent continuity of
consciousness that exists in everyday normal awareness is in
fact a precarious illusion that is only made possible by the associative
connections that exist between related bits of conversation, task
orientation, etc. We have all experienced the instant amnesias that
occur when we go too far on some tangent so we "lo se the thread
of thought" or "forget just what we were going to do,"etc. Without
the bridging associative connections, consciousness would break
down into a series of discrete states with as little contiguity as is apparent in
our dream life.
42

The Psychobiology of Mind-Body Healing

According to this view, what we usually experience as our ordinary

everyday state of awareness or consciousness is actually habitual patterns
of state-dependent memories, associations, and behaviors. I have conceptualized
"creative m om ents" in dreams, artistic and scientific creativity,
and everyday life as breaks in these habitual patterns (1972/1985). The new
experience that occurs during creative moments is regarded as " th e basic
unit o f original thou ght and insight as w ell as personality ch a n g e." I have
described the possible psychobiological basis of creative moments as follows
(Rossi, 1972/1985, p. 158):
Experiencing a creative moment may be the phenomenological correlate of a critical
change in the molecular structure of proteins within
the brain associated with learning (Kimble, 1965) or the creation of
new cell assemblies and phase sequences (Hebb, 1963).
Erickson's use of psychological shock (Rossi, 1973/1980) to evoke creative
moments during hypnotherapy as a means of breaking out of maladaptive patterns of
state-bound learning will be explored in Chapters 4 and 5.
Meanwhile, experimental support for the essential identity between the
processes of psychological dissociation and state-dependent learning was
forthcoming from the Hilgards' research on the use of hypnosis in the
relief of pain (Hilgard & Hilgard, 1975). The Hilgards expressed their view
as follows (p. 183):
Another approach to dissociated experiences is the peculiar action
of certain drugs upon the retention and reinstatement of learned experiences,
leading to what is called state-dependent learning. If
learning takes place under the influence of an appropriate drug, the
memory for that learning may be unavailable in the nondrugged
state, but return when the person is again under the influence of the
drug. This occasionally happens with alcohol: the drinker forgets
what he said or did while intoxicated, only to remember it again
when next intoxicated. Because the memory is stored, but unavailable except under
special circumstances, this phenomenon has some
characteristics of hypnotic amnesia. Presumably, when the site and
nature of these effects become known, they may have some bearing on the
physiological substratum for hypnosis.
In his neodissociation theory of hypnosis, Ernest Hilgard then integrated
historical and modern, experimental and clinical data to document how
State-Dependent Learning

43

the major classical phenomena of hypnosis can be conceptualized as forms

of "divided consciousness" (Hilgard, 1977, pp. 244-245):
If information acquired in one state, as under the influence of a
drug, is forgotten in the nondrugged state, but recalled again in the
drug state, that is an experimental illustration of a reversible amnesia. This
arrangement is of course the paradigm of state-dependent
learn in g. The literature has been reviewed by Overton, who is also
one of the leading investigators in the field (Overton, 1972, 1973).
. . According to Overton (1973), drug discrimination . . . may be
based "o n the dissociative barrier which impairs a transfer of training between
the drug and the no-drug condition." T he concept o f
dissociation em ployed by O verton is consonant w ith neodissociation theory.
T hat is, tw o types o f beh av ior m ay be isolated from each oth er because o f
differen t available inform ation . (Italics added)

The next development in my understanding of the relation between

hypnosis and state-dependent learning came in the early 1980s, when I
experienced the similarities between the psychobiological characteristics
of ultradian rhythms and the "com m on everyday trance" that Erickson
utilized for hypnotherapeutic healing (Rossi, 1972/1985, 1981, 1982,1986a).
This led to the formulation of the ultradian theory of hypnotherapeutic
healing, which was summarized as follows (Rossi, 1982, p. 23):
The similarities between the behavioral characteristics of ultradian
cycles (a multioscillatory system of psychophysiological processes
involving many parasympathetic and right-hemispheric functions
which have a 90-minute periodicity throughout the 24-hour day) and
those of the "com m on everyday trance" led the author to propose
a new state(s) theory of hypnosis. The background for this proposal
developed over eight years of observing the clinical, hypnotherapeutic techniques
of Milton H. Erickson, whose work appeared to
utilize a similar 90-minute periodicity. The ultradian theory of hypnotherapeutic
healing proposes that (1) the source of psychosomatic
reactions is in stress-induced distortions of the normal periodicity
of ultradian cycles, and (2) the naturalistic approach to hypnotherapy
facilitates healing by permitting a normalization of these ultradian
processes.
Extensive reviews of the research (Kripke, 1982) indicated that the suprachiasm
atic nucleus o f the h y p oth alam u s w as probably a m ajor regu lator o f these
44

The Psychobiology of Mind-Body Healing

rhythm s , w hich were sensitive to learning and conditioning by both psychological

and physiological factors. An independent verification of these findings came

when I accidentally stumbled upon the remarkable work of Werntz (1981;

Wemtz, Bickford, Bloom, & Shannahoff-Khalsa, D., 1981), who found additional
experimental evidence for the role of the hypothalamus as the source
and mediator of ultradian rhythms in cerebral dominance, nasal dominance,
and autonomic nervous system integration. The exciting theoretical implication of
Werntz's work was its provision of an empirical link between
Western psychophysiological research on altered states of consciousness
and the Eastern yogic practices of ancient times (Rossi, 1986a). This developing
rapprochement between Eastern and Western conceptions of the
relationship between mind and body is further supported by Benson's
independent line of research (1983a, b), which described the "relaxation
response" in yoga, meditation, and prayer as having its healing source
in an integrated hypothalam ic response, resulting in a generalized decrease
in sympathetic nervous system activity.
The next breakthrough in my understanding came about a year later
when I read McGaugh's (1983) review of recent research on the neurobiology of
memory and learning. This research reported that hormones
released during periods of stress modulated memory and learning in the
limbic system (specifically, in the amygdala and hippocampus). I immediately
realized that: (1) these were the same hormones of the hypothalamicpituitary-
endocrine system that Selye had found to be the source of stressrelated
psychosomatic problems; and (2) the new neurobiological research
on memory and learning, and Selye's classical psychosomatic research,
were both essentially state-dependent memory and learning phenomena.
More recently, Izquierdo (1984) has independently reported laboratory
research on "endogenous state dependency"; he confirms that memory
depends on the relation between neurohormonal and hormonal states.
According to Izquierdo, the first explicit statement regarding the endogenous state
dependency hypothesis was made by Zometzer in 1978 (p. 646):
In normal memory formation the specific pattern of arousal present in the brain at
the time of training may become an integral component of the stored information.
The neural representation of this
specific pattern of arousal might depend on the pattern of activity
generated by brainstem acetylcholine, catecholamine, and serotonin
systems. It is this idiosyncratic and unique patterned brain state,
present at the time of memory formation, that might need to be
reproduced, or at least approximated, at the time of retrieval in order
for the stored information to be elaborated.
State-Dependent Learning

45

Zornetzer's psychobiological hypothesis appears to be the clearest forerunner of

what I am formulating here as the "state-dependent theory of
mind-body healing and therapeutic hypnosis."
Although state-dependent memory, learning, and behavior (SDMLB)
have been the subject of well-controlled experimental research for the past
40 years (Overton, 1978; Rossi & Ryan, 1986), they are less familiar than
classical Pavlovian and Skinnerian operant conditioning. Therefore, it
might appear on first acquaintance that SDMLB is an exotic and highly
specialized form of learning that is a minor variant of classical or operant
conditioning. Actually, the reverse is true: SDMLB is the broad, generic
class of learning that takes place in all complex organisms that have a
cerebral cortex and limbic-hypothalamic system; Pavlovian and Skinnerian
conditioning are specific varieties of SDMLB. The pioneering investigators
and their followers were unaware, for the most part, of the role of
limbichypothalamic SDMLB factors in their early learning experiments.
Pavlov, for example, was not able to take into account all the subtle intemal
responses of stress in his dogs that were conditioned to salivate with
the external paired association of powdered meat and a sound. Most current
psychobiologically oriented researchers and theorists in memory and
learning (Lynch, McGaugh, & Weinberger, 1984) are in general agreement
(though with varying vocabularies) that there are at least two classes of
internal response involved in the memory and learning of all higher organisms: (1)
there is a specific locus of a memory trace on a molecularcellular-synaptic level
(Hawkins & Kandel, 1984; Rosenzweig & Bennett,
1984); and (2) there is an involvement of the amygdala and hippocampus
of the limbic-hypothalamic system in processing, encoding, and recall of
the specific memory trace that may be located elsewhere in the brain
(Mishkin & Petri, 1984; Thompson et al., 1984). It is this second factor involving
the limbic-hypothalamic system that engages memory, learning,
and behavior with the subtle state-dependent factors that encode psychosomatic
problems that are resolvable by therapeutic hypnosis and other
methods of mind-body healing.
A careful comparison of the work of Selye and Erickson indicates that
they were both dealing with the same basic phenomenon of state-dependent
memory and learning as the genesis and resolution of psychosomatic problems: Selye
from the perspective of physiological research; Erickson from
the psychological perspective. Neither, however, was apparently aware
of the concept of state-dependent memory and learning, and of how it
could serve as the common denominator of their work.
I will present the work of Selye and Erickson in more detail in the next
chapter. First, however, let us consolidate our understanding of the state-
The Psychobiology of Mind-Body Healing

46

dependent theory of mind-body healing and therapeutic hypnosis with

two illustrative clinical problems: traumatic amnesia and multiple personality.
Illustrative C ase E xamples

T raum atic A m nesia

In a recent doctoral dissertation on "M ood State-Dependent Memory

and Lateralization of Em otion," Gage (1983) has described Erickson's
pioneering role in developing state-dependent memory approaches to
therapeutic hypnosis as follows (pp. 1 4 1 5 ‫) ־‬:
Milton H. Erickson, who investigated memory phenomena such
as hypnotic hypermnesia, posthypnotic amnesia and posthypnotic
suggestion, was an early pioneer in the area of mood SDM [StateDependent Memory].
Although in his writings he never labeled his
work "state-dependent memory," this was clearly the topic of some
of his investigations. He perfected a method which would allow peopie who were
amnesic for clinically relevant events to remember
them in every detail. His method was based on a reorienting process which recreated
the sights, sounds, sensations, thoughts and
feelings surrounding the forgotten event (cf. Erickson, 1937, 1939).
His "reorienting" is clearly the same process as that described by
mood SDM.
A direct quotation from Erickson's report on the "Development of Apparent
Unconsciousness During Hypnotic Reliving of a Traumatic Experien ce" will serve to
illustrate this point. In this case, Erickson utilized age
regression as a means of investigating the "psychic development" of a
young man who had recently recovered from a psychotic episode (Erickson, 1937/1980,
pp. 45-59):
The experimental procedure consisted of training the patient to
enter profound somnambulistic hypnotic trances, during which, by
means of a series of hypnotic suggestions, he was disoriented completely and then
reoriented to an earlier period of his life. When thus
reoriented, by the employment of carefully worded systematic suggestions and
questions, he was induced to relive past events in a
chronologically progressive fashion, describing them in detail to the
State-Dependent Learning

47

experimenter as if they were in the course of actual development in

the immediate present. An attending stenographer recorded in full
the entire course of the experimental events, including the descriptive material.
In every instance for which adequate data were available from sources other than
the patient himself, it was found that
events of the distant past were relived and recounted by the patient
with remarkable vividness and with richness and accuracy of detail.
Study of the experimental findings disclosed an incident of peculiar interest,
illustrative in an unusual fashion of psychosomatic interrelationships. This
incident concerned the development of what
appeared to be a state of unconsciousness as the patient relived the
experience of a homicidal assault which had occurred two years
previously, when he was 17 years old. All previous information concerning this
assault consisted of the statement by the patient that
he had been "taken for a ride" and beaten so badly that hospitalization had been
necessary. He seemed to have complete amnesia for
all informative details of this experience, including even the name
of the hospital. Extensive and persistent questioning in the ordinary
deep hypnotic trance, as well as in the normal waking state, secured
only unimportant items, despite the fact that he seemed to be cooperating to the
limit of his ability.
When the day of this event was reached in the hypnotic reliving
of his past life, the patient expressed his fears over his employment
as a police informer, vividly portraying intense anxiety concerning
threatened criminal vengeance, and his entire behavior and appearance were
suggestive of a most harried state of mind. When the hour
of 4 p.m. was reached in his reexperiencing of the events of this day,
he relived, with marked intensity of feeling, the scene of his being
ordered into an automobile by two men whom he knew to be criminal characters and
his fearful behavior during the course of a long
drive, during which he pleaded piteously with his abductors in a terrified fashion.
Finally, he reenacted his forced acceptance of a bottie of pop from the criminals,
fearfully and hesitantly drinking from
an imaginary bottle. As he swallowed, he grimaced, mumbled that
it tasted bitter, asked if it was poisoned, and dodged and cowered
as if evading a blow. His entire appearance continued to denote intense terror.
Shortly after completing the act of drinking, he belched
and suddenly looked bewildered. His pupils, which previously had
been fluctuating constantly in size, became widely dilated, and fine
lateral nystagmus developed. He then rubbed his eyes, complained
that he could not see plainly, said that everything was getting dark
48

The Psychobiology of Mind-Body Healing

and that he was dizzy, and began shaking his head as if to throw
off something or to rouse himself. Questioning by the experimenter
elicited the information that the patient felt himself becoming sleepy.
It was noted that his speech, previously clear, was now thick and
indistinct and that his appearance had changed from that of terror
to that of somnolence.
At this time the patient was sitting on a couch, and every few
seconds the experimenter had been testing him for the presence of
catalepsy as an index of his continuance in the hypnotic state. After
about two minutes of decreasing activity, during which the patient
shook his head more and more slowly and mumbled with increasing inarticulateness,
his eyes closed, despite his apparent effort to
keep them open. Suddenly he gave a short, gasping grunt and collapsed, sprawling
inanimately over the couch. Immediate examina‫־‬
tion by the experimenter disclosed complete loss of hypnotic rapport,
with absence of the catalepsy which hitherto had been consistently
present. Physically, there were sagging of the lower jaw and marked
atony of the muscles of the legs and arms. Also, the patellar and
pupillary reflexes, which are consistently present during hypnotic
states, were absent. The respiration and pulse, which had been
greatly increased during the state of terror, had decreased somewhat
during that of somnolence. Now they were found to be markedly
diminished in rate and so weak and faint as to be barely perceptible. In brief, the
patient presented every appearance of being unconscious. However, before the blood
pressure and accurate counts
of the pulse and respiration could be taken, the patient seemed to
be recovering. He stirred slightly and moaned, and catalepsy returned slowly.
Shortly he opened his eyes and, after staring vacantly
around, weakly closed them again. It was noted that the pupils were
still widely dilated, that fine nystagmus was present, and that the
eyes were not focused. The patient licked his lips repeatedly, moaned
for water, and weakly rubbed his forehead, grimacing with pain as
he did so. He paid no attention to the experimenter's insistent questions, "W hat's
the matter? What's happening?" except to say, "It's
dark, dark." This was followed by a second collapse, of slower onset
than the first but apparently of the same character, with the same
physical findings except that the respiration was deep and labored
while the pulse was slow and firm. Repeated attempts were made
by the experimenter to arouse the patient, but he remained unresponsive for several
minutes. Finally, catalepsy returned, and the
patient opened his eyes and stared about unseeingly. Nystagmus
State-Dependent Learning

49

was absent, and the pupils were somewhat dilated but responsive
to light. He twisted his head about, moaned, rubbed his neck as if
it were painful, rubbed his forehead gently, grimacing as if with pain,
and shivered constantly. Again, he licked his lips repeatedly and
kept moaning for water. No response was made to the experimenter's insistent
questioning except the monosyllables ‫ ״‬light" and
"w o o d s." Now and then he put his hands to his ears, rubbed them
feebly and mumbled, "b u zzin g ."
Soon the patient seemed to recover to a considerable degree, and
he again became fairly responsive to the experimenter's inquiries,
which concerned the events he was reliving. There followed a relatively inadequate
account, as compared with his initial communicativeness, of lying in a ditch
alongside a road through a woods, of
being cold, wet, and uncomfortable, and of suffering from intense
thirst, roaring in the ears, headache, and a painful, bleeding wound
on his forehead, from which he went through the act of wiping blood
in a gingerly fashion. He also declared that it seemed to be morning.
From then, he recounted in a fragmentary fashion the experience
of being picked up by some men and taken to a hospital. The reliving of the next
two days was also disjointed and inadequate, but that
of subsequent events was complete, during the course of which the
name of the hospital was obtained.
This reexperience of a homicidal assault illustrates how state-bound information is
generated by an altered psychophysiological state (particularly the alarm reaction
of the autonomic nervous system and the endocrine
system, leading to increased respiration, pulse, and blood pressure) that
can be accessed via therapeutic hypnosis. Erickson accessed state-bound
information by carefully retrieving the contexts and frames of reference
in which it was embedded (Erickson & Rossi, 1979). As he said in the
above case, "T he employment of carefully worded systematic suggestions
and questions . . . to relive past events in a chronologically progressive
fashion" was an important key to the success of his procedure. These
systematic questions and suggestions accessed the memory sets that enabled the
patient to relive the traumatically isolated (amnesic) state-bound
memories.
Erickson's manner of accessing state-bound memories by reviewing the
context and sensory-perceptual cues surrounding their original acquisition
was fundamentally different from the manner of traditional authoritarian
hypnotism involving direct suggestion. For example, in the traditional
procedure of inciting the subject to "R em em ber!" there was a reliance on
50

The Psychobiology of Mind-Body Healing

the alleged "hypersuggestibility" of the hypnotic state. Erickson (1932/1980)

found in his initial investigations, however, that hypersuggestibility was not
a characteristic o f hypn osis. He described it as follows (p. 495):
In the writer's own experience . . . hypersuggestibility was not noticed, althou gh
the list o f individual subjects totals approxim ately 300 and
the num ber o f trances several thousand. Further, a considerable number
were hypnotized from 300 to 500 times over a period of years. Also,
several of the subjects were immediate relatives with consequent intimate daily
contact, and they were trained to respond, in experimentation, quickly and readily
to the slightest suggestion. Far from making
them hypersuggestible, it was fou n d necessary to deal very gingerly with
them to keep from losing their cooperation , and it was often felt that they
developed a com pensatory negativism toward the hypnotist to offset an y increased
suggestibility. Subjects trained to go into a deep trance instantly at
the snap o f a fin g er w ould successfully resist w hen unw illing or m ore
interested in oth er projects. Even when persuaded to give their consent

against their original wishes, the induction of a trance was impossible. Nor were
those subjects more suggestible to other people,
since, when their services were "loaned" to the author's colleagues,
the production of hypnosis in them, despite their extensive training, was just as
hard as it had been originally for the author. And
the same thing was found true when the author "borrow ed" subjects. In brief, it
seem s probable that if there is a developm ent o f increased
suggestibility , it is negligible in extent. (Italics added)
The clause, " it was found necessary to deal very gingerly with th em ,"
is the key to a more adequate interpretation of therapeutic hypnosis as
Erickson developed it. Hypnotic subjects are hypersensitive , not hypersuggestible
(Ellenberger, 1970, p. 115). It could be said that good hypnotic
subjects have an easy access to their state-dependent experiences because
of their sensitivity. This sensitivity is the quality that makes them amenable to
accepting and carrying out suggestions if they are in a cooperative
relationship with the hypnotherapist. It is also the quality that enables
them to be more receptive to the subtle and often unrecognized nuances
of hypnotic communication that have been called the "dem and characteristics"
(Orne, 1962) or the "minimal cues" (Erickson, 1964/1980, 1980b)
of the hypnotic situation. Some particularly talented subjects can utilize
their sensitivity to realign their sensory-perceptual and mental processes
in a way that allows them to experience the classical phenomena of hyp-
State-Dependent Learning

52

nosis and a variety of unusual and innovative state-dependent patterns

of mind-body interactions.
Multiple Personality and State-Dependent Memory
In her Ph.D. dissertation, Jody Lienhart (1983) has formulated a statedependent
theory of multiple personality as exemplified by five welldocumented cases (Sybil
[Schreiber, 1973]; Chris Sizemore [Thigpen &
Cleckley's The Three Faces of Eve, 1957; Sizemore, 1977]; Christina Peters
[Peters, 1978]; Betsy [Brassfield, 1980, 1983]; and herself, Jody Lienhart
[Brassfield, 1983; Putnam, 1982]). Lienhart had the opportunity to present
an unusually thorough analysis of both the objective and subjective facts
of each case, since she herself is one of them. She described the scope of
her study and some of the theoretical assumptions she found support for,
as follows (1983, pp. 6-7):
Implicit in each of the studies of childhood trauma is the pervasive
nature of paradoxical communication. Frequently, this double bind
communication style appears during the formative, preverbal stages
of childhood in which interpretation of these messages is confused.
This results in insufficient experiential learning which would allow
appropriate translation of the confused messages (Hilgard & Marquis,
1961).
Characteristically, hypnosis is produced by paradoxical statements
in which the messages are incongruent (Haley, 1963). Numerous
studies have revealed that the processes of learning and recall differ under the
hypnotic state than in normal “ forgetting" (Hilgard,
1977).
This study presents the theoretical assumption that multiple personality is
developed through early childhood state-dependent learning. Furthermore, it is
hypothesized that this learning occurs as a
result of the hypnoidal effects of childhood trauma such as abuse
and sexual molestation. The child, unable to translate the paradoxical nature of
the messages he receives, fragments into a trance state.
Furthermore, it is suggested that memories incorporated during each
of these hypnoidal experiences are similar to knowledge acquired
during state-dependent learning.
Under hypnosis, Lienhart was able to recall the critical incident of her
own traumatic dissociation and the formation of a new personality before
52

The Psychobiology of Mind-Body Healing

her fourth birthday, when she was seduced by her "U ncle Bulen". She
provides an unusually vivid description of her subjective state of being
confused and "hypnotically stunned" by this traumatic incident (1983,
pp. 74-75):
The actual incident which triggered the first personality fragmentation was an
attempt by Bulen to force the child into an act of
fellatio. Jo Ella certainly had no conception of why the erect penis
was being shoved into her mouth. She could only respond to his
ominous threats and the sensation of choking on this enormous
"th in g ." She could neither cope with the awful fear nor could she
flee from it. At this point, Jo Ella's mind simply blanked out the
dreaded experience. It was as if she had completely separated from
her body and had disappeared.
Moments, or maybe even hours later, the figure of the small child
could be seen huddled against the large stucco building. It was late
afternoon and the chill of early autumn brushed through her homemade dress. But
this was not the same Jo Ella who had earlier struggled against the powerful grasp
of her favorite "U ncle B u len." The
new child, Jo Ella II, was later dubbed the Kid. All memory traces
of the earlier incident had vanished.
The Kid was a perfect mimic and could ape the original personality
very precisely. But this child was a totally new person in almost
every way. Her perception of her world had been irretrievably altered. The previous
incident had left complete confusion in the
child's mind and this "lost tim e" could not be re-established within
its contextual setting. Neither was it possible to cope with the incident because
there were no experiential counterparts with which to
compare it. Jo Ella II was hypnotically stunned and yet unable to find
any of the words which would have allowed her to deal with the
experience, either for herself or others.
Lienhart evaluates her own case (1983, pp. 89-90):
Jody's case history is replete with similar self-contradictions which
bind the child into an unresolvable conflictual state. The good, generous and
loving uncle becomes a person who is cruel and sexually
exploitive. Since the early Jo Ella cannot reconcile these extreme
polarities, she enters into a trance state which emotionally removes
her from the scene. The emergent personality, Jo Ella II, is amnesic
for the incident. Indeed, the only access to the encapsulated experience is through
hypnosis or through its reemergence in a situation
which may have similar contextual cues.
State-Dependent Learning

53

In this description of the formation of a multiple personality, we find

the salient characteristics of the state-dependent theory of thearapeutic hypnosis:
a situation of extreme psychophysiological distress results in an amnesia
for the stressful incident that is reversible by hypnosis. Jody's case, as well as
others in Lienhart's dissertation, emphasizes another important feature
required of an adequate state-dependent theory of therapeutic hypnosis:
It illuminates the process of falling into a spontaneous state of hypnosis under
circumstances of traumatic stress (Cheek, 1960); it also illuminates the role
of the double bind or paradoxical communication in precipitating and
maintaining the dissociated state. Lienhart's case well illustrates the role
of therapeutic hypnosis in accessing the memories encapsulated by the
traumatic process of state-bound learning so that they can be therapeutically
reintegrated into the total personality.
Lienhart concludes her analysis with a formulation of the role of context and
mental sets in making knowledge consciously available in one
state and not another. We will quote a portion of her view because it serves
as a bridge to the language of "memory cues" as it is used by experimental
psychologists in state-dependent memory research. Lienhart's insight that
knowledge is separated into intellectual and emotional sets is of particular
significance, since it provides support for Erickson's hypnotherapeutic approach of
accessing emotional and intellectual memories independent of
one another when he felt he was dealing with traumatic processes in his
patients (Erickson & Rossi, 1979). Lienhart concludes (1983, pp. 8 8 8 9 ‫) ־‬:
Just as hypnosis requires intense concentration rather than "sleep,"
the multiple has learned to concentrate totally on certain memories
from the past. The underlying problem appears to be one of retrieval
from an infinite number of memory sets. It is within the retrieval process that the
perceptual distortions occur. This creates a chaotic confusion because the
individual memory units are not encapsulated
within the proper "s e ts " in an orderly fashion. Thus, a memory cue
from one period of life is stored with the wrong "memory set." Consequently,
certain stimulus cues may trigger one of the behavior
response sets but within the wrong context or sequence. The process is crudely
similar to the distortions, condensations and symbolic
connections which occur during the dream state. Knowledge which
is accessible in one state is not available during the altered state as
it is integrated poorly and distributed more randomly within the
range of recall of the dominant personality.
Another interesting feature demonstrated by multiples that is not
well understood by researchers is the emotional detachment from
54

The Psychobiology of Mind-Body Healing

the appropriate "intellectual" set. It would appear that some affective experiences
are stored independently from their intellectual
counterparts. As a result of this, an emotional unit from one set may
attach itself to a constellation of cues which make up a totally different
cognitive set.
The "infinite number of memory se ts," each more or less state-bound,
is what makes up the seemingly random patterns of associations that we
experience as subjective consciousness in everyday life (Erickson, Rossi,
& Rossi, 1976). Therapeutic hypnosis accesses these memory sets in a
systematic manner to reactivate precisely those that are required for healing
(Erickson & Rossi, 1979).
Recent theory and research on the phenomenon of multiple personality
indicate that the subpersonalities can have different cognitive (Silberman,
Putnam, Weingartner, Braun, & Post, 1985) and psychophysiological response patterns
as well. Braun (1983a, b) has used the concept of statedependent learning to
account for the different memory systems in multiple
personalities because "information which is encoded under one psychophysiological
condition is best retrieved under the same psychophysiological condition" (1983a,
p. 133).
In an objective study of multiple personality, Ludwig et al (1972) found
that "th e only dissociated functions among the different states of consciousness
pertained to emotionally laden information, skills, and activities
associated with each specific personality" (Ludwig, 1983, p. 94). Neutral
information, skills, and activities unrelated to the emotional issues of any
aspects of the multiple personality were not dissociated. This emotionally
laden aspect of dissociated or state-bound information in both multiple
personality and hypnosis points once again to the functional involvement
of the limbic-hypothalamic system as the major mind-body connection
(transducer) for emotional processes.

A PSYCHOBIOLOGICAL RESOLUTION OF THE M 1N D -B0D Y PROBLEM

If we take these views of recent psychobiological research to their logical

conclusion, we have a pragmatic solution to the centuries' old mind-body
problem—indeed, a resolution of the Cartesian dualism of mind and body.
Mind and body are not separate phenomena, one being somehow spirit
and the other matter. Mind and body are both aspects of one information
system. Life is an information system. Biology is a process of information
transduction. Mind and body are two facets or two ways of conceptualizing
this single information system.
State-Dependent Learning

55

Most theories of mind-body relationships stop short at this point without

saying anything more definite about how mind and body are connected
and how they communicate. Here, we will not avoid this basic issue by
omission or vague philosophical nostrums. The state-dependent theory
of mind-body communication and healing can be expressed as four integrated
hypotheses:
1) The limbic-hypothalamic system is the major anatomical connecting link between
mind and body.
2) State-dependent memory, learning, and behavior processes encoded in the
limbic-hypothalamic and closely related systems are the major information
transducers between mind and body.
3) All methods o f mind-body healing and therapeutic hypnosis operate by accessing
and reframing the state-dependent memory and learning systems that
encode symptoms and problems.
4) The state-dependent encoding o f mind-body symptoms and problems can be
accessed by psychological as well as physiological (e.g., drugs) approaches—
and the placebo response is a synergistic interaction of both.

The major thrust of these hypotheses is that mind-body information transduction and
state-dependent memory, learning, and behavior mediated by the
limbic-hypothalamic system, are the two fundamental processes of mindbody
communication and healing. Medical science has specialized in all
the anatomical, physiological, and pharmacological methods of accessing
and facilitating healing; that is, it has focused almost exclusively on the
"body sid e" of the mind-body equation. In this chapter we have developed an
experimentally based psychophysiological rationale for understanding how
psychological factors can facilitate healing as well. Statedependent memory,
learning, and behavior phenomena are the "m issing
link" in all previous theories of mind-body relationships. They bridge the
mysterious gap between mind and body; they are the common denominator between
traditional Western medicine and all the holistic, shamanistic,
and spiritualistic approaches to healing that depend upon highly specialized
cultural belief systems, world views, and frames of reference.
We are now in a position to explain the many forms of iatrogenic illness
and healing that have been so difficult for Western medicine and psychology to
understand. The state-dependent theory of mind-body healing
can elucidate, for example, how even in our modern age, researchers
(Dunlap, Henderson, & Inch, 1952) could have found that 30 percent of
the 17,000 medical prescriptions they studied in England were actually
56

The Psychobiology of Mind-Body Healing

placebos in the sense that the drugs did not have any specific physiological
effect on the conditions for which they were prescribed. We can now understand how
any drug that alters any aspect of the body's sensory-perceptual
or physiological responsiveness on any level can disrupt the more-or-less fragile
state-dependent encoding of symptoms and thereby evoke a "nonspecific" but very
real healing effect that we call the "placebo response."
Let us now turn our attention to a more detailed study of the relationship between
mind-body symptoms, state-dependent learning, and therapeutic hypnosis through a
comparison of the pioneering research of Hans
Selye and Milton Erickson.
4
Stress and Psychosomatic Phenomena:
Pioneering Work of Hans Selye
and Milton Erickson

UR1NG the past half century, the study of stress and psychosomatic

phenomena has been the major stimulus for investigating mind-body

communication and healing. Our approach to this area will be to update
and integrate the work of two major pioneers: the physiologist Hans
Selye, and the psychiatrist and hypnotherapist Milton Erickson. These two
investigators contributed profoundly original observations to our understanding of
psychosomatic phenomena: Selye primarily from his innovative physiological
experiments on stress; Erickson primarily from his
open-ended, naturalistic investigations of spontaneous psychosomatic
dysfunctions during hypnosis. Integrating their work leads to a more comprehensive
understanding of mind-body problems and the means of facilitating their resolution.
In this chapter we will review Selye's formulation of the General Adaptation
Syndrome (GAS), which has been described aptly as the foundation
of psychosomatic medicine. We will use the concept of state-dependent
memory and learning and its natural consequent, state-bound information and
behavior, to update Selye's view of the GAS. Recent research that has
deepened our understanding of the functions of the hypothalamus then
will be used to integrate Selye's concept of the GAS with Erickson's view
of the experiential and psycho-neuro-physiological basis of hypnotherapy.
S elye's C oncept of the G eneral A daptation S yndrome (G A S)

Selye acknowledged the influence of the great French physiologist,

Claude Bernard, in the evolution of his concept of the General Adaptation
Syndrome (1974). Bernard stated that one of the most characteristic fea
57
58

The Psychobiology of Mind-Body Healing

tures of all life is its ability to maintain the constancy of its inner milieu, the
environment within its skin. Walter Cannon (1932, 1953) later called this
property homeostasis: the characteristic of maintaining a steady internal
physiological state despite external changes in the environment. Life's
response to any injury or disease could be characterized as an effort to
maintain its homeostatic balance against the intrusion or change from the
outside world. Selye's first original contribution was to show that whatever the
source of biological stress intruding upon the organism, it would
react with the same pattern of response to restore its internal homeostasis.
He described his process of discovery as follows (Selye, 1974, pp. 24-27):
In 1926, as a second year medical student, I first came across this
problem of a stereotyped response to any exacting demand made
upon the body. I began to wonder why patients suffering from the
most diverse diseases that threaten homeostasis have so many signs
and symptoms in common. Whether a man suffers from a severe
loss of blood, an infectious disease, or advanced cancer, he loses his
appetite, his muscular strength, and his ambition to accomplish
anything; usually, the patient also loses weight, and even his facial
expression betrays that he is ill. What is the scientific basis of
what at that time I thought of as the "syndrom e of just being
sick"?
. . . How could different stimuli produce the same result? In 1936, this
problem presented itself again—under conditions more suited to exact laboratory
analysis. It turned out in the course of my experiments
in which rats were injected with various impure and toxic gland
preparations that, irrespective of the tissue from which they were
made or their hormone content, the injections produced a stereotyped syndrome (a
set of simultaneously occurring organ changes),
characterized by enlargement and hyperactivity of the adrenal cortex, shrinkage (or
atrophy) of the thymus gland and lymph nodes,
and the appearance of gastrointestinal ulcers.
. . . It soon became evident from animal experiments that the same
set of organ changes caused by the glandular extracts were also produced by cold,
heat, infection, trauma, hemorrhage, nervous irritation, and many other
stimuli. . . . This reaction was first described,
in 1936, as a "syndrome produced by various nocuous agents" and
subsequently became known as the General Adaptation Syndrome
(GAS), or the biological stress syndrome. Its three stages—(1) the alarm
reation; (2) the stage of resistance; and (3) the stage of exhaustion.
Stress and Psychosomatic Phenomena

59

State-Dependent Learning and the General Adaptation Syndrome

The first two stages of Selye's G A S—the alarm reaction and the state of
resistance—take on a profoundly new significance in the light of the more
recent research in state-dependent memory and learning. The alarm reaction is
characterized by the activation of the sympathetic nervous system,
which stimulates the release of epinephrine and norepinephrine from the
adrenal medullae. As we noted earlier, M cGaugh's research (1983) demonstrated that
these are the same hormones (among others) that modulate
the retention of memory. Learning and memory acquired during Selye's alarm
reaction therefore tend to be state-dependent! A person in a traumatic car accident
experiences an intense rush of the alarm reaction hormones. His
detailed memories of the accident are intertwined with the complex
psychophysiological state associated with these hormones. When he returns
to his usual or "n o rm al" psychophysiological states of awareness a few
hours or days later, the memories of the accident become fuzzy or, in really
severe cases, as illustrated in the case of traumatic amnesia of the previous
chapter, the victim may be completely amnesic. The memories of the accident have
become "state-bound"—that is, they are bound to the precise
psychophysiological state evoked by the alarm reaction, together with its
associated sensory-perceptual impressions of the accident.
Gold (1984) recently validated this experimentally when he found that
" a single injection of epinephrine results in long-lasting change in brain
function. . . . The findings suggest that some hormonal responses may
not only regulate neuronal changes responsible for memory storage but
may also themselves initiate long-lasting alterations in neuronal function"
(p. 379).
Selye's next stage, the stage of resistance, is the period during which
psychosomatic symptoms become particularly evident and troublesome.
In our car accident example, the psychosomatic response could be any part
of the alarm reaction that was originally experienced—anxiety, pain, hysterical
paralysis, headaches, ulcers, etc. The victim now is struck with a
subtle "problem of adaptation" that traditional physical medicine often
does not know how to deal with. This is especially the case when the initial
cause of the stress (such as the car accident) has disappeared and yet the
mind-body—having learned a new defensive (psychosomatic) mode of
adaptation, continues with it. The psychosomatic mode of adaptation was learned
during a special (usually traumatic) state-dependent psychophysiological condition;
it continues because it remains state-bound or locked into that special
psychophysiological condition even after the patient apparently returns to his
normal mode of
functioning.
60

The Psychobiology of Mind-Body Healing

Selye proposed a number of solutions for the psychosomatic problems

manifested during this stage of resistance. Most typically, medication could
be used to counteract the stressor hormones or, in extreme cases, surgery
could remove the adrenals that produce the hormones. Selye frequently
described this stage of resistance as being "stuck in a groove." That was
his way of describing what we now recognize as state-bound psychophysiological
behavior. Selye reasoned that if a shock could get one stuck
in a groove, perhaps another shock could get one out again so that the
person could "snap out of disease" (Selye, 1976, p. 9). He believed that
the various forms of shock (electroconvulsive and insulin shock treatment
for the mentally ill, psychological shock, etc.) were types of nonspecific
therapies that counteracted many of the nonspecific aspects of the GAS. In
a following section we will see how this understanding of the relationship
between shock and the nonspecific approach to psychosomatic problems
has an almost exact, though previously unrecognized, correspondence to
Erickson's use of psychological shock as a general (nonspecific) approach
to a variety of emotional problems.
State-Dependent Memory, Mood, and the Murder of Robert Kennedy
An unusually clear example of how a traumatic situation involving the
heightened state of Selye's alarm reaction can generate state-bound information
accessible by hypnosis is provided in the following description
of the assassination of Robert Kennedy (Bower, 1981, p. 12):
[This] illustration involves a talk I had recently with Vernard Diamond, a forensic
psychiatrist who lives in the Bay Area, about a
famous criminal case he dealt with—the case of Sirhan Sirhan, the
man who assassinated Bobby Kennedy in Los Angeles in 1968. . . .
Interestingly, Sirhan has absolutely no recollection of the actual
murder, which occurred in the small kitchen of the Ambassador
Hotel where he pumped several bullets into Kennedy. Sirhan carried
out the deed in a greatly agitated state and was completely amnesiac with
regard to the event. Diamond, called in by Sirhan's attorneys, hypnotized Sirhan
and helped him to reconstruct from memory the
events of that fateful day. Under hypnosis, as Sirhan became more worked
up and excited, he recalled progressively more, the memories tumbling out
while his excitement built to a crescendo leading up to the shooting. At that
point Sirhan would scream out the death curses, "fir e " the shots,
and then choke as he reexperienced the Secret Service bodyguard
nearly throttling him after he was caught. On different occasions,
Stress and Psychosomatic Phenomena

61

while in trance, Sirhan was able to recall the crucial events, sometimes speaking,
other times recording his recollections in automatic
writing, but the recall was always accompanied by great excitement.
The curious feature of the case was that material uncovered under
hypnosis never became consciously available to Sirhan in his waking state, and he
denied that he committed the murder. Moreover,
he denied that he had ever been hypnotized by Diamond, denied
that it was his own voice on the tape recorder, and denied that it
was his handwriting—he alleged that Diamond must have hired an
actor or a handwriting specialist to mimic him. Sirhan eventually did
accept the theory that he must have killed Bobby Kennedy, rationalizing it as an
act of heroism in the cause of Arab nationalism. But
his belief was based on ‫ ״‬hearsay," much as is my belief that I was
born on a Wednesday evening—I must have been there but I sure
cannot remember it. (Italics added)
The generation of state-bound information in an extreme psychophysiological state
of alarm is clearly evident in this case: "Sirh an carried out
the deed in a greatly agitated state and was amnesiac with regard to the event.
. . . Under hypnosis, as Sirhan became more and more worked up and
excited, he recalled progressively more, the memories tumbling out while
his excitement built to a crescendo leading up to the shooting." The
"greatly agitated state" was a heightened state of the psychophysiological
alarm response that was so extreme that Sirhan's memories became statebound: They
were dissociated from his normal waking consciousness so
that he had a complete amnesia for the shooting. Hypnosis enabled Sirhan
to reexperience this extremely altered psychophysiological state, and with
it, "th e memories [came] tumbling out while his excitement built to a
crescendo." This well-documented illustration of the intimate association
between the endocrine system, the alarm response, and state-bound information in
the form of an amnesia that can be reversed under hypnosis
is typical of many examples. By accessing the heightened state of emotion in which
these memories were state-bound, hypnosis was able to
retrieve them.
The objection could be raised that the extreme stress of the Sirhan Sirhan
case might be an exception in generating state-bound information; after
all, the situation is very different in more typical daily living where emotions
and moods are of a milder nature. Bower (1981; Gilligan & Bower,
1984) has undertaken a series of experimental studies investigating this
generation of state-bound information by the emotional and mood states
typical of daily living. He used "hypnotically induced moods . . . to create
62

The Psychobiology of Mind-Body Healing

an experimental analog of affect-state-dependent learning" to measure

memory and recall (Bower, 1981, p. 131). He found that when subjects
learned material in a hypnotically-induced happy mood, they recalled it
better when they were again in a happy mood. The same affect-statedependent
learning took place when a hypnotically-induced sad mood
was the acquisition condition for learning.
Emotional states were also significant for recalling childhood memories:
In a happy mood, subjects recalled more happy memories from childhood;
in a sad mood, they recalled more sad memories. Bower's work demonstrates how
emotions can generate state-bound information that is accessible by hypnotically-
induced moods matching the acquisition condition
in which the information was first encoded. Bowers formulated an "associative
network theory of memory and em otion" to explain the "m oodstate-dependent
retrieval" that can be activated by physiological or symbolic verbal processes.
Gazzaniga (1985) has discussed recent research in
left and right cerebral hemispheric processes supporting the view that
these associative "netw orks of the m ind" can act as semiautonomous
"m od u les" with many of the functional characteristics of the "unconscious" and
with what we are calling here "state-bound information and
behavior."
It is precisely in such interactions of the physiological and symbolic,
demonstrated in the work of Bowers and Gazzaniga, that we recognize
the type of mind-body connections most easily accessible by hypnosis.
This experimental work, together with that of other investigators (Blum,
1967, 1972; Gage, 1983) thus provides a sound research base for the efficacy of
therapeutic hypnosis, in which patients' associative networks and
frames of reference are carefully accessed and utilized for resolving mindbody
problems (Erickson & Rossi, 1979; Erickson, 1985).
E rickson's H ypnotic Investigations
of P sychosomatic P henomena

Erickson's original contributions to the field of psychosomatic medicine

are contained in four papers that were published together in the January
1943 issue of the journal Psychosomatic Medicine (1943a, b, c, d/1980). These
papers on the psychological components of psychosomatic phenomena
summarized the results of a decade of wide-ranging experimental and
clinical hypnotic work that took place during the same time period when
Selye was making his fundamental discovery of the physiological components. In a
sense Erickson's and Selye's research was both complementary and reciprocal: Selye
discovered the same physiological response
Stress and Psychosomatic Phenomena

63

to different stressors in what he termed the "G eneral Adaptation Syndrom e";
Erickson discovered psychologically different responses to the
same stressor in what he termed "coincidental phenom ena." Taken together, their
work provides a comprehensive picture of the genesis and
methods of resolving psychosomatic problems.
Viewed in isolation, Selye's work would imply that since different stressors all
generate the same physiological syndrome (adrenal cortex enlargement, immune system
suppression, and gastrointestinal tract ulceration),
everyone should manifest the same physiological dysfunctions, whatever
the source of stress (mental or physical). The fact that each individual
actually manifests different physiological patterns indicates that there is
another component to the stress response. This was called the "specific
component" by Selye: It included the specifics of the physiological trauma
(a knife wound and a burn both arouse the same GAS but each obviously
has different physical and physiological features), as well as the psychological
variations of those learned conditioned responses accumulated from
the individual's life history. Selye, however, was silent on the subject of
the dynamics of these conditioned psychological components. It is this
unique pattern of psychologically conditioned responses within each individual
(which makes up the state-dependent filter of Figure 1, p. 26) that
Erickson explored in his studies of psychosomatic phenomena.
Erickson begins one of his early papers on the "Hypnotic Investigation
of Psychosomatic Phenom ena" with the following description of "coincidental phenom
ena" (1943c/1980):
The purpose of this paper is to present an account of various psychosomatic
interrelationships and interdependencies frequently encountered as coincidental
phenomena during the course of hypnotic experimentation on normal subjects. . . .
These coincidental phenomena
are not those usual and expected changes in psychological, physiological, and
somatic behavior that are essentially common to all
hypnotic subjects in profound trances, such as alterations in reaction time,
sensory thresholds, muscular tonus, and similar items of
behavior. Rather, they are distinct from such psychosomatic manifestations of the
hypnotic trance, and they are in all probability expressive, not o f the state o f
hypnosis itself, but o f the interrelationships of
hypnotically induced behavior and conditions within the trance state. That
is, after a profound trance state has first been secured, specific hypnotic
instructions can then be given to the subject to elicit responses
of a particular sort and in a chosen modality of behavior. However,
in addition to the behavior that is suggested, there may also be elicited, seem
64

The Psychobiology of Mind-Body Healing

ingly as coincidental manifestations, marked changes in one or another

apparently unrelated modality of behavior, (pp. 145-146)
. . . Thus, for example, one subject rendered hypnotically deaf
might show many changes in visual, motor, and other forms of behavior . . . while
another subject rendered hypnotically colorblind
might show many disturbances of motor behavior but no changes
in the auditory sphere. . . , Subjective feelings of nausea and vertigo invariably
developed in one subject w henever a state of hypnotic deafness became well
established for her. . . . Additionally she
showed nystagmoid m ovem ents and pupillary dilation. . . . Another subject . . .
with the onset of hypnotic deafness [experienced]
an extensive anesthesia. Until this anesthesia was corrected he could
not recover his hearing. . . . Several other subjects have shown a
com parable inability to recover from induced behavior changes until the
coincidental developments were first corrected, (pp. 1 4 8 1 4 9 ‫; ־‬
Italics added)

. . . They [the coincidental developments] constitute essentially individual

manifestations which occur under a wide variety of circumstances and many different
associations. Furthermore they are
not constant in their appearance for all subjects in the same situation. . . .
However, the findings do tend to remain constant for the
specific modality of behavior under investigation in the individual
subject, although repeated hypnotic experiences tend to lessen progressively
the extent and duration of the phenomena likely to cause the subject discomfort,
(p. 146; italics added)
From the point of view developed in this section, we would characterize
Erickson's "coincidental phenom ena" as manifestations of the uniquely
individual state-bound patterns of information and behavior that each person
acquires as a result of his or her particular life history of experiential
learning. These individual patterns are the basis of each person's unique
repertory of hypnotic responsiveness, which can be utilized therapeutically. (These
individual patterns may also be conceptualized as manifestations of the "creative
unconscious" of each person.) When the person is
subjected to undue stress over a period of time, these "coincidental phenom ena"
become the basis of the psychosomatic symptoms that express
the experiential learnings encoded in the memory filters of the limbic
system.
Erickson's finding that "repeated hypnotic experiences tend to lessen
progressively the extent and duration of the [coincidental] phenomena
likely to cause the subject [psychosomatic] discomfort" is the basis of one
Stress and Psychosomatic Phenomena

65

of his hypnotherapeutic approaches to mind/body dysfunctions. An example of

Erickson's early use of this approach was presented in his paper
called the "Hypnotic Investigation of Psychosomatic Phenomena: A Controlled
Experimental Use of Hypnotic Regression in the Therapy of an
Acquired Food Intolerance." A review of this case provides us with a clear
example of how the state-dependent learning of a psychosomatic symptom and a phobic
response (perhaps involving the autonomic nervous
system, and especially the gastrointestinal component of Selye's GAS)
can be resolved hypnotherapeutically (Erickson, 1943b/1980, p. 170):
A subject in her early twenties was inordinately fond of orange
juice and drank it at every opportunity. One day, because of gastrointestinal
distress, she decided to try self-medication and proceeded to take castor oil,
first mixing it with orange juice to disguise its
taste. Unfortunately this concoction caused acute gastric distress: she
became violently nauseated and she vomited repeatedly. Following
this she went to bed. The next morning she felt much better and very
hungry. She went to the kitchen to get her customary glass of orange
juice. Quite unexpectedly she found that the sight, smell, and taste
of orange juice caused immediate nausea and vomiting and she
could not drink it.
Instead of making a spontaneous recovery from this acute violent
distaste for oranges, she continued to manifest it until it became
almost phobic in character. She could not endure the thought of
oranges in the refrigerator, and her family had to cease using them.
Even the sight of oranges in fruit markets caused her to develop feelings of
nausea.
Erickson reported that the origins of this conditioned gastrointestinal
problem had another, highly emotionally charged determinant which
resolved itself within a few days, and which he did not detail in his paper.
The subject's conditioned distaste for orange juice persisted, however.
This is very typical of psychosomatic problems and goes to the heart of
the dilemma they present. The problem origins of a state-dependent pattern of
memory and learning are often easily resolved, but the psychosomatic symptoms that
they give rise to persist! The new dysfunctional
pattern has become "functionally autonom ous": It endures as a form of
state-bound information and behavior that expresses itself independently
and indeed frequently in seeming defiance of the conscious will/ego.
Because of the now-isolated character of the symptom, Erickson refused
to treat it with direct hypnotic suggestion, even though the subject pleaded
66

T h e P sychobiolo gy o f M in d -B o d y H ea lin g

with him to do so. Instead he chose an indirect approach. At a social

gathering one evening, the subject was persuaded by the guests to act as
a hypnotic subject. Erickson then used her to demonstrate age regression,
wherein she was reoriented to a period two years before she experienced
her unfortunate association between orange juice, castor oil, and the highly
charged emotional problem. After being in this age-regressed state for
20 minutes (a typical time period Erickson used to " s e t" a deeply somnambulistic
hypnotic trance), she was able to join the guests in drinking
orange juice without any adverse reaction. At no time was she given anv
direct suggestions to ameliorate or resolve her symptom. She was merely
provided with an opportunity to drink orange juice, and she did so with
pleasure. She was then awakened from trance with an amnesia for all that
had taken place. During the remainder of the evening, "h er facial expression was
frequently puzzled and reflective, and she kept rolling her tongue
about her mouth and passing it gently over her lips as if she were trying
to sense some elusive taste." Several days later the subject reported that
she had somehow "spontaneously unconditioned" herself and had regained her original
liking for orange juice.
The salient feature of this case is how Erickson's indirect approach enabled the
subject to reexperience her original liking for orange juice in an
age-regressed state without interference from her learned negative gastrointestinal
response. From the state-dependent memory and learning point
of view, we would say that her age-regressed state-of-being bypassed the
gastrointestinal symptom that was learned in a later state-of-being. When
she was to once more experience her original liking for orange juice, the
symptom was depotentiated or unconditioned (Rossi, 1973 1980; Erickson
& Rossi, 1976 1980) without any interference from her conscious mind's
negative expectation.
This form of hypnotherapy is very different from the classical approach
of using direct suggestion to "com mand aw ay" or inhibit a symptom.
Erickson's indirect approach utilizes the mind's own naturalistic means
of self-healing, without the intrusion of direct suggestions that could only
be expressive of the therapist's limited view of how the cure "sh o u ld "
take place. The therapy takes place not by a hypnotic command imprinted
on the subject's mind, but by circumventing what Erickson called "learned
limitations" and accessing therapeutic response potentials that already
exist within the subject. In this case, the learned limitation was a clear
example of "a state-bound pattern of information and behavior" that
encoded a distressing symptom which interfered with the subject's original response
of enjoying orange juice. Erickson's indirect approach via
age regression accessed her state-bound symptom in a permissive manner
Stress and Psychosomatic Phenomena

67

that allowed her own creative resources to do the actual healing. Later,
I will provide additional case examples of how this type of therapeutic
hypnosis can be more adequately conceptualized from our psychobio‫־‬
logical perspective rather than from the traditional but misleading perspective of
hypnosis as a programming of mind and behavior. Indeed,
Erickson characterized programming as a "very uninformed w ay" of attempting to do
hypnotherapy (Erickson & Rossi, 1979, p. 288).
In a little known or appreciated early paper on the nature of hypnotic
psychotherapy, Erickson (1948/1980) outlined his rationale for a radically
new concept of "tran ce" as a period of creative reorganization. He states
it as follows (p. 38):
The induction and maintenance of a trance serve to provide a
special psychological state in which the patient can reassociate and reorganize
his inner psychological complexities and utilize his own capacities in a
manner in accord with his own experiential life. . . . Therapy results
from an inner resynthesis of the patient's behavior achieved by the
patient himself. It's true that direct suggestion can effect an alteration in the
patient's behavior and result in a symptomatic cure, at
least temporarily. However, such a "c u re " is simply a response to
suggestion and does not entail that reassociation and reorganization
of ideas, understandings and memories so essential for actual cure.
It is this experience of reassociating and reorganizing his own experiential
life that eventuates in a cure, not the manifestation of responsive behavior which
can, at best, satisfy only the observer.
Let us now turn our attention to a more detailed exposition of this
creative approach to the reassociation and reorganization of mind-body
problems, which I have described as a new language of mind-body communication and
therapeutic hypnosis (Rossi, 1987).
5
The New Language of
Mind-Body Communication

n this chapter we will focus on effective approaches for facilitating mind-

body communication. We will learn how words, phrases, questions,

and a variety of search strategies can access the problems encoded in statebound
memory and make information available for self-help. These approaches are all
explorations of how we can best actualize human potential
rather than manipulate and control behavior. Our work does not involve
overt or covert conditioning, "influence communication," or programming.
We do not even use "su ggestion" in the conventional sense of putting
an idea into another person's mind. Rather, we simply access state-dependent
memory, learning, and behavior systems and make their encoded information available
for problem-solving. The locus for control of the
healing process remains within the patient at all times. The therapist is
a facilitator, guide, and consultant.
Insofar as it is possible, we will always use the patient's own words,
attitudes, and world view as the most desired route to accessing the problem areas.
Our approaches are usually problem-centered because "problem s" are paths to the
person's "growing ed ge." Symptoms are often
signals of the need for personal development. All of our therapeutic approaches
actively involve the patients in taking action, even in the first
session, that will move them quickly to better coping skills and a position
of self-efficacy.
E very A ccess is a R eframe

The basic premise for all the approaches outlined in this book is, "Every
access is a reframe." Each time we access the state-dependent memory,
learning, and behavior processes that encode a problem, we have an opportunity to
"reassociate and reorganize" or reframe that problem in a
68
New Language of Mind-Body Communication

69

manner that resolves it. This premise is based upon the recent research
in memory, learning, and cognition that was examined previously (Chapter 3; Lynch,
McGaugh, & Weinberger, 1984). Memory does not operate
like a tape recorder in which we simply play back exactly what we learned.
Memory is always a constructive process whereby we actually synthesize
a new subjective experience every time we recall a past event. Pribram
(1986) expresses this active synthetic process of memory as follows:
Images and other mental contents as such are not stored, nor are
they "localized " in the brain. Rather, by virtue of the operation of
the local brain circuitry, usually with the aid of sensory input from
the environment, images and mental events emerge and are constructed. A similar
mechanism involving the motor mechanisms of
the brain can account for intentional, planned behavior. The evidence that such a
mechanism exists is presented in Languages of the
Brain and elsewhere (Pribram, 1971,1976; Pribram et al., 1981). Much
of my laboratory research has been involved in demonstrating that
brain function is active, not passive, in its interactions with environment
and elucidating the processes operative in this active aspect of mind.
This research has shown that the intrinsic cortex and limbic formations
of the forebrain actively organize sensory input, etc. (see review by Pribram,
1980). (Italics added)
Mind and nature are in constant change and creative flux. It is irritating
to us when our memories of the same event are different from those of
another person, and when even our memories change over time. These
entirely natural differences and changes are the despair of our courts of
law, which are based upon the rather naive view of a constant, unchanging,
objective reality where "facts are facts" rather than the subjective
constructions of our own minds. The law requires that a witness repeat
the same story in the same way every time. The natural mind, by contrast,
tends to repeat the same story with variations, seemingly seeking to constantly
update and reframe "reality" in keeping with the new information
and views it is spontaneously generating.
What is the despair of the law, however, is the opportunity of the psychologist!
When the mind naturally reviews memories from slightly different perspectives, for
example, it is spontaneously engaged in constructing
alternate realities. This spontaneous construction of alternate realities has
survival value in a constantly changing environment. People who do not
recognize, welcome, and integrate these spontaneous changes are condemned to living
an uncreative existence in an outmoded past (Rossi,
70

The Psychobiology of Mind-Body Healing

1972/1985). Most of us are unaware of how strongly we have been programmed to live
in this way. We struggle in vain to preserve our past way
of thinking, feeling, and doing until a symptom or problem becomes manifest
evidence of our lack of adaptation to the current and ongoing changes
that are taking place. Our symptom or problem is then our best guide to
where ‫ ״‬inner work" needs to be done to readapt and recreate ourselves.
Each time we mentally review (access) what our problem is about, we can
depend upon our mind to spontaneously reframe it in a slightly different
way as it seeks an answer.
T hree-S tep R outines for P roblem-S olving

At the Evolution of Psychotherapy Congress in Phoenix, Arizona, it was

estimated that there are now over 300 different forms of psychotherapy
(Rossi, 1987). All these therapies facilitate mind-body communication and
healing to some degree. One could get lost in their bewildering complexities by
trying to focus on all the nuances of difference between them. On
the other hand, they all share the same three-step routine for problemsolving:
1) Therapist and patient initiate a communication process together;
2) They engage in some sort of therapeutic work; and
3) They hopefully have some criteria for problem resolution so they
know when to discontinue the interaction.
In traditional hypnotherapy, the three steps go somewhat as follows:
1) Establish trust and rapport;
2) Offer therapeutic suggestions for creative inner work; and
3) ‫ ״‬Wake u p " the patient and ratify the resolution of the problem
(Erickson & Rossi, 1979).
If the problem is not resolved, then carry out the same three steps again
in another way, perhaps using different suggestions and patterns of inner
work based upon what was learned from the first effort. The process is
iterative: You do the three steps over and over, each time learning more
about the patient's inner condition and resources, which then can be
facilitated with greater effectiveness the next time around.
The three-step routines presented in this chapter range from the simple
to the complex. They are easy to learn in the order in which they are
presented, since experience with each builds the therapeutic skills needed
Neio Language of Mind-Body Communication

71

to do the next one effectively. All of the routines are variations of a basic
accessing formula, to which we will now turn our attention.
The Basic Accessing Formula
The essence of all the therapeutic approaches in this chapter can be
found in what may be called the basic accessing formula. Hypnotherapists
have used this formula in one way or another for centuries. It was analyzed and
formulated by Erickson and Rossi (1976/1980) as the "implied
directive." The basic accessing formula is fundamentally different from
all previous forms of direct authoritarian suggestion in that it does not
involve imprinting, conditioning, or programming the subject with the
therapist's view of how problem-solving should take place. Rather, the
accessing formula simply provides a framework for the patient's accessing
of the state-bound encoding of his or her problem and facilitates information
transduction so that inner healing can take place.
The basic accessing formula may be expressed in many different ways,
but it always has three standard parts:
1) A time-binding introduction that initiates an inner search of statedependent
memory, learning, and behavior systems;
2) Accessing and transduction of the state-bound problems and symptoms;
3) An observable behavioral response signaling when the process of
accessing and therapeutic transduction is completed.
When the patient responds to this inner accessing formula by quieting
down and closing the eyes, we have an observable behavioral response
indicating that inner work is taking place. This is an entirely natural and
easily accepted approach to inner problem-solving, because it utilizes the
typical everyday process we all experience when we turn inward momentarily to
figure out how to deal with an issue. This expression of the accessing formula
introduces and facilitates a process of reviewing memories
associated with the problem. As will be seen, there are many expressions
of the accessing formula that can facilitate new learning, the reframing
of outmoded ideas, and the channeling of self-expression in more adequate ways for
problem-solving.
Research on creative thinking (Rossi, 1972/1985) has demonstrated that
the essence of the new is usually generated within us on an unconscious
level. The conscious mind simply receives the new idea and subjects it
to validation and integration with previous patterns of understanding. The
72

The Psychobiology of Mind-Body Healing

bo x

2 Basic Accessing Formula

1. T im e-binding introduction initiating in n er search

A s s o o n a s y o u r i n n e r m i n d [c r e a t i v e u n c o n s c i o u s ,
s p i r i t u a l
g u i d e , e t c .] k n o w s
2 . A ccessing state-bound sources of problem
t h a t y o u c a n r e v i e w s o m e i m p o r t a n t m e m o r i e s r e l a t
e d to th e
s o u rc e o f th a t p ro b le m ,
3 . Observable behavioral signal of problem-solving
y o u w i ll f e e l y o u r s e l f g e t t i n g m o r e c o m f o r t a b l e a
s y o u r e y e s
c l o s e [th e o b s e r v a b l e b e h a v i o r a l r e s p o n s e ] to r e v
i e w t h e m .

basic accessing formula structures an opportunity for something new to

happen on an unconscious level at the source of creativity. It is a way of
focusing a patient's mental resources (e.g., state-dependent memories,
sensory-perceptual associations, emotions, habits, and various patterns
of learning, etc.) and directing them toward a creative state of problemsolving.
Recent research in the neurobiology of learning (Rosenzweig &
Bennett, 1984) suggests that new proteins are synthesized in appropriate
brain cells during learning. We may speculate that the various forms of
the accessing formula outlined in this and the following chapters actually
"facilitate the internal synthesis of new protein structures that could function as
the biological basis of new behavior and phenomenal experience"
(Erickson, Rossi, & Rossi, 1976).
Let us now examine in detail some of the variations of the basic accessing
formula that are particularly useful for clinical problems.
Accessirtg State-bound Resources for Problem-Solving
This general three-stage approach to problem-solving by accessing the
patient's inner resources was originally described by Erickson and Rossi
(1979, pp. 1-14) as a basic model for therapeutic hypnosis. It is being
generalized here into a procedure that is useful for a wide range of problems that
patients can resolve for themselves during a period of "inner
w ork."
New Language of Mind-Body Communication

73

Stage 1: Readiness Signal for Inner Work. In this first stage of the approach,
the therapist asks the patient to review the history and nature of the problem.
This review begins the activity of accessing and spontaneous reframing
that is characteristic of all memory processes. This review thus initiates
the actual process of therapy, even though the patient may believe the
problem is "on ly being talked ab ou t." In the positive atmosphere generated by
the empathic therapeutic transaction, the patient will often experience a
spontaneous partial remission of the symptom, or may gain some
insights into how the problem might be resolved. These initial therapeutic
explorations are, of course, supported by the therapist, who helps the
patient recognize how the "in n er m ind" or "creative unconscious" is in
a constant state of inner work, during which it is attempting, and even
now succeeding with, various parts of the total problem-solving process.
The patient is encouraged further, for example, by reviewing earlier life
situations in which the patient or an acquaintance may have solved a
similar problem.
The first stage of this approach reaches its climax when a positive therapeutic
framework has been established and the patient now looks expectantly to the
therapist for an "a n sw e r." The answer is supplied by
introducing the patient to an internal problem-solving process, somewhat
as follows:

"Now that you are ready to continue therapy on an even deeper

level, you can begin by simply becoming more sensitive to yourself.
[Pause]
"When a deep part of your inner mind knows it can resolve that
problem [pause], you w ill fin d yourself getting more and more comfortable, and
your eyes w ill close.”
In the typical therapy situation, the patient already has sufficient cultural
frames of reference to support this expectation that creative problemsolving can be
initiated by a relaxed process of inner work and reflection.
When the patient does, in fact, make a few bodily adjustments to get
comfortable, and does, in fact, close the eyes as directed, the therapist has
the observable behavioral responses indicating that the ideal internal
psychobiological conditions for inner healing are being set in motion.
The phrase "getting more and more com fortable" is more than just a
cliche—it initiates a shift in autonomic system balance from sympathetic
toward parasympathetic dominance. It lowers the patient's overall psychobiological
level of arousal (ARAS), as the proprioceptive and kin-
The Psychobiology of Mind-Body Healing

74

bo x

3 Accessing State-Bound Resources for Problem-Solving

1 . Readiness signal for in n er work

W h e n a d e e p p a r t o f y o u r i n n e r m i n d k n o w s it c a n r e s o
l v e t h a t
p ro b le m [p a u s e ], y o u w ill fe e l y o u rs e lf g e ttin g m o re a n d
m o re
c o m fo rta b le , a n d y o u r e y e s w ill c lo s e .

2. A ccessing and transducing state-bound resources

N o w y o u r i n n e r m i n d c a n c o n t i n u e w o r k i n g a ll b y i t s
e l f to
s o l v e t h a t p r o b l e m in a m a n n e r t h a t f u l l y m e e t s a ll y
o u r n e e d s .
[P a u s e ]
T h e r e a r e m e m o r i e s , l i f e e x p e r i e n c e s , a n d a b i l i t
i e s t h a t y o u r in n e r m i n d c a n u s e in m a n y w a y s y o u m a y n
o t h a v e r e a l i z e d b e fo re.

3. Ratifying problem-solving
W h e n y o u r i n n e r m i n d k n o w s t h a t it c a n c o n t i n u e to d e
a l e f f e c t i v e l y w i t h t h a t p r o b l e m , y o u w i l l f i n d y o
u r s e l f w a n t i n g to
m o v e a b i t [ p a u s e ] , a n d y o u w i l l o p e n y o u r e y e s a n d c
o m e f u ll y
a le rt.

esthetic input from all of the body muscles diminish. This tends to shift
attention away from irrelevant external stimuli toward the internal statedependent
memory, learning, and behavioral systems that need to be
engaged for problem-solving. Closing the eyes immediately enhances
alpha wave (and eventually theta wave) generation in the brain, which
is associated with creative sensing, feeling, and imagistic experience. This,
in turn, means we have facilitated a shift from the rational and linear
processes of left-hemispheric thinking toward the more primary, holistic
processing characteristic of the right hemisphere, with its closer associations to
the mind-body, limbic-hypothalamic information transduction
system.
Instead of relaxing, closing the eyes, and turning inward, however, a
patient may occasionally become more restless or distressed and alert. This
indicates that the ideal therapeutic conditions for the first stage have not
been met yet, suggesting that there may be another issue the patient needs
to deal with before the creative process of problem resolution can begin.
The therapist needs to reengage the patient with exploratory questions,
somewhat as follows:
Nezo Language of Mind-Body Communication

75

"I wonder if there are any other questions or problems you need
to deal with first, before you do the inner work?"
This carefully worded exploratory question contains an important implication: The
patient will do the inner work after first dealing with whatever
other issue remains (Erickson & Rossi, 1979, 1980; Erickson, Rossi, &
Rossi, 1976). This implication is also an instruction that facilitates the planning
function of the prefrontal cortex. The creative inner work is being
carefully organized and sequenced to follow whatever other issue remains.
Once this has been accomplished, the therapist can again offer the readiness
signal for inner work:

"When a deep part of your inner mind knows it can resolve that
problem [pause], you w ill fe e l yourself getting more and more comfortable, and
your eyes zvill close.”
The first stage of establishing the readiness signal for inner work is thus
an iterative therapeutic procedure: It is done over and over again, so as
to immediately resolve any issue that interrupts the process of turning
inward for a comfortable period of problem-solving. When the patient
finally goes into comfort with eyes closed, the therapist can proceed with
the second stage.
Stage 2: Accessing State-bound Resources. After the patient's eyes close,
the therapist can allow a quiet period of inner work to proceed entirely
on its own. It is valuable to carefully observe the patient during this brief
period of time. Many different patterns of responsiveness may be evident.
Sometimes the patient's eyelids flutter a bit just as they close, as is
characteristic of a classical hypnotic induction. Occasionally the eyeballs will
roll upward and/or squint toward the nose as the eyelids close. These
movements have been cited by some (Spiegel & Spiegel, 1978) as an indication of a
capacity for deep trance. After the eyes are closed, the eyelids
may undergo momentary bursts of rapid, fine, vertical vibratory movements that may
indicate the accessing of state-bound inner processes.
Sometimes there are rapid left and right horizontal movements that suggest an inner
landscape is being actively observed. Occasionally there may
be large, slow, rolling movements of the eyeballs under the closed eyelids
(Weitzenhoffer, 1971), which are again suggestive of deep states of altered
experience. These eyelid movements all indicate that the patient is engaged in a
search process which is ideal for this stage of inner work.
76

The Psychobiology of Mind-Body Healing

Sometimes the patient evidences simple quietude with no movements at

all. Indeed, there seems to be an inverse relationship between the quality
of inner work taking place and the degree of outer bodily activity (Erickson
& Rossi, 1981).
The therapist may occasionally question patients about their inner experience when
they manifest these different patterns of behavior. So little
experimental research has been done in this area that we do not always
know what individual patterns of response provide useful information
about the therapeutic process. In any case, when the patient has been
engaged in an inner process of self-involvement for a few minutes, we
are ready for the second stage of accessing and transducing state-bound resources,
that is supported somewhat as follows:

"Now your inner mind can continue working all by itself to solve
that problem in a manner that fully meets all of your needs. [Pause]
"There are memories, life experiences, and abilities that your inner mind can use
in many w ays you may not have realized before."
These apparently casual statements contain implications that facilitate
the problem-solving process in subtle ways. The clause, "Your inner mind
can continue working all by itself," implies that there is a developing
dissociation between the consciously driven activity of typical left-hemispheric
thinking, in which one is engaged in willfully directing one's
thoughts, and the self-organizing and autonomous primary process of the
right cerebral hemisphere. There is a subtle depotentiation of the conscious
mind's typical frames of reference and habitual patterns of activity (that
may be reinforcing the problem), and a reinforcement of the more autonomous primary
processing that holds the promise of creative problemsolving.
The second sentence, "There are memories, life experiences, and abilities that your
inner mind can use in many ways you may not have realized
b efore," is a means of accessing and transducing state-dependent memory, learning,
and behavior systems that now need to be engaged for
problem-solving. Ideally, patients should receive this most important
facilitation in their own words, and in terms that are congruent with their
personal belief systems.
Table 3 lists a variety of cognitive, emotional, sensory-perceptual, and
behavioral signs that are indicative of significant involvement in the inner
work of accessing and reframing the state-dependent memory and learning systems
that encode problems. It is valuable to recognize these signs
because they indicate when patients may be more available for therapeutic
Nezu Language of Mind-Body Communication
table

77

3 A partial listing of cognitive, emotional, sensory-perceptual,

and behavioral signs of significant involvement with inner
work and state-dependent phenomena.

Blushing or blanching of face

Comfort, relaxation
Emotional responses
Economy of movement
Eyeball changes
Eyelid changes and closure
Facial features relaxed
Feeling distant (dissociated)
Literalism
Movements slow or absent
Retardation of blinking, startle, and
swallowing reflexes
Pulse slowing
Pupillary changes
Respiration slowing
Response attentiveness
Sensory, muscular, and body changes

Sensory-perceptual distortions
Sleep stages
Spontaneous altered state phenomena
Age regression
Amnesia
Anesthesia
Catalepsy
Hallucinations
Illusions
Time distortion
Speech minimal or absent
Stretching
Tears
Time lag in motor and conceptual behavior
Vocal changes
Yawning

This table is an adaptation of the "Indicators of Trance Development" in Erickson,

Rossi, and Rossi,
1976.

change. When patients are in tears, for example, they are experiencing
particular emotional states that will enable them to respond to questions
and therapeutic approaches in a certain, often healing manner. A deeper
state of relaxation or therapeutic catalepsy (outer body immobility with
correspondingly intense inner work) can obviously enable some patients
to be more receptive to those state-bound feelings, impulses, images, and
ideas that can be of therapeutic value in helping them reframe their dominant but
problem-plagued ways of thinking and being.
Stage 3: Ratifying Problem-Solving. The third stage of ratifying problemsolving and
ending the therapeutic session is, like the first two stages,
made dependent upon the patient's inner responsiveness to the therapist's "im plied
directives." When the therapist senses that a satisfactory
amount of therapeutic work has been accomplished, this third stage may
be initiated somewhat as follows:

"When your inner mind knows that you have resolved that problem to the fullest
extent at this time, and that you can deal effec-
78

The Psychobiology of Mind-Body Healing

tively with it, you will find yourself wanting to move a bit. [Pause]
"You will open your eyes and come fully alert."
The patient usually stretches and readjusts his posture when the eyes
open. This spontaneous body reorientation is in part a response to the
therapist's words ("You will find yourself wanting to move"), and in part
an entirely natural and spontaneous orientation to state-dependent modes
of "n orm al" social relatedness in the world. Patients who have a talent
for experiencing deeper altered states traditionally associated with therapeutic
hypnosis will often comment how they have been " o u t," "far
aw ay," "really into it," "in a trance," or "felt drugged or hypnotized."
The world may seem brighter for a moment or two. There may even be
a sense of a loss or enhancement of the third dimension: The world seems
flatter or deeper for a few minutes. All these spontaneous reports of
altered states are accepted as an entirely natural and positive indication
of effective inner work; they are, as noted above, all indications of a deep
accessing of state-dependent phenomena that may be reframed for therapeutic change.
The patient usually makes some spontaneous remarks about the inner
experience and the constructive symptom/problem changes that have
taken place. This is entirely in keeping with the manner in which this third
stage of ratifying the therapeutic work was initiated with the words,
"W hen your inner mind knows that it can continue to deal effectively with
that problem, you will find yourself wanting to move a bit. [Pause] And you
will open your eyes and come fully alert."
These words imply that there will be no impulse to move until an increased ability
to cope with the problem has been experienced. This implication, like all the other
implications, gives the patient's unconscious
processes free choice—in this case, the freedom to complete the inner work
in its own way and make its own choice about when movement and
awakening will take place.
The phrase, "W hen your inner mind knows that it can continue to deal
effectively with that problem ," contains a creative ambiguity that again
allows the patient's unconscious to make the most suitable choice in line
with its own best ways of functioning: It may have been able to completely
resolve the problem "h ere and now " in the therapy session, or it may
have to continue active inner therapeutic work after the session has ended.
Creative ambiguity facilitates free choice! We all function on many levels;
while apparently living our normal lives on one level and playing out
certain roles, we can be engaged in intense inner creative work and
selfreorganization on levels that are preparing for new roles and activities in
the future.
Nezo Language of Mind-Body Communication

79

Incubating Mind-Body Healing

This variation of the Basic Accessing Formula derives from a number
of different sources. Philosophers such as Vaihinger (1911) and the constructivists
(Watzlawick, 1984) discuss the use of imagination via the "asif" phenomena and
self-fulfilling prophecies in the formation of our experiential reality and " f a
te ." We are the victims of fate when we allow our
unconscious, via its own autonomous creative process, to construct our
future. If we have little or no relationship to these unconscious processes,
we have no say in the construction of our future. We can take a hand in
the construction of our future with inner work, however. Erickson, for
example, developed what he called "pseudo-orientation in tim e" as a
method whereby patients could generate their own futures by accessing
and facilitating inner possibilities that existed only in embryonic form.
Some clinicians are currently exploring the use of imaging as a major modality for
facilitating the realization of positive self-fulfilling prophecies
(Achterberg, 1985; Shorr, Sobel, Robin, & Connella, 1980) in mind-body
healing. Other investigators are using other modalities, such as the "felt
se n se ," which Gendlin (1978) describes as the essence of psychotherapeutic
change.
Our approach is to utilize as many modalities of mind-body information
transduction as are available to the individual. The accessing formula for
incubating mind-body healing is an adaptation of Mills and Crowley's "Inner
Resource Draw ings" (1986), a drawing strategy they use with children.
In their approach, the child is asked to draw (1) the problem as it is currently
experienced; (2) the problem when it is resolved; and (3) how to
get from the first to the second drawing. In work with adults, I have
modified this approach by utilizing suggestion to stimulate an inner search
in these three areas.
In the second half of this book, we will explore some of the physiological
pathways by which these mind-body healing processes take place. From
a psychobiological point of view, we may suppose that this accessing formula draws
upon the imaginative and planning functions of the prefrontal
cortex, as well as visually stored images of inner resources and problemsolving
routines that may be encoded in previously inaccessible statebound patterns. The
frequent experience of emotional release that accompanies the insights and
forgotten memories that come "spontaneously"
to consciousness during this three-step routine are the typical signs of
having accessed and therapeutically reframed state-bound patterns of
memory, learning, and behavior. The psychological reorientation to a
future when the problem is solved apparently adds a novel stimulus and
therapeutic frame of reference that enables patients to break out of the
The Psychobiology of Mind-Body Healing

80

bo x

4 Incubating Mind-Body Healing

1 . Readiness signal fo r present problem review

W h e n y o u r i n n e r m i n d is r e a d y to r e v i e w a ll a s p e c t s o
f t h a t
p r o b l e m a s y o u a r e c u r r e n t l y e x p e r i e n c i n g it [ p a u
s e ] ,
y o u 'l l f i n d y o u r s e l f g e t t i n g m o r e c o m f o r t a b l e a n
d y o u r e y e s
w i l l c l o s e . [P a u s e ]
R e v i e w , e s p e c i a l l y , a ll p a r t s o f it y o u d o n 't k n o w h
o w to d e a l
w ith y e t.
2 . Incubating curren t and hiture healing
N o w e x p lo re th e fu tu re h e a lin g p o s s ib ilitie s . H o w d o y o u
se e
y o u r s e l f ? H o w d o y o u f e e l ? W h a t a r e y o u d o i n g n o w t h
a t th e
p r o b l e m is c o m p l e t e l y h e a l e d ? [P a u s e ]
N o w l e t y o u r i n n e r m i n d r e v i e w h o w y o u a r e g o i n g to g
e t f r o m
t h e p r e s e n t p r o b l e m [p a u s e ]
to t h e f u t u r e w h e n y o u a r e h e a l e d . [P a u s e ]
W h a t a r e s o m e o f t h e s t e p s y o u w i l l t a k e to f a c i l i t a
t e y o u r h e a l i n g ? [P a u s e ]

3. Ratifying mind-body healing

W h e n y o u r i n n e r m i n d k n o w s it c a n c o n t i n u e t h e h e a l
i n g p r o c e s s e n t i r e l y o n its o w n , a n d w h e n y o u r c o n s c
i o u s m i n d k n o w s
it c a n c o o p e r a t e w i t h th i s h e a l i n g [ p a u s e ] ,
y o u w ill fin d y o u rs e lf s tre tc h in g , o p e n in g y o u r e y e s , a
n d fe e lin g r e f r e s h e d a s y o u c o m e f u l l y a l e r t .

"present problem fram e" that has limited their access to their own inner
resources.
Symptom Scaling and Prescription
This variation of the basic accessing formula introduces two new approaches: (1)
scaling the currently experienced intensity of a problem by
attaching a numerical value to it; and (2) prescribing the symptom or problem,
whereby the patient is directed to carry out the seemingly paradoxical task
of voluntarily making it worse. Our psychobiological orientation suggests
that scaling may be a method of coordinating the languages and activities
of the left and right cerebral hemispheres in relation to a problem. The
right hemisphere may encode a problem in the analogical-metaphorical
New Language of Mind-Body Communication

81

processes typical of emotions, body language, and dreams. In this form

the problem may not be available to the more linear, logical and rational
resolution routines of the left hemisphere. These left hemispheric pro‫־‬
cesses may be accessed and associated with the problem by scaling it, since
the left hemisphere is more facile with both numbers and words such as
‫ ״‬more or less intense, better and w orse.‫״‬
By asking patients to experience the problem, we are presumably turning
on right-hemispheric processes that have a readier access to the statedependent
encoding of the problem. By simultaneously asking patients
to scale the problem, we are presumably activating and focusing more
consciously directed left-hemispheric skills on the problem. By then asking
patients ‫ ״‬to make the problem worse and better‫ ״‬a number of times in
fairly rapid succession, we are presumably asking them to coordinate left
and right cerebral hemispheric activity in getting more and more experience in
accessing and controlling the problem's experiential and behavioral manifestations.
A currently evolving principle of left-right hemispheric interaction is that
some functions that are apparently indigenous in beginning their development in the
right hemisphere gradually acquire supraordinate controls in
the left hemisphere. The average person who simply enjoys listening to
music, for example, utilizes predominantly the right hemisphere in this

bo x

5 Scaling the Symptom or Problem

1 . Sym ptom scaling and prescription

O n a s c a l e o f 1 to 1 0 0 , w h e r e 1 0 0 is t h e w o r s t , w h a t n u m
b e r e x p re s s e s th e d e g re e to w h ic h y o u a re e x p e r ie n c in g
th a t p ro b le m
a t th is m o m e n t? S c a le it r ig h t n o w .
2 . Problem prescription
N o w le t th e p r o b le m g e t w o r s e . S c a le it. N o w le t th e p ro b
le m
g e t b e tte r . S c a le it. E tc .
3 . Ratifying the therapeutic response
[T h i s t h e r a p e u t i c e x e r c i s e is e n d e d w h e n t h e p a t i e
n t h a s m a d e
a n o b v io u s th e ra p e u tic g a in b y lo w e rin g th e o rig in a l s c a
lin g
s c o re o f th e p r o b le m , a n d b y e x p r e s s in g c o n f id e n c e in
b e in g
a b le to c o n tin u e p ra c tic in g th is p ro b le m -s o lv in g ro u tin e
fo r b e tt e r a n d b e t t e r r e s o l u t i o n i n t h e f u t u r e .]
82

The Psychobiology of Mind-Body Healing

activity. A professional musician, however, has left-hemispheric dominance when

occupied with music (Mazziotta, Phelps, Carson, & Kuhl,
1982; Phelps & Mazziotta, 1985). We could hypothesize that a patient who
scales and rehearses a symptom that was originally encoded in the right
hemisphere could be developing left-hemispheric control as he develops
expertise in turning the symptom on and off. This would lead to the prediction that
Positron Emission Tomography would find a shift from rightto left-hemispheric
dominance as patients rehearsed and gradually gained
control over problematic behavior. We would expect to find the same
right-left hemispheric shift in subjects who learned to control symptoms
via biofeedback.
Paradoxical Therapy. The so-called paradoxical aspects of this approach
of problem and/or symptom prescription deserve further comment since
paradox has generated so much interest recently as a new form of therapy
(Seltzer, 1985; Weeks & L'Abate, 1982; Zeig, 1980a, b). From our psychobiological
point of view, paradoxical therapy is not paradoxical at all: As
we have seen, to prescribe a problem or symptom is actually the most
direct path to accessing its psychobiological sources encoded within the
state-dependent memory, learning, and behavior systems of the brain.
Paradoxical therapy only seems paradoxical from a logical point of view
wherein patients try to avoid the experience and expression of a problem
in the hope that it will thereby "go aw ay." Avoiding, resisting, or blocking
a problem, however, only prevents one from accessing and therapeutically
reframing it. When a problem or symptom "h au n ts" a patient, it is only
because mind and nature are attempting to bring it up to consciousness
so it can be resolved.
As was indicated earlier, research in the neurobiology of memory and
learning indicates that the process of accessing and recall is not simply
that—accessing and recall are always a synthetic process of reconstruction.
As such, prescribing the symptom is actually a process of reconstructing
it. When we ask a person to experience a symptom voluntarily rather than
resisting it, we are drastically altering the internal dynamics and statedependent
memory and learning systems that allow the symptom to flourish. We have changed it
from a dissociated and involuntary action to a
voluntary action; we are undoing its state-bound character. When we ask
a person to scale the intensity of the symptom, we are changing it further
by adding a novel, conscious, evaluative orientation to it. This new evaluative
orientation immediately potentiates problem-solving processes; it facilitates
coping skills and self-efficacy; and the patient's ego is strengthened
in its relationship to the formerly dissociated symptom.
Neio Language of Mind-Body Communication

83

The clinical effectiveness of these paradoxical approaches is supported

by the fact that they are now used by so many different schools of psychotherapy
(wherein they have been given different names). Most theorists
in these different schools have expressed a sense of puzzlement as to why
these approaches work, however. Since the paradoxical approaches make
such exquisite sense from our psychobiological perspective, it may be
worthwhile to review the many names and formulations that have been
given to them. Our psychobiological approach may be seen as a common
denominator underlying all the following (Seltzer, 1985, p. 20):
From the psychoanalytic perspective, which includes the work of
paradigmatic psychotherapists, we have inherited the descriptors
"an tisuggestion," "going with the resistance," "joining the resistance,"
"reflecting (or 'mirroring') the resistance," "siding with
the resistance," "paradigmatic exaggeration," "supporting the defe n ses,"
"reductio ad absurdum ," "reenacting an aspect of the
psychosis," "mirroring the patient's distortions," "participating in
the patient's fantasies," "out-crazying the patient," and "th e use
of the patient as consultant." From the vantage point of behavior
therapy, we may appreciate paradoxical elements in such procedures
as "blow u p ," "im plosion," "flood ing," "instructed helplessness,"
"m assed practice," "negative practice," "paradoxical intention,"
"stim ulus satiation,” and "sym ptom scheduling." In gestalt therapy, an approach
where the actual term "p arad ox" is rarely employed, the attempt to foster change
paradoxically may be recognized in the therapist's cruel-to-be-kind suggestions to
"stay with
the [negative] experience," or to "exaggerate the feeling" (sensation, experience,
speech, movement, etc.). Lastly, in the communication-systems school of therapy—by
far the most vocal in endorsing
and elucidating paradoxical strategies—we have the following miscellany of terms
and titles: "th e confusion technique," "declaring hopelessn ess," "exaggerating
the position," "paradoxical injunction,"
"paradoxical instructions," "paradoxical rituals and tasks," "paradoxical written m
essages," "restraining (or 'inhibiting') change,"
"predicting a relapse," "prescribing a relapse," "positive connotatio n " (or
"interpretation"), "refram in g," "red efinition," and "relabeling," "sym ptom
prescription" (or "prescribing the resistance,
symptom or system "), "therapeutic paradox," and the "therapeutic
double b in d ." R.P. Greenberg, in an article intriguingly subtitled,
"T h e Power of Negative Thinking" (1973), refers generally to several
of the above methods as "anti-expectation techniques," which should
84

The Psychobiology of Mind-Body Healing

serve as a reminder of the point made earlier that the paradoxical

essence of all these methods is in their apparent irrationality from
the perspective of the client.
Our simplified approach to " scaling and problem prescription" may be
enriched by the special points of view and vocabulary of all these ways
of accessing and therapeutically reframing symptoms and problems.
Information Channeling and Transduction
Psychoanalysis seeks to resolve symptoms and problems by analysis;
behaviorism deals with them by conditioning and extinction. Our
psychobiological approach seeks to channel and transduce symptoms and
problems into creativity. An infinite range of therapeutic creativity and
healing can be explored via the ideodynamic channeling and transduction
of symptoms and problems. All of the sensory-perceptual modalities are
involved: vision and imagery, audition, proprioception-kinesthesia, smell,
taste, and all possible combinations of these as they are expressed in significant
aspects of mind-body communication and human identity. Box 6
illustrates some of the basic channels for the transduction of a number of
these state-dependent modalities.
In Chapter 2 we touched upon Bernheim's original formulation of the
ideodynamic as the basic mechanism of information transduction in hypnosis. In
Chapter 4 we reviewed Erickson's hypnotic investigations of "coincidental
phenomena" as spontaneous occurrences of intermodal sensory
transformations in the etiology of psychosomatic symptoms. Mishkin's
memory and learning research (1982) reviewed in Chapter 3, as well as
current investigations in the "multichannel integrations of nonverbal
behavior" (Siegman & Feldstein, 1985), provides a new experimental research base
for studying how information is transmitted, transduced, and
sometimes "stu ck " in a state-bound form so that it becomes what people
ordinarily label as a problem or a symptom.
C.G. Jung was one of the early explorers in depth psychology who used
intermodal information transduction as a therapeutic method. He called
this process of integrating conscious and unconscious elements the "transcendent
function" (Jung, 1960, pp. 67-91). When Jung's patients became
overwhelmed with emotions, he sometimes would have them draw a picture of their
feelings. Once the feelings were expressed in the form of
imagery, the images could be encouraged to speak to one another. As soon
as a dialogue could take place, the patient was well embarked on the pro-
New Language of Mind-Body Communication

bo x

85

6 State-Dependent Modalities in
Mind-Body Communication
IM AG ER Y
S elf-reflection
process

R epresen tation
process

A W A R EN ESS
(C O G N ITIO N )

EM O TIO N

\
Psychophysiological
process

Psychosynthetic
process

S E N S A TIO N
(P E R C E P T IO N )
Sensorym otor
process

A ctualization
process
* B EH AVIO R

Some basic processes of psychological change evident in dreams and psychotherapy.

Each of these modalities of human experience has statedependent features. They are
all involved in the process of information
transduction, which is the essence of symptom and problem resolution.
(From Rossi, 1972/1985)

cess of reconciling different aspects of his dissociated psyche. Jung described his
approach as follows (Jung, 1960, pp. 81-83):
In the intensity of the emotional disturbance itself lies the value, the energy
which he should have at his disposal in order to remedy the state of reduced
adaptation. Nothing is achieved by repressing this state or devaluing it
rationally.
In order, therefore, to gain possession of the energy that is in the
wrong place, he must make the emotional state the basis or starting
point of the procedure. He must make himself as conscious as possible of the mood
he is in, sinking himself in it without reserve and
noting down on paper all the fantasies and other associations that
come up. Fantasy must be allowed the freest possible play. . . .
The whole procedure is a kind of enrichment and clarification of
86

The Psychobiology of Mind-Body Healing

the affect, whereby the affect and its content are brought nearer to
consciousness, becoming at the same time more impressive and
more understandable. This work by itself can have a favourable and
vitalizing influence. At all events, it creates a new situation, since
the previously unrelated affect has become a more or less clear and
articulate idea, thanks to the assistance and cooperation of the conscious mind.
This is the beginning of the transcendent function, i.e.f of
the collaboration of conscious and unconscious data.
The emotional disturbance can also be dealt with in another way,
not by clarifying it intellectually but by giving it visible shape. Patients who
possess some talent for drawing or painting can give expression to their mood by
means of a picture. . . . Visual types
should concentrate on the expectation that an inner image will be
produced. As a rule such a fantasy-picture will actually appear—
perhaps hypnogogcially—and should be carefully observed and
noted down in writing. Audio-verbal types usually hear inner words,
perhaps mere fragments of apparently meaningless sentences to
begin with, which however should be carefully noted down too.
. . . Such persons have little difficulty in procuring the unconscious
material and thus laying the foundation of the transcendent function.
There are others, again, who neither see nor hear anything inside
themselves, but whose hands have the knack of giving expression
to the contents of the unconscious. Such people can profitably work
with plastic materials. Those who are able to express the unconscious
by means of bodily movements are rather rare. The disadvantage
that movements cannot easily be fixed in the mind must be met by
making careful drawings of the movements afterwards, so that they
shall not be lost to the memory. Still rarer, but equally valuable, is
automatic writing, direct or with the planchette. This too, yields
useful results.
We now come to the next question: what is to be done with the
material obtained in one of the manners described? To this question
there is no a priori answer; it is only when the conscious mind confronts the
products of the unconscious that a provisional reaction
will ensue which determines the subsequent procedure. Practical experience alone
can give us a clue. So far as my experience goes, there
appear to be two main tendencies. One is the way of creative formulation, the other
the way of understanding. (Italics in original)
This quotation comes from Jung's paper, "The Transcendent Function,"
which he worked on for 40 years (between 1916 and 1957) before he con
New Language of Mind-Body Communication

87

sented to its publication. One could say that it represents the essence of
his psychotherapeutic methodology. From the psychobiological point of
view being formulated in this book, I would say that Jung is describing
a process of channeling and transducing into consciousness the statebound
information that encodes symptoms and problems by "w hatever
sensory-perceptual-expressive modality is most natural to the patient."
His methods can be seen as the generally unrecognized forerunners of
the use of similar techniques in gestalt therapy, transactional analysis,
cognitive and behavior therapy, psychosynthesis, and all the more recent
forms of analogy and metaphor in Ericksonian psychotherapy (Lankton
& Lankton, 1983; Mills & Crowley, 1986; Zeig, 1985).
The ideodynamic channeling and transduction of problems and symptoms are thus the
psychobiological basis of a wide variety of current forms
of psychotherapy. Because of this, most schools of psychotherapy can
easily utilize the accessing formulas outlined in this and the following
chapters. The first stage in this approach is to identify the modality in
which the patient's problem is state-bound. One very inhibited patient,
for example, continually opened and closed her hands in an absent-minded
manner while giving a halting account of her problem. It was difficult to
get a clear account, but it was obvious that she was attempting to integrate
many complex inner and outer issues about whether or not she should
have a child. I utilized her spontaneous hand movements to channel the
exploration, transduction, and integration of her issues, as is indicated
in Box 7.
This apparently simple example illustrates a number of significant points
about the inner accessing and resolution of problems that patients have
difficulty expressing. In traditional psychoanalytic theory, this patient's
behavior would be called "resistan ce." From a psychobiological perspective,
however, so-called resistance is a problem in accessing state-bound
information and transducing it into a form in which it can be utilized for
problem-solving. The first statement, "Y ou are dealing with many issues
that are difficult to express," is an obvious truth that the patient found
easy to accept. As such, it initiated a cooperative therapeutic framework
by recognizing her current experiential reality. I then utilized an ongoing
portion of her experiential reality by noticing her spontaneous body language—the
opening and closing of her hands (the proprioceptive-kinesthetic modality) as she
struggled to express herself in words (the linguisticverbal modality). This body
language was a channel of self-expression
already well associated with the state-bound information that was having
difficulty reaching the verbal modality.
I therefore utilized this strong body language when I initiated a chan-
The Psychobiology of Mind-Body Healing

88

bo x

7 Problem Channeling and Transducing to

Facilitate Self-Expression

1 . R ecognizing the cu rren t experiential situation

Y o u a r e d e a l i n g w i t h m a n y i s s u e s t h a t a r e d i f f i c u l
t to e x p r e s s .
[P a u s e ]
2 . C ha nneling and transducing state-bound information
S o w h e n y o u f e e l y o u r s e l f c l o s i n g in o n a n i m p o r t a n
t i s s u e , l e t
y o u r h a n d s c lo s e a s y o u g e t a h o l d o f it. R e v i e w it q u i e
t l y in
y o u r o w n m i n d f i r s t . [P a u s e ]
3 . E xpressin g and ratifying problem resolution
W h e n y o u h a v e th e w o r d s a n d id e a s t h a t c a n h e l p y o u r e
s o l v e
t h a t i s s u e , y o u 'l l f i n d t h o s e h a n d s o p e n i n g . [P a u s
e ]
A n d y o u c a n t e l l m e j u s t e n o u g h a b o u t it s o I c a n h e l p
y o u fu rt h e r w i t h th e n e x t i s s u e .

neling and transduction with " S o when you feel yourself closing in on
an important issue, let your hands close as you get a hold of it." This
metaphor of "closing in " and "getting a hold o f" channels and transforms
her body language into verbal terms. As such, this simple statement tends
to facilitate an intermodal transduction from the kinesthetic to the verbal
modality.
The third stage of expressing and ratifying problem resolution was initiated with
another form of the accessing formula, "W hen you have the
words and ideas that can help you resolve that issue, you'll find those
hands opening." The patient is allowed to do her inner work of accessing
and problem resolution entirely on her own; she is learning and rehearsing
more effective ways of working with herself.
The next sentence, "A nd you can tell me just enough about it so I can
help you further with the next issu e," directs her to a more focused form
of self-expression in order to advise the therapist about the next issue
needing resolution. Thus, the entire procedure is patient-centered and
iterative: There is an absolute minimum of analysis and interpretation by
the therapist; the patient generates, step by step, whatever conscious
insights are needed to facilitate further problem-solving.
New Language of Mind-Body Communication

89

Ideomotor Signaling
One of the most popular methods of accessing and resolving problems
in therapeutic hypnosis today is via ideomotor signaling. There are two
basic approaches: (1) the original naturalistic or utilization approach of
Milton H. Erickson (1961/1980), and (2) the more highly structured approach of
Cheek and LeCron (Cheek & LeCron, 1968; LeCron, 1954).
Erickson's naturalistic style was to utilize whatever form of ideomotor
mannerisms were already being expressed by a patient. If a patient tended
to nod or shake his head spontaneously in a seemingly unconscious manner during the
therapy session, for example, Erickson would recognize
the movement as an ideomotor signal from a nonverbal level of mind-body
responsiveness. Other natural ideomotor mannerisms might be expressed
through the eyes (blinking or squinting during stress) and movements of
the arms, legs, or hands. In the last section I utilized a patient's absentminded
opening and closing of her hands as a naturalistic approach to
ideomotor signaling that was particularly suitable for her.
The more highly structured approach of Cheek and LeCron, by contrast,
uses a standard form of ideomotor finger signaling for all patients. Responses of "
y e s ," " n o ," " I don't know ," and " I don't want to answ er,"
are assigned to the different fingers of the patient's hand. This is followed
by a series of questions that can be answered with the finger signals. The
questions are designed to access the source of the problem and find a
resolution of it. A typical approach involves patients in a structured form
of age regression in which they are asked to reorient themselves to a time
before the problem became manifest. The therapist then asks a series of
questions that can be answered by the finger signals to facilitate a careful,
detailed review of all the sensory-perceptual learnings, attitudes, and
frames of reference that contributed to the source of the problem and to
its current maintenance.
In Box 8 1 have outlined a way of introducing ideomotor finger signaling
that is acceptable to most patients. As indicated, all questions are phrased
so they can be answered with a simple yes or no finger signal. Cheek and
LeCron (1968) give more examples of how a series of questions can be
phrased to deal with a variety of clinical problems. Box 9 illustrates how
ideomotor head signaling can be introduced as an interesting variation.
Again, all questions are phrased so that a simple nod or shake of the head
is sufficient to answer the question.
In a series of richly documented clinical papers, Cheek (1957-1981) has
responded to the criticism that his ideomotor approach encourages pa-
90

The Psychobiology of Mind-Body Healing

bo x

8 Ideomotor Finger Signaling to Access

and Reframe Problems

1. Identify yes/no fin g e r signal

R e v i e w a h a p p y o r d e e p l y s a t i s f y i n g m e m o r y a n d l e t
's s e e
w h i c h f i n g e r l i f t s , l i f t s u p , s o r t o f b y i t s e l f , to
s i g n a l y e s .
[P a u s e a s p a t i e n t i d e n t i f i e s t h e y e s f i n g e r b y l i f
t i n g it .]
N o w re v ie w a n u n h a p p y e x p e rie n c e a n d d is c o v e r w h ic h
fin g e r
l i f t s to s i g n a l n o . [P a u s e u n t i l p a t i e n t i d e n t i f i e
s th e n o f i n g e r .!
2 . Access source and maintenance o f problem
L e t y o u r i n n e r m i n d t a k e y o u b a c k to a t i m e b e f o r e y o
u r e x p e r i e n c e o f th e p r o b l e m , a n d t h e n le t t h a t y e s f
i n g e r s i g n a l j u s t s o
I 'l l k n o w y o u 'r e t h e r e . W il l it b e o k a y to g o o v e r it a l l
, s te p b y
s t e p , s t a r t to f i n i s h , j u s t w h a t 's h a p p e n i n g a s y o u
e x p e r i e n c e d
th e p r o b l e m th e f i r s t t i m e ?
[ T h i s is f o l l o w e d b y a s e r i e s o f q u e s t i o n s t h a t c a n
b e a n s w e r e d
w i t h y e s o r n o f i n g e r s i g n a l s to i d e n t i f y t h e s t a t e
- b o u n d e x p e r i e n c e s a n d fe e lin g s a s s o c ia te d w ith th e o
rig in a l a c q u is itio n o f
th e p r o b l e m . T h i s is t h e n f o l l o w e d b y y e s o r n o q u e s t
i o n s to
i d e n t i f y c u r r e n t a t t i t u d e s a n d c i r c u m s t a n c e s t h
a t m a i n t a i n th e
p r o b l e m .]
3 . Ratify conditions for problem resolution
W il l it n o w b e o k a y f o r y o u to b e c o m p l e t e l y f r e e o f t h
a t p r o b l e m ? O r is t h e r e a d a te in t h e f u t u r e w h e n y o u c
a n s e e y o u r s e l f
f r e e o f it?
[I f n e c e s s a r y , th i s is f o l l o w e d b y a s e r i e s o f q u e s t
i o n s to a s c e r t a i n a ll t h e c o n d i t i o n s t h e t o t a l p e r s
o n a l i t y n e e d s to r e a l i z e f o r
p r o b l e m r e s o l u t i o n .]

tients to confabulate answers that please the therapist. He has formulated

a three-point criteria for evaluating the psychobiological validity of the
patient's therapeutic involvement with this procedure, which he discussed
as follows (Cheek, 1981, pp. 8 9 9 0 ‫) ־‬:
With newer hypnotic techniques using repetitive subconscious
review below conscious, verbal levels of awareness, it is possible to
reveal cause and effect relationships between sensory input and
resulting responses. My conclusions have been drawn in consulta-
New Language of Mind-Body Communication

92

tion with more than 3,000 surgical patients and 15 men and women
who have been unconscious due to head injury. . . .
Can we trust the information offered with ideomotor investigative
methods? We know that hypnotized people are peculiarly able to
fabricate information, either to please a hypnotist or to permit their
escape from having to relive a very traumatic experience. This ability
seems to rest at higher, more conscious levels of thought. It does
not seem to occur at deeper horizons of awareness. We can trust the
information when its eventual conversion to verbal reporting has followed this
sequence:
1)
We witness physiological signs of distress. Frowning, accelerated breathing, and
pulsation of neck vessels tell us that something
is stressful, but the hypnotized subject does not "k n o w " what is
happening when we ask.

bo x

9 Ideomotor Head Signaling to Access

and Reframe Problems

1. Identify yes and no ideomotor head signals

W h e n y o u r u n c o n s c i o u s is r e a d y t o r e v i e w t h e s o u r c
e s o f t h a t
p r o b l e m , y o u 'l l f i n d y o u r h e a d n o d d in g y e s . A s y o u r
e v i e w
s o m e o f th e n e g a tiv e c o n s e q u e n c e s o f th a t p ro b le m , y o
u r h ea d

can sh a k e n o .

2. Access source and maintenance o f problem

W h e n y o u h a v e r e tu r n e d to a tim e ju s t b e fo re th e o n s e t o f
th a t
p ro b le m , y o u r h e a d c a n n o d . [P a u se l
A n d w i l l it b e o k a y t o r e v i e w h o w y o u e x p e r i e n c e d it t
h e f i r s t
t i m e ? [ T h i s is f o l l o w e d b y a s e r i e s o f q u e s t i o n s t o
i d e n t i f y th e
s ta te -b o u n d e x p e rie n c e s a s s o c ia te d w ith th e o rig in a l a
c q u is itio n
o f th e p r o b le m a n d th e c u rre n t c ir c u m s ta n c e s a n d a ttitu
d e s th a t
m a i n t a i n i t .]

3. Ratify conditions for problem resolution

W i l l it n o w b e o k a y f o r y o u t o b e f r e e o f t h a t p r o b l e m
[o r s e e a
d a t e o n a c a l e n d a r w h e n y o u w i l l h a v e r e s o l v e d it s a
t i s f a c t o r y
l y l ? [ T h i s is f o l l o w e d b y a s e r i e s o f q u e s t i o n s t o a
s c e r t a i n a ll
c o n d itio n s th a t th e to ta l p e r s o n a lity n e e d s to re a liz e fo
r p ro b l e m r e s o l u t i o n .]
92

The Psychobiology of Mind-Body Healing

2) An ideomotor signal identifies the beginning of the experience

after we see the physiological changes. If asked about the event, the
subject will continue his verbal level ignorance of the event.
3) Verbal reporting is possible after a variable number of subconscious scanning of
the event. If the event is relatively nonthreatening, it may be quickly reported.
[On one occasion] it took 13 reviews
of the entire operation before my first success in retrieving a memory.
If there is any question about the validity of a report, we have
found we can ask for an answer to the question, "D oes the inner
part of your mind agree with what you have just told m e?" I would
not place any weight on evidence offered by a confirmed alcoholic,
drug addict, or pathological liar using ideomotor methods, nor
would I trust evidence offered by a criminal suspect. My studies of
anesthetic experiences have not included people in these categories.
From the point of view developed in this book, I would say that Cheek's
physiological, ideomotor, and verbal levels are examples of state-bound
patterns of information that had become dissociated from each other.
Psychosomatic symptoms are expressions of these dissociations; therapy
is achieved by facilitating information transduction between them. It is
evident from Cheek's above statement that his repetitive questioning
evokes recursive inner searches on the "d e e p e r," state-dependent
psychobiological levels until the sought-for material is transduced into the
verbal level. Because this method specializes in the facilitation of recursive
processes, it is most ideally suited for treatment of traumatic situations.
As we have seen, trauma induces an altered state wherein memories are
encoded in a state-bound form that is frequently not available to ordinary
ego consciousness. Cheek has investigated a variety of traumatic or altered-state
situations that produce such state-bound effects: critical illness
(1969), childbirth (1975, 1976), general anesthesia (1981), accidents (1960),
dream states (1965), frightening sexual experiences such as rape (1960),
and the death or serious injury of a loved one (1960). Cheek's approach
is particularly applicable in situations where highly directive, short-term,
and exploratory efforts are needed to quickly access symptoms and the
effects of trauma that reach deeply into the psychophysiological levels of
memory storage, imprinting, and learning. The highly emotional responses
that are frequently obtained when traumatic material is uncovered with
this approach require careful clinical management by well-trained therapists. In
Chapter 7 an example of Cheek's work will be presented to illustrate its highly
variable and creative characteristics in accessing and
transducing mind-body problems associated with the effects of stress on
the autonomic and endocrine systems.
New Language of Mind-Body Communication

93

Ultradian Approaches to Healing

The most recent psychobiological approach to mind-body communication and healing
utilizes ultradian rhythms. Elsewhere I have presented
data detailing the similarities between many of the cognitive and behavioral
characteristics of these rhythms and the "com mon everyday trance"
(Rossi, 1 9 82,1986a). Since much of the theory and practice of using these
psychobiological rhythms for healing has been covered in these papers,
we will simply outline an accessing formula utilizing the rhythms in this
section.
Since ultradian rhythms occur at 90-minute intervals, their subtle behavioral
manifestations will be apparent to the observant therapist during
most therapy sessions that last at least that long. For example, when it
is observed that the patient is spontaneously entering a quiet or innerdirected
mood, one can be fairly certain that an ultradian resting phase
is being experienced. The therapist can facilitate and utilize the healing
potentials of this "ultradian break" by simply commenting on it in an
approving manner, and by allowing the patient's unconscious to do some
quiet inner work for five to 20 minutes without attempting to sustain the
outer dialogue. If the ultradian resting phase is unrecognized and ignored,
then this is the period of the therapy session during which the patient
typically manifests "resistan ce" in the form of many otherwise unaccountable
symptoms (moodiness, partial withdrawal, irritability, tongue
slips, memory gaps, and the types of "m istak es" we all make when we
are tired and need to rest). While it is always of value to understand the
psychodynamic implications of these "resistan ces," it is also wise to
recognize them as the behavioral signs of the need to allow the unconscious to do
its own inner healing work.
Practical, clinical illustrations of this ultradian approach will be presented in
the second half of this book. Meanwhile, it is important to note that,
because the cognitive, emotional, and behavioral manifestations of ultradian
rhythms are so similar to manifestations of altered states and hypnosis, there will
be a natural temptation for therapists to "su g g est" or
evoke these behaviors even when they are not present. Indeed, this is
what most hypnotherapists do: they "suggest" or "condition" the patient
to go into hypnosis when they are ready, rather than when the patient's
unconscious (and physiology) is ready. This highly directive approach is
often successful because ultradian rhythms are very flexible in their
manifestation; they can be "sk ip p ed " and their cycle lengths easily changed
in most individuals. This more typical hypnotherapeutic approach apparently works
well enough much of the time. I believe, however, that
when the hypnotherapist is too arbitrary in imposing his own, rather than
The Psychobiology of Mind-Body Healing

94

bo x

10 The Ultradian Accessing Formula

1. Recognizing and facilitating natural ultradian rhythms

I n o t i c e y o u r b o d y s e e m s to b e g e t t i n g q u i e t e r in t h e
s e l a s t f e w
m o m e n t s , a n d y o u 'r e n o t s a y i n g m u c h a s y o u l o o k o u t
t h e w i n d o w [o r w h a t e v e r w i t h d r a w a l b e h a v i o r t h e p
a t i e n t is m a n i f e s t i n g ] . I w o n d e r if t h a t m e a n s y o u r
u n c o n s c i o u s is r e a d y to e n t e r
a c o m f o r t a b l e p e r i o d o f t h e r a p e u t i c h e a l i n g ? [P a
u s e ]
I f it is , y o u 'l l f i n d y o u r s e l f g e t t i n g e v e n m o r e c o m
f o r t a b l e ,
w ith y o u r e y e s c lo s in g .
2 . Accessing and utilizing ultradian healing
Y o u c a n c o n t i n u e a l l o w i n g t h a t c o m f o r t to d e e p e n ,
j u s t a s y o u
d o w h e n y o u e n jo y ta k in g a b re a k o r a m u ch n e e d e d n a p .
[P a u se !
Y o u m a y o r m a y n o t b e a w a r e o f j u s t h o w y o u r u n c o n s c i
o u s is
d o i n g e x a c t l y w h a t it n e e d s to d o to d e a l w i t h th e i s s u
e s t h a t
c a n b e b e s t r e s o l v e d a t t h i s t i m e . [ A l l o w a f i v e - to
2 0 - m i n u t e
p e r i o d o f q u i e t i n n e r w o r k .]
3 . Ratifying continuing ultradian healing and coping
W h e n y o u r u n c o n s c i o u s k n o w s it h a s d e a l t w i t h t h a t
i s s u e to
th e fu lle s t e x te n t p o s s ib le a t th is tim e , [p a u s e ]
a n d w h e n y o u r c o n s c i o u s m i n d k n o w s it c a n r e c o g n i z
e a n d
a l l o w y o u to c o n t i n u e t h i s i n n e r h e a l i n g a f e w t i m e
s a d a y
w h e n it f e e l s n a t u r a l ,
[p a u s e ]
y o u 'l l f i n d y o u r s e l f w a n t i n g to s t r e t c h a n d o p e n y o
u r e y e s ,
c o m in g fu lly a w a k e , a le rt, a n d r e f re s h e d .

the patient's, timing for hypnotic work, it can set off resistance and paranoid
reactions. It is now a question for empirical research to determine
whether patients have a better overall clinical response to therapeutic
hypnosis when their natural ultradian rest rhythms are utilized rather than
ignored.
A careful review of all the boxed outlines in this chapter clarifies how
they are all variations of the basic accessing formula that was introduced
in the beginning. They all use the same three steps: a suitable introduction, a
period of inner work, and a final ratification of the value of the
therapy accomplished. The variations of this basic three-step approach are
New Language of Mind-Body Communication

95

ways of increasing the therapist's flexibility in adapting to the particular

needs of each individual patient. The following chapters will provide further
examples of how each of these variations may be used for accessing
and resolving a broad range of psychobiological problems.
SECTION II

The Psychobiology of
Mind-Body Healing
6
An Overview of Mind-Body
Communication and Healing

AVANTS h ave debated whether mind can move mountains. In this volume we explore the
more humble question of whether mind can
move molecules. In the preceding chapters I surveyed the central role of
the limbic-hypothalamic system in mediating and modulating emotionally-laden
psychobiological processes. Here I document in greater detail the
relationship between the anatomy and functions of the limbic-hypothalamic
system and the development and resolution of psychosomatic problems.
Evidence is presented to support the view that psychosomatic problems
can be most adequately conceptualized as dysfunctions encoded within
the state-dependent learning of the limbic-hypothalamic system of mindbody
information transduction.
In this and the following chapters, we examine the four major systems
of mind-body information transduction modulated by the limbic-hypothalamic system:
the autonomic, endocrine, immune, and neuropeptide systerns. The basic thrust of
current research in psychobiology is in studying
how all four of these systems communicate with each other in sickness
and in health. We explore the anatomy and functions of each of these four
systems successively and examine some of the mind-body symptoms,
problems, and diseases that have been found most closely associated with
each. Insofar as it is possible, we review case studies illustrating some of
the innovative hypnotherapeutic approaches that are currently being developed to
deal with the types of mind-body healing typical of each system.

T h e A n ato m y a n d F u n ctio n s o f H ypo th a la m us

One seeks in vain for clarity regarding the basic anatomy and functions
of the hypothalamus! Each medical textbook seems to picture something
different, depending upon which functions are being discussed and which
99
100

The Psychobiology of Mind-Body Healing

methods are being used (Ganong, 1985; Guyon, 1981; Kandel & Schwartz,
1985; Ornstein & Thompson, 1984). The hypothalamus does not appear
to be a discrete, easily identifiable organ as are the heart, the lungs, or
the cerebral hemispheres. Rather, the hypothalamus is a locus of tissues
with seemingly vague boundaries at the base of the forebrain. It is made
up of many important nuclei or centers of mind-body transduction and
regulation. The functions of many of these nuclei, as depicted in Figure
2, are so different from one another that they seem to be entirely independent
processes, accidentally thrown together in close proximity.
What appears on first view to be "accid en t," however, is assuredly only
a sign of our ignorance of nature's significant design. In fact, a careful
study of the functions of these nuclei indicates that they are all concerned
with the regulation of our internal environment via the autonomic, endocrine,
immune, and neuropeptide systems.
The hypothalamus is an incredibly small area of the brain for such an
important set of functions: It is about the size of a pea and weighs but

AUTONOMIC _
ENDOCRINE
SYSTEM
------------ ► SYSTEM
(A)
(E)

IMMUNE
SYSTEM
(I)

______________

2 Some functions of the hypothalamus as the source of mind/body transduction to the

autonomic (A), endocrine (E), and immune systems (I).

f ig u r e
Overview of Mind-Body Communication and Healing

101

a few grams! Figures 2, 3a, and 3b illustrate how the hypothalamus is the
central focus of the limbic system in the brain. The word limbic means
border, it was originally used to describe the border between the "h igher"
mind functions of the cerebral cortex and the "lo w e r" structures of the
brain involved with the regulation of emotions and body physiology. The
hypothalamus receives signals from all parts of the nervous system so that
it functions as a central information exchange concerned with the wellbeing of the
entire body.
Guyon has described the central role of the hypothalamus as follows
(1981, pp. 700-701):
The hypothalamus lies in the very middle of the limbic system. It
also has communication pathways with all levels of this system. In
turn, it and its closely allied structures, the septum and mammillary
bodies send output signals in two directions, (1) downward through
the brain stem mainly into the reticular formation of the mesencephalin, pons, and
medulla, and (2) upward toward many areas of the
cerebrum, especially the anterior thalamus and limbic cortex. In addition, the
hypothalamus indirectly affects cerebral cortical function
very dramatically through activation or inhibition of the reticular activating
system that originates in the brain stem.
The hypothalamus is thus the major output pathway of the limbic systern. It
integrates the sensory-perceptual, emotional, and cognitive functions of mind with
the biology of the body. Since the limbic-hypothalamic
system is in a process of constantly shifting psycho-neuro-physiological states,
all
learning associated with it is, o f necessity, state-dependent.
T h e H ypo t h a la m u s an d the A u to no m ic N ervo us S ystem

The hypothalamus has been called the "h ead ganglion" of the autonomic nervous
system because it is the major integrator of the body's basic
regulatory systems (hunger, thirst, sex, temperature, heart rate, blood
pressure, etc.). This is of central significance for our concepts because the
autonomic nervous system has been regarded traditionally as the major
means by which therapeutic hypnosis achieved its biological effects. The
autonomic system is itself made up of two branches: (1) the sympathetic
system that is involved in the energizing or alarm response whereby heart
rate, blood pressure, respiration, etc., are stimulated; and (2) the
parasympathetic system whereby the same functions are relaxed. Recently some
researchers (Bulloch, 1985) have included the entric system (which is pri
102

The Psychobiology of Mind-Body Healing

marily concerned with the internal regulation of the stomach, intestines,

etc.) as a third branch of the autonomic nervous system. The entric system
usually carries out its functions semi-independently of the autonomic systern,
however. Since it is primarily regulated by the newly recognized
messenger molecules of the neuropeptide system, we will discuss it under
that heading.
T he H ypo th a la m us and the E ndocrine S ystem

Most of us are familiar with the pituitary as the "m aster gland" of the
endocrine system that regulates all the other hormones of the body. The
hypothalamus mediates the information that governs even the pituitary,
however. When a person encounters pain, for example, the thalamus
serves as a sensory relay station that transmits a portion of the signal
directly to the hypothalamus even before the pain is experienced consciously. This
is true for all other sensations as well, with the exception
of olfactory signals, which are transmitted to the hypothalamus through
the amygdala. Even the concentrations of nutrients, electrolytes, water,
neurotransmitters, and hormones in the blood and cerebrospinal fluid can
excite or inhibit the various feedback control centers in the hypothalamus
that regulate the internal environment of the body either directly or via
the pituitary. From the other side of the limbic border, the realm of "m ind "
can influence the hypothalamus by the excitatory or inhibitory neural
impulses of the cerebral cortex that are converted into pituitary regulation
by the specialized neurons of the hypothalamus.
How much is really known today about these specialized neurons of
the hypothalamus—about how mind and body actually communicate on
a cellular and molecular level? We all know that the philosophically in‫־‬
dined have debated this problem for centuries, but do we have any real
facts about it today? Surprisingly, the answer is a definite yes. Figures 3A
and 3B are illustrations of the mind-body transducers that function on the
cellular level between the hypothalamus and the pituitary.
Whatever mind may be, most of us have a fairly reliable hunch that it
is intimately associated with the activity of the 21 0 0 0 0 0 ‫ ׳‬000‫׳‬000‫׳‬°°°*
connections
among the nerve cells of the brain. Whatever the body may be, most of
us recognize it at base as flesh, blood, glands, bone, and the way all of
these tissues are regulated by hormones, and so forth. Figures 3A and 3B
illustrate two types of nerve cells in the hypothalamus that have become
This is the number two multiplied by itself a hundred million times. According to
Carl
Sagan (1977), this means that there are m ore possible m en tal states in each
person 's brain
than th ere are atom s in th e know n un iverse!
Overview of Mind-Body Communication and Healing

103

specialized into mind/body transducers. They receive electrical impulses

of mind (the cerebral cortex) on one end just like any conventional nerve
cell of the brain; on the other end, however, they discharge a "releasing
factor" or hormone to regulate some tissues of the body.
For example, Figure 3A illustrates how nerve cells in the arcuate nucleus
of the hypothalamus produce hormone-releasing factors that are released
into a local bloodstream to the anterior pituitary. From the anterior pituitary an
endocrine hormone prolactin is then secreted to turn on milk secretion in a woman's
breasts. Figure 3B illustrates how cells from the paraventricular and supraoptic
nuclei of the hypothalamus transduce nerve impulses
from higher cortical sources into mind-modulating effects on the production of the
hormones vasopressin and oxytocin. These are stored in the
posterior pituitary cells until they are released into the general bloodstream
to regulate the kidneys and other organs during stress. Many such cells from
the different nuclei of the hypothalamus transduce the neural information of mind
into the somatic processes of the body via the pituitary and endocrine system.
This understanding of how these neurons in the hypothalam us
transduce neural information of mind into hormonal messenger molecules
of the body is called neurosecretion; it is the central concept of modern
neuroendocrinology. The existence of such neuroendocrinal information transducers
is the basic reason for conceptualizing the new field of psycho-

3A
Mind/body connections from higher
centers of mind to hypothalamus, to
anterior pituitary, and to remainder of
body.
f ig u r e

F I G U R E 3B
Mind/body connections from higher
centers of mind to hypothalamus, to
posterior pituitary, and to remainder
of body.
104

The Psychobiology of Mind-Body Healing

biology as a branch of information theory. It is the key insight that unites

biology and psychology within the single framework of information theory
in a manner that makes mind-body communication and healing an empirical science
rather than a pious hope.
T he H ypotha la m us and the I m m une S ystem

The most recently recognized regulatory function of the hypothalamus

is its influence on the immune system. Our understanding of this central
modulation of the immune system is still so new that it has not yet been
incorporated into the standard texts of psychophysiology and medicine.
The pioneering work of Ader (1981) and Stein, Schleifer, and Keller (1981),
among others, however, has begun to uncover the actual psychophysio‫־‬
logical mechanisms whereby the hypothalamus can alter both cellular and
humoral immune activity in its anterior and posterior nuclei. We will
explore some current views on the mind modulation of these processes
in a later section on cancer, rheumatoid arthritis, and asthma.
T he H ypo th a la m us and the N europeptide S ystem

Neuropeptides are the messenger molecules that are formed when information is
transduced from neural impulses of mind into hormones of
the body (described earlier as neuroendocrinal information transduction). The
concept of the neuropeptide system of mind-body communication is so
new that much of its anatomy and functioning is a matter of speculation
among a relatively small vanguard of researchers. It is well-known, however, that
the hypothalamus is a central hub of neuropeptide activity. This
system appears to overlap the autonomic, endocrine, and immune
systems, in that they all apparently utilize neuropeptides as ‫ ״‬messenger
molecules" to communicate within themselves and with each other. Because these "m
essenger m olecules" travel throughout the body in so
many different ways, the neuropeptide system has incredibly pervasive
and flexible patterns of communication. The neuropeptide system may thus
be the most multifaceted channel for information transduction and the expression
of state-dependent memory and learning. We will explore a number of speculations
about its possible role in the "body im age," sexuality, emotions,
and the mediation of some of the so-called mysterious phenomena of hypnosis that
remain unexplained even today.
7
Mind Modulation of
the Autonomic Nervous System

ypn o sis h a s lo n g been recognized as an effective means of modulat-

ing the autonomic nervous system (Braun, 1983b; Crasilneck & Hall,
1959, 1985; Gorton, 1957, 1958). Most investigators, however, have had
little to say about the actual psychobiological processes involved. An initial
approach to exploring these processes is diagrammed in Figure 4, which
illustrates some of the major anatomical and functional relationships between mind,
hypothalamus, and the autonomic nervous system.
In general, mind influences of the cerebral cortex reach the hypothalamus
via its associated limbic system structures, the hippocampus, amygdala,
and thalamus. The hypothalamus then mediates these mind influences
to the autonomic nervous system via the lower brain stem control centers,
which serve as relay stations to the sympathetic and parasympathetic
nervous systems. Stimulation in appropriate areas of the hypothalamus,
for example, can activate the sympathetic system control centers of the
heart strongly enough to increase the arterial blood pressure by more than
100 percent. Other hypothalamic centers can control body temperature
by regulating blood flow to or from the surface of the skin, increase or decrease
salivation and gastrointestinal activity, and cause bladder emptying.
The vital processes of all the organs regulated by the autonomic nervous
system are subject to the influences of state-dependent learning via their
association with the hypothalamic-limbic system, which feeds our life histories of
experiential learnings into them. In other words, all the organs
illustrated in Figure 4 can respond psychosomatically. During times of stress,
state-bound patterns of information may be generated in the regulation
of any individual organ or combination of them. These patterns may then
become manifest as the unfortunate responses that we call "psychosomatic
problems." To understand how this is possible, it will be necessary to look
105
106

The Psychobiology of Mind-Body Healing

MIND ___________________ BODY__________________________ CELL

4 Mind modulation of the autonomic nervous system and its two branches,
the sympathetic (activating) and the parasympathetic (relaxing), down to the
cellular level.
f ig u r e
Mind Modulation of the Autonomic Nervous System

107

at how mind modulates the biochemistry within the individual cells of

each organ regulated by the autonomic nervous system.
M ind M o du la tio n o f C ellu la r A ctivity
via th e

A uto n o m ic N ervo us S ystem

Weiner (1977) has commented on the general state of disbelief and

apathy regarding what we now know about how the mind and central
nervous system actually modulate the complex chemical machinery of
each living cell in the body. It took more than a few centuries for humanity
to believe and utilize the implications of Copernicus's finding that the
earth revolves around the sun and not vice versa. Likewise, it seems as
if it will take more than a few decades, if not centuries, for most people
to understand and learn to use the m ind's ability to facilitate healing at
the cellular and biochemical levels.
Figure 4 is an overview of the three-stage process whereby mind modulates the
activities of the cells via the autonomic nervous system. Stage one
consists of mind-generated thoughts and imagery (neural impulses) in the
frontal cortex (Achterberg, 1985). In stage two these mind-generated impulses are
filtered through the state-dependent memory, learning and
emotional areas of the limbic-hypothalamic system, and transduced into
the neurotransmitters that regulate the organs of the autonomic nervous
system. The autonomic nervous system finally branches into the sympathetic
(activating) and parasympathetic (relaxing) systems. The sympathetic
system terminal nerve endings secrete the neurotransmitter norepinephrine
(usually) to activate receptors on the cells of the organs they modulate (the
heart, lungs, pancreas, intestines, etc.), while the parasympathetic system
terminal nerve endings secrete acetylcholine. These neurotransmitters initiate the
third stage in the process of information transduction from the
thoughts, images, and emotions of mind to the biochemical responses
within the individual cells of the tissues and organs of the body. This final
stage of the process runs somewhat as follows:
1) The neurotransmitters are messenger molecules that signal the tissues of each of
the body's vital organs by first binding with receptors
in their cell walls. This process is illustrated in the lower portion of
Figure 4, where neurotransmitters can be seen crossing the "nervecell junctional
gap" and fitting into the receptors of the cell wall. This
changes the molecular structure of the receptor.
2) Since the receptor is a part of the cell wall, the change in its molecular
structure can alter the permeability of the cell wall to various ions
108

The Psychobiology of Mind-Body Healing

(sodium, potassium, calcium, etc.). These ionic changes alter the

electrical properties of the cells to promote activities characteristic
of each cell.
3) Another way the receptor can transmit information is by activating
an enzyme in the cell membrane such as adenylcyclase. This enzyme,
in turn, initiates the formation of adenosine triphosphate (ATP) and
cyclic adenosine monophosphate (cAMP)—the so-called second messenger system—which
then initiates and energizes the characteristic
metabolism of each cell.
Although this outline of the three stages provides only the barest sketch
of hundreds of incredibly complex biochemical reactions, it is sufficient
to illustrate our major point: Mind modulates the biochemical functions within
the cells of all the major organ systems and tissues of the body via the autonomic
nervous system. Later we will trace the analogous routes by which the
endocrine, immune, and neuropeptide systems can also transduce information from
mind to molecules in the appropriate cells of the body.
The Psychobiology of Healing at the Cellular Level:
Tissue Regeneration and Cancer
At a recent conference on neuroimmunology Melnechuk outlined how
the autonomic nervous system plays an important role in the psychobiology
of healing as it operates at the cellular level (1985, pp. 5 7 5 8 ‫) ־‬:
It should also be recalled that nerves, the immediate source of
neurotransmitters, play a trophic (growth) role in the emergence of
at least some organs during embryonic growth and development.
In later life, nerves are also known to play a role in the continuous
development of taste buds and in the regeneration of the adrenal
gland and other tissues. Since nerves go everywhere in the body,
the neurotransmitters they release may play a lifelong role in the metabolism,
biosynthetic activity, and division of all cells. Neurotransmitters would do this
either as trophic factors in themselves, as some
evidence suggests, or additionally, as I propose, by modulating the
activity of the growth factors effective in the tissues they innervate.
In the latter case, they would affect either the growth factors themselves, or
their receptors, or the second messengers triggered by the
growth factors in their target cells. It is worth sketching this elaboration
because oncogenes, the genes whose expression can cause can
Mind Modulation of the Autonomic Nervous System

109

cer, seem to code for variants of growth factors, growth-factor receptors, and
their second messengers. Accordingly, psychoneural modulation of oncogenic growth
factor activity may help explain so-called
spontaneous and miraculous cancer remissions. . . .
Positive emotions appear to have specific biochemical correlates,
which in turn have specific effects on tissues and diseases. Since the
autonomic nervous system, which is affected by emotions, appears
to secrete not only the long-familiar catecholamine neurotransmitters [e.g.,
epinephrine, norepinephrine, dopamine] but also the newly recognized peptide
neurotransmitters, it can in principle deliver
quite specific profiles of messengers to individual tissues. Recently, sensory
nerves have been found to secrete peptide neurotransmitters at their peripheral
ends, so they too could affect tissue
growth.
From this perspective, then, in which the nervous system releases
neurotransmitters that modulate growth factors, the brain, as the
organ of emotions and attitudes, seems to be in a position to dispatch
appropriate mixtures and amounts of growth-modulating neurotransmitters and
hormones to particular sites.
It is evident from this quotation that psychobiologists are finally beginning to
discover the actual biochemical steps by which mind can modulate
molecules at the cellular and genetic levels, thereby explaining the mysteries of
spontaneous healing, the placebo response, and so-called miracle
cures. The challenge for hypnotherapists is to determine how to facilitate
healing at these specific biochemical stages within the cells, as they are
illuminated by basic research. While we are still very far from being able
to do this, the following sections touch upon some pioneering studies in
this area.
M ind M o d u la tio n o f B lo od F lo w and
th e A uto no m ic

N ervo us S ystem

Barber (1978, 1984) has brought together a fascinating overview that

demonstrates how therapeutic hypnosis can be effective in healing a wide
variety of apparently unrelated mind-body problems. This suggests that
the phenomena of focused attention, imagery, biofeedback, and therapeutic hypnosis
all operate by altering the direction of blood flow. Altering
blood flow by directed thinking, imagining, and feeling is one of the basic,
common factors in the resolution of most, if not all, mind-body problems.
110

The Psychobiology of Mind-Body Healing

The following well-documented list expands upon Barber's work by detailing the
healing processes that can be facilitated by the mind modulation
of blood flow to the various tissues and cells of the body:
1) Warming and cooling different parts of the body to deal with headaches (Barabasz
& McGeorge, 1978; Barber, 1978, 1984; Erickson,
1943c/1980);
2) Controlling blushing and blanching of the skin (Barber, 1978,1984;
Erickson, 1980c);
3) Stimulating the enlargement and apparent growth of breasts in
women (Barber, 1984; Erickson, 1960a/1980; Williams, 1974);
4) Stimulation of sexual excitation and penile erection (Barber, 1978,
1984; Crasilneck, 1982);
5) The amelioration of bruises (Barber, 1984; Cheek, 1962a);
6) Controlling bleeding in surgery (Banks, 1985; Cheek, 1969);
7) Minimizing and healing burns (Barber, 1984; Cheek, 1962a; Moore
& Kaplan, 1983);
8) Producing localized skin inflammations similar to previously experienced burns
(Barber, 1984);
9) Curing warts (Johnson & Barber, 1978; Ullman, 1959);
10) Producing and curing diverse forms of dermatitis (Barber, 1984;
Ikemi & Nakagawa, 1962);
11) Ameliorating congenital ichthyosis (Barber, 1984; Mason, 1952,
1955);
12) Aiding coagulation of blood in hemophiliacs (Banks, 1985; Barber,
1984);
13) Ameliorating the alarm response (Cheek, 1960,1969; Rossi, 1973/1980);
14) Ameliorating hypertension and cardiac problems (Benson, 1983a,
b; Gruen, 1972; Schneck, 1948; Wain, Amen, & Oetgen, 1984;
Yanovski, 1962);
15) Ameliorating Raynaud's disease (Conn & Mott, 1984; Jacobson et
al1973 ‫;) ״‬
16) Enhancing the immune response (Black, 1969; Hall, 1982-83; Lewis,
1927; Mason, 1963).
The next step is to identify the actual psychobiological mechanisms that
govern the processes of blood flow hypothesized to underlie this diverse
array of healing. Here, however, we rapidly reach the limits of our current
understanding. To comprehend even these limits, we first need to review
what is definitely known about the control of blood flow. The regulation
Mind Modulation of the Autonomic Nervous System

Ill

of blood flow is usually considered under three headings: (1) autonomic

nervous system, (2) humoral systems, and (3) local tissue controls. We
will consider each in turn.
1)
Autonomic Nervous System. With its branches in the sympathetic and
parasympathetic systems, the autonomic nervous system regulates blood
flow by dilating or constricting blood vessels. This regulation takes place
primarily via the action of neurotransmitters at sympathetic nerve endings
located on the arteries, arterioles, metarterioles, veins, and venules (but
not on capillaries and their sphincters). The parasympathetic system, by
contrast, has only a minor role in the regulation of blood flow: Its only
important effect takes place via the vagus nerve, which can decrease heart
rate and contractility.
There are important characteristics of this autonomic nervous system
control: It can occur quite rapidly (it begins within one second and reaches
full development in five to 30 seconds), and it can regulate large parts of
the body simultaneously. The entire system usually acts automatically on
an unconscious level under control of the vasomotor center in the brain
stem. This automatic control center, however, is subject to mind modulation via the
limbic-hypothalamic system, which can send excitatory or
inhibitory information to it. Many parts of the cerebral cortex can modulate
the controls of the vasomotor center, usually via the limbic-hypothalamic
system. These parts include the motor cortex, the anterior temporal lobe,
and especially the frontal cortex with its capacity for utilizing and directing
the psychobiological expression of learning encoded within the limbic
system. Many parts of the cerebral cortex dealing with a variety of
sensoryperceptual processes (imagery, kinesthesia, audition) can initiate the
routes
by which state-dependent memory and learning can be funneled through
the limbic-hypothalamic system to modulate blood flow by the autonomic
nervous system.
One of the major effects of the autonomic nervous system on blood flow
that is mediated by the hypothalamus is the alarm response. When suddenly exposed
to a personal danger, strong patterns of stimulation to the
hypothalamus are transduced into powerful vasodilation and/or constriction of blood
supply to muscles and glands. Arterial blood pressure rises,
heart output increases, and the blood system becomes ready to supply
oxygen and nutrients to the tissues that need them. This alarm response
is one of the "m ass action" effects of the autonomic nervous system on
blood flow. It is of great value in preparing the body to meet emergencies,
but it leads to stress and associated psychosomatic problems if continued
for an unreasonably long period.
11 2

The Psychobiology of Mind-Body Healing

2) Humoral Control of Blood. Humoral control refers to the substances such

as hormones, ions, and other factors in the body fluids that can regulate
blood flow. A number of hormones that are part of the endocrine system
(to be outlined later) can be turned on by the autonomic nervous system.
The sympathetic branch of the autonomic nervous system, for example,
can stimulate the adrenal medulla (center of the adrenal glands) to secrete
two such hormonal agents, epinephrine and norepinephrine, that are
distributed throughout the body to regulate blood flow by constricting or
dilating blood vessels. Norepinephrine constricts most of the vascular
systems of the body. Epinephrine has a similar effect on most tissues, except
for its mild vasodilation of skeletal and cardiac muscles when blood is
needed (particularly during the alarm response).
This humoral control over blood flow lasts longer than the faster but
shorter-acting direct stimulation by the release of neurotransmitters at the
sympathetic system nerve endings, which act on the major endocrine
organs illustrated in Figure 4. When this longer-acting, humoral mechanism gets out
of control, however, it leads to excess and continued stress,
eventually resulting in the psychosomatic problems associated with Selye's
General Adaptation Syndrome.
3) Local Tissue Controls of Blood Flow. As we get closer to the local control
systems which determine how much blood reaches the individual cells
of tissues via the arterioles and capillaries, our knowledge of the possibilities
of mind modulation grow even dimmer. It has been mentioned that
arterioles are innervated directly by the sympathetic nervous system and
indirectly by epinephrine and norepinephrine released into the blood by
the adrenal medulla. Arterioles are thus subject to mind modulation via
the hypothalmic-autonomic route. Capillaries, on the other hand, are more
closely regulated by the local tissue needs for oxygen and nutrients. The
mechanism of this control is the small muscular precapillary sphincter that
surrounds the origin of the capillary.
There are two major theories regarding the regulation of these precapillary
sphincters: the vasodilation theory, and the oxygen demand theory
(Guyon, 1981). The vasodilation theory proposes that the greater the rate
of metabolism, the greater the release of local vasodilators (such as carbon
dioxide, lactic acid, and adenosine phosphate) that open the precapillary
sphincters, metaterioles, and arterioles. Adenosine is a particularly important
dilator at this level because it is released by heart cell muscles when
coronary blood flow becomes too little; thus, insufficient release of adenosine
could be related to the incidence of cardiac problems. The fundamental role of
adenosine triphosphate (ATP) as the "second messenger system"
Mind Modulation of the Autonomic Nervous System

723

within the cells of the body that transduces mind information from the
cortical-limbic-hypothalmic-autonomic pathway is diagrammed in Figure 4.
The oxygen demand theory is also known as the "nutrient dem and"
theory since many nutrients are also involved. The locus of action in this
theory is on the precapillary sphincters, which are continually in vasomotion and
whose openings are approximately proportional to the metabolic
needs of the tissues. I am not aware of any proposed mind-modulating
effects at this level, although one could speculate that the appetite and
thirst control centers of the hypothalamus could be involved through processes not
yet well understood.
A pioneering research effort in the voluntary and hypnotic control of
oxygen in the tissues was recently performed by Olness and Conroy
(1985). They found that children (ages seven through 17) who were experienced in
self-hypnosis were able to increase oxygen in their tissues
(as measured continuously by a Novamatrix transcutaneous monitoring
system). One child even voluntarily decreased the oxygen level. The authors
of this study do not discuss the psychophysiological mechanisms involved,
but they conclude that their study documents voluntary control over this
aspect of autonomic nervous system functioning.
H ypn o th era peu tic A ppr o a c h es to th e A uto no m ic S ystem

An important example of the mind modulation of cellular activity via

the autonomic nervous system occurs when its sympathetic branch signals
the adrenal medullae (center of the adrenal glands) to secrete epinephrine
and norepinephrine into the bloodstream to activate the alarm response
throughout the body. Coping with this alarm response is of great importance during
accidents, life emergencies, and medical interventions
(such as surgery) in which the victim's or patient's fear could contribute
to excess blood loss, hypertension, cardiac problems, and even physiological shock.
Reassurance from any responsible person (doctor, nurse,
medical aide, helpful bystander) can greatly mitigate the stress-induced
aspects of the emergency by attenuating the sympathetic alarm reaction
and substituting the calming effects of the parasympathetic system. In this
section we will review a number of hypnotherapeutic approaches that
have been used successfully in a wide variety of clinical practices dealing
with the alarm response.
1)
Controlling Bleeding During Surgery and Hemophilia. Banks (1985) has
recently reported how hypnotic suggestion can be used to control bleeding
114

The Psychobiology of Mind-Body Healing

during acute gastrointestinal hemorrhage, angiography (X-ray studies of

blood vessels), and embolization (intentional injection of vessel blocks into
arteries feeding an abnormality). Banks recognizes that stress and confusion during
these medical procedures are in themselves sufficient to induce a state of
heightened sensitivity wherein the patient is receptive to
suggestions without the formal induction of hypnotic trance. During the
angiography procedure, for example, excess bleeding can be stopped or
turned on again with the following suggestions (Banks, 1985, p. 80):
‫'׳‬This may seem strange, but has anyone asked you to stop bleeding yet?"
The patient's quizzical look and verbal response of " n o " elicited
the following short verbalization:
"T hen why don't you stop bleeding? Nozvl I know it sounds like
an unusual request, but it really would help us to help you; and after
all, you really have been controlling bleeding—all of your life—probably without
knowing consciously what you have been doing. You
get cut or scratched and you stop bleeding, just like you increase your
heart rate when you get frightened, and you slow it down when you
relax—you do it but you don't know how. So you don't need to consciously know how
you stop your bleeding but it will help us if you
just let it happen . . . nozvl"
If it is later required to turn bleeding back on, the doctor suggests
the following:
"S o far you have really done well. You have stopped your bleeding completely. But
in order to show what zvas bleeding, you now
need to undo whatever it was that you have done. You don't need
to know how, but just let it go ahead and bleed, now, so we can see
if we have found the correct sp o t."
These simple but well-formulated requests take advantage of a number
of indirect hypnotic suggestions summarized by Erickson and Rossi (1980).
The reader can recognize how these requests are actually a variation of
our basic accessing formula: (1) There is a time-binding introduction of
"W hy don't you stop bleeding? Nowl"; 2) there is an accessing of statedependent
unconscious processes that can control bleeding " if you just
let it happen"; and 3) there is a recognizable behavioral response that
ratifies the inner process when the bleeding actually stops.
Banks asks why a hemophiliac patient can stop bleeding from a tumor
that should not respond to normal physiological controls, as follows (1985,
p. 85):
Mind Modulation of the Autonomic Nervous System

115

Does he produce a spasm in normal feeding arteries? . . . Activate

clotting factors? Neither hemophiliacs nor physicians who work with
them have a logical explanation of how they achieve their dramatic
results without demonstrable circulating factor Vili [a blood factor
needed for normal blood coagulation but absent in hemophiliacs]:
we can do no better.
From the theoretical perspective of this book, one could infer that the
limbic-hypothalamic-autonomic system is the route by which hemophiliacs
achieve their results: The sympathetic branch of the autonomic system
could constrict the blood vessels and thus shut off the blood flow.
2)
Ideomotor Signaling for Accessing Problems Associated with Surgical Anesthesia,
Accidents, Critical Illness. David Cheek (1959) made a number of original
discoveries on the "U nconscious Perception of Meaningful Sounds
During Anesthesia as Revealed Under H ypnosis." A typical example of
his work was reported as follows (Cheek, 1957, p. 109):
This 27-year-old dentist volunteered for investigation of his appendectomy at the
age of 15. He stated that he had always wondered
if a "g h o s t" surgeon had done the operation but had never known
just why he felt this. He was curious to find out if his impression
was correct, and it was the impression of the writer that the curiosity was free of
malevolence.
During the induction the subject related his sensation of light
trance to that experienced after he had been knocked unconscious
during a football scrimmage at the age of 16. Asked if there were
another experience which felt similar, he indicated a " y e s " with his
finger and regressed back to the induction of anesthesia for his appendectomy one
year earlier. This equating of the hypnotized state
with previous experiences of delirium or with unconsciousness from
diabetic coma or chemical anesthesia has been frequent in the writer's experience.
Q: "W here are you now ?"
A: " I think I'm in the O.R. [operating room]—I'm not going down
very w ell." (Respiratory rate jumps from 14-28.)
Q: "A re you scared?"
A: Finger: " N o ."
Q: "D o you hear any sounds?"
A: "T he fan is going—they are talking back and forth—not to m e."
116

The Psychobiology of Mind-Body Healing

Q: "Is there anything that worries you?"

A: Finger: " Y e s ." Verbal: " N o ."
Q: "W ould it be all right to hear it consciously?"
A: Finger: " Y e s ." Verbal after a pause: "Y ou better cut h ere."
Q: "W here does it come from ?"
A: "It seems to be coming from Sobie" (the family physician). The
subject is now urged to go back over this and give the exact
words as though he were replaying the record.
A: " I think we better cut h ere."
Q: "Is there anything after that that disturbs you?"
A: "Y e s " (with finger after pause of ten seconds). Verbal: "It
seems like they can't find it. 'It's tucked under'—that comes
from the doctor on the left side of the table" (Sobie). After
another pause (25 seconds), "C om e on, we got to get this
out of h ere."
Q: "W hose voice is that?"
A: "It doesn't seem to be Sobie. He seems to be on the left and
somebody else is on the right, and somebody is down at the
foot."
Q: "D oes this statement frighten the deep part of your brain?"
A: Finger: " N o ."
Q: "D oes the deep part of your brain feel anything?"
A: Finger: " N o ." Verbal: "Ju st a little hyper-awareness of the
lower right quadrant." (Note the later-orientation choice of
words )
Q: "D o you feel any discomfort while they are looking?"
A: Verbal: " N o ."
When now asked to indicate the next thing, he states that nothing
is being said, but he senses a feeling of relief and he knows they have
found the appendix.
A little later the subject says, "Now the light is right over my head.
It didn't use to be over my head. It's brighter. I guess they must have
taken the mask off or som ething."
Q: "A re they finished?"
A: Finger: " N o ."
He now seems disturbed because, although they have talked as
though finished with the surgery, they decide to put another clamp
on the skin.
Mind Modulation of the Autonomic Nervous System

227

This illustration of the ideomotor finger signaling method of accessing

state-bound information encapsulated from normal waking consciousness
by chemical anesthesia reveals a number of interesting features. The first
is that the patient's respiratory rate jumped from 14 to 28. This indicates
that an important psychobiological shift was taking place as the traumatic
memories of the operation were beginning to be accessed under hypnosis.
Another significant feature of this finger signaling example was the conflict
between the ideomoter and verbal levels. Thus in response to Cheek's
question, "Is there anything that worries you?" the finger signaled "y e s "
while the patient answered " n o ." Such conflicting responses are the
reason why Cheek uses three levels of psychobiological responsiveness
to assess the degree of therapeutic involvement and validity of his clinical
investigations. Let us review these three levels again in the context of the
above illustration.
1) The first level typically involves increased perspiration, respiration,
and heart rate. These are all indications of autonomic system arousal
and, together with M cGaugh's (1983) work cited earlier on the hormonal and
neuroendocrinal encoding of life experience, would be
the basis of this first level of psychobiological responsiveness. Responses on this
level can be regarded as involuntary.
2) The second level is the ideomotor finger signal itself, which is usually
experienced by subjects as moving in an autonomous and involuntary manner. Some
subjects, however, experience the movement as
partially voluntary; others simply do no know whether or not it is
completely involuntary.
3) The third level is that of verbal report. Many subjects experience this
as completely voluntary; others are less sure; and for some, it even
seems to be involuntary.
I would describe these three levels as interacting patterns of state-bound
information. Because of the traumatic acquisition conditions under which
the limbic-hypothalamic autonomic nervous system encoded this information, it is
not available to the person's usual associative networks of
consciousness. The normal processes of information transduction have
broken down. Cheek's finger signaling approach to accessing this statebound
information is a unique way of reestablishing the process of information
transduction between the physiological, ideomotor, and verbal
levels.
Cheek has his subjects review the state-bound m em ories at the
ns

The Psychobiology of Mind-Body Healing

ideomotor level a number of times before attempting to obtain a verbal

report. It is tempting to speculate that this need to ‫ ״‬review" is actually
a procedure for accessing and reactivating Hebb's (1949) "cell assemblies
and phase sequences" (1949) and Gazzaniga's "m ind m odules" (1985)
that encode the state-bound information in neural associative networks.
Repeating the accessing and reactivating process increases the probability
that transduction between the physiological and verbal levels will be
reconnected. Confirmation of Cheek's general ideomotor approach to accessing and
reframing traumatic memories is currently appearing in numerous research programs.
Barnett (1984), for example, has recently reported the results of a ten-year study
of "th e role of prenatal trauma in
the development of the negative birth experience." In this study he has
used the finger signaling method to access memories that could be implicated in a
wide range of functional disorders, including alcoholism, anxiety, depression,
asthma, phobias, nail-biting, sexual dysfunction, and
marital problems.
From the area of laboratory research, Cheek's work on the unconscious
perception of meaningful sounds during surgical anesthesia was confirmed
in animal research by psychobiologists Weinberger, Gold, and Sternberg
(1984). They found that anesthetized experimental animals could learn the
conditioning of an auditory signal when they received a dose of epinephrine to put
them in a state of heightened psychophysiological arousal.
These researchers suggested that since epinephrine is an important
neurotransmitter, it functions to consolidate memory storage. This is a striking
confirmation of McGaugh's work quoted earlier on the psychobiological
encoding of state-bound information.
In human research Henry Bennett (1985), a psychologist at the University of
California at Davis, is confirming that unconscious learning during
surgery can influence its outcome and the rate of recovery. Clearly, more
work with humans under controlled conditions is needed to explore the
parameters, limitations, and further possibilities in this area.
T he P sy ch o bio lo g y o f C o pin g :
C onverting N egative T hreat into P ositive C h allen g e

The ability to cope with stress is currently emerging as one of the most
significant factors in the psychobiology of health and illness (Gentry,
1984). Most schools of psychotherapy consider enhanced coping skills as
a goal and criterion of the effectiveness of the therapeutic work. Selye's
pioneering work on the psychobiology of stress, of course, is the source
of this current recognition of the significance of coping. In the later stages
Mind Modulation of the Autonomic Nervous System

119

of his work, Selye (1974) differentiated between the type of stress that
caused illness, and the type of stress—"e u stre s s "—that was life-enhancing.
This distinction corresponds nicely with the views of humanistic psychologist
Abraham Maslow (1962), who divided human motivation into
two branches: (1) deprivation motivation that engendered negative feelings
and illness because of a lack of the basic necessities of life, and (2) being
motivation that enhanced life with positive feelings of love, joy, hope, and
happiness.
The psychobiological basis of this distinction between negative and
positive emotions in response to stress has recently been investigated by
a number of researchers (Holroyd & Lazarus, 1982; Lazarus & Folkman,
1984). They found a significant difference in the body's response to "threat”
(stress) and "challenge" (eustress). Threat is associated with two factors:
(1) an increase in the blood level of catecholamines (epinephrine and
norepinephrine, secreted from the adrenal medulla in response to sympathetic
stimulation described earlier as the alarm response of the autonomic nervous
system); and (2) the release of cortisol into the bloodstream by the
adrenal cortex (signaled by the pituitary gland sending ACTH to the adrenal cortex,
as illustrated in Figure 1). Challenge, on the other hand, is
associated only with an elevation in catecholamine levels.
In a study on the biochemistry of self-efficacy (or coping), Bandura (1985)
found that there was an elevation in catecholamine levels in patients who
were experiencing a phobia. He then found that the greater their sense
of being able to cope with their phobia, the lower their catecholamine
levels. The greater the sense of self-efficacy, the less stress is experienced
and the lower the catecholamine levels remain. This suggests a basic principle of
psychobiological therapy: Convert the negative stress o f threat into
a positive coping experience o f challenge. This novel way of conceptualizing
the therapeutic aim of the various forms of the basic accessing formula
is illustrated in Box 11.
A hypnotherapeutic approach to phobias based on a variation of our
basic accessing formula (originally described as the "three-stage utilization
approach to hypnotherapy" in Erickson & Rossi, 1979) was utilized
by Nugent, Carden, and Montgomery (1984) "in an effort to validate both
the approach and the supposition that creative unconscious processes can
thus be accessed and utilized therapeutically." The purpose of their "standard
suggestion form " was to "access and direct creative unconscious processes toward
the creation and implementation of satisfactory solutions
to recurrent problem behaviors" (p. 201). In three experimental cases, they
found that a single hypnotherapeutic session was sufficient to resolve
sleep disturbance problems and phobias for hypodermic needles. Their
The Psychobiology of Mind-Body Healing

120

bo x

11 Converting Negative Threat to Positive Challenge

1. Readiness signal for inner work

Y o u w i l l k n o w w h e n y o u a r e r e a d y to e x p l o r e h o w y o u c
a n
d e a l m o r e e f f e c t i v e l y w i t h t h a t p r o b l e m [p a u s e ]
w h e n y o u fin d y o u rs e lf g e ttin g m o re c o m f o rta b le w ith e a c
h
b r e a t h y o u t a k e [p a u s e ]
a n d y o u r e y e s m a y e v e n c l o s e a s y o u f o c u s o n it .

2. Reframing threat into challenge

Y o u c a n c o m f o r t a b l y r e v i e w a ll a s p e c t s o f y o u r p r o
b l e m t h a t a r e
m o s t t h r e a t e n i n g [p a u s e ]
a n d w o n d e r h o w y o u w i ll s u c c e s s f u l l y r e s o l v e e a c h
a s a w o r t h w h ile c h a lle n g e .

3. Ratifying problem-solving
A n d w h e n y o u k n o w th a t y o u ca n c o n tin u e th a t c o n s tru c
tiv e
a p p r o a c h [p a u s e ],
y o u 'l l f i n d y o u r s e l f r e a d y to s t r e t c h , a w a k e n , a n d
s h a r e j u s t
o n e o r t w o e f f e c t i v e w a y s y o u w i l l e n j o y u s i n g to m e
e t t h o s e
c h a lle n g e s .

therapeutic approach to a phobia for needles in one college subject they

call " B " was described as follows (Nugent, Carden, & Montgomery, 1984,
pp. 2 0 2 2 0 3 ‫) ־‬:
Following our pre-induction talk a trance induction was initiated.
B responded to the internal visualization induction by rapidly developing a deep
trance. She was then given the creative task of finding a way she could remain
awake and alert during future procedures involving needles. We gave this task via a
"standard"
suggestion form used in all applications of our procedure: "N ow
your unconscious mind can do what is necessary, in a manner fully
meeting all your needs as a person, to insure that (desired therapeutic
outcome), and as soon as your unconscious knows that you will
(desired therapeutic outcome), it can signal by (appropriate ideomotor
signal)." The specific suggestion given B was: "N ow your unconscious mind can do
what is necessary, in a manner fully meeting all
your needs as a person, to insure that you remain comfortably awake
Mind Modulation of the Autonomic Nervous System

121

and alert anytime you receive an injection in the future, and as soon as
your unconscious knows you will remain comfortably awake and alert
when receiving an injection, it can signal by lifting your right hand into
the air off the chair." This suggestion was our communicative effort
to access and direct unconscious processes to the creation and implementation of
altered behavioral responses to injection. Three
minutes after this suggestion was given, B's right hand lifted jerkily into the
air. She was then awakened and experienced a complete
amnesia for the trance period.
It would now be desirable to determine the relative effectiveness of using
this hypnotherapeutic formula to lower catecholamine levels in comparison with the
behavioral approach described by Bandura.
U ltradian R h yth m s and the A u to no m ic N ervo us S ystem

The discovery of the ultradian rhythms that regulate many functions

of the autonomic and endocrine systems is a recent research milestone
that has important implications for the development of new approaches
to therapeutic hypnosis (see Rossi, 1982, 1986a). In this section we will
outline some implications of the ultradian-autonomic link; in the next
chapter we will deal with the ultradian-endocrine relationships.
The concept of dominance in the functioning of the cerebral hemispheres
has a long tradition in physiology and medicine (Gazzaniga, 1985). Until
the present time it was presumed that hemispheric functioning was not
only specialized in function but also fixed in time. A series of studies
during sleep (Goldstein, Stoltzfus, & Gardocki, 1972; Gordon, Frooman,
& Lavie, 1982), however, indicated that there were natural, 90-minute
ultradian rhythms in hemispheric dominance that might affect psychological
functioning. Every 90 minutes during sleep, for example, most
people experience a period of dreaming (REM sleep). Klein and Armitage
(1979) then found that there were natural, 90-minute oscillations of ultradian
rhythms in the mental activity and cognitive style of normal subjects
when they were awake: Left- and right-hemispheric dominance tended
to alternate with this ultradian periodicity.
The next experimental step was taken by Debra Werntz (1981), who
found that these ultradian rhythms in cerebral hemispheric dominance
were contralaterally associated with similar alternations in the nasal
breathing cycle. That is, when the left nostril was open and taking in air,
the right cerebral hemisphere had an EEG pattern indicative of greater
activity, and vice versa. In a subsequent study (Werntz et al., 1981), she
122

The Psychobiology of Mind-Body Healing

found that changing nasal breathing from one side to the other also changed
cerebral hemispheric dominance! Not only was the nasal breathing rhythm
a natural, non‫־‬invasive window on cerebral hemispheric activity, but voluntarily
induced changes in airflow between the left and right nostrils
could be used to change the locus of activity in the left and right cerebral
hemispheres in the highest levels of brain and mind! She and her colleagues
outlined a theory of these relationships with the autonomic nervous system as
follows (Werntz et al., 1981, pp. 4-6):
We feel that the correlation of the nasal cycle with the alternation
of cerebral hemispheric activity is consistent with a model for a single
ultradian oscillator system and imposes a new conceptual understanding for the
nervous system. . . . We propose an even more
complete and integrated theoretical framework which incorporates
an organization for all ultradian rhythms and their regulation by the
autonomic nervous system, most specifically the integration of autonomic and
cerebral hemispheric activity. It could be suggested at this
point that there might be some basis to believe that the "separate
forms of intelligence" localized in each hemisphere require an increased metabolic
support of the contralateral side of the body in
terms of the overall bias they might serve. In this context, the nasal
cycle can be viewed as an easily measureable indicator or "window" for this
framework.
. . . . Thus the whole body goes through the Rest/Activity or
Parasympathetic/Sympathetic oscillation while simultaneously going
through the "L eft Body-Right Brain/Right Body-Left Brain" shift.
This then produces ultradian rhythms at all levels of organization
from pupil size to higher cortical functions and behavior. . . . It is
important to note that this represents an extensive integration of
autonomic and cerebral cortical activity, a relationship not previously
defined or studied. We propose that as the nasal cycle probably is
regulated via a centrally controlled mechanism, possibly the hypothalamus, altering
the sympathetic/parasympathetic balance, this occurs throughout the body including
the brain and is the mechanism
by which vasomotor tone regulates the control of blood flow through
the cerebral vessels thereby altering cerebral hemispheric activity.
For thousands of years the Eastern yogis have claimed they could regulate their
states of consciousness by regulating their breathing in the practice they called
pranayama (Rossi, 1985, 1986a). They have also claimed that
their supposedly miraculous control over their body physiology was re
Mind Modulation of the Autonomic Nervous System

123

lated to the conscious regulation of their breathing rhythms. Since these

feats of mind-body control deal primarily with the autonomic nervous
system, Werntz's work may provide a theoretical and empirical bridge to
the ancient yogic traditions.
Conversations with David Shannahoff-Khalsa (1983) of the Jonas Salk
Institute of La Jolla, California, suggested that an exploration of any mindbody
state or problem involving the autonomic nervous system could be
undertaken safely and easily by shifting cerebral hemispheric dominance
via the nasal breathing rhythm. I have detailed several methods for shifting
hemispheric dominance in this way previously (Rossi, 1986a,b). My
favorite method is to simply lie down comfortably on one side of my body
or the other. Lying on the right side, for example, causes the right nostril
to become congested, while the left nostril opens within a few minutes.
This, in turn, reflexively tends to activate the right cerebral hemisphere.
By lying on the left side, the left cerebral hemisphere is activated.
Preliminary explorations with this simple method as outlined in Box 12
have yielded fascinating experiential results. A functional headache due

bo x

12 Shifting Cerebral Hemispheric Dominance and

Mind-Body States

1 . Identifying nasal dom inance and m ind-body state

W h e n y o u a re e x p e rie n c in g a m in d -b o d y s ta te y o u w o u ld
lik e
to e x p l o r e a n d t r a n s f o r m , f i r s t d e t e r m i n e w h i c h n
o s t r i l is c l e a r .
2 . Sh ifting nasal and hem ispheric dom inance
L ie o n y o u r s id e , w ith th e c le a r n o s tril d o w n w a r d . T h is w
ill
s h ift re f le x iv e ly y o u r c e re b ra l d o m in a n c e w ith in a fe w m
in u te s
to t h e h e m i s p h e r e o n t h e d o w n w a r d s i d e . S i m p l y r e c
e i v e a n d
w o n d e r a b o u t th e s e n s o ry , p e rc e p tu a l, e m o tio n a l, c o g
n itiv e , o r
s y m p to m a tic s h ifts ta k in g p la c e a ll b y th e m s e lv e s w ith in
th e
n e x t f i v e to 2 0 m i n u t e s .
3 . Ratify hem ispheric and mind-body shifts
In a n u p r ig h t p o s itio n , n o tic e th a t th e fo r m e rly b lo c k e d
n o s tril
is n o w c l e a r , a n d v i c e v e r s a . R e c o r d t h e m i n d - b o d y
c h a n g e s
th a t a c c o m p a n ie d th is n a s a l-c e r e b r a l h e m is p h e r ic s h
ift a n d
s t u d y t h e c h a r a c t e r i s t i c p a t t e r n s o f y o u r r e s p o n
s e s to g u i d e
y o u rs e lf fu rth e r.
124

The Psychobiology of Mind-Body Healing

to simple stress or overwork, for example, often can be made to change

its intensity and location relatively quickly simply by shifting the nasal
rhythm iron one side to the other. Some patients have reported that pain
can be shifted ideodynamically into a feeling of pleasant warmth, coolness,
or whatever, by shifting sides. Moods, negative affects, and body discomfort can be
imaged and reflected upon with more meaningful insight after
five or six minutes of playing with one's sensory transformations in this
manner. Elsewhere I have published some of my personal experiences of
accessing profound, autohypnotic states of "lucid somnambulism" by
shifting to right-hemispheric dominance during ultradian rest periods
(Rossi, 1972/1985).
In his book, Meditation and the Art of Dying (1979), Dr. Usharbudh Arya
has described an interesting relationship between the nasal cycle, sexual
orgasm, and the highest states of bliss in samadhi. According to ancient
yogic literature, both nostrils are open during sexual orgasm, and during the
deepest meditative states of samadhi. The ectasy of this form of
meditation he describes is due to "upw ard implosions . . . of kundalini
. . . so that celibacy becomes easier and more enjoyable than se x ." It remains
for Western science to assess these observations.
These preliminary observations on the relationships between the autonomic nervous
system, cerebral hemispheric dominance, and behavior
open an extremely wide range of interesting possibilities for developing
new psychobiological approaches to therapeutic hypnosis, mind-body healing, and the
facilitation of human potentials. Another look at Figure 4 at
this point will provide the reader with an overview of the profound scope
of many of the approaches touched upon in this chapter: figure 4 illustrates a
complete path of information transduction, mediated by the autonomic nervous
system, that exists between mind, body, and molecular
processes within each cell of the body. This path of information transduction is
being modulated constantly and automatically on an involuntary,
unconscious level by the state-dependent encoding of memory, learning
and behavior from our experiences of everyday life. Continuing research
and clinical practice will reveal the avenues by which we can learn to
facilitate these mind-body processes of communication in a more voluntary manner.
In the next chapter we will extend these possibilities by
exploring what we already know about the mind modulation of the endocrine system.
8
Mind Modulation of the
Endocrine System

h e en do crine system is comprised of many organs located throughout

the body that secrete hormones into the bloodstream to regulate cellular metabolic
functions, such as the rates of chemical reactions for metabolism, growth, activity
level, sexuality, etc. Figure 5 illustrates how some
of the major organs and functions of the endocrine system can be influenced by mind
modulation processes via the limbic-hypothalamic system.
Virtually all these organs of the endocrine system can either mediate or
be the loci of psychosomatic problems.
The pituitary gland at the base of the brain is the "m aster gland" of the
endocrine system: It sends out hormones as "m essenger m olecules" to
regulate all the other hormone-producing organs of the body (see Figure
5). The pituitary, in turn, is modulated by the limbic-hypothalamic system.
As indicated earlier, the hypothalamus is comprised of many nuclei or
nerve centers that act as receiving stations to pick up information about
the internal environment from the blood and cerebrospinal fluid, and about
the external environment from the sense organs. The limbic-hypothalamic
system is the major center for integrating this information with the processes of
mind, and then transducing this newly integrated information
to the pituitary, which in turn regulates all the other organs of the endocrine
system. The actual cells of the hypothalamus that transduce the
nerve impulses of mind into the secretions (hormonal-releasing factors)
that regulate the pituitary were illustrated earlier in Figures 3A and 3B (p.
103).
Within the past decade a revolutionary series of discoveries about the
multiple roles of many endocrine hormones has transformed our understanding of
memory, learning, and behavior (Guillemin, 1978; Henry,
1982; Snyder, 1980). The traditional role of hormones in regulating meta-

125
126

The Psychobiology of Mind-Body Healing

MIND
BODY
CELL
5 Mind modulation of the endocrine system, with three examples at the
cellular level of the still theoretical "mind/gene connection."
f ig u r e
Mind Modulation of the Endocrine System

127

bolic functions of the body is currently being supplemented by a growing

realization of how they also may function as neurotransmitters and neuromodulators
that facilitate mind-body communication at many levels within
the brain itself. This is possible because the cell receptors that are activated
by these hormones are present in brain tissues as well as in body tissues.
Table 4 lists a number of endocrinal hormones that operate on cell receptors in
both brain and body.
The most extraordinary development that has taken place recently in
the field of endocrinology involves the discovery of the new class of
pituitary hormones called the endorphins and enkephalins. These hormones
have many regulatory functions of psychological interest, including the
modulation of stress, pain, moods, sexuality, appetite, addictions and
substance abuse, work and sports performance, as well as the basic processes of
learning and memory (Davis, 1984).
The discovery of the endorphins is so new that there is still no general
agreement about their physiological classification. Margules (1979), for
example, has postulated that the endorphin system represents a new division of the
autonomic nervous system that is basically concerned with the
"conservation and expenditure of bodily resources and energy in anticipation of
famine or feast" (p. 155). This view is supported by many lines
of evidence, including the distribution of endorphins throughout the body
and many brain areas (hypothalamus, pituitary, nucleus raphe magnus,
periaquaductal grey), as well as in the spinal cord and gastrointestinal
tract.
Since a major biosynthetic source of one of the major endorphins (/3endorphin) and
enkephalins (meta-enkephalin) comes from the same
mother molecule as the adrenocorticotropic hormone (ACTH) in the anterior
pituitary, however, many authorities now consider this entire system
to be part of neuroendocrinology. /3-endorphin has the same secretory
release dynamics from the pituitary as ACTH: It is basically released into
the bloodstream in response to stress (physical, emotional, cognitive, and
imaginative), as well as in response to natural daily (circadian) biorhythms.
It is important to recall the psychobiological source of the endorphin hormones
when evaluating the meaning and implications of the many still
contradictory claims concerning the functions of the endorphin system.
Since many of the multiple functions of hormones are mediated either
directly or indirectly by the limbic-hypothalamic-pituitary system, they
are accessible to mind modulation and hypnotherapeutic intervention.
That is, although hormones usually function autonomously, we now
know that their activity is modulated by significant life experiences and
encoded in the form of state-dependent memory, learning, and behavior.
Rosenblatt (1983) has pointed out that whenever a receptor for a drug is
128
table 4

The Psychobiology of Mind-Body Healing

The multiple functions of some hormones that have related

functions in mind and body

1) As described earlier, Selye discovered that corticotropin releasing factor (C R

F)
is a hypothalamic hormone which mediates the release of ACTH by the
pituitary, which in turn tells the adrenal cortex of the body to release cortisol
into the bloodstream. This is the traditional role of hormones acting
on receptors in cells of the body's organs as described by classical endocrinology.
Recently, however, it has been discovered that there are receptors for CRF and ACTH
in brain cells which can mediate stress-like behavior and psychological variables
such as attentiveness, memory, and learning
(Izquierdo, 1984; McGaugh, 1983; Rigter & Crabbe, 1979).
2) Cholecystokinin (C C K ) is a hormone that is active from the esophagus in the
throat to the small intestine. It modulates gall bladder contraction, pancreatic
enzyme, and motility of the gastrointestinal tract. Receptors for CCK
also exists in brain cells,however, where it controls satiety (probably by its
action on the hypothalamic control centers). Thus, it may become important in
future treatment of obesity (Kissilef et al., 1981). This, of course,
also suggests a psychobiological route by which mind may modulate appetite. Candace
Pert (1986), Chief of Brain Biochemistry for the National Institute of Mental
Health, speculates that CCK also may mediate what peopie mean when they speak of
"gut feelings."
3) Insulin was first known to be a hormonal secretion of the pancreas involved
in carbohydrate metabolism by increasing the uptake of glucose by cardiac,
muscle, liver, and adipose tissue, etc. Recent physiological studies of its
receptors in the brain, as well as behavioral studies, indicate that it modulates
eating behavior by direct effects on cerebral capillaries (Pert et al.,
1985).
4) Gonadotrophin-releasing horm one (G n R H ) from the hypothalamus stimulates
the release of pituitary hormones such as gonadotrophins, lutenizing hormone (LH),
and follicle-stimulating hormone (FSH), that in turn stimulate
growth and regulate the physiology of sexual processes. When receptors in
the brain of rats are activated by GnRH, they show sexual behavior and
posturing.
5) Vasopressin or antidiuretic horm one (A D H ) is released from the posterior
pituitary when it receives appropriate posterior signals from the hypothalamus.
In classical endocrinology, vasopressin was studied for its regulation of
kidney action, water balance, and urine flow. Now it is also being recognized for
its effects as a vasoconstrictor in regulating blood flow. When cell
receptors in the brain are activated, however, vasopressin has been found
to enhance memory and learning (McGaugh, 1983). There is also a relationship
between circadian rhythms and ADH levels in the cerebrospinal fluid.
All of this research suggests that the different levels of learning and memory that
occur throughout the 24-hour cycle may be related to ADH fluctuations in its access
to many different brain tissues.
Mind Modulation of the Endocrine System

129

present in the brain or elsewhere in the body, that means there are endogenous
substances (usually hormones) which are intended by nature to
interact with these receptors. This was the important lesson taught by the
discovery of the endorphins, which were discovered only when researchers
looked for them after the receptors for the opiate drugs (heroin, morphine,
etc.) had been identified in the brain.
The autonomic, endocrine, immune, and neuropeptide systems all operate by
activating receptors on the surfaces of the individual cells of the
tissues of the body. These receptors are like locks that must be opened
to turn on the internal activities of the cells' cytoplasm (and even their
genes). The neurotransmitters of the autonomic nervous system, the hormones of the
endocrine system, and, as we shall see later, the immunotransmitters of the immune
system, all function as "m essenger molecules" or keys that open the receptor locks
on the surface of the cells. This
messenger molecule and cell-receptor communication system is the psychobiological
basis o f mind-body healing, therapeutic hypnosis, and holistic medicine in
general.
If each cell of the body is like a miniature factory, its receptors are locks
on the doors. The autonomic, endocrine, immune and neuropeptide systerns are
communication channels whereby mind may activate genes and
the internal cellular machinery. The genes, of course, are the ultimate
blueprints for building, organizing, and regulating how the cellular machinery
works.
Incredible as this may seem, we already have some understanding of
a number of the psychobiological routes by which mind modulates gene
action. We touched upon M elnechuk's (1985) view of how mind could
modulate gene action via the limbic-hypothalmic-awfonom/c system route
in the last chapter. In the next section we will outline a more well-documented
route by which mind can modulate gene activity via the limbichypothalam ic-
endocrine system.
T he M ind - G en e C o n n ec tio n via th e E n do crine S ystem

When I first began to discuss the mind-gene connection (Rossi, 1985) as

a means by which hypnotherapeutic approaches could be developed to
modulate gene activity, my conjectures were greeted as a novel form of
science fiction. Genes seem so inviolate, with 60,000 or so of them apparently
carefully guarded within the microscopic nucleus of each living
cell of the body. We usually think of genes as resting quietly until the
chromosomes suddenly spring into action in the process of cell division.
The actual facts are quite different: Many genes are in a process of continuous,
dynamic equilibrium with cellular metabolism. This genetic-cellular equilibrium is,
in turn, modulated by neurotransmitters and hormones
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The Psychobiology of Mind-Body Healing

that ultimately come as messengers from the central nervous system.

A general model of the mind-gene connection requires a survey of the
entire series of transduction processes that take place from mind and
neural events, to blood, tissue, and cellular processes, and finally to the
molecular activity of genes within the nucleus of each cell. In Figure 5 this
transduction process is divided into three stages.
Stage one consists of mind operating in the area of the anterior frontal
cortex (Achterberg, 1985) as the generative locus for organizing imagery
in healing and health. These frontal lobe processes are then filtered through
the individual's repertory of experiential life learnings encoded in statedependent
memory, learning, and behavior processes of the limbic-hypothalamic system.
Stage two is the transduction of these learnings by the hypothalamus into
the hormone-releasing factors that regulate the endocrine's pituitary gland
(see Figures 3A and 3B, p. 103). The pituitary in turn releases a host of
hormones which regulate the entire endocrine system of the body, as
illustrated in Figure 5.
Stage three takes place on the cellular level when these hormones turn
on the cAMP system or pass directly to the nucleus of the cell to activate
gene processes. Genes are involved in providing the information for building new
proteins, which in turn serve as structural elements of the cell
or as building blocks for enzymes that facilitate the basic biochemical process of
each cell.
This is the three-stage process which I term the mind-gene connection. Let
us now review an example of this process at the cellular level to illustrate
how thyroid and steroid hormones, modulated by mental stress, actually
regulate gene action.
Mind modulates gene activity via the cortical-limbic-hypothalamic-pituitary axis,
which, as we have seen, is a basic information transduction
route for psychosomatic processes. The pituitary sends hormones to glands
such as the adrenal cortex and the ovaries and testes, which in turn secrete
steroid hormones that penetrate into the cells and direct the genes to
synthesize proteins. These proteins then function as structural elements,
enzymes, or vehicles that activate other cellular functions. The sequence
of information transfer within the cell runs somewhat as follows.
1) While most hormones require a special receptor mechanism on the
cell wall to initiate the process of transfer into the cell, the steroid
hormones have a special ability to pass directly into the cytoplasm
within the cells.
2) Once within the cell, the steroid hormone enters the cytoplasm (the
Mind Modulation of the Endocrine System

131

basic matrix of the living substance of the cell) where it binds with
a specific receptor protein.
3) This hormone-receptor protein complex is then able to move into the
nucleus of the cell where the genes reside.
4) The hormone-receptor complex undergoes transformations that activate a specific
set of structural genes on the DNA strand to form
"m essenger R N A ."
5) The messenger RNA then diffuses through the nucleus back into the
cytoplasm, where it serves as an information template that tells the
ribosomes ("factories" of the cells) how to sequence a series of amino
acids into new peptides and proteins. Many of the peptides formed in
this manner facilitate communication within the cell as well as between
cells, tissues, and the autonomic, endocrine, and immune systems.
Figure 5 illustrates how hormones modulated by mind ultimately influence gene
activity in a way that is significant for three levels of behavior:
(1) thyroid hormone regulation of our basal metabolism and general level
of activity; (2) androgen (testosterone) hormonal regulation of sexual and
aggressive behavior, and (3) the stress-mediating effects of adrenal cortical
hormones (e.g., aldosterone) on kidney function. Each follows the type
of five-stage sequence outlined above, with significant variations as illustrated
in Figure 5.
Thyroid hormones play a vital role in regulating the metabolic processes
of practically all the tissues of the body. General levels of body activity,
emotional tension, and health are all a function of how the thyroid regulates the
metabolic machinery of the cells. It is now known that the thyroid
operates by acting directly upon the genetic material within the nucleus
of each cell. One of the proposed mechanisms by which its hormones
enter the cell is illustrated in Figure 5. After entering the cell, one of the
thyroid hormones (triiodothyronine, or T3) binds to a cytoplasmic protein
(CP) that concentrates it. T3 then binds directly to receptors on the nuclear
membrane to gain entry to the genetic material. Messenger RNA (mRNA)
is then generated and transported out to the cytoplasm, where it is used
as a template by the ribosome "factories" located on the endoplasmic
reticulum (ER) to produce the proteins and enzymes characteristic of the
cell's functions. T3 can also bind to receptors on the mitochondria of the
cell to mediate energy, oxygen, and other metabolic functions.
Androgens. Testosterone is an example of an androgen hormone from
the endocrine system that regulates sexual libido. It has been implicated
in a wide range of behaviors ranging from normal assertiveness to criminal
aggression. It enters the cells and operates directly upon the genetic
132

The Psychobiology of Mind-Body Healing

material by following the general five-stage paradigm described above,

with the variations illustrated in Figure 5. After testosterone enters the
cells, it is converted into dihydrotestosterone (DHT), which is accepted by
the receptor on the nuclear membrane and transported to the genetic site of
action. Again, mRNA is produced and enters the cytoplasm to guide the formation of
new proteins for the androgen actions of cell growth, and so forth.
Adrenal Hormones. Aldosterone is a hormone secreted by the adrenal
cortex under the influence of stress. Aldosterone has many sites of action
throughout the body. The effect of aldosterone on the renal tubular cells
of the kidney are illustrated in Figure 5. The cytoplasm of the renal tubular
cells contain a specific receptor protein that binds the aldosterone hormone
and carries it to the genes to produce the new proteins. Within 45 minutes,
the new proteins within the renal cells promote sodium reabsorption from
the tubules and potassium secretion. This is an example of the vital "so dium-
potassium pum p" that is basic to many different systems of the
body. A chronic excess of aldosterone and other hormones secreted by
the adrenal cortex (e.g., cortisol), however, has been implicated in many
forms of hypertension and in Selye's "D iseases of Adaptation."
Selye (1976, pp. 1 7 0 1 7 1 ‫ ) ־‬has listed the following "Diseases of Adaptation"
due to stress: "high blood pressure, diseases of the heart and of
the blood vessels, diseases of the kidney, eclampsia, rheumatic and rheumatoid
arthritis, inflammatory diseases of the skin and eyes, infections,
allergic and hypersensitivity diseases, nervous and mental diseases, sexual
derangements, digestive diseases, metabolic diseases, cancer, and diseases
of resistance in general."
It is beyond the scope of this volume to provide further detail about the
incredibly complex psychobiological processes involved in each of these
mind/body dysfunctions. Medical and psychological specialists are needed
to focus on the details of each illness to elucidate the actual psychobio‫־‬
logical processes involved. Once these are clarified, we can proceed to
create the new hypnotherapeutic approaches of the future that will access
and utilize the specific mind-body processes needed to facilitate healing.
Current hypnotic approaches do not yet make use of what is outlined here
regarding the mind-gene connection. As we learn to use these incredible
advances in psychobiological understanding, a great renaissance of hypnotherapeutic
methodology can take place.
P sych o bio lo g ical " C lo c k s " and M ind -B ody P roblems

As indicated earlier, a salient though still generally unrecognized feature

of the regulation of the endocrine system by the hypothalamic-pituitaryadrenal axis
is the periodic nature of this regulatory process. We are all
Mind Modulation of the Endocrine System

233

familiar with some of the basic rhythms of life: the monthly reproductive
rhythm in women, the circadian (24-hour) rhythm of sleep and wakefulness, and the
ultradian rhythms (11/2 -hour) we began to explore in the last
chapter. It is now recognized that all these rhythms are ultimately regulated
by neuroendocrinal sources in the brain—primarily in the hypothalamus,
the pituitary, and the pineal gland. There is also much to suggest that even
the entire life cycle of life and death is regulated by hormonal messengers.
Because of this fact, the process of aging is included in our discussion.
Since these life rhythms are regulated by the same hormones that modulate memory
and learning, we can expect to find state-dependent memory
and learning phenomena associated with all the interesting aspects of life
we touch upon.
U ltradian R h yth m s , th e E n do crine S ystem ,
and

P sych o so m a tic P roblem s

The endocrine system is mediated in a rhythmical manner by nerve

centers in the hypothalamus. These "suprachiasmiatic nu clei" of the
hypothalamus (Figure 2) function as biological "clocks" (Poirel, 1982) that
regulate both the circadian and ultradian rhythms governing a variety of
biological processes mediated by the autonomic and endocrine systems.
In Chapter 7 , 1 described how ultradian rhythms modulate autonomic nervous system
activity. Here I describe how ultradian and circadian rhythms
regulate endocrine system activity. Because there are many mind-body
functions that are modulated by both the autonomic and endocrine systerns (such as
stress reactions and activity levels), some of the material
of this chapter will overlap with and extend the concepts presented earlier.
Dement and Kleitman (1957) found that a 90-to-120-minute ultradian
rhythm was a "basic-rest-activity-cycle" (the BRAC hypothesis) which ran
continuously throughout the 24-hour day. In his monumental work on
sleep and wakefulness, Kleitman (1963) concluded that this basic-restactivity-cycle
was due to an endogenous oscillation that had profound
implications for physiology and behavior. One implication can be found
in the typical pattern of our work-day activity, which appears to fall into
90-minute ultradian rhythms: Begin work at 9:00 a.m .; take a break midmorning,
around 10:30 a.m .; have lunch 90 minutes later at noon; return
to work at 1:00 p.m. and have mid-afternoon break at 2:30 or 3:00 p.m .;
then cocktail time, dinner time, and so forth. Even during sleep, a prominent
ultradian rhythm is found in the 90-to-120-minute periodicity of
dream (REM) sleep. In a recent summary of ultradian cycle research,
Kripke noted how many of these behavioral and psychological processes
are associated with endocrine metabolism as follows (1982, p. 336):
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The Psychobiology of Mind-Body Healing

The wealth of phenomenology which has been uncovered in pursuit of the BRAC
hypothesis should console any investigator troubled
that the hypothesis remains controversial. Dramatic behavioral cycles
have been discovered, both in man and lower primates, and perhaps
these cycles have important ethologic functions. Cycles in fantasy,
hemispheric dominance, and perceptual processing have been described. The
significance of these cycles in both normal and pathologic psychologic functioning
deserves our attention. Episodic hormone secretion seems to be a fundamental
property of endocrine metabolism,
and it is somehoiv related to the REM cycles. The suggestion that the
pituitary is only responsive to intermittent releasing hormone stimulation is
particularly exciting, for it suggests one way in which ultradian cycles may be a
functional necessity. (Italics added)
One of the most interesting recent theories about the genesis of psychosomatic
problems is that they result from the behavioral disruptions of the
ultradian rhythms that modulate both autonomic and endocrine system functioning.
Orr, Hoffman, and Hegge (1974), for example, reported that most
humans manifest a stable ultradian rhythm when under quiet conditions.
When their subjects were overstressed with extended performance tasks
(e.g., monitoring complex panel meters), however, their ultradian rhythms
underwent major disruptions in amplitude and patterning. In association
with earlier experimental work with rhesus monkeys, these investigators
concluded that psychosomatic responses (heart rate alterations, gastritis,
ulcers, asthma, dermatological problems) were a consequent of the continual
disruption of the body's natural ultradian cycles. As is typical of
psychosomatic problems arising from real-life stress, they found that there
were highly individualized patterns in this disruption process: "T he same
stressor can produce quite different physiological and behavioral responses
patterns in different subjects . . . and there appears to be no simple relationship
between a physiological response and specific behavioral response" (p. 1000).
Work by Friedman (1972, 1978) on oral drive rhythms in obesity-bulimia
and by Friedman, Kantor, Sobel, and Miller (1978) on neurodermatitis
provides further confirmation of the genesis of psychosomatic problems
in the disruption of ultradian rhythms. This interruption of ultradian
rhythms was accomplished by keeping experimental animals in continuous
activity on treadmills—which is analogous to humans' disrupting their
normal ultradian rhythms by not taking a rest break every 90 minutes or so.
The lack of determinism or specificity in psychosomatic illness has been
a basic problem that has puzzled researchers and clinicians alike (Weiner,
Mind Modulation of the Endocrine System

235

1977). Generally, individual differences in psychosomatic responses to the

same stressor are attributed to vague genetic, constitutional, and conditioning
factors (Selye, 1976). Our focus on the role of state-dependent
learning and memory suggests a more exact answer to this problem of socalled “
indeterminancy" in psychosomatic illness. As with all mind-body
connections, psychosomatic problems are highly individualized expressions of the
learnings and life experiences of each person that have been
encoded as state-bound information and behavior. Because the sources
of this state-bound information are not easily available to the associations
and frames of reference of our habitual patterns of awareness, we tend
to be amnesic for the reason underlying the problem.
The research on ultradian rhythms of the endocrine system suggests
another nonspecific approach to psychosomatic problems that already may
be the common denominator in many of the broadly used and frequently
effective psychotherapeutic approaches generally described as hypnosis,
autogenic training, meditation, relaxation training and the relaxation response
(Benson, 1975, 1983a, b). Elsewhere (Rossi, 1982, 1986a) I have
described how many of the behaviors associated with the rest phase of
ultradian rhythms are identical with Erickson's behavioral observations
of readiness for the “ common everyday trance." This led to the hypotheses
(1) that Erickson was actually using the rest phase of the ultradian rhythms
to achieve deeply therapeutic trances; and (2) that self-hypnosis in particular
could be most effective during this period (Rossi & Ryan, 1986).
I have summarized the relationship between the genesis of psychosomatic problems by
the stress-induced disruption of the body's natural
ultradian rhythms and their resolution via hypnosis as follows (Rossi,
1982, p. 26):
The implications of this association between disruptions of the
ultradian cycle by stress and psychosomatic illness are profound. If
the major proposal of this section is correct—that therapeutic hypnosis involving
physiological processes is actually a utilization of
ultradian cycles—then we can finally understand in psychophysiological terms why
hypnosis traditionally has been found to be an
effective therapeutic approach to psychosomatic problems: Individuals who override
and disrupt their own ultradian cycles (by ignoring their
natural periodic needs for rest in any extended performance situation, for
example) are thereby setting in motion the basic physiological mechanisms
of psychosomatic illness. Most of this self-induced stress could be conceptualized
as left-hemispheric processes overriding their ideal balance with right-hemispheric
processes and associated parasympa
136

The Psychobiology of Mind-Body Healing

thetic functions. Naturalistic therapeutic hypnosis provides a comfortable

state wherein these ultradian cycles can simply normalize themselves and
thus undercut the processes of psychosomatic illnesses at their psychophysiological
source.
Simply experiencing a comfortable therapeutic trance can normalize our
basic-rest-activity-cycle and its associated regulation of many endocrinal
and autonomic system ultradian rhythms that control our basic metabolism. This
normalization process can be regarded as the essence of the
nonspecific approach to therapeutic hypnosis. In practical clinical work
(Erickson & Rossi, 1979), there is always a balance between specific and
nonspecific hypnotherapeutic approaches. As we gain increasing knowledge of each,
we can proceed with greater confidence and effectiveness.
Taking a Break and the Common Everyday Trance: A Case Study
The following case reported to me by Connie Crosby, M .S.W ., during
her internship at the C. G. Jung Institute of Los Angeles, illustrates this
point:
A middle-aged, Caucasian woman, whose major source of distress
was a feeling of inadequacy in every respect, reported that she had
gone to her doctor complaining of a strong, persistent smell of ammonia whenever
she urinated. The doctor responded by telling her
to cease wearing pantyhose and to wash her genital area more frequently. The
patient was outraged because, as she said, the smell
of ammonia was coming from an internal, not an external, source.
How dare this doctor insinuate that she was not fastidious!
She then discussed a second source of discomfort for her, which
centered around her secretarial job. She complained that she worked
too hard and was not appreciated for it. She was very faithful about
" never" leaving her desk. She stated, with evident pride, that she
urinated before leaving for work and then not again until she returned home. In the
next breath she castigated herself for her tendency to daydream and for her
inability to concentrate upon the task
at hand. Consequently, much of her time at work was unproductive.
Putting the two issues together, I asked her how much water she
drank. She replied, "None! Water has not passed my lips for years.
I hate it. Besides, if I drank water, I'd have to leave my desk—and
who would answer the phone?"
I then explained that people require a break at least every 90
Mind Modulation of the Endocrine System

137

minutes in order to work efficiently. In addition, I suggested that

the strong smell of ammonia might be due to a highly concentrated
urine and that to heal her body she needed to drink 64 ounces of
water daily. But, knowing the patient, I couched my statement in
terms of improving her job performance: In order to eliminate daydreaming and work
more effectively, she had to leave her desk for
a few minutes every 90 minutes. She would then find herself returning to work with
full concentration. One way to ensure that she
made time for breaks was to drink water from a carafe she was to
place on her desk. Her body would then remind her to get up by
an urgent need to urinate. To become a truly conscientious secretary, she
had to urinate at least every 90 minutesl
After objecting for a few minutes, the patient agreed to try my
plan. Weeks later she reported that the smell of ammonia had disappeared entirely
and that, oddly enough, she was actually enjoying
her job. Furthermore, she had received a bonus and a compliment
from her boss. To top it off, this lonely woman had also made a
friend in the ladies' room at work; they have since gone to the
movies together.
Overt hypnosis was not used in this case, nor was the patient told that
she was experiencing the "common everyday trance" when she let herself
take a break, drink, urinate, and daydream every 90 minutes. The simple
reframing of "taking a break" into "increased work efficiency," however,
introduced enough change to profoundly influence many levels of her
functioning—all the way from the biochemical to the social. We will now
review how ultradian rhythms can be used more specifically to enhance
self-hypnosis and posthypnotic suggestion.
Self-Hypnosis Utilizing State-Dependent Learning in Ultradian Rhythms
I originally developed the ultradian approach to self-hypnosis by the
curious route of trying to maximize the effectiveness of posthypnotic suggestion.
One of Erickson's basic views about hypnotherapy was that
posthypnotic suggestions were most effective when they were associated
with "behavioral inevitabilities." It is inevitable that the patient will "w ake
u p " soon, walk out of the office, go home, eat, sleep, dream, work, etc.
Erickson would associate therapeutic posthypnotic suggestions with those
inevitable daily behaviors mediated by the endocrine system that he felt
were most personally meaningful for the individual patient (Erickson &
Rossi, 1979). What could be more inevitable than the fact that everyone
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The Psychobiology of Mind-Body Healing

exercises his or her own unique pattern of slightly altered states via natural
ultradian rhythms throughout the day? I have outlined a number of ap‫־‬
proaches for utilizing these slightly altered states (that Erickson called the
"common everyday trance") to enhance the effectiveness of posthypnotic
suggestion and self-hypnosis. All of these approaches depend on the statedependent
learning and memory aspect of giving suggestions and training
during a specific period of the patient's natural psychobiological ultradian
rhythms.
One of the simplest of these approaches is to notice during a clinical
interview when the patient's behavior indicates that the rest phase of an
ultradian rhythm is being experienced. As described in Chapter 5, the
patient will appear to be in a quiet moment of reflectiveness or inner
reverie: the body becomes immobile; reflexes such as eye blinking or swallowing may
be slowed or absent; the eyes may manifest a "far away" look
and simply close spontanously for a moment or two; heart beat and respiration are
slowed, and so forth. (See Rossi, 1986a, for a detailed discussion of the minimal
cues indicating how the experience of this rest phase
of the ultradian rhythms is similar to self-hypnosis.)
The essence of Erickson's "naturalistic approach" was to utilize this
quiet moment for a hypnotic induction with a therapeutically motivating
statement such as, "If it's okay for you to continue to explore that issue
[or whatever] just as you are, your unconscious will let those eyes close
as you continue comfortably." The therapist then simply observes with
quiet expectancy. If the eyes do not close after a moment or two, another
therapeutic alternative may be offered, such as, "Bu t if there is another
issue that is more important, you'll find yourself getting a little restless
for a moment or two until it pops into your conscious m ind."
These two statements taken together comprise a naturalistic and therapeutic double
bind: Whichever alternative is chosen helps the patient
move in a therapeutic direction. When the eye-closing alternative is chosen,
one can be fairly certain that conditions conducive for state-dependent
learning in hypnotherapy are being facilitated. Posthypnotic suggestions
then can be associated with similar periods throughout the patient's normal day,
when it is appropriate to "take a break and let your eyes close
for a few moments to allow your unconscious to review what you need
in order to continue your therapeutic progress."
Many people find that the rest phase of their ultradian rhythm is the
best time to meditate or do self-hypnosis. An ultradian approach to selfhypnosis
utilizes natural psychobiological rhythms that are more deeply
rooted in the state-dependent matrices of personality than the artificially
conditioned processes characteristic of all other methods. I recommend
Mind Modulation of the Endocrine System

139

that patients simply close their eyes and tune into comfort, wherever it
may be in their bodies. During such naturalistic rest periods I find it of
value to avoid any form of verbal self-suggestion that might distort the
self-healing needs of the total personality. I simply suggest that patients
"allow your unconscious to do its own work in its own w ay ."
I do recommend, however, that patients wonder how their unconscious
will resolve whatever problem they want to deal with. Wondering is another of those
words such as comfort, relaxation, and sleep that has a specific
ideodynamic significance that goes well beyond the cognitive meaning.
When we tune into comfort, relaxation, and sleep, we are facilitating
statedependent parasympathetic responses and the restorative and healing
effects associated with them. I would hypothesize that the word wondering
tends to facilitate a degree of dissociation from the person's habitual ego
controls, which in turn may facilitate some of the creative and mythopoetic
aspects of right-hemispheric processing. Since the right hemisphere has
closer associative ties to the limbic-hypothalamic system, wondering may

13 Naturalistic Self-Hypnosis:
The Ultradian Healing Response

bo x

1. Recognizing and facilitating the ultradian healing response

W h e n y o u 'r e t i r e d , i r r i t a b l e , o r s i m p l y f e e l t h e n
e e d t o t a k e a
b r e a k , r e c o g n i z e it a s a m o m e n t o f o p p o r t u n i t y t o f
a c i l i t a t e
y o u r n a tu ra l u ltra d ia n h e a lin g re s p o n s e .

2. Accessing and utilizing inner resources

E x p l o r e w h e r e t h e c o m f o r t is in y o u r b o d y . [P a u s e ]
N o t i c e h o w it s p r e a d s a n d d e e p e n s , a s y o u i d l y w o n d
e r a b o u t
h o w y o u r u n c o n s c io u s ca n u tiliz e th e ra p e u tic a lly y o u r p
re v io u s
life e x p e r ie n c e s o f o p tim a l h e a lin g a n d b e in g a b le to d e
a l w ith
c u rre n t p ro b le m s a ll b y its e lf.

3. Ratifying continuing ultradian healing and coping

A f t e r a w h i l e y o u 'l l n o t i c e t h a t y o u 'r e a w a k e a n d a w
a r e o f
y o u rs e lf , b u t s o m e h o w y o u w e re n o t a m o m e n t a g o . Y o u
lo o k
a t t h e c l o c k a n d n o t i c e t h a t 1 0 to 2 0 m i n u t e s h a v e g o
n e b y t h a t
y o u c a n n o t a c c o u n t fo r. R e c o g n iz e th e c o m f o rtin g , h e
a lin g
c h a n g e s th a t h a v e ta k e n p la c e a n d r e s o lv e to d o th is a g
a in , a
fe w tim e s a d a y , w h e n e v e r y o u n e e d to .
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The Psychobiology of Mind-Body Healing

be used as a nonrational and nondirective approach to facilitating a healing

relationship with one's unconscious processes. Wondering absent-mindedly
about a personal problem during the comfort of a psychobiological ultradian rest
period is a natural way of accessing and spontaneously reframing
and resolving the state-bound encoding of the problem.
Since so many psychosomatic disorders have been found to be exacerbated by the
psychobiological stress of disrupted ultradian rhythms, we
can regard this form of naturalistic hypnosis as a general approach that
could supplement any other orthodox form of treatment. I have discussed
how lucid dreaming (LaBerge, 1985), lucid somnambulism, and profound
self-therapeutic states of identity transformation are not uncommon among
those who have practiced this naturalistic form of ultradian self-hypnosis
(Rossi, 1972/1985).
C ircadian R h yth m s , the E ndocrine S ystem , a nd A ffect D isorders

While the daily 24-hour sleep-awake rhythm has been studied extensively for
decades, it is only recently that the human circadian system has
been found to consist of at least two oscillating rhythms that are normally
in a homeostatic relation to each other. One rhythm controls the daily
regulation of temperature, cortisol secretion, and REM sleep. The other
rhythm controls sleep and the endocrine hormones released during sleep,
such as growth hormones and prolactic. Life conditions that disturb these
rhythms lead to the breakdowns in optimal functioning we associate with
jet lag, work-shift alterations, and stress-induced changes in the sleep
cycle.
One of the major theories of endogenous depression is that it is related
to phase disruptions between the two circadian rhythms. Four classical
features of depression that could have their source in disrupted circadian
phase sequencing are as follows (Wehr, 1982):
1) Early morning awakening in which one of the circadian rhythms is out
of phase with the other in the day-night cycle;
2) Diurnal variations in mood wherein patients feel worse in the morning
after awakening and better in the evening just before bedtime;
3) The cyclicity of mania and depression with its associated state-dependent
memory and learning features;
4) The seasonality of mania and depression, with depression usually occurring in
the spring and mania occurring commonly in the summer.
Great variations in these characteristics are found in individual patients
and careful case studies are required to determine effective treatment by
Mind Modulation of the Endocrine System

141

altering the timing of the sleep cycle, exposure to extra artificial light in
the morning and evening, etc. The relationship between light and endogenous
depression is traceable to the fact that there are separate neural
channels linking the retina of each eye directly to these suprachiasmatic
nuclei in the hypothalamus (Bloom, Lazerson, & Hofstadter, 1985). These
suprachiasmatic nuclei of the hypothalamus act as pacemakers for the
entire endocrine system.
A more definite common denominator between the affect disorders
mediated by the limbic-hypothalamic-pituitary-endocrine system and hypnosis is that
they both involve state-dependent phenomena. It has been
found that the cognitive processes of manic-depressive patients manifest
typical state-dependent memory and learning characteristics. These patients were
able to recall verbal information learned during their manic
state better during their next period of mania; likewise, information learned
during depression was recalled better when they were depressed again
(Weingartner, Miller, & Murphy, 1977). Similar findings on "affect state
dependency" have been found in normal volunteers and in depressed
patients who were subjected to therapeutic alterations of their mood and
biological rhythms through sleep deprivation (Weingartner & Murphy,
1977). These findings have led clinicians to explore the clinical implications for
state-dependent learning in psychotherapy (Reus, Weingartner,
& Post, 1979).
A popular hypnotherapeutic method that we can now recognize in
retrospect as contingent upon such affect state dependency encoded by
endocrine system hormones (McGaugh, 1983; Izquierdo, 1984) is what
Watkins has called the "affect bridge." In an exploration of the history
of problematic emotions and ego states, Watkins (1978,1980) had his patients "g o
back in time to when you last experienced that em otion." When
a series of memories is recalled through this affect bridge, one arrives at
the forgotten traumatic source of a personality problem that had previously been
unavailable to the patient. The affect bridge functions as a
state-dependent pathway to the encoded source of a problem that can now
be accessed and reframed therapeutically.
T ra n sfo rm a tio n s in W o m en ' s C o n s c io u s n e s s :
T h e R o le o f H o rm o n a l R h yth m s

We have seen how hormones from the endocrine system are fundamentally involved in
the modulation of memory, learning, and consciousness itself. Since there are so
many hormonal changes during a woman's
monthly reproductive cycle and during pregnancy, childbirth, and nursing
periods, we would expect that some state-dependent phenomena would
142

The Psychobiology of Mind-Body Healing

become manifest. While a recent computer search on the relationship between

menstruation and pregnancy, on the one hand, and memory, learning, emotions,
attitudes, and behavior changes, on the other, produced
thousands of references, none was focused specifically on state-dependent
phenomena. A careful reading of these papers, however, reveals many
state-dependent effects that were not recognized as such by the authors.
In this section we will review only a few of the hormonal rhythms that
are known to produce subtle but significant effects on the creative transformation
of women's consciousness.
Progesterone and Endorphin in the Monthly Cycle
One of the first reports of such effects involves the hormone progesterone, which
was found to facilitate state-dependent behavior (Stewart,
Krebs, & Kaczender, 1971). Large quantities of progesterone are released
monthly when it is necessary to increase the blood supply to the uterine
wall to prepare for the egg's implantation if pregnancy should occur.
Progesterone is also a messenger molecule that normally is involved in
feedback to the pituitary, which it signals to inhibit the secretion of luteinizing
hormone when the ovulation process is completed. Since progesterone has been shown
experimentally to produce state-dependent effects,
it is at least theoretically possible that its shifting concentration in a wornan's
body could modulate memory, learning, attitudes, emotions, and
personality.
/3-endorphin, which is one of the neuropeptide hormones of the endocrine system
most strongly associated with endogenous state-dependent
effects (Izquierdo, 1984), has been implicated recently in the regulation
of luteinizing hormone in women with normal periods (Blankstein et al.,
1981). The investigators hypothesize that stress-related distortions in the
central nervous system release of /3-endorphin are related to amenorrhea
(lack of menstruation), and perhaps other menstrual disorders such as
premenstrual syndrome (PMS) and dysmenorrhea (painful menstruation).
Hypnotherapy has a long history of successful intervention in menstrual disorders
(Crasilneck & Hall, 1985). Leckie (1964) reported that in 25
cases of dysmenorrhea, 80 percent of the patients were freed of the symptom,
usually with the presentation of simple, direct suggestions. Erickson
(1960b/1980) employed more complex psychodynamic approaches to resolving many forms
of menstrual distress that served important psychological needs in women. He
reported that menstruation could be skipped,
precipitated, interrupted, or prolonged as a function of emotional stress.
Crasilneck and Hall (1985) believe that, quite apart from psychodynamic
Mind Modulation of the Endocrine System

743

factors, the effectiveness of therapeutic hypnosis in dealing with a variety

of menstrual disorders "m ay lie in calming the patient and allowing more
normal functioning of the usual hypothalamic regulation of the menstrual
cycle" (p. 361).
Oxytocin and Memory o f Labor
Oxytocin is a hormone that is releasd from the uterus in massive amounts
during labor. It is also secreted by the posterior pituitary to modulate
lactation and maternal behavior. It is interesting to note that two basic hormones
released by the posterior pituitary apparently have opposite effects
on memory: vasopressin, as was outlined earlier, has an enhancing effect
on memory and learning; oxytocin has the reverse effect in producing
amnesia. This effect of oxytocin is regarded by some researchers (Weingartner,
1986) as responsible for the amnesia that usually cloaks a woman's
memory of her experience of giving birth.
Many women feel cheated by this memory loss of one of the most significant
experiences of their lives, and have consulted hypnotherapists for
help in recovering their memory of the event. One such hypnotherapeutic
effort was recorded and published in verbatim detail by the author (Erickson &
Rossi, 1979, pp. 282-313). The remarkable feature of this case was
that as the woman gradually recovered bits and pieces of her memories
of giving birth to her child, she spontaneously reorganized her own personal
identity. She recovered many earlier traumatic and amnesic memories that had become
associated with the process of giving birth. She experienced a spontaneous
personality maturation with the retrieval of the
lost memories. This is a clear example of the guiding psychobiological
premise of our approach as discussed in Chapter 5: Every access is a reframe.
In this case, the reframe involved a profound transformation in the wornan's
consciousness of herself as a total person.
Postpartum Depression
A recent critical analysis of the scientific literature on postpartum depression
(Hopkins, Marcus, & Campbell, 1984) indicates that there are
three distinct varieties of it:
1) Postpartum Maternity Blues. This is apparently a short-lasting depressive
alteration in mood that lasts from 24 to 48 hours. It occurs in
50-to-80 percent of women and is characterized by episodes of tearfulness and
crying that may be associated with poor sleep (with its
144

The Psychobiology of Mind-Body Healing

consequent alterations in the circadian rhythms discussed above),

stress, irritability, and anger.
2) Postpartum Depression. About 20 percent of women experience mild
to moderate depressive episodes that can last six to eight weeks after
giving birth, though the condition may persist for a year in some.
3) Postpartum Psychosis. This is a relatively rare reaction that occurs after
one in a thousand births.
Because of the profound neuroendocrinal changes that take place during
childbirth and parturition, many researchers have postulated a biological
basis for these disorders. The wide prevalence of the maternity blues suggests that
it is a ‫ ״‬normal" psychobiological response. An association between menstrual
problems and postpartum depression, however, suggests that women who have
difficulty in physiologically compensating for
the relatively minor hormonal changes of the menstrual cycle or who are
biologically hypersensitive to subtle endocrinological changes, will have
even greater difficulty adjusting to the dramatic decrease in placental
steroid output during parturition (Dalton, 1971). The tremendous variability in
individual reactions to the life stress of the entire birth process suggests the
importance of considering the role of attitude, understanding,
and social support in these depressive episodes.
A Psychobiological Hypothesis
One of the most peculiar myths among some psychoanalysts of the past
generation was that when a woman in analysis became pregnant, the
analysis might as well cease. It was believed that during pregnancy wornen would
take an artificial "flight into health" and so be resistant to the
hard work of undoing psychodynamic repressions. It took me many years
to overcome this pejorative view of the situation. Indeed, women do experience
profound emotional and personality shifts during pregnancy, but
the shifts can involve a truly valuable and nonresistant process of permanent
personality transformation and maturation.
The psychobiological perspective suggests an unexpected and highly
controversial hypothesis that could be misunderstood and abused all too
easily. I will state it nonetheless: The pervasive hormonal shifts women ex‫־‬
perience during their critical periods of psychobiological transformation (puberty,
menstruation, pregnancy, childbirth, nursing, menopause) lend a certain flexi‫־‬
bility to their state-dependent memory, learning, attitudes, and emotional systems,
so that they may be more open and available to personality change and
transformation during these periods. As is always the case with change, it can be
Mind Modulation of the Endocrine System

145

for good or ill. When the change is unsupported and misunderstood, it

can lead to maladaptation, depression, and illness; when the change is
welcomed as an opportunity for personality growth and transformation,
a more adequate state of consciousness and development can take place
(Rossi, 1972/1985).
There is a vast and interesting literature on the role of traditional customs,
rituals, and symbolism as support systems for women during their
critical periods of psychobiological transformation (Brown & Graeber, 1982;
Harding, 1955; Markowitz, 1985). It remains as a fascinating possibility
for future research to explore how this psychobiological perspective can
be used for facilitating feminine psychology. Moreover, its counterparts
in masculine psychology may be even more subtle.
T h e P sy c h o b io lo g y o f R ela tio n sh ip

Interest is developing in the role of psychobiological rhythms in relationships.

Some investigators have suggested that the synchronization of
biological rhythms in men and women could facilitate relationships. Leonard
(1981), for example, has described relationship exercises that have been
used to teach couples to synchronize rhythms. Circadian and ultradian
research suggests that partners who work, eat, and sleep together find
that their biological rhythms are in " s y n c ," so that they are often in the
mood to make love together as well. When partners are stressed so that
their work, eating, and sleeping rhythms are askew, however, their relationship can
suffer greatly (Chiba, Chiba, Halberg, & Cutkomp, 1977).
B io lo g ic a l C lo ck s and th e A ging P ro cess

Recent theoretical developments in the study of the aging process have

emphasized how biological clocks of the hypothalamus operate by modulating the
activity of the autonomic, endocrine, and immune systems.
Since the hypothalamic-pituitary-endocrine axis plays the predominant
role in most of these theories, however, we will discuss the aging process
in this chapter focusing on the endocrine system.
Walford (1983) has integrated much of the experimental data on aging
into a comprehensive three-stage theory that corresponds very closely to
the three levels we have used to organize our overviews of mind-body
communication in Figures 4 (p. 106) and 5 (p. 126) and will use in Figures
6 (p. 151) and 7 (p. 184) as well. It will be helpful to summarize our three
levels of mind-body communication as an introduction to discussion of
Walford's theory. Our three levels are as follows:
146

The Psychobiology of Mind-Body Healing

1) The basic mind-body transducer is the limbic-hypothalamic system

of the brain.
2) Messenger molecules (neurotransmitters and hormones) are the vehides for
communicating information between all the major systems
of mind-body regulation (the autonomic, endocrine, immune, and
neuropeptide systems) and their central integration and control
center in the limbic-hypothalamic system.
3) The limbic-hypothalamic system ultimately modulates the biochemical processes at
the genetic and molecular levels within each living
cell of the body.
Walford's theory of the aging process uses a similar outline as follows
(1983, pp. 89-92):
One theory holds that the "clock‫ ״‬of aging lurks in the hypothalamus, a pea-sized
area of brain a bit posterior to a spot midway between your ears. It regulates
hunger, rage, sleep, sexual
desire, and to some extent, development and aging. Dr. Caleb Finch
at the University of Southern California has detected significant
decreases in neurotransmitter chemicals in the hypothalamus from
old compared to young animals. Released at a nerve ending and
picked up by receptors on the adjacent nerve cell's surface, the
neurotransmitters are a class of brain chemicals which transmit impulses from one
nerve to the next. The hypothalamus and its transmitters regulate the pituitary
gland hanging nearby from the base
of the brain. When instructed to do so by the hypothalamus, the
pituitary releases a bevy of important hormones such as growth hormone, ACTH,
thyroid-stimulating hormone, and others. Hormonal
variations programmed by the hypothalamus and carried out by the
pituitary may induce the onset of aging, just as other variations
within the same axis bring on puberty. . . .
The endocrine system is altered with age not only in its primary
hormone levels but in the numbers of receptors located at the surfaces of cell
membranes, and within the fluid space inside the cell.
Many hormones must first react with cell receptors in order for their
message to influence the program of the cell. . . .
The sequence is: hormone receptor‫►־־‬
second messenger ‫♦ ־‬cell nucleus‫♦ ־‬turning on of the appropriate genes. The loss of
many types
of receptors from the cells of old animals interferes with this progression.
Notice that we are gradually progressing from a molecular level
Mind Modulation of the Endocrine System

147

(like DNA repair) to a systems level. There may well be two kinds
of aging clock, one in the brain's hypothalamus orchestrating growth
and development, another in each individual cell, the two clocks
roughly synchronized and providing what is designed to be a failsafe system. I
shall be outlining experiments at the systems level involving either the endocrine
or immune machineries that lead to
rejuvenation of many features of aging—but not to extension of maximum life span. A
two-clock model might explain the reason for what
appears at first sight a stubborn paradox.
At a systems level the neuroendocrine and immune systems have
been regarded, not necessarily as clocks, but as pacemakers for aging. The cause of
aging is at a deeper, molecular level, but the way
the molecular disarray manifests itself in sagging tissues, wrinkled
skin, gray hairs, and declines in nearly all bodily functions is via the
hormonal or immune systems, and probably both.
The prominent role of all the major hormones of the endocrine system
is evident in Walford's theory of the aging process. His discussion of how
the aging process can be slowed down in a practical manner emphasizes
the biological role of exercise and nutrition in modulating the endocrine
"pacem akers" of aging. Walford does not deal with the psychological
implications of the fact that the biological clocks of the hypothalamus which
regulate the endocrine system are so easily modified by our attitudes,
thoughts, and emotions, as we have seen in this chapter. Although he
recognizes the same three major levels of information transduction that
are illustrated in Figures 4, 5, 6, and 7, Walford's focus is on the biological
rather than the psyc/iobiological.
As we have seen in previous chapters, research on stress is the principal
way in which researchers have been able to measure the effects of psychological
factors on the biological. Research on the psychobiology of
aging uses this same route. Stress reduction is currently seen as the most
practical psychological path to life extension (Groer, Shekleton & Kant,
1979). Since the biological clocks of the aging process are located in the
hypothalamus, it is natural to use the limbic-hypothalamic route as a
psychobiological approach to facilitating life extension.
As indicated previously, Benson (1983a, b) has gathered extensive cultural and
experimental data to support his view that the "relaxation response" in yoga,
meditation, prayer, and hypnosis has its psychosomatic
healing source in facilitating an integrated hypothalamic response that
reduces stress. While Benson has emphasized the role of the hypothalamus in
regulating the sympathetic branch of the autonomic nervous
148

The Psychobiology of Mind-Body Healing

system, the data presented in this book indicate that a well-integrated

hypothalamic response will also optimize the functioning of the endocrine,
immune, and neuropeptide systems. Because all of these systems of mindbody
communication are modulated by the biological clocks of the hypothalamus, the
ultradian relaxation response outlined in Box 13 (p. 139) may
be the most practical, effective, psychobiological means we have at present for
accessing and potentiating healing and rejuvenation of mind-body
processes.
A well-integrated limbic-hypothalamic system response at the psychotherapeutic
level means that we are marshalling the appropriate statedependent memory,
learning, and behavioral processes encoded by hormones of the endocrine system that
are needed to facilitate restoration and
healing. This is most simply accomplished by using whatever variation
of the basic accessing formula is appropriate for a given clinical situation.
The accessing formulas all seek to enhance a healing process of ideodynamic
information transduction.
We may suppose that encoded in the limbic-hypothalmic system are
experiential modes for optimal functioning, as well as the problematic
patterns we have discussed. These optimal patterns are undoubtedly
associated with happy memories of health, well-being, joyful experiences,
creative work, and effective coping. They are the raw material or inner repertory
of resources that our accessing formulas seek to utilize in healing. The
fundamental task for each individual is to learn how to access and utilize
his or her own unique inner repertory of psychobiological resources that
can ultimately modulate biochemical processes within the cell. In the
following two chapters, we will review how current experimental and
therapeutic work with the immune and neuropeptide systems is beginning to
demonstrate the exciting possibility of mind modulation of cellular
responses to facilitate healing.
9
Mind Modulation of
the Immune System

he most recently research ed ,

exciting, and com plex m ind-body relationship con cern s the role of the central
nervous system , early life
exp erien ce, em otions, and learning in m odulating the im m une system .

M edical history has alw ays taken note of th e anecdotal evidence for the
seem ingly anom alous m iracle cures a n d faith healings th a t have been reported
from time to time (Ellenberger, 1970). Anthropologists have collected
data on the healing rituals an d practices of " n a tu re m edicine" that seem ed
a m ixture of herbal an d faith healing. N ow psychologists such as L eShan
(1977) an d A chterberg (1985) have assem bled em pirical evidence pointing
to th e role of m in d a n d belief in achieving th e se healing effects. U ntil
recently th e re h as b een n o system atic scientific ap p ro ach to th e se
issues.
The research of A der and the " n e w im m unologists," how ever, has created
an u n p re c e d e n te d bridge b etw ee n m in d a n d body: T heir experim
ental
research dem onstrates how behavioral conditioning can inhibit or enhance
im m u n e system resp o n se (A der, 1981, 1983, 1985; G h an ta, H iram oto,
Solvason, & S pector, 1985; Solom on, 1985).
The im m une system has been recognized only recently as a th ird m ajor
regulatory system of th e body, on equal p ar w ith th e autonom ic nerv o u s
system a n d th e en docrine system . In this ch ap ter w e will outline just
en o u g h of the basic facts about th e im m u n e system to give us access to
new w ays of th in k in g about h o w h y p n o th e ra p e u tic ap p ro ach es
can be
d ev elo p ed to facilitate its optim al functioning.
A natomy and F unctions of the Immune S ystem

The anatom y an d functions of the im m une system are sim ple to u nderstan d in a
general w ay b u t incredibly com plex an d still m ysterious in their
particulars. M ost textbooks begin by defining the im m une system in term s
149
150

The Psychobiology of Mind-Body Healing

of its function of resisting almost all types of invading organism s or toxins

that could dam age the body. There are tw o basic types of im m unity: innate
and acquired.
We are born w ith innate immunity, w hich provides a general, nonspecific
defense against all invaders. The skin, along w ith the acid secretions and
digestive enzym es of the stomach, provides a first line of innate im m unity.
The second line of defense is w ithin the blood, w here there are w hite
blood cells and num erous m olecules (e.g., lysosom es, basic polypeptides,
and certain proteins) th at can attack and destroy m any types of invading
path o g en s. W hite blood cells are form s of innate im m unity th at function
as mobile units to destroy foreign invaders w ithin the bloodstream . W hite
blood cells are also called lymphocytes since they concentrate them selves
in the lym ph system of the body. Figure 6 illustrates w here the m ajor
centers of im m une system tissue are concentrated and som e of their comm
unication netw orks w ith the autonom ic and endocrine system .
The adult h u m a n has about 7,000 w hite blood cells per cubic m illim eter
of blood. There are m any types of w hite blood cells, w ith typical percentages as
follows: neutrophils, 62%; eosinophils, 2.3%; basophils, 0.4%;
m onocytes, 5.3%; and lym phocytes, 30%. In innate im m unity it is m ainly
the neutro p h ils an d m onocytes th a t destroy invading bacteria, viruses,
and other toxins. The n eutrophils are the m ature cells that attack and
destroy bacteria an d viruses in the circulating blood. The m onocytes are
im m ature cells th at initially have very little ability to fight path o g en s in
the blood. W hen th ey en ter tissues near areas of injury, how ever, they
increase their size fivefold (to 80 microns, so they can actually be seen w ith
the naked eye): as these new ly enlarged cells called macrophages, they have
a greatly increased capacity for com batting pathogens.
Acquired or adaptive immunity is th e ability of the body to develop very
pow erful an d specific defenses against particular types of lethal bacteria,
viruses, and toxins. A cquired im m unity does not develop until after the
first invasion of a foreign substance. A ny such substance (bacteria, toxins,
etc.) capable of stim ulating the im m une system into action is called an antigen.
A cquired im m unity develops out of the process of recognizing antigens and
creating tw o broad classes of defense against them : hum oral
and cellular im m unity. Both types of im m unity originate in the bone marrow , w
hich produces stem cells.
Humoral immunity consists of stem cells from the bone m arrow that
m ature into a type of w hite blood cell called B-cell lymphocytes. These are
d istributed th ro u g h o u t the lym ph system of the body by the blood, as
illustrated in Figure 6. The blood is continually filtered th ro u g h these
lym ph system s (lymph nodes, spleen and Peyer's patches, etc.). If antigens
Mind Modulation of the Immune System

151

2
‫ס‬
ENDOCRINE
SYSTEM

‫כה‬

O
U

*s

Receptors sensitive to autonomic^

and endocrine system mediators
listed above.

To Hypothalamus,
Autonomic, and
Endocrine Systems

ACTH ,TSH
Endorphins
Thymosins
Lymphokines
Etc.

n
w
r
r

>

Antibodies released
in the bloodstream

6 Mind modulation of the immune system: some of neurotransmitters of

the autonomic nervous system and hormones of the endocrine system that communicate
with the immune system, and the immunotransmitters that "talk back."
f ig u r e
152

The Psychobiology of Mind-Body Healing

are present in the blood, they stimulate the B‫־‬lymphocytes to evolve into
plasma cells which can synthesize antibodies (large globulin molecules called
immunoglobulins) with the specific ability to destroy that antigen. This
detection system provides major defenses against viral and bacterial in‫־‬
fections and is involved in the allergic reactions. There are five major
classes of antibodies which have been named: IgA, IgD, IgE, IgG, and
IgM. The Ig m eans im m unoglobulin, while the other letters identify the
class types. The role of the IgE antibody in producing allergic reactions
will be discussed later.
Cellular immunity is developed when stem cells from bone marrow travel
to the thym us gland, which m atures them into T‫־‬cell lym phoctyes (sen‫־‬
sitized white blood cells) that destroy the invading antigens directly. Some
of these T‫־‬cell lymphocytes then travel to the skin via the blood; there the
epidermis generates horm ones that further facilitate T‫־‬cell maturation
(Edelson & Fink, 1985). The skin over the entire surface of the body is thus
an intrinsic part of the immune system. There are many forms of T ‫־‬cells
that can help or suppress other com ponents of humoral and cellular immunity
(Hokama & Nakamura, 1982; W aksm an, 1985). M any of these
im m une com ponents are open to psychosocial influences (Ader, 1983;
Ghanta et al., 1985). Acquired immunity thus has a specific developmental
h isto n 7in each individual; its functions are therefore particularly subject
to the influence of state-bound information acquired in early life experience.
E vidence for the M ind M odulation of the Immune S ystem

To understand how mind can influence the immune system, we need

to view one more special aspect of how the T‫ ־‬and B-lymphocytes operate:
They have receptors on their cell surfaces that can turn on, direct, and
modify their immune functions. These receptors are the molecular basis
of the influence of mind on the lym phocytes. Receptors, as m entioned
previously, are like locks that can be opened to turn on the activities of
each cell. As also discussed, the keys that open these locks are the messenger
molecules of the mind-body: the neurotransmitters of the autonomic
nervous system, the hormones of the endocrine system, and the immunotransmitters of
the immune system. The form and structure of these messenger and receptor m
olecules, which must fit each other to turn on
cellular activity, give us a profound insight into the essentially architectural
nature of life and mind.
As we have seen in the previous chapters, mind regulates both the
endocrine and autonomic systems in three stages. Figure 6 illustrates a
similar path for the mind modulation of the immune system; however,
Mind Modulation of the Immune System

153

th ere are additional com plications, since the autonom ic, endocrine, an d
im m u n e system s can also m odulate each o th e r's activity. The th ru st of
the m ost recent thinking of im m unologists is that the im m une system can
com m unicate back to the hypothalam us and the autonom ic an d endocrine
system s via im m u n o tran sm itters. N icholas Hall an d his colleagues (Hall,
M cGillis, S pangelo, & G oldstein, 1985) have ou tlin ed this conception as
follows (p. 806s):
A n increasing am ount of data su p p o rts the hypothesis th a t there are
bidirectional circuits betw een the central nervous system (CNS) and
the im m u n e system . Soluble pro d u cts th a t ap p ea r to transm it inform
ation from th e im m u n e co m p artm e n t to th e C N S include thym osins, lym
ph o k in es, a n d certain proteins. O pioid p ep tid es, adrenocorticotropic horm
one (ACTH), and thyroid-stim ulating horm one
(TSH) are ad ditional p ro d u cts of lym phocytes th a t m ay function in
im m unom odulatory neuroendocrinal circuits. It is p roposed that the
term " im m u n o tra n s m itte r" be u sed to describe m olecules th at are
p ro d u ced p red o m in an tly by cells th a t com prise the im m une system
b u t th a t tran sm it specific signals a n d inform ation to n e u ro n s an d
o th e r typ es of cells. . . . C ertain thym osin p ep tid es can serve as imm
unotransm itters by m odulating the hypothalam ic-pituitary-adrenal
an d gonadal axes. C onsiderable evidence . . . su p p o rts the hypothesis th a t
th e n erv o u s system is capable of altering th e course of imm u n ity via au
tonom ic a n d n eu ro en d o crin e p ath w ay s.
Figure 6 also lists som e of th e n e u ro tra n sm itte r a n d neu ro en d o crin
al
m echanism s by w hich o th e r stru ctu res of the brain (e.g., sensory ganglia
a n d pineal gland) m ay m odulate im m une function. A der (1983) has sum m arized
six ty p es of experim ental data th a t d o cu m en t m in d -m o d u la tin g
influences on the im m une system . I have u p d a te d his list w ith a few basic
references as follows:
1) N euronanatom ic an d neurochem ical evidence for the innervation of
ly m p h o id tissue (bone m arrow , thym us, spleen, tonsils, P e y er's
patches, lym ph nodes, etc.) by the central nervous system (Bulloch,
1985). This m eans th a t m ind (via th e central n erv o u s system ) has
direct neu ral access for m od u latin g all th ese organs of th e im m une
system .
2) The observations th a t inhibiting or stim ulating the h y p o th a lam u s
results in changes in im m unologic reactivity, and, conversely, that
activation of an im m une response in the body results in m easurable
1 54

The Psychobiology of Mind-Body Healing

changes within the hypothalamus (Roszman, Cross, Brooks, & Markesbery, 1985; Stein,
Schleifer, & Keller, 1981). Since the hypothalam us
is regulated by higher brain centers (via connections w ith the limbic
cortex), these intercom m unications betw een the im m une system and
h y p o th alam u s m ay be o pen to m ind m odulation.
3) The finding that lym phocytes bear receptors for horm ones of the
endocrine system an d n eu ro tra n sm itters of the autonom ic nervous
system (Cohn, 1985; W ybran, 1985). This m eans th at all the m indm odulating
effects of the autonom ic and endocrine system s m ay be
com m unicated to the im m u n e system as well. This conclusion is
su p p o rte d by the next point as well.
4) Evidence that alterations of horm one an d n eurotransm itter function
m odify im m unologic reactivity and, conversely, that elicitation of an
im m une response is accom panied by changes in horm onal and neurotransm itter
levels (Besedovsky, del Rey, & Sorkin, 1985; Hall &
G oldstein, 1985).
5) D ata d o cum enting the effect of behavioral interventions, including
conditioning, on various p aram eters of im m une function (A der,
1985; G orczynski, M acrae, & K ennedy 1982).
6) Experimental and clinical studies in w hich psychological factors such
as stress (Palm blad, 1985; Stein et al., 1985) an d d epression (Stein
et al., 1985) have been fo u n d to influence the o nset of disease processes.
M aclean an d Reichlin (1981) also noted m any indirect w ays in w hich
m ind can m odulate the im m une response th ro u g h changes in behavior.
T hese include altered diet, circadian rhythm s, sleep-w ake cycles, body
tem p eratu re, blood volum e, an d local vascular reactions.
The ultim ate task of the h y p n o th e ra p ist is to learn how to access and
utilize all these m ind-body m echanism s. H ow far w e are from actually
doing this! Yet the w ell-docum ented research cited by A der (1983) and
Locke et al. (1984) concerning the influence of psychosocial factors, m ood,
and belief system s on illness, disease, and healing clearly indicates that
the m ind is continually m odulating the im m une system . W hat success
hy p n o sis currently achieves in m odulating im m une function is via the
nonspecific approaches that w ork to a certain degree (even spectacularly
well in som e cases), even though w e usually do not know w hat the therapeutic m
echanism s of action are. W e can drive a car quite well w ithout
know ing how the engine operates, b ut w h en there is a breakdow n, the
m ore detailed our know ledge of engine m echanism s, the better w e will
be able to fix it. The p resen t state of o u r h y p n o th e ra p eu tic know
ledge of
Mind Modulation of the Immune System

255

these m ind-body m echanism s is som ew hat akin to the average driver w ho

know s there is an engine so m ew h ere th a t does som ething w h e n w e tu rn
on a key a n d p u s h the gas pedal. H ow ever, currently th ere are a n u m b e r
of innovative research program s studying how m ind m odulation an d hypnosis can
influence specific features of the im m une system. In the following
sections w e will review som e of th e se p rogram s to learn w h at they can
tell us about developing new h y p n o th e ra p eu tic approaches to facilitating
im m unological functioning.
M ind M odulation of Innate Immunity

It is cu rren tly being d em o n stra te d th a t the im m u n e system can be

influenced by m ind m ethods w ith appropriate education and training. It will
be recalled th a t n eu tro p h ils com prise alm ost tw o -th ird s of th e b o d
y 's innate im m unity of w hite blood cell defenses. A ny m eans of p o te n
tiatin g
th eir function w o u ld surely be a significant step in com batting disease.
A recent doctoral dissertation study by Barbara Peavey (1982) investigated
the effect of a train in g p ro g ram d esig n ed to en h an ce relaxation by
biofeedback (using EM G m uscle relaxation a n d te m p e ra tu re biofeedback).
She fo u n d th a t w hile the n u m b e r of neu tro p h ils rem ained th e sam e,
they
w ere fo u n d to function significantly b etter w ith successful relaxation
training.
A n even m ore fascinating approach to facilitating neutro p h il activity has
b een re p o rte d by S chneider, Sm ith, an d W itcher (1984). They com bined
belief w ith im agery training to explore the relationship b etw een im agination
an d the im m une system . S tudents w ho believed they could consciously
control their o w n im m une system w ere first given inform ation about how
w hite blood cells functioned an d sh o w n microscopic slides of actual
neutrophils, w hich w ere to be incorporated into their im agery training. They
then listened to an audiotape w ith suggestions for relaxation an d imagery.
They practiced im agining an d draw in g pictures of th e ir im agery, w hich
w ere later objectively scored. A fter six sessions of such training, it w as
fo u n d th a t subjects could greatly increase or decrease th e n u m b e r of
circulating n eu tro p h ils in th eir bloodstream .
N eu tro p h ils could be described as the " w a n d e rin g S am urai w arrio rs"
of the bloodstream . As m e n tio n ed earlier, n eu tro p h ils are an im p o rtan
t
p art of the im m u n e sy ste m 's resp o n se to bacteria, viruses, a n d o th e
r injurious antigens th a t attem p t to invade the body. They can attack foreign
antigens even as th e y circulate in the blood. N eu tro p h ils have a w ide
range of activities th a t en h an c e their abilities to reach an d destro y
antigens: They can m igrate th ro u g h the bloodstream to the locus of injury,
156

The Psychobiology of Mind-Body Healing

change their shape, an d th e n squeeze th ro u g h the pores of the blood

vessels to reach areas of tissue dam age. This process of m ovem ent tow ard
an area of injury is called diapedesis. N eutrophils m ay also adhere to the
insides of the blood vessel by the process of margination. W hen tissues are
invaded or dam aged, they respond by creating an inflam m ation that tends
to physically en tra p the injurious agents so th a t they do not sp read any
fu rth er th ro u g h o u t the body. The inflam ed area also diffuses chem ical
agents thro u g h the tissues that attract the neutrophils, th u s causing them
to stick to the sides of the capillary cell walls (m argination) an d th e n
squeeze th ro u g h the walls (diapedesis) to the source of inflam m ation.
In their analysis of four initial experim ental studies, Schneider, Sm ith,
a n d W itcher (1983, 1984) su rm ised that their im agery training exercises
w ere influencing the process of m argination in neutrophils. T hat is, the
exercises w ere not increasing or decreasing the num ber of neutrophils per
se in the body but, rather, w ere changing their m ovem ent an d the potential loci
of their im m une system activity. As w e shall see later in our
discussion of asthm a, this finding could have p ro fo u n d im plications for
u sing im agery an d hy p n o sis to am eliorate hyperactive responses of the
im m une system in allergic reactions.
M i\ d M odulation of A cquired I mmunity

Sm ith an d M cDaniel (1983) began their studies of the m ind m odulation

of the im m une resp o n se by successfully repeating Black's (1963) initial
finding th a t h y p n o tized subjects could su p p ress the so-called M antoux
reaction (a m ild skin test for tuberculosis th at is p ro d u ced by an
antigenantibody reaction of the acquired im m u n e system ). R ather th a n h y
pnotizing their subjects, how ever, Sm ith an d M cDaniel u sed a behavioral
conditioning paradigm to d em o n strate the role of expectation in m odulating
this particular im m une response: The M antoux reaction took place
on the arm of the subjects w here it w as expected b u t not on the other arm
w h ere subjects did not expect it. This p roved th a t there w as n o th in g
intrinsic about hypnosis in the m odulation of the im m une system ; hypnosis
w as sim ply a convenient w ay of focusing the m in d 's inner resources to
activate or inhibit a physiological response.
Sm ith, M cKenzie, M arm er, & Steele (1985) th e n sou g h t to establish
w h eth er the m ind m odulation of the M antoux reaction could be replicated
using a different type of antigen-antibody response (the b o d y 's response
to the varicella zoster viral antigen) and a different form of m ind m odulation
(m editation rather than hypnosis or conditioning). A n advantage of using
Mind Modulation of the Immune System

157

th e varicella zoster antigen w as th a t th e b o d y 's im m une response to it

could
be objectively m e asu re d in tw o w ays: (1) in vivo, by m easu rin g th e size
of th e skin test reaction o n th e su b ject's arm (just as w ith th e M antoux
reaction), a n d (2) in vitro, by m easuring th e degree of lym phocyte stim
ulation in a blood sam ple from th e subject. Sm ith an d his colleagues (1985)
described their elegant, single-case stu d y experim ental design, th eir subject's
E astern m editation m e th o d , a n d th e statistically valid results as
follow s (p. 2110):
In light of th e above findings, w e hypothesized th at a highly selected
subject could use m ed itatio n or self-hypnosis to m o d u late h e r imm u n e
resp o n se. The p arad ig m w as a sim ple, single-case d esign in
w hich th e subject w as h er o w n control. S he w as given a skin test
w eekly for nin e w eeks. D uring th e first th ree w eeks (phase 1) sh e
w as told to react norm ally. The second th re e w eeks (phase 2) she
w as asked to try to inhibit h e r reaction using any psychologic practice or tech
n iq u e she chose. Finally, for th e final th ree w eeks (phase
3) she w as again ask ed to react norm ally. W e h y p o th e siz e d th at th e
im m une response during the second phase w ould be decreased comp a re d w ith th
e first a n d th ird p h ases.
The subject is a 39-year-old w o m an w ho h as follow ed an E astern
religious practice for th e last nin e years. D uring m ost of this tim e,
as p art of h e r religious practice, she w ou ld u sually m editate once
or tw ice daily for ab o u t 30 m in u tes. For th e last th re e years, sh e has
follow ed a specific tantric g en era tio n m editation practice w h ereb y
" h ig h e r en e rg ie s" are visualized a n d she seeks to transform herself
into th o se energies.
D uring th e p h a se 2 periods of the original a n d repeat experim ent,
sh e w o u ld usually reserve abo u t five m in u tes of h e r daily m editation
for a tten tio n to th e stu d y . First she w o u ld dedicate h e r intention co
ncerning th e stu d y for universal good in ste ad of self-adv ancem ent. She w o u
ld also tell h er bod y n o t to violate its w isdom
concerning h er defense against infection. Finally she w ould visualize
th e area of ery th em a a n d in d u ra tio n getting sm aller a n d sm aller.
Soon after each p h ase 2 injection, she w ou ld pass h er h a n d over h er
arm , se n d in g " h e a lin g e n e rg y " to th e injection site. . . .
The data confirm ed th e h y p o th e sis th a t this subject could voluntarily m o
d u late h e r im m u n e resp o n ses by a psychic m echanism .
Both a clinical m easure, d elayed hypersensitivity, a n d a n in vitro
m easure, lym phocyte stim ulation of im m u n e response, w ere affect
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The Psychobiology of Mind-Body Healing

ed. In other w ords, it appears that the subject, acting w ith intentions,
w as able to affect not only h er skin test response b u t also th e response of h
er lym phocytes stu d ied in the laboratory.
Sm ith et al. concluded their rep o rt by noting th at their w ork establishes
the "in te n tio n a l direct psychological m odulation of the h u m a n im m une
s y ste m ." Their em phasis on the intentional an d voluntary aspect of the
psychological situation is of great im portance. Previous w ork on the m ind
m odulation of the im m une system via hypnosis, placebos, and behavioral
conditioning d em o n strated th a t m ind-body healing processes could be
activated by o utside influences. The w ork of Sm ith an d his colleagues,
how ever, im plies that hum ans can train them selves to facilitate their ow n
inner m ind-body healing processes. The researchers concluded their paper
w ith a note of cautious optim ism as follows (1985, p. 2111):
The results from this stu d y certainly cannot be generalized to all
hum ans; how ever, perhaps other people have the ability to m odulate
their im m une resp o n se or to develop the capacity to do so. C ertainly, these
data, along w ith the previously cited results, sho u ld allow
for m any new carefully d esigned studies to be u n d erta k en .
If it proves to be the case th a t h u m a n s can significantly m odulate
their im m une response, th e n tw o im p o rtan t outcom es m ay occur.
The m echanism of infectious or neoplastic disease on set associated
w ith various psychological processes such as hopelessness or depression can
possibly be b etter u n d ersto o d . P erhaps, also, intentional
m odulation can be used therapeutically to increase or decrease imm une response, d
e p en d in g on the particular disease state.
Let us now tu rn to an overview of how the v oluntary m odulation of
im m une system responses could facilitate healing in a variety of illnesses
such as cancer, asthm a, allergies, an d rh eu m ato id arthritis.
M ind M odulation of Immune S ystem D ysfunctions

Bowers and Kelly (1979) have outlined three m ajor w ays in w hich the
im m une system can becom e dysfunctional in psychosom atic illness. It can
becom e underactive, hyperactive, or misguided in its efforts to defend the
body. These three errors of the im m une system are exem plified by cancer,
bronchial asthm a, and rheum atoid arthritis, respectively. While this
classification is an oversim plification of the facts, it is useful in providing a
set
Mind Modulation of the Immune System

159

of m odels for organizing o u r thinking about these issues. In w h a t follows,

I will amplify a n d u pdate Bowers and Kelly's presentation of how the new
ap p ro ach es to th e ra p eu tic h y p n o sis th a t em p h asize p atien t
skills could
facilitate healing of th ese th ree ty p es of im m u n e dysfunction.
The Underactive Immune System in Cancer
This section will outline h ow som e of the basic elem ents of th e im m une
system com m unicate a n d interact w ith each o th e r in dealing w ith th e
p h e n o m e n o n of cancer. It is im p o rta n t to u n d e rs ta n d th a t th
e bo d y develops cancer cells as an apparently natural process th ro u g h o u t
the entire
lifespan w ith o u t th e gro w th of clinically recognizable cancer tum ors. This
is illustrated by th e fact th a t on e form of cancer cell (neuroblastom a) is
m u ch h ig h e r even in babies th a n in th e clinical incidence of th e disease.
O n th e o th e r e n d of th e scale, p o stm o rtem au to p sies o n practically
all
m ales 50 or over show evidence of prostatic cancer cells, y et actual clinical
cancer is n o t ev id en t in m ost of them .
Since m ost p eople do n o t d evelop cancer even th o u g h cancer cells are
continually p ro d u c e d , th e b o d y m u st h av e a n atu ra l im m
unological surveillance system th a t seeks o u t a n d destroys th e single cancer
cells before
they grow into clinically evident tum ors. In general it is fo u n d th a t
stressinduced release of adrenocorticosteroids causes a suppression of this natural
im m unological surveillance system . A m k rau t a n d S olom on (1975),
S havit et al. (1985), a n d Stein, Keller, a n d Schleifer (1985) have p o in ted
o u t th a t only a slight d ep ressio n of this system is n e e d e d to greatly
increase th e p e rso n 's susceptibility to pathogens, particularly those th a t
are
constantly p resen t a n d challenging th e b o d y 's integrity, such as th e
spontan eo u sly form ed cancer cells.
There are a variety of im m une system processes th at protect against such
tu m o r form ations. These include the previously m entioned m acrophages,
T-lym phocytes, a n d B‫־‬lym phocytes (A m kraut & Solom on, 1975; Solom on
& A m kraut, 1981), as w ell as K (killer) cells, NK (natural killer) cells, a n d
cytotoxic T cells (see H okam a & N akam ura, 1982, for details). The K cells
are of u n certain im m unological lineage b u t are d e p e n d e n t o n
antibodies
for th e ir activity a n d are th erefo re also called antibody-dependent cytotoxic
cells. The NK cells are also of u n certain origin b u t it is k n o w n th a t
their
activity against cancer cells is increased by interferon. Interferon is a im m
unological factor th at is released by T-cells a n d m acrophages. Recent studies
in m an indicate th a t NK cells play a significant role against a variety of
viral infections, including those due to herpes an d viral oncogenesis (viral-
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The Psychobiology of Mind-Body Healing

pro d u ced cancers). The m ajor theory of oncogenesis is that tum or formation
takes place w h en those com ponents of the im m une surveillance
system are d ep ressed or underactive (Stein et al. 1985).
Let us now exam ine a variety of approaches researchers an d clinicians
are currently developing to fight cancer by enhancing those aspects of the
im m une system that are depressed. As w e found w ith the autonom ic and
endocrine systems, it will be necessary to trace the source of the potentially
m ind-m odulating effects on the im m une system right dow n to the genetic
a n d m olecular levels.
The Genetic and Molecular Level of Immune System Communication in Cancer.
This section will present an overview of current thinking about the genesis
of cancer an d the lines of natural a n d acquired defense against it. The
cancer story is very m uch involved w ith ou r developing u n d e rsta n d in g
of genes and the m essenger m olecules th at regulate norm al cell grow th.
As w e have seen in the tw o previous chapters, norm al cells all have genes
that receive m essenger m olecules from the m ind-m odulating central control
processes in the lim bic-hypothalam ic system via the autonom ic an d
endocrine system s. M any researchers now believe th at cancer begins
w hen these norm al grow th-regulating genes are dam aged and tu rn ed into
cancer-producing oncogenes. O ncogenes speed up or change the structure
of pro tein s that the cell m anufactures so th a t grow th becom es w ildly
uncontrolled in the form of useless tissues an d tum ors that eventually take
over the entire body and kill it. The norm al genes th at are tu rn e d into
oncogenes occupy loci on the chrom osom es that are vulnerable to dam age.
Because of this they are called "p ro to -o n c o g e n e s." They are converted
into oncogenes by w h at have becom e kno w n as " c a rc in o g e n s."
Radiation from X-rays, radioactivity, and excess sunlight, toxins such as
sm oke and chem icals foreign to the body, an d a variety of viruses are
am ong the m ost w ell-know n carcinogens. Such carcinogens o perate by
en terin g the cell nucleus d u rin g a vulnerable stage of cell division and
transform ing a proto-oncogene into an oncogene by (1) causing a genetic
m utation (a change in the blueprint for the structure of grow th proteins),
or (2) breaking the norm al arran g em en t in w hich genes are recom bined
into chrom osom es.
Natural and Acquired Defenses Against Cancer. There are a num ber of wellk n ow n w
ays of defeating the grow th and spread of cancer cells once they
are form ed. This section will review three of the b o d y 's natural defenses,
an d a n u m b er of w ays by w hich researchers are enhancing them .
Interferon is a m essenger m olecule protein th a t facilitates a process of
Mind Modulation of the Immune System

161

innate im m u n ity or n atu ral defense against infection. It w as originally

discovered in 1957 by Alick Isaacs an d Jean L in d en m an n of th e N ational
Institute of M edical R esearch in E ngland. W henever a virus attacks a cell,
th e cell p ro d u ces interferons (alpha an d beta are tw o w ell-know n form s
of it) to interfere w ith the v iru s's toxic activity. In addition, the
interferons
can directly attack an d kill fully form ed cancer cells by (1) interfering w ith
th eir m etabolism or giving T- an d B‫־‬cells an d m acrophages m essages to
d estro y cancer cells (M arrack & K appler, 1986). Early clinical trials w ith
interferon were disappointing because it was only available in small amounts.
R esearchers have recently learned how to m ass-produce interferon in the
laboratory, h ow ever. W hen large am o u n ts have been injected into the
body, in terferon has b een successful in e n h an c in g th e cancer-fighting
potential of T- a n d B-cells an d m acrophages against a variety of cancers.
In actual practice, it is currently being com bined w ith oth er form s of
anticancer processes, such as th e follow ing.
Interleukins are also naturally p resen t p rotein m essenger m olecules th at
facilitate im m u n e system com m unication an d defense against p ath o g en s
in the body. T hey o p erate as h o rm o n e or m e ssen g er m olecules betw een
T- a n d B-cells a n d m acrophages to facilitate their defense against toxins
an d even fully form ed cancers. A research team lead by Steven R osenberg
(R osenberg et al., 1985) of th e N ational C ancer Institu te has recently
sueceeded in m ass-producing interleukin-2 and using it to activate the b o d y 's
T-cells to p ro d u ce cytotoxic T-cells th a t can directly attack cancer tissues.
It h as been fo u n d to be dram atically effective in sh rinking tu m o rs by 50
percent or m ore (including com plete cancer rem ission) in the h u m a n trials
recently co n d u cted .
Tumor necrosis factor (TNF) is an o th e r n atu ra l form of in n ate im m unity
against pathogens, originally discovered in 1975 by Lloyd O ld at the
SloanKettering Cancer C enter in N ew York. It has been found that w hen bacteria
infect the body, m acrophages increase in nu m b er and secrete the protein
TNF, w hich can directly attack cancer cells an d tissues as well. T hrough
th e processes of genetic engin eerin g in th e laboratory, TNF now can be
cloned an d m ass-p ro d u ced . W hen injected into th e body, it actually attacks
an d causes cancer cells to blacken a n d die by som e as yet u n k n o w n
m echanism ; w h e n it is u sed in com bination w ith interferon an d oth er
cancer-killing d ru g s, it is even m ore effective. In the laboratory, it either
d estroys or h am p ers th e g ro w th of tw o -th ird s of th e cancer cells
against
w hich it h as been tested . TNF is currently being te sted in h u m a n s in a
variety of m ajor m edical centers.
Monoclonals are a n o th er feat of genetic engineering th a t h old prom ise
for destro y in g a w ide variety of cancers in a n u m b e r of different w ays.
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The Psychobiology of Mind-Body Healing

M onoclonals are produced by first rem oving a sam ple of cancer cells from
the body and injecting them into a m ouse. The m o u se's im m une system
th e n produces B‫־‬cells th at have antibodies designed to attack th a t particular
cancer; that is, an acquired im m unity is produced. These B‫־‬cells w ith
the cancer antibody are th e n rem oved from the m ouse an d fused w ith
an o th er fast-dividing line of cancer cells in the test tube to produce the
so-called " h y b rid o m a s" —a kind of hearty hybrid cell that now m ass-
produces the m onoclonal w ith the specific antibodies for the patient's cancer.
These cancer-attacking antibodies are then harvested and purified. Usually
their potency is en h an ced even fu rth er w h en oth er anticancer d rugs are
attached to them . W hen these m ixtures are injected into the original patient,
they act as " sm a rt b o m b s" by attacking only the cancer cells of the
body. This occurs because their antibody portion functions as a key th at
can only tu rn the receptor locks on the cancer cell walls. M onoclonals are
th u s deadly m essenger m olecules designed for a specific cancer-fighting
m ission.
The N ational Cancer Institute has estim ated that about 50 percent of the
cure rate against cancer by the year 2000 will com e from these new ly
evolving cancer therapies. The oth er 50 percent will com e from cancer
p revention program s. The point of interest to our m aterial is the fact that,
in one w ay or another, all the cu rren t cancer therapies are facilitated by
m essenger m olecules th at poten tiate the im m une sy stem 's potency. O ur
u n d e rsta n d in g of how m ind m eth o d s can su p p o rt these processes at
the
m essenger m olecule level is still in an em bryonic stage, but as w e will see
now , evidence is accum ulating for the potential application of therapeutic
hy p n o sis in this area.
Psychobiological Models for Facilitating Cancer Therapy. A m ajor line of evidence
for a m ind-body connection in the genesis of cancer is w h at has
com e to be know n as the life change stress studies (D ohrenw end & D ohrenw end,
1974). A ny form of stress resulting in a significant life change (e.g.,
the d eath of a family m em ber, job change, family relocation) can activate
the cortical-hypothalam ic-pituitary-adrenal axis described earlier to produce the
corticosteroids th a t su p p ress the im m une surveillance system .
A nxiety, depression, an d low ego stren g th are all associated w ith
underactivity of the im m une system . The m ajor th ru st of cu rren t research in
this area is that coping ability is the significant factor in determ ining w hether
stress will have a d ep ressan t effect on im m unocom petence. Locke et al.
(1984), for example, found that experiencing the sym ptom s of anxiety and
dep ressio n in response to a stressful life change indicated poor coping
ability an d resulted in a decrease in the activity of natural killer cells; on
Mind Modulation of the Immune System

163

th e o th e r h an d , good coping ability (few sy m p to m s in th e face of

considerable life change stress) w as associated w ith h igher n atu ral killer
cell
activity.
W ell-controlled experim ental evidence that hypnosis can effect changes
in th e im m unological surveillance system is gradually accum ulating. Hall
(1982-1983) has found that highly hypnotizable young subjects can significantly
increase th eir cellular im m u n ity (both T- an d !?‫־‬lym phocyte activity).
Frankel (1985) a n d his colleagues are exploring th e use of hypnotic
suggestion to eith er en h an ce or d ep ress cellular im m u n ity in resp o n se
to
injections of antigens.
A review of the n ew er ap p ro ac h es to th e ra p eu tic h y p n o sis that have
b een fo u n d effective in en h an c in g im m u n o co m p eten ce w ith cancer
patients revealed at least five basic applications: relaxation, im agery, ref
raming, m editation, a n d reinforcing coping skills. Since stress d ep resses the
im m u n e sy stem by th e p ro d u ctio n of adrenocorticoid h o rm o n es, it w
as
an im p o rtan t b re a k th ro u g h to find th a t h y p n o th e ra p e u tic m
e th o d s em phasizin g sim ple relaxation could low er th e plasm a level of th
ese horm ones (Sachar, 1969).
The popular visualization/relaxation procedure developed by the Simonto n s (S im
onton, S im onton, & C reighton, 1978) contains an in terestin g
cognitive reframing approach. W hile m ost people w ho are afraid of cancer
typically view it as a pow erfully destructive disease, the Sim ontons refram e
this erro n eo u s view : The cancer cells are described as ‫ ״‬w e a k " an d "confu
s e d " w hile th e im m u n e sy ste m 's w hite blood cells are " s tr o n g " an
d
" p o w e rfu l," like sharks attacking m eat. Because their cancer program also
includes group therapy for resolving underlying problem s an d developing
coping skills, the S im ontons have not b een able to differentiate w hich
factor of th eir ap p ro ac h is m ost effective. H all's (1982) w ork u sin g
their
im agery a n d refram ing, how ever, does clarify th a t this ap p ro ach can
enhance cellular im m unity.
A seem ingly o pposite h y p n o th e ra p eu tic approach has been developed
by A inslie M eares (1 9 8 2 8 3 ‫ ) ־‬in w h at he calls " m e n ta l ata ra x is."
H e describes this as a form of intensive m e ditation th a t evokes an " in n e r
stilln e s s " th a t is " c e n tra l in o rig in ." His approach is th e o p p o
site of th e
S im o n to n s' a n d of all th o se w ho seek to increase th e p a tie n t's com
fort,
relaxation, or coping skills, because it requires no act of will. As M eares
describes it, " A n essential feature of this form of m editation is the absence
of striving, of trying, a n d of u sing o n e 's w illp o w e r." H e claim s his
«ipproach leads to a nonverbal u n d e rsta n d in g of th e self an d th e
universe
th a t can effectively lead to a regression of very serious form s of cancer.
M eares has h ad personal, d eep experiences in his form of intensive m edi
164

The Psychobiology of Mind-Body Healing

tation. H e believes th at this is com m unicated to p atients nonverbally on

an unconscious level, thus providing further positive reinforcem ent of the
possibilities aw aiting their experiences w ith " m e n ta l atarax is."
M ost cu rren t practitioners use a " g a rd e n v arie ty " of all the above
approaches (M argolis, 1982-83; N ew ton, 1982-83). The w ork of Finkelstein
a n d G reenleaf (1982-83) is typical: For a prospective three-year stu d y of
cancer, they have prepared a ten-m inute audiotape containing suggestions
th at seem ingly cover the entire range of h y p n o th e ra p eu tic m ethods we
have discussed. The advantage of these broadly general m ethods is that
th ey follow the Ericksonian principle of allow ing the p a tie n t's ow n
unconscious to select w hich suggestions are need ed to facilitate therapeutic
activity (Erickson & Rossi, 1979). This lack of specificity, how ever, m eans
that w e cannot determ ine scientifically just which therapeutic m echanism s
are involved.
M ost therapists are in agreem ent th at som e sort of special condition,
state, or utilization of m ind can enhance im munological functioning. From
the perspective developed in this chapter, it could be said that h u m a n
functioning is so complex that there appears to be an alm ost infinite variety
of sta te-d ep en d en t learning a n d m em ory m ind-body system s utilizable
for healing pu rp o ses. Because each individual has a unique history of
learnings and life experiences, every case is essentially a new therapeutic
s tu d y in w hich specific and nonspecific hypnotherapeutic approaches can
be explored for their effectiveness.
A n overall psychobiological model for facilitating cancer regression is presented
in Box 14, w hich is an u p d a te an d expansion of a sim ilar psychophysiological
m odel presented by A chterberg (1984). The m ost general an d easily
accessible route to m ind-body healing is through the naturalistic ultradian
healing response th at can be recognized and utilized every 90 m inutes (as
described in the previous tw o chapters). Individuals can learn how to optim ize
their natural u ltrad ian healing responses by accessing the positive
sta te-d ep en d en t psychobiological resources associated w ith life experiences
involving effective coping an d feelings of efficacy an d hopefulness.
For som e individuals this approach will be sufficient. O thers will do better by
using the u ltrad ian healing resp o n se to optim ize their m ore active
efforts in using the S im onton an d A chterberg attack im agery on the w eak
an d hopeless cancer cells. Yet other individuals will engage in the deeper,
personal psychodynam ic processes of active im agination by psychoanalytic
therapists (H illm an, 1983; Jung, 1929/1984; M indell, 1982, 1985a, b;
W oodm an, 1984), or the m ore spiritually oriented approaches of M eares
(1982-83). The art and science of these forms of m ind-body healing involve
essentially a creative and constructive process th a t individuals m ust ex-
Mind Modulation of the Immune System

bo x

14 A Psychobiological M odel for Facilitating C ancer T herapy

165
266

The Psychobiology of Mind-Body Healing

plore in their ow n w ay as they learn to m axim ize their psychobiological

potentials.
The Hyperactive Immune System in Asthma and Allergies
A sthm a is currently being recognized as a problem characterized by a
hyperactive im m une response. From the im m unological point of view
(H okam a & N akam ura, 1982), asthm a usually involves a hyperirritability
of the bronchial m ucosa in the lungs w ith eosinophils (which, as w e have
seen, com prise two to three percent of the w hite blood cell count). A sthm a
can occur at any age and is recognizable by a w heezing and shortness of
breath, w hich can range from m ild discom fort to a life-threatening crisis
of respiratory failure. There are tw o broad classes of asthm a: extrinsic and
intrinsic (H okam a & N akam ura, 1982).
Extrinsic (also called by the term s allergic, immunological, or atopic) asthm a
is m ediated by IgE an d can be associated w ith allergic rhinitis (inflam m ation
of the nasal passages) an d urticaria (hives, a disease characterized by
severe itching an d slightly elevated w hite patches of the skin th at rarely
lasts m ore th a n tw o days). Skin tests are positive to specific antigens and
th e IgE levels are usually elevated. This is the form of asthm a th a t is
com m on in early infancy, childhood, an d about half of the adult population. It
tends to be seasonal on exposure to plant allergins, an d so forth.
Intrinsic (also called nonallergic, nonatopic, or idiopathic) asthm a occurs
prim arily in adults, usually after the occurrence of an infectious respiratory
illness (w hich app aren tly activates the im m une system ). It te n d s to be
m ore chronic, w ith bronchial obstructions occurring unrelated to seasonal
exposure to allergins. In addition, the IgE level is generally normal. In spite
of these im m unological differences, the clinical m anifestations of extrinsic
an d intrinsic asthm a are so similar that their psychophysiological m echanism s
are believed to follow the sam e or sim ilar route. The hypothalam us
has been d em o n strated experim entally to stim ulate or attenuate allergic
reactions (Frick, 1976; Stein, Schiavi, & C am erino, 1976) in anim als. The
sym pathetic branch of the autonom ic nervous system stim ulates the allergic
reaction by releasing histam ine from the tissues, w hile the parasym pathetic
(relaxation) branch inhibits it.
Circadian and Ultradian Rhythms in Asthma. The chronobiological influences of
circadian rhythm s on the occurrence of asthm atic attacks has been
investigated (Reinberg, G ervais, & G hata, 1977). The peak of dyspenic
reactions (shortness of breath) has been show n to coincide in tim ing w ith
the peak of skin reactions to histam ine and allergins over the 24-hour daily
Mind Modulation of the Immune System

167

cycle, so th a t m ost attacks occur b etw ee n m id n ig h t a n d 3:00 a.m . T

hese
daily variations in susceptibility a n d illness have been traced to circadian
rh y th m s th a t are ap p are n tly in itiated in th e h y p o th a lam u s, w
hich m ediates its effects (in association w ith th e pineal g la n d 's resp o n
siv en ess to
the daily light a n d dark cycle) th ro u g h th e endocrine system . It has been
fo u n d th a t circadian rh y th m s in blood eosinophils d e p e n d in p art u p
o n
the daily rh y th m s in the release of ACTH from the pituitary a n d its stim
ulation of horm ones from the adrenal cortex. This is the sam e hypothalam icpitu
itary -ad ren al axis described by Selye as th e m ajor resp o n se to stress
in the "D ise ases of A d a p ta tio n ."
There are a num ber of easily understandable m ind-body routes by w hich
the nonspecific h y p n o th e ra p eu tic approaches (such as B en so n 's
"relaxation re s p o n s e " ) can am eliorate allergic resp o n ses in a variety
of psychosom atic illnesses. In m y o w n clinical w ork, I h ave fo u n d th a t
th e form of
self-hypnosis described earlier as the u ltradian relaxation resp o n se is
particularly effective w h en done in com bination w ith sym ptom scaling so that
the p atien t gradually attains volu n tary control over allergic a n d asthm atic
resp o n ses. A h e ig h te n e d sensitivity to th e m inim al cues th a t signal
the
beg in n in g of an asthm atic resp o n se enable th e p atie n t to convert the
asthm atic sym ptom into a signal for facilitating self-healing. Lankton (1987)
is cu rren tly d eveloping a related E ricksonian ap p ro ach th a t com bines
sy m p to m scaling a n d m etap h o r.
In w orking w ith asthm atics, as well as w ith any o ther sym ptom reaction
that m ight have a life-threatening potential (e.g., status asthmaticus w herein
the p atien t literally can n o t get his breath), it is alw ays w ise to have
qualified m edical p erso n n el available on th e p rem ises. W hen u sin g th e
sym ptom scaling ap p ro ac h in such cases, one nev er asks the p atie n t to
experience an y th in g m ore th a n 25 percent, or at m ost 30 percent, of th e w
orst
previous reaction. The sym ptom scaling should never get above 50 percent
of th e type of severe resp o n se th a t could cause a m edical em ergency.
S ym ptom resp o n ses scaled in low er a n d low er ranges are actually the
goal, because w e are usually attem p tin g to h eig h ten the p a tie n t's aw
areness of only the m ost m inim al cues th a t are n e e d e d to convert the sym
ptom into a signal for healing.
Studies of the effectiveness of hypn o th erap y w ith asthm a an d its related
clinical m anifestations have been review ed by several researchers (Bowers
& Kelly, 1979; D ePiano & Salzberg, 1979; W adden & A nderton, 1982). The
great variety of m e th o d s described as " h y p n o tic " m akes it difficult to
assess these stu d ies, w hich usually are a m ixture of w h at w e described
earlier as th e specific a n d nonspecific approaches. It seem s likely th at
satisfactory resolution of th ese issues will be achieved only by isolating
168

The Psychobiology of Mind-Body Healing

an d stu d y in g the effects of h ypnosis on specifically k now n an d easily

m easurable allergic responses. Pioneering w ork in this area has been initiated by
Ikem i an d N akagaw a (1962) for allergic derm atitis and allergic
resp o n ses to food, an d by K aneko an d T akahashi (1963) for chronic urticaria.
The largest body of research in the hypnotic alteration of acquired
im munological allergic responses (such as the tuberculin skin test by Black,
1969, an d M ason, 1963) is ripe for replication in light of the greater knowledge
w e now have about the m ind-body connections involved. O ne cannot help b u t w
onder, for exam ple, if the m ovem ent of n eutrophils facilita ted by m ental im
agery discussed earlier (S chneider et al., 1984) could
n ot be a d ap ted to shift the locus of the closely related eosinophils from
the bronchial tracts to am eliorate the hyperactive im m une resp o n se in
asth m a a n d its related allergic dysfunctions.
The Misguided Immune System in Autoimmune
Dysfunctions and Rheumatoid Arthritis
A n auto im m u n e dysfunction is one in w hich the im m une system , in
a perilous error of identity, attacks th e tissues of the self as well as those
of foreign invaders. A fundam ental issue in im m unology is the m eans by
w hich the body distinguishes betw een antigens (or foreign substances)
an d w hat is natural: This is the distinction betw een nonself an d self that
breaks dow n during an au toim m une dysfunction. C urrently it is believed
th at this " le a rn in g " process takes place durin g fetal d evelopm ent as a
result of the direct contact betw een the b o d y 's ow n substances a n d the
receptor sites on the surface of the w hite blood cells. The im m une system
learns to recognize self by disarm ing the antigen-antibody reaction in relation to
all the natural substances (autoantigens) of the body.
As life goes on, how ever, there are m any p athw ays for the b reakdow n
of the central m echanism s underlying self-recognition. Usually the breakdow n
involves a disruption of the norm al pathw ays of interaction betw een
the T- an d B-cells w ith autoantigens. A utoim m une disorders are usually
associated w ith m alignancies, im m une deficiency syndrom es, injuries,
and aging. In this section w e will review recent research on rh eu m ato id
arthritis as an exam ple of how new hypnotherapeutic approaches to autoim m une
dysfunctions could be developed.
R heum atoid arthritis (RA) is a generalized system ic illness th at usually
has a slow onset m anifested by sym ptom s of fatigue, muscle stiffness, and
parasthesias (unusual sensations of burning, prickling, num bness). As the
disease progresses, the major joints of the body (shoulders, elbows, w rists,
fingers, hips, knees, ankles, and toes) are experienced as swollen and stiff.
Mind Modulation of the Immune System

169

A cute an d chronic joint pain develops w hile m oving an d even at rest, and
there is grow ing restriction in joint m ovem ent. The severity of the problem
fluctuates over tim e w ith p erio d s of rem ission occurring; som etim es an
a p p are n tly com plete " s p o n ta n e o u s " recovery takes place.
The physiology of the joint problem s in RA is still the subject of research,
a n d the au to im m u n e aspects of th e disease are n ot yet entirely clear. It
is th o u g h t, h ow ever, th a t th e im m ediate problem is d u e to th e excess
gro w th of the cells in the synovial m em brane, w hich norm ally covers the
interior of the joint in a th in layer a n d secretes a lubricating fluid. O n e
h y p o th e sis of th e m echanism for this process is th a t th e Epstein-B arr
virus* alters th e synovial tissu es (or th e cartilage or joint tissues them
selves) so th a t th e im m u n e system m istakenly m arshals an attack th a t
causes the synovial tissues to proliferate excessively (Silberner, 1985). The
excess tissue sp read s into th e joint, causing th e sw elling th a t ultim ately
d estro y s th e cartilage an d , in advanced cases, re n d e rin g th e joint imm
obile. It is believed th a t b oth cellular (T‫־‬cell lym phocytes) a n d h um oral
(B‫־‬cell lym phocytes) im m unopathology are involved in the m istaken identity
attack th a t n o w takes place. M acrophage activity is th e n greatly increased
to rem ove the debris. Excess enzym es in tu rn cause m ore cartilage
dam age. It is believed th at negative em otions increase m uscle tension an d
the resulting excess activation of the sym pathetic branch of the autonom ic
n e rv o u s sy stem can fu rth e r exacerbate th is d e te rio ra tin g c o n d
itio n
(A chterberg & Lawlis, 1980; W einer, 1977).
The m ind-body connection in RA is believed to be m ediated via our now
fam iliar limbic-hypothalamic-pituitary route. A chterberg a n d Law lis (1980)
have outlined the possible dynam ics of the process, sum m arized as follows.
1) In the RA patient, the stresses of life th at are usually filtered th ro u g h
m ind-cortical processes are b lu n ted ; th e p erso n frequently a p p ea rs
to be devoid of affect, em otionally flat or colorless, a n d " w ith o u t
so u l." This lack of em otion has been described as alexithymia—literally, a
condition in w hich one is "w ith o u t w ords for feelings." N em iah,
Freyberger, a n d Sifneos (1976) have p ro p o se d th a t psychosom atic
patients have a defective p a tte rn of associative connections betw een
their cortex a n d their limbic system .
2) N eural activity th at is usually associated w ith em otions is n ot experienced
in th e h ig h e r cortical p ath w ay s of m ind b u t is in ste ad shortcircuited
th ro u g h th e h y p o th alam u s an d its direct associations w ith
* Epstein-Barr virus is a versatile herpes virus which infects many people
throughout
the world but does not always produce symptoms.
170

The Psychobiology of Muni-Body Healing

the autonomic, endocrine, and immune system s. RA (and perhaps

psychosomatic symptoms in general) is thus a form of body language
that substitutes for the lack of verbal (left hemisphere) and imagisticemotional
(right hemisphere) language. This condition has also been
described as pensée opératoire, or the inability to fantasize.
3) The use of body language instead of cognition, fantasy, and emotion
may involve an increase in muscle tension in the RA patient which,
in turn, increases joint pain and actually accelerates destruction within the
joints by increasing intra-articular temperatures (that stimulate
lysomal enzymatic activity).
4) There may be an accelerating cycle of interaction betw een the immune system and
the hypothalamus that is characterized by positive
biofeedback, which worsens the RA condition instead of correcting
it (as would be the case with the normal negative biofeedback processes).
The concept of alexithymia as a structural or genetic defect in the mindcortical
and limbic-hypothalamic areas is still a highly speculative theory
regarding the genesis of RA in particular, and psychosom atic disorders
in general. A more conventional psvchodynamic explanation by Erickson
and Rossi (1979) was based on the denial, suppression, and/or repression
of right-hem ispheric experience so that the left hem isphere lacked the
inform ation needed to express the problem in words. While further research will be
needed to differentiate betw een the relative merits of these
two views, they are in agreement that state-bound information is of essence
in psychosom atic dysfunctions. The normal accessing and flow of inf orm ation in
the mind-body system are either blocked, short-circuited, or
misguided so that the body is left to process information that would be
better dealt with at the level of mind in a symptomatic m anner.
Erickson's approaches to patients who exhibited varying degrees of
chronic pain, hopelessness, apathy, or blunted affect involved his usual
exploration of their ability to use the classical m echanism s of hypnotic
dissociation, displacem ent, time distortion, and so forth, in combination
with his often unusual approach of emotional provocation (see Volume 4 of
Erickson, 1980). A great deal of the controversy surrounding Erickson's
work has centered on his unconventional use of shock, surprise, and embarrassm ent
(Rossi, 1973/1980) to provoke what we now recognize as
heightened states of autonomic system arousal. For example, he frequently used bold
measures to provoke patients with a variety of organic brain
dysfunctions to higher levels of rehabilitative effort (Erickson, 1963/1980,
1980a).
As I mentally review my observation of Erickson's work with a variety
Mind Modulation of the Immune System

171

of p atien ts d u rin g the last eight years of his life, I now realize th a t this
factor of em otional arousal a n d provocation w as alm ost alw ays p resen t.
Even w h e n he a p p ea red to be acting in a benign an d gentle m anner, I frequ
en tly w o u ld catch a gleam of m ischievousness in his eye as he u sed a
seem ingly in n o cen t w o rd or p h rase w ith h id d e n levels of m eaning th a
t
w ere d esigned to arouse the p a tie n t's em otional dynam ics in unexpected
w ays. M ore often th a n not, h ow ever, I w o u ld m iss th e se m ultiple levels
of com m unication th a t could break th ro u g h th e p a tte rn s of state-b o u
n d
inform ation in the p atien t's total m ind-body system until Erickson patiently
explained th e m to m e (Erickson & Rossi, 1979, 1981; Erickson, Rossi,
& Rossi, 1976). H e alw ays seem ed to be having a lot of fun as he engaged
p atien ts on th e se m ultiple levels, a n d a positive th e ra p eu tic b o n d w
ou ld
exist even w h e n negative em otions h ad b een aroused. In each case Erickson w
as careful to access a n d utilize p a tie n ts' o w n u n iq u e rep erto ry of
life experiences to help them create new m ental fram ew orks an d identities
th a t en g ag e d th eir a ro u sed em otions a n d perso n ality stru ctu re s.
In this
regard Erickson used an integration of both nonspecific (em otional arousal
a n d the alarm response) an d specific approaches (the p a tie n t's u nique life
experiences) to facilitate the h y p n o th e ra p eu tic process. M ost of these
app roaches have n ev er been replicated because th ey w ere co n sid ere d to be
m anifestations of E rickson's idiosyncratic personality an d his flair for the
dram atic (H ilgard, 1984) ra th e r th a n of legitim ate th e ra p y . A s w e
have
seen in our earlier discussions about the m ind m odulation of the endocrine
a n d autonom ic n erv o u s system s, how ever, th e use of th e dram atic to
arouse state-bound m em ories an d em otions has a so u n d psychobiological
basis. The blocked or dysfunctional m em ory, em otion, a n d fan tasy processes of
patients w ith rheum atoid arthritis w ould seem to be an ideal test
category for exploring a n d ex tending E rickson's pio n eerin g h y p n o th e ra
peutic ap p ro ach es to th e arousal a n d utilization of each p a tie n t's u n
iq u e
m ind-body rep e rto ry of resp o n se abilities.
A case illustration of how state-b o u n d aspects of o n e 's total personality
can be encoded in th e form of rh eu m a to id arthritis a n d released by an
accessing process of active imagination is p ro v id ed by a Jungian analyst,
A lbert K reinheder. H e describes his personal encounter w ith this disease
a n d his self-healing, as follow s (pp. 6 0 6 1 ‫) ־‬:
Tw o years ago m y life seem ed to be flow ing along beautifully. I
h ad gained som e respect in m y profession, m y health w as excellent,
an d all in all I th o u g h t I w as doing quite well. At this seem ingly high
p o in t in m y life's achievem ents I w as afflicted w ith rh eu m a to id
arthritis. I becam e, by necessity, an anti-hero. I h a d severe pain in
172

The Psychobiology of Mind-Body Healing

every joint of m y body, including even my jaw bones. A fter being

aw ake for tw o or three h o u rs an d doing m y norm al sed en tary ac‫־‬
tivities, I w ould be exhausted and need to go back to bed. My shoulders an d elbow
s w ere so stiff th a t unassisted, I co u ld n 't p u t on m y
jacket nor w ith o u t help could I rise from a pro n e position.
I tried everything, including physicians, chiropractors, nutritionists, m asseuses,
an d tarot cards, b ut n o th in g seem ed to w ork. N ot
know ing w hat else to do, I decided to talk to my pain. H ere is a sampie of the
dialogues that m aterialized:
M e : Y ou hold m e tight in your grip, an d you do not let m e go.

If you crave m y u n d iv id ed attention, you have received it.

W hatever I atten d to, I m u st also atten d to you. Even w hen
I w rite, I feel you in m y h an d , an d alw ays in all parts of my
body. I am terribly frightened by you. I have no control over
you, no access to you, no pow er to influence you. You need
only go a little fu rth er, an d th e n I am utterly helpless. Will
you ever stop? W hy are you here?
P ain : I am here to get y our attention. I m ake know n m y presence. I show you m
y pow er. I have a pow er b eyond your
pow er. My will surpasses yours. You cannot prevail over
me, but I can easily prevail over you.
M e : But w hy m ust you destroy m e w ith your pow er?
P ain : I do so because I will no longer let you disregard m e. You
will bow dow n before m e an d hum ble yourself, for I am He
of w hom there is no other. I am the first of all things, an d
all things spring from me, and w ithout m e there is nothing.
I w an t to be w ith you closely in your th o u g h ts at all tim es.
T hat is w hy I press you in the grip of m y pow er an d m ake
you think only of m e. N ow , w ith m y presence in you, you
can no longer live th e sam e w ay and do the sam e things.
These dialogues gave m eaning to m y disability. Before, m y pain
w as only a curse to be elim inated. N ow it is revealed to be "H e-ofw hom ‫־‬there‫־‬
is‫־‬no‫־‬o th e r." A nd this great-one desired intimacy w ith
me. N ow I knew w h at before w ere only w ords to me: O ur w o u n d
is the place w here the Self finds en try into us. The calam ity that
strikes m ay be th e election, the call to individuation.
I becam e aw are th a t m y life h ad to change. W hen people are in
the tw enties, thirties, an d p erh ap s th ro u g h th e forties, it is am azing
to discover how totally ego-centered people can be an d still
prosper. But sooner or later, the larger personality asserts itself. "T he
Mind Modulation of the Immune System

173

tim e is c o m in g ," m y pain said to m e, " w h e n I will p u t a stop to all

those th in g s th a t com e before y o u r love for m e ." A n d h e said further:
" It is so pressing a n d im portant that you love m e and stay w ith
m e th at you will be crippled a n d paraly zed by an y th in g th a t threatens to
be m ore im p o rtan t th a n I. Love m e first. To ignore m e brings
death , disease, a n d d e stru c tio n ."
W hen a neurosis or a sickness com es to one, it does not m ean that
h e is an inferior p e rso n w ith a defective character. In a w ay, it is a
positive sign sh o w in g p otentials for grow th, as if w ith in there is a
g reater p ersonality pressin g to the surface. W hen arthritis cam e to
m e, I w e n t back into analysis. I d id so, I su p p o se , because I h a d
arthritis. But th e in ten tio n of th e unconscious w as probably th e o th e r
w ay aro u n d . A rthritis cam e so th at I w o u ld go back into analysis.
W e are n ev er fully analyzed. As conditions change, th e re are new
psychic contents to integrate. O nce a w indow is o p en ed to the archetypal w
orld, th e re is no w ay to close it again. E ither w e grow w ith
th e in d iv id u atio n urge, or it grow s against us.
A recent seven-year follow -up (personal com m unication) has indicated
th a t Dr. K rein h ed er is still sym ptom -free. This p ro fo u n d view of th e
d eep e r possible m ean in g of illness has b een expressed by sh am an s an d
healers of all cultures an d tim es. Dr. K reinheder's experience w ith arthritis
d em o n strates h o w illness can be a call to sto p o n e 's habitu al activities
to
seek o ut the d e e p e r m ean in g s th a t are evolving in o n e 's existence.
This
is th e basis of th e u ltrad ian healing process I call " c o n v e rtin g a sy m
p to m
into a sig n a l."
C onverting a S ymptom into a S ignal

T uning into a sym ptom w ith an attitude of respectful inquiry rather than
the usual p atien t stance of avoidance, resistance, a n d rejection is the first
step to accessing th e state-d ep en d en t m em ories an d associations that m ay
be signals from those parts of the personality that are in need of expressive
developm ent (individuation). I usually introduce the concept of converting
a sy m p to m into a signal of th e n e e d for a b ro ad er creative d ev elo p m
en t
in th e p a tie n t's in n e r life so m ew h at as follow s (Rossi, 1986b, p. 20):
You can use a n atu ral form of self-hypnosis by sim ply letting
yourself really enjoy taking a break w h en ev er you n eed to througho u t th e
day. You sim ply close yo u r eyes a n d tu n e into th e parts of
y o u r b o d y th a t are m ost com fortable. W hen you locate th e com fort
you can sim ply enjoy it a n d allow it to d e e p e n a n d sp re a d th ro u g h
1 74

The Psychobiology of Mind-Body Healing

o ut your body all by itself. C om fort is m ore th a n just a w ord or a

lazy state. Really going deeply into com fort m eans you have tu rn ed
on your parasym pathetic system —your natural relaxation response.
This is the easiest w ay to m axim ize the healing benefits of the rest
p h ase of your b o d y 's natural u ltradian rhythm s.
As you explore yo u r in n er com fort you can wonder how your
creative unconscious is going to deal w ith w hatever sym ptom , problem or issue
th at you w ant it to deal w ith. Your unconscious is the
in n er regulator of all your biological an d m ental processes. If you
have problem s it is probably because som e u n fo rtu n ate program m ing from the
past has interfered w ith the natural processes of regulation w ithin yo u r
unconscious. By accepting an d letting yourself
enjoy th e norm al periods of u ltrad ian rest as they occur th ro u g h o u t
the day, you are allow ing y o u r b o d y /m in d 's natural self-regulation
to heal an d resolve your problem s.
Your attitu d e tow ard y o u r sym ptom an d yourself is very im porta n t du rin
g this form of healing hypnosis. Your symptom or problem
is actually your friend! Your symptom is a signal that a creative change is
needed in your life. D uring y o u r periods of com fort in ultrad ian
selfhypnosis, you will often receive quiet insights about your life, w hat
you really w ant, a n d how to get it. A new thoughtfulness, joy,
greater aw areness, and m aturity can result from the regular practice of ultradian
self-hypnosis.
T he Immune S ystem, Information, and C onsciousness

S tep h e n Black is an English researcher w ho pio n eered the use of hypnosis in

the m ind m odulation of acquired im m unological reactions that
previously w ere th o u g h t to be p urely biological processes. His research
on the use of h y pnosis to m odulate the im m une response of h u m a n subjects
to the tubercular bacillus (the M antoux reaction) (Black, H um phrey,
& N iven, 1963) an d allergic reactions of the skin (Black, 1963; Black &
Friedm an, 1965) w as the inspiration of m any researchers described in this
ch ap ter (Sm ith, M cKenzie, M arm er, & Steele, 1985; Sm ith & M cDaniel,
1983). Black w as guid ed in his investigat an ard en t philosophical interest
in establishing the conceptual unity of m ind, body, and life itself. His hypnotic
investigations of acquired im m unity w ere for him an empirical m eans
of solving the m ind-body problem —the separation of m ind and bod w hen
ty into tw o separate conceptual realm s since the tim e of D escartes. Since
this is essentially the sam e m ind-body issue we are dealing w ith in this
Mind Modulation of the immune System

bo x

175

15 C o nverting a S ym ptom into a Signal

1. Scaling to convert symptoms into signals

O n a s c a l e o f o n e to 1 0 0 w h e r e 1 0 0 is t h e w o r s t , w h a t n u
m b e r
e x p re s s e s th e d e g re e to w h ic h y o u a re e x p e rie n c in g th a t
s y m p to m rig h t n o w ?
R e c o g n i z e h o w t h a t s y m p t o m i n t e n s i t y is a c t u a l l y
a s i g n a l o f
ju s t h o w s tr o n g a n o th e r , d e e p e r p a rt o f y o u n e e d s to b
e r e c o g n iz e d a n d u n d e rs to o d rig h t n o w .
2 . Accessing and inquiry into symptom meaning
W h e n y o u r i n n e r m i n d ( c r e a t i v e u n c o n s c i o u s , e t
c .) is r e a d y to
h e l p y o u a c c e s s t h e d e e p e r m e a n i n g s o f y o u r s y m p t o
m s , y o u 'l l
fin d y o u r s e lf g e ttin g q u ie t a n d c o m f o rta b le w ith y o u r e y
e s
e v e n t u a l l y c l o s i n g . [P a u s e ]
Y o u c a n re v ie w th e o rig in a l s o u rc e s o f th a t s y m p to m [p a u
s e ],
y o u c a n a s k y o u r s y m p t o m w h a t it is s a y i n g t o y o u [ p a u
s e ] ,
y o u c a n d is c u s s w ith y o u r s y m p to m w h a t c h a n g e s a re n e
e d e d
in y o u r l i f e .

3. Ratifying the significance and value of new meaning

H o w w ill y o u n o w u s e y o u r s y m p to m as a n im p o r ta n t s ig n a
l?
[T h e s ig n if ic a n c e o f w h a te v e r n e w m e a n in g s c o m e u p u s
u a lly
c a n b e r e c o g n i z e d i n t u i t i v e l y b y t h e s u b j e c t . N e w
m e a n i n g is
in v a ria b ly a c c o m p a n ie d b y a ffe c ts (te a rs , e n th u s ia s m ,
th a n k f u ln e s s ). A r e s c a lin g o f s y m p to m in te n s ity a t th is
tim e w ill u s u a ll y r a t i f y t h e v a l u e o f t h i s f o r m o f i n n
e r w o r k .]

book, w e will review Black's ideas a n d explore th eir im plications for curre n
t thinking.
Black u sed the new ly developing information theory of the 1960s as a conceptual
base for proposing a com m on definition of biological life a n d m ind.
To u n d e rs ta n d th e significance of his definition it is im p o rta n t to
have a
basic co m p re h en sio n of inform ation theory, w hich w e to u c h ed u p o n
in
C hapter 2. W hile inform ation theory w as originally form ulated as a m
athematical m odel (S hannon & W eaver, 1949; W iener, 1948) for em erging comm
unication technologies, it rapidly w as fo u n d useful for conceptualizing
all processes of ch an g e a n d transform ation. In C h ap ter 2, for exam ple,
w e su m m a rized th e view th a t all biological a n d psychological processes
176

The Psychobiology of Mind-Body Healing

could be u n d ersto o d as different form s of inform ation transduction. O ne

w ay of resolving the m ind-body problem is to say that m ind an d body
participate in similar processes of inform ation transduction. We review ed
the w ork of m any theorists and experim ental psychologists w ho used inform ation
theory as the conceptual basis for understanding how hypnosis
could m ediate the m ind m odulation of the b o d y 's physiology (Bowers,
1977).
W hile inform ation theory is Usually form ulated in m athem atical language, it
will be sufficient for our purposes to state its basic idea as follows:
The more improbable an idea or event is, the higher its informational value. In
com m onsense term s: W hatever is routine, ordinary, and expected in our
lives usually does not contribute any new inform ation to us. W hat is new ,
m ysterious, an d interesting, how ever, does contribute. Thus w hatever is
nezv for a perso n has high inform ational value.
Chapter 2 described how the ascending reticular activating system (ARAS)
an d the locus coeruleus are the parts of the brain stem that activate
consciousness w h en new and novel stim uli are presented. The nezv can come
from the outer environm ent or be generated w ithin during creative states
of thinking and dream ing. Repetitive and routine life situations an d habitual p
attern s of ideation, on the o ther h an d , te n d to low er o n e 's level
of consciousness an d p u t the m ind to sleep. This leads us to the basic
insight th at consciousness (and m ind in general) thrives on inform ation.
Mind is nature's supreme design for receiving, generating, and transducing
information.
In this inform ational conception of m ind, the w ord design has im portant
im plications. D esign im plies form an d structure. Inform ation is usually
m anifest to us as changes in design, form, and structure. The significance
of this structural view of inform ation for u n derstanding how the phenom enal
aspects of m ind an d the m aterial aspects of brain an d body can be
em braced w ithin the sam e conceptual fram ework is well described by Karl
Pribram (1986, in press):
M aurice M erleau-Ponty, an existentialist philosopher, has authored a book
entitled The Structure of Behavior (1963), w hich in both
spirit and content show s rem arkable resem blances to our ow n Plans
and the Structure of Behavior (Miller, G alanter, & Pribram , 1960; see
also Pribram , 1965), w hich tackles th e issues from a behavioral and
inform ation-processing vantage. I do not m ean to convey h ere that
there is no distinction betw een a behavioristic an d an existentialphenom
enalistic approach to m ind. Elsew here I detail this distinetion in term s of a
search for causes by behaviorists and a search for
Mind Modulation of the Immune System

277

inform ational structure reasonably (m eaningfully) com posed by phenom enologists

(Pribram , 1979). W hat I do w an t to em phasize h ere
is th a t b o th ap p ro ach es lead to conceptualizations th a t can n o t be
classified readily as either m ental or m aterial. B ehaviorists in their
search forions by an ard en t philosophical interest in establishing the
co nceptual u n ity of m ind, body, a n d life itself. H is h ypnotic
investigations of acquired im m unity w ere for him an em pirical m eans
of solving the m ind-body p roblem —th e separation of m in d a n d bod
w h en th e y are tackling o th e r com plex organizations. A n d structural
concepts are akin to th o se of m o d e rn physics w h ere particles arise
from th e in teractions a n d relationships am ong processes.
U n d e rsta n d in g h o w c o m p u ter pro g ram s are co m p o sed helps to
tease ap a rt som e of th e issues involved in th e " id e n tity " approach
in dealing w ith th e m in d /b rain relationship: Because o u r introspections p
ro v id e no a p p a re n t connection to th e functions of th e neu ral
tissues th a t com prise th e brain, it h as n ot b een easy to u n d e rs ta n d
w h a t th eo rists are talking ab o u t w h e n th e y claim th a t m ental a n d
brain processes are identical. N ow , because of th e co m p u ter/p ro gram
analogy, w e can su g g est th a t w h a t is com m on to m ental operations a n d
the brain " w e tw a re " in w hich the operation is realized,
is som e o rd e r w hich rem ains invariant across tran sfo rm atio n s. The
term s "in fo rm atio n " (in the brain an d cognitive sciences) and "structu r e "
(in linguistics a n d in m usic) are th e m ost com m only u se d to
describe such identities across transform ations.
O rd e r invariance across tran sfo rm atio n s is n o t lim ited to com puters an
d com puter program m ing. In m usic w e recognize a B eethoven
sonata or a Berlioz sy m p h o n y irrespective of w h e th e r it is p resen te d
to us as a score on sh eets of p ap er, in a live concert, over o u r high
fidelity m usic system , a n d even in o u r autom obiles w h e n d isto rted
an d m uffled by noise an d poor reproduction. The inform ation (form
w ithin), th e structure (arrangem ent) is recognizable in m any realizations. The
m aterials w hich m ake the realizations possible differ considerably from each
other, b u t th e se differences are n o t p a rt of the
essential p ro p erty of the musical form. In this sense, the identity approach to
th e m ind/brain relationship, despite th e realism of its embodim ents, partakes
of Platonic universais, i.e., ideal orderings w hich
are liable to becom ing flaw ed in th eir realization.
In th e co nstruction of co m p u ter languages (by h u m a n s) w e gain
insight into h ow inform ation or stru ctu re is realized in a m achine.
The essence of biological as w ell as of co m putational hierarchies is
th a t h ig h e r levels of organization take control over, as w ell as being
178

The Psychobiology of Mind-Body Healing

controlled by, low er levels. Such reciprocal causation is ubiquitous

in living system s: th u s the level of tissue carbon dioxide no t only
controls the neural respiratory m echanism b u t is controlled by it.
D iscovered originally as a regulatory principle w hich m aintains a
constant environm ent, reciprocal causation is term ed "h o m eo stais."
R esearch over the past few decades has established that such feedback m echanism s
are ubiquitous, involving sensory, m otor, a n d all
sorts of central processes. W hen feedback organizations are hooked
u p into parallel arrays, they becom e feedforw ard control m echanism s w hich
operate m uch as do the w ords (of bit an d byte length)
in com puter languages (Miller et al., 1960; Pribram , 1971).
P rib ram 's use of this structural concept of inform ation enables him to
u n ite m ental an d physiological relationships in a single fram ew ork of
reciprocal causation or hom eostasis that is characteristic of all our
illustrations of m ind-body com m unication (Figures 1-7). W ith this background
of understanding, w e can now retu rn to Black's use of inform ation theory
to conceptualize how the im m une system provides a m odel of m ind-body
com m unication and healing. In the following quotations, Black m akes use
of the concept of inform ation as structures th a t are new (im probable) to
define life and m ind (1969):
It is th e n the basis of my arg u m en t th a t since the A ristotelian form
of all m atter "co n ta in s in fo rm atio n " in som e degree an d since "in form
ation in the form of fo rm " is apparently essential to living matter, it is
according to the improbability of the form of matter—as distinct
from its energetic substance—that life should be defined.
I therefore p u t forw ard the definition: that life is a quality of matter
which arises from the informational content inherent in the improbability
of form. (p. 46)
I therefore p u t forw ard a second hypothesis: that mind is the informational
system derived from the sum improbability of form inherent in the
material substance of living things, (p. 56)
Inform ation, of course, can be tran sm itted in all sorts of w ay s—
from the m odulations in a w ireless wave, to the black an d w hite patterns on the
pages of this book. A nd to w orkers in biology at the
m olecular level, the concept of both transm itting a n d recording inform ation "
in the form of fo rm " is certainly no th in g new .
But the facts h ere are not generally looked at in this kind of w ay.
Although the difference may even seem trivial—and by some dam ned
as " m e ta p h y s ic a l" —it is nevertheless im p o rtan t to m y them e. For
Mind Modulation of the Immune System

179

I h o p e to sh o w from the clinical an d experim ental evidence of psychosom atic

m edicine, th a t w h atev e r th e stability of th e genetic substance, m uch of
the inform ation reco rd ed by the b o d y in the form
of form can in th e course of life m ake its o w n contribution b oth to
sickness a n d to h ealth, (p. 47)
Black's view oiform as the informational essence of life an d m ind sounds
very abstract until w e rem em b er th a t it is tru e at th e m olecular level. It
is, in fact, the form a n d stru ctu re of m e ssen g er m olecules a n d their
receptors th a t tu rn on a n d m o d u late the activity of life w ithin all the
cells
of the body. Black's pioneering research w as a step in dem onstrating how
this is tru e for m in d-body com m unication via the im m u n e system , as
illu strated in Figure 6. As indicated in prev io u s chapters, w e n ow know
it is also tru e for the autonom ic (Fig. 4, p. 106) a n d en d o crin e (Fig. 5,
p.
126) system s. In the next ch ap ter w e will learn ho w it is valid for the
n e u ro p e p tid e system as well.
It w as probably because Black w as so concerned w ith th e essentially
unconscious n a tu re of m in d -b o d y inform ation tra n sd u c tio n in
psychosom atic p roblem s th a t he d id n o t give any co rresp o n d in g
definitions of
consciousness. I believe that the definition of consciousness as " a process
of self-reflective inform ation tra n sd u c tio n ," w hich I p ro p o sed in C
hapter
2, fits adm irably w ell w ith Black's view s, how ever. Som e of th e m ajor
m odalities or form s of inform ation tran sd u ctio n th a t m ake u p th e
content
of consciousness w ere p re se n te d in Box 6 (p. 85). W hile th ese m ental
m odalities (em otions, im agery, cognition, etc.) are at a different level of
d escription th a n b o d y a n d m olecule, they are all u n ite d by our
currently
emerging view o f life, biology, and mind as being essentially informational
transform ations of each other.
The practical application of this u n itary conception of form in psychobiological
p h e n o m e n a is evident in m any of the schools of p sy ch o th erap y
th a t d eveloped ou t of the classical d e p th psychologies of F reud an d Jung.
O ne im m ediately thinks, for exam ple, of gestalt therapy an d all its
derivatives. Jung, him self, gave a central place to th e significance of form in
his
basic concept of the archetype as a " p sy c h o id " or psychobiological structure
that form ed the essence of ideas, symbols, an d processes of transformation. H e
described his view s as follow s (Jung, 1960, p. 33):
T here is n o t a single im p o rtan t idea or view th a t does n ot possess
historical an teced en ts. U ltim ately th ey are all fo u n d e d o n prim ordial
archetypal form s w hose concreteness dates from a tim e w h en
consciousness did n o t think, b u t only perceived. " T h o u g h ts " w ere
The Psychobiology of Mind-Body Healing

180

objects of inner perception, not th o u g h t at all, but sensed as external p

henom ena—seen or heard, so to speak. Thought was essentially
revelation, not invented b ut forced u p o n us or bringing conviction
th ro u g h its im m ediacy and actuality. Thinking of this kind precedes
the primitive ego-consciousness, and the latter is m ore its object than
its subject. But w e ourselves have n ot yet clim bed the last peak of
consciousness, so w e also have a pre-existent thinking, of w hich w e
are not aw are so long as we are su p p o rted by traditional sym bols—
or, to p u t it in the language of dream s, so long as the father or the
king is not dead.
There are m any im portant associations here. I believe th a t Black's conception
of life and m ind as " th e inform ational content in h e re n t in the
im probability of fo rm " is the fundam ental axiom for an information theory
of image, archetype, symbol, and the mythopoetic dimension of right-hemispheric
consciousness in general and mind-body healing in particular. The p ro fo u n d
reach of inform ation theory into our current conceptions of psychotherapy
is usually not im m ediately obvious. W hen I first form ulated the following
h y p o th esis about the significance of original dream experience for the
d ev elo p m en t of identity and consciousness, for exam ple, I h ad no idea
th a t it w as actually a phenom enological expression of an inform ational
th eo ry of m ind (Rossi, 1972 1985, p. 25):
That which is unique, odd, strange or intensely idiosyncratic
in a dream is an essence of individuality. It is an expression of original
psychological experience and, as such, it is the raze material out of which new
patterns of awareness may develop.
H y p o t h e s is 1 .

W hat is "u n iq u e , odd, strange or intensely idiosyncratic" is, of course,

a subjective experience of w h at inform ation theory describes as the high
inform ational value of an im probable event. As n o te d earlier in C hapter
2, w e can now better appreciate w hy the m ind-body gives greatest attention to "n
o v e l stim u li": Sim ply p ut, they have a higher inform ational
value. W hen we focus p a tie n ts' attention w ith w h at they experience as
new or novel, we are m axim izing the probability of facilitating therapeutic
processes involving inform ation tran sd u ctio n of high value. This can
becom e the basis of m any therapeutically stim ulating approaches to m indbody
healing.
This is probably the reason w hy patients w ho have not found help by
conventional m edicine intuitively tu rn to the unusual and often seem ingly
bizarre approaches of other cultures and "holistic m edicine." This is how
Mind Modulation of the immune System

m ystery an d the numinosum (Jung, 1960) of religious practices an d strange

cults can cure: T hey all help p atien ts break o u t of th e learned lim itations
of their familiar thinking an d lifestyle th at are encoding the adaptive value
of their sickness or problem . The u nusual practices of the m ystery religions
a n d foreign healers break th ro u g h th e constricting a n d d ead e n in g
effect
of the fam iliar to access a n d activate the h ig h inform ational value of the
new w ith in the b o d y -m in d of the patien t.
This excursion into th e byw ays of an inform ational th eo ry of psychobiology an
d m ind-body healing has taken us far from the research of Black
on the hypnotic m odulation of the im m une system and the m ajor concerns
of this ch ap ter w ith m ind-body healing. H ow ever, this integration of
previously sep arate stu d ie s in fields as diverse as p h ilosophy, religion,
cultural anthropology, psychology, biology, neurology, and molecular genetics
is precisely w h at is m ost valuable in o u r d eveloping in form ation th eo ry
of m in d-body healing. In the next a n d final chapter, w e will w itn ess an
even m ore p ro fo u n d integration of all these areas of inquiry for th e
creation of consciousness a n d healing.
IO
Mind Modulation of
the Neuropeptide System

h e v a n g u a r d o f neurobiological research today suggests th at an entirely

new u n d e rsta n d in g of m ind-body com m unication integrating
th e autonom ic, endocrine, an d im m u n e system s is being conceptualized
in th e neuropeptide system. W orking in the Brain Biochem istry D ivision of
the N ational Institute of M ental H ealth, Pert and her colleagues have proposed
that neuropeptides and their receptors function as a previously unrecognized
psychosom atic netw ork. They sum m arized their view s as follow s (Pert, Ruff, W
eber, & H erkenham , 1985, p. 820s):

A m ajor conceptual shift in neuroscience has been w ro u g h t by the

realization th a t brain function is m o d u lated by n u m ero u s chem icals
in addition to classical neurotransm itters. M any of these inform ational
substances are n e u ro p ep tid es, originally stu d ied in o th e r contexts as
horm ones, ‫ ״‬gut p ep tid es," or grow th factors. Their num ber presently
exceeds 50 an d m ost, if not all, alter behavior an d m ood states, alth o u g h
only en d o g en o u s analogs of psychoactive drugs like m orphine, Valium, an d
phencyclidine have been well appreciated in this
context. W e now realize th at th eir signal specificity resides in receptors
(distinct classes of recognition m olecules), rath e r th an the close
juxtaposition occurring at classical synapses. R ather precise brain
distribution patterns for m any n eu ro p ep tid e receptors have been determ ined.
A n u m b er of brain loci, m any w ithin em otion-m ediating
brain areas, are enriched w ith m any types of n e u ro p ep tid e receptors
suggesting a convergence of inform ation at these " n o d e s ." A dditionally, neu
ro p ep tid e receptors occur on mobile cells of the im m une
system s; m onocytes can chem otax to n u m ero u s n eu ro p ep tid es via
processes sh o w n by structure-activity analysis to be m ediated by
182
Mind Modulation of the Neuropeptide System

183

distinct receptors indistinguishable from those fo u n d in brain. Neuropeptides

and their receptors thus join the brain, glands, and immune system
in a network o f communication between brain and body, probably representing the
biochemical substrate o f emotion. (Italics ad d ed )
P ert's use of th e term "inform ational substance" to describe the essential
m essenger function of th e n eu ro p e p tid e system is a n ew w ay of
integrating th e data a n d b eh av io r from th e p reviously sep arated fields of
know ledge in psychology, neurology, anatom y, biochem istry, a n d m olecular
biology. There is m uch research suggesting th at th e central a n d autonom ic
nervous system s, an d the endocrine an d im m une system s are all channels,
carriers, or vehicles for th e m essenger m olecules of th e n e u ro p e p tid e
systern (Besedovsky, del Rey, & Sorkin, 1985; Blalock, H arbour-M cM enam in,
& Sm ith, 1985; Bloom, 1985; Felton et al., 1985). A n overview of the neurop e p
tid e system as far as it is cu rren tly u n d e rs to o d is illustrated in Figure
7. As can be seen, th e n e u ro p e p tid e system a d d s to, overlaps w ith, a n
d
integrates all the previously discussed system s of m ind-body com m unication
(Figures 1-6). For clarity, w e will outline six focal areas of th e neurop e p tid
e system th a t are th e subject of in ten se research at this tim e.
1)
The Limbic-Hypothalamic Locus of Neuropeptide Activity. O u r view of the
fundam ental role of th e lim bic-hypothalam ic system "filter" in m ind-body
com m unication th a t w as illu strated in Fig. 1 (p. 26) is confirm ed by recen t
co n ceptualizations of th e n e u ro p e p tid e system , as follow s (Pert et
al., 1985, p. 821s):
A fu n d a m e n ta l feature sh a re d by all n e u ro p e p tid e recep to rs w
hose
brain d istrib u tio n h as b een well stu d ie d is p ro fo u n d e n ric h m en t
at
a n u m b e r of th e sam e brain areas. M any of th ese n e u ro p e p tid e
receptor-rich areas can be fo u n d w ithin an intercom m unicating conglom erate
of brain structures classically term ed " th e limbic sy ste m ,"
w hich is considered to m ediate em otional behavior; in unanesthetized
h u m a n s u n d erg o in g brain stim ulation as a p relu d e to surgery for
epilepsy, far-ranging em otional expression can be elicited by stim ulation of
cortex n ear th e am ygdala, th e core of th e limbic system . The
am ygdala, as w ell as th e h y p o th a la m u s a n d o th e r limbic system
associated stru ctu re s, w ere fo u n d initially to be enriched in opiate
recep to rs in m onkey a n d h u m a n brains. Later m ap s of n u m e ro u s
other n eu ro p ep tid e receptors in brain [including substance P, bom besin,
cholecystokinin, n e u ro te n sin , insulin, a n d transferrin] have
The Psychobiology of Mind-Body Healing

1 84

Limbic Hypothalamic System

‫ס‬

m
3a.
o
3‫־‬
n

3
c

‫ס‬

3 o

0‫־‬
‫גש‬

O
3
V;

GO

Sensitive to non-cognitive
stimuli (bacteria, viruses,
tumors)

ENDORPHINS

*
Lymphocytes

‫־‬

‫־‬

‫־‬

o
w
r
r

Possible peripheral sites of action

Nerves

If

1r

Vascular
system

Heart

Skin &
muscles

Lungs

Sensory
organs

Other

f i g u r e 7 The nodal or focal areas of the neuropeptide com m unication system .

The
cen tral role of the endorphin n europep tides in m ind/body regulation is em pha-

sized.
Mind Modulation of the Neuropeptide System

185

continued to im plicate the am ygdala an d o ther limbic system -associated stru

ctu re s (e.g., th e cingulate cortex) as a source of receptorrich sites w h ere m
ood p resu m ab ly is biochem ically m odified.
Evidence for th e central role of the lim bic-hypothalam ic system a n d the
opiate n e u ro p e p tid e s (the e n d o rp h in s a n d enkephalins) in a
variety of
em otional processes a n d m ood diso rd ers is by now overw helm ing. The
netw orks of n eu ro n s that m ediate these m ind-body p attern s of com m
unication extend outside the limbic system to other brain areas (olfactory bulb,
habenula, interp ed u n cu lar nucleus), an d to the low er brain stem reticular
activating system , to w hich w e will now tu rn o u r attention.
2)
The Brain Stem and Spinal Cord Locus of Neuropeptide Activity. The new
m e th o d s of n e u ro p e p tid e research suggest an extension of limbic system
b o u n d arie s to include th e m od u latio n of sensory inform ation, as follows
(Pert et al., 1985, p. 821s):
. . . The dorsal horn of m am m alian spinal cord w here n eurons transm itting
inform ation from g lands, skin, a n d o th e r p erip h eral organs
m ake th eir first synaptic contact w ith th e central n erv o u s system ,
is enriched w ith virtually all n eu ro p ep tid e receptors. A lthough it has
n ot previously been considered part of th e limbic system , neuropeptide receptors
here, as p o stu la te d for o th e r sen so ry w ay-stations,
m ay filter a n d prioritize incom ing sensory inform ation so th at the
w hole o rg a n ism 's p erce p tio n is m ost com patible w ith survival.
The m ind m o d u latio n of senso ry -p ercep tu al processes is a classical
characteristic of hyp n o tic p h e n o m e n a (O rne, 1972). The localization of
n e u ro p e p tid e receptors at th e m ajor sensory w ay-stations in th e central
n erv o u s system strongly suggests th a t th e y play an im p o rtan t role in
the
psychobiological m echanism s of hypnotically generated illusions an d
hallucinations, as w ell as in hypnotically in d u c ed analgesia a n d anesthesia.
The p eria q u ed u cta l grey region of th e brain stem a n d th e dorsal h o rn
of the spinal cord are im portant relay stations for pain transm ission; they
are rich in th eir balanced use of the e n d o rp h in s a n d th e n eu ro p e p
tid e
called " su b sta n c e P ." S ubstance P facilitates the transm ission of pain;
the
e n d o rp h in s block pain transm ission by inhibiting th e release of substance
P. T here has b een a great deal of controversy reg ard in g th e possible role
of these neuropeptides in m ediating hypnotically-induced analgesia. Some
early w orkers (Barber & M eyer, 1977; G oldstein & H ilgard, 1975; O lness,
W ain, & N g, 1980; Spruiell et al., 1983) w ere u nable to d em o n strate any
186

The Psychobiology of Mind-Body Healing

effect of h y pnosis on their m easures of the en d o rp h in n eu ro p ep tid es,

w hile others (D om angue, M argolis, Lieberm an, & Kaji, 1985) continue to
find suggestive experim ental evidence for it. The m any subtle a n d not
easily m easurable and controllable variables that influence both hypnosis
and neuropeptide activity make these experim ental studies doubly difficult
to assess.
It is probably significant th a t the one experim ental stu d y th a t fo u n d
hypnotic anesthesia to be m ediated by endorphins w as w ith a subject w ho
w as in a deep som nam bulistic trance (S tephenson, 1978). All the other
experim ental studies in this area u sed m any hypnotic subjects, b u t they
w ere not carefully assessed in a clinical m a n n er to determ ine if they h ad
achieved a som nam bulistic state. Indeed, m any experim entalists (Barber,
1972; Sarbin & Coe, 1972) p u rp o rtin g to use hypnosis do not even believe
it is an altered state. Erickson (1967/1980) an d W eitzenhoffer (1982) have
n o te d separately how this sad lack of u n d e rsta n d in g of the classical
historical criteria for the som nam bulistic state has given rise to m any of the
am biguous and negative findings of su p p o se d ly controlled experim ental
studies of hypnosis.
W hat is clear from these studies, how ever, is th at there are at least tw o,
an d probably m any, m echanism s of anesthesia. In fact, recent experim ental
research (Shavit et al., 1985) has confirm ed th a t there are at least
two form s of analgesia: O ne is m ediated by the endorphins w hile the other
is not. The im m une system su p p ressio n effects of stress are associated
w ith the e n d o rp h in -m ed ia ted form of analgesia. This process will be
touched u p o n in the next section.
3 & 4) The Immune and Endocrine System Integration by Neuropeptides. The
im m une and endocrine system s th at are the third an d forth loci of neurop ep
tid e action are so closely in terrelated th a t w e will discuss th em together. M
ost of the horm ones, hypothalam ic controls, an d neu ro en d o crinal m essenger
m olecules m entioned in this section are n europeptides.
Blalock, Harbour-M cM enam in, and Sm ith (1985) have described this
interrelationship betw een the im m une a n d endocrine system s as follows (p.
858s):
While num erous studies have dem onstrated that the neuroendocrine
system can control im m une functions, it is only now becom ing app a re n t th a t
the control is reciprocal in th a t the im m une system can
control neuroendocrine functions. In this paper, recent studies w hich
seem to provide a m olecular basis for this bidirectional com m unication are
review ed. These studies suggest that the im m une an d n eu r
Mind Modulation of the Neuropeptide System

187

o endocrine system s re p re se n t a totally in teg rate d circuit by virtue

of sh arin g a com m on set of h o rm o n es, such as corticotropin, thyrotropin, a
n d e n d o rp h in s, a n d the receptors. Possible h ypothalam ic
a n d im m unologic controls of this circuitry are discussed.
In a closely related p ap er, Sm ith, H arbour-M cM enam in a n d Blalock
(1985) have described the overall significance of this interaction b etw ee n
the im m u n e a n d neu ro en d o crin e system s for m ind-body com m unication
in health a n d disease, as follow s (p. 779s):
N u m e ro u s indirect a n d anecdotal exam ples su g g est th a t th e re is a
link betw een an individual's m ental state and his or h er susceptibility
to or recovery from disease. A lth o u g h a direct connection h as not
b een p ro v en , it is logical for this to involve an interaction b etw ee n
th e b rain a n d im m u n e system . A gro w in g body of evidence h as
sh o w n th a t h o rm o n es, in particular glucocorticoids [a gro u p of horm
ones p ro d u c e d by th e ad ren al cortex] released d u rin g stress, can
m odulate im m une system functions. M ore recent evidence suggests
th a t n eu ro en d o c rin e p o ly p e p tid e h o rm o n e s are also im m u n o
m o d ulatory. This th e n is fairly good evidence for a m echanism by w hich
th e central n erv o u s system m ight influence the course of a disease.
C onversely, the question of how diseases seem to alter m ental states
a n d cause ap p aren tly u n rela ted physiologic or hom eostatic changes
in the h o st is only b eg in n in g to be an sw ered . A possible explanation for
this feature of disease is a recent finding in o u r laboratory
th a t stim u lated leukocytes p ro d u ce m olecules a p p a re n tly identical
to p itu ita ry h o rm o n es th a t are capable of signaling th e n e u ro en d o
crine system . . . . The im m une an d neuroendocrine system s ap p ear
able to com m unicate w ith each o th e r by v irtue of signal m olecules
(horm ones) a n d receptors com m on to b o th system s.
The low er po rtio n of Figure 7 (the cellular level) is an ad ap tatio n of
Sm ith, H arbour-M cM enam in a n d Blalock's (1985) m odel. T heir w ork
(pub lish ed in th a t p a p e r a n d in Blalock, H arbour-M cM enam in, & Sm ith,
1985) im plies that the im m une system can function as a sensory " o rg a n ,"
signaling th e central n erv o u s system abo ut noncognitive stim uli such as
bacteria, tum ors, viruses, an d other toxins w ithin the body. As can be seen
in Figure 7, th e e n d o rp h in n e u ro p e p tid e s play a central role in the
m indbody regulation of all th e m ajor system s of th e body. If hypnotically ind
u ced com fort could be d e m o n stra te d to facilitate th e activity of any one
of th e se system s, it w o u ld be an im p o rta n t link in the grow ing lines of
188

The Psychobiology of Mind-Body Healing

evidence su pporting the therapeutic use of hypnosis as a m eans of m indbody com m

unication an d healing.
5)
Enteric Nervous System: The Gastrointestinal Locus of Neuropeptide Activity. The
enteric nervous system regulates the gastrointestinal organs in
sem i-indepen dent m anner (Bulloch, 1985). This system is estim ated to be
of comparable complexity with the neural system of the spinal cord (Gerson,
Payette, & R othm an, 1985), an d it has been used as a m odel to stu d y the
ontogenetic developm ent of the central nervous system . Various horm onal
neuropeptides of the enteric-gastrointestinal system are also independently active
in the central nervous system : The endorphins, substance P, and
som atostatin are am ong the m ost p ro m in en t (see Table 5, pp. 1 9 9 2 0 1 )
‫־‬.
The sam e som atostatin m olecule th a t is u sed as a m essenger substance
in n eu ro n s of the cerebral cortex, h ippocam pus, an d h ypothalam us,
for exam ple, is used as a horm one m essenger w h e n it is p ro d u ced in the
pancreatic islets to regulate insulin an d glucagon secretion.
The use of hypnosis for am elioration of gastrointestinal distress has a
long history (Crasilneck & Hall, 1959; G orton, 1957; W einer, 1977). The
cu rren t challenge is to illum inate th e actual m ind-body com m unication
processes involved in the therapeutic effects. A reassessm ent of neuropeptide
activity in the gastrointestinal areas d u rin g hypnosis w ould seem to
be a good approach to this issue (W einer, 1977).
W hen our em otional state is optim al, w e are hardly ever aw are of the
enteric system 's autom atic activity. W hen w e are em otionally upset, how ever,
the entire gastrointestinal tract can express our discom fort. The sensitivity of
the gastrointestinal tract to m ental stress is one of th e m ost
w idely recognized m anifestations of psychosom atic problem s (Alexander,
1950; W einer, 1977). The w ay in w hich the early psychoanalysts such as
C .G . Jung described this connection betw een m ind and stom ach is typical
(1976, p. 88):
There is hardly a case of neurosis w here the entrails are n o t disturbed. For
instance, after a certain dream a diarrhoea h ap p e n s, or
there are spasm s in the abdom en. . . . I know of a nu m b er of cases
of people w ho did not know w h at they o ught to do, people w ho got
lazy w h en they sh o u ld have organized their lives on a som ew hat
larger scale, w ho om itted their d uty an d tried to live like chickens,
an d they th en got frightful spasm s in the abdom en.
In an o th er source Jung w rote (1929/1984, pp. 1 3 0 1 3 1 ‫) ־‬:
Mind Modulation of the Neuropeptide System

189

Instinctive pow ers are released, partly psychological, partly physiological, an d

th ro u g h th at release the w hole disposition of the body
can be ch an g ed . People in such a state of m ind are in a condition
for infections a n d physical d isturbances. You kn o w ho w close the
connection is b etw een th e stom ach a n d m ental states. If a bad psychic state
is habitual, you spoil y o u r stom ach. . . .
If w e u p d a te J u n g 's term inology from "in stin c tiv e p o w e rs " to " m
in d body com m unication sy ste m s," w e could hardly have a b etter description
of the far-reaching effects of sta te -d e p e n d e n t enteric-gastrointestinal
distress. It could be speculated th a t th e w id esp read early practices of "re a
d in g " the entrails of sacrificed anim als for p u rp o ses of divination an d
healing m ay have com e ab o u t because of th e easily recognized association
b etw ee n m ental a n d intestinal states. P eoples from m any early cultures
felt th a t th e ir th in k in g actually cam e from th eir abdom inal area (Jung,
1950). T hat m o d e rn m an can learn ho w to utilize the enteric-gastrointestinal
system as a creative feeling function is illustrated by th e interesting
case of the " th ir d voice of the m in d -b o d y " p re se n te d below .
A law yer in his m id-thirties h a d b een accidentally sh o t in th e abd o m en
a n u m b e r of years earlier. The bullet h a d d am ag ed his p an creas a n d a
po rtio n of his sm all intestine, w hich h a d to be rem oved surgically. The
em otionally traum atic aspects of the event, as well as the rem aining physical
sensitivity in th e w o u n d e d area, left him w ith a problem . For m any
years he h a d experienced fears, repetitive traum atic dream s, gastrointestinal
discom fort, a n d a h a u n tin g lack of self-confidence—even th o u g h
he h a d g ra d u a te d w ith h o n o rs from one of th e leading Ivy League
universities, h a d clerked for a w ell-know n sen ato r in W ashington, a n d w as
acknow ledged as a fu tu re leader in his special field of intern atio n al law.
A lth o u g h he w as u n aw are of th e periodic u ltrad ian rh y th m s of
gastrointestinal activity (see Rossi, 1986a), he had learned from his ow n personal
experience th at even after recovering from his w o u n d he could no longer
subject him self to th e abuse of skip p in g m eals a n d w orking for exten d ed
perio d s w ith no rest breaks. In spite of this aw areness, he recently h ad
been subjected to a variety of stresses d u rin g a critical career shift, w hich
precip itated a severe bo u t of diverticulitis. This led him to seek
psychobiological counseling.
In th erap y he w as able to learn self-hypnosis well en o u g h to control the
pain of his diverticulitis. H e also felt reassu red to learn th a t the ultradian
rhythm s of enteric-gastrointestinal activity w ere norm al, th o u g h he
recognized th at his old bullet w o u n d h ad aw ak en ed him to a special
sensitivity
190

The Psychobiology of Mind-Body Healing

to these rhythm s. He had always regarded this sensitivity as a " p ro b le m "

until I inquired about the details of how he experienced it. H e rep o rted
th at his " g u ts " w ould m ake loud noises that could be heard by others
in the room w hen he was involved in adm inistrative m eetings and discussions w
ith his clients. We soon cam e to regard this problem as a " th ird
voice" that w as p resen t particularly w h en he w as in a tight and " se n
sitive" professional situation in w hich he need ed "ex tra w isd o m ." I
suggested that, rath er th an tty to su p p ress this sym ptom , he let him self
becom e even m ore sensitive to it so that he could hear w h at it h a d to say
w h en it w hispered, rath er th a n p u ttin g it off until it h ad to shout so
loud
everyone in the room could h ear it! In this m an n er I w as helping him
convert his sym ptom into a signal (as discussed in the last chapter).
At this point he experienced a m edical em ergency w hich his internist
described as a life-threatening attack of diverticulitis. He th e n h ad the
following dream . (See Rossi, 1972/1985, for a general discussion of healing
dream s.)
I dream ed m y wife an d I w ere going to the do cto r's because I h ad
a cut on m y stom ach. I was upset about leaving work for this. I w as also
looking at other rehabilitation program s in Philadelphia on the w ay
to the doctor's. I ran into a volunteer nurse from the hospital w here
I w orked. She asked me suspiciously if I was looking for other work
at these hospitals. I told her no—we have visited the hospitals, but did not
talk to any administrators about work possibilities. I felt guilty. T hen we
w en t outside this o ther hospital w hich w e w ere visiting. I pulled on
a swollen part of my stomach and a huge pustular sac came out from my
intestine. The inside of m y intestines started to bleed. I felt good, relieved
that I had gotten the infected part out, b ut w as afraid of the
bleeding. I im m ediately called m y internist.
It w ould be easy to miss the healing processes constellated in this dream
by glibly interpreting the events as depicting conflict and m ere w ish fulfillm
ent. For a professional w orkaholic, it w as naturally u p settin g to leave
w ork and all too tem pting to seek m ore w ork at a hospital. Instead, his
dream ego tu rn s aw ay from using the hospital as a w ork opp o rtu n ity and
facilitates his ow n healing process by pulling out the infected pustular sac
from his intestine. This suggests that he is now rechanneling his excessive
an d stressful w ork activity into in n er healing in cooperation w ith his
internist. This dream signaled the significant turning point of transform ing
his problem into a creative function. Indeed, m y client gradually sueceeded in
refram ing his problem as he becam e m ore an d m ore aw are of
Mind Modulation of the Neuropeptide System

w h at th e th ird voice of his m in d -b o d y w as saying to him . The o u tsid e

w o rld 's voice m ight th re a te n him , his o w n voice m ight trem ble in resp
o n se, b u t th e th ird voice w ith in his g u t w o u ld let him kn o w in no
uncertain term s ju st w h ere an d w h e n he h a d to d raw the line. W h en his
conscious voice vascillated in indecision, the third voice of th e m ind-body
w o u ld counsel him as follows:
Be firm , you have to take care of yourself, d o n 't let th e w orld eat
you up! D o n 't let th e m take u p y o u r lunch h o u r w ith yet an o th er
m eeting.
D o n 't let an y o n e step on y our guts, be responsible to yourself
w h e n no one else is.
A ccepting h u m a n lim itations is the better part of w isdom . The ego
is a m a d m a n th a t has led m a n y excellent m e n to th eir destru ctio n .
It d o e s n 't m a tter w h at o th e rs think; it's m y com fort th a t gives m e
life.
The third voice that w ould no longer perm it him to abuse him self physically or
em otionally eventually becam e a creative function th a t counseled
him on m any " to u c h y " in ternational situations in w hich he h ad to
negotiate w ith a special sensitivity th a t only his g ut could provide. A fter m
any
years h e even tu ally recognized th a t his w as essentially th e w ay of the
sh am an : he w as learning to use his form er illness to sensitize him self to
th e h id d e n ills an d w ays of healing th e societies in collision a ro u n d
him .
This case illustrates th e fu n d a m e n ta l difference b etw ee n o u r
psychobiological ap p ro ac h of conceptualizing sy m p to m s as m alad ap tiv e
form s
of inform ation transduction that can becom e im portant signals for creative
personal developm ent, an d the m ore typical stance of behavioral m edicine
an d classical co nditioning th e ra p y w hich regard sym ptom s as problem s
th a t have to be extin g u ish ed (G entry, 1984). As illustrated in Box 16, ou r
ap p ro ach is also very different from th e traditional psychoanalytic goal
of using analysis as a m eth o d of resolving problem s. The behaviorist an d
psychoanalytic approaches both throw aw ay valuable inform ation by placing them
selves in opposition to the problem netw ork. O u r psychobiologica! approach u ses
th e se data by accessing th e sta te -d e p e n d e n t m em ory,
learning, an d behavior system s th at encode problem s a n d refram ing them
into creative functions. Many types of chronic pain and recurrent symptoms
and problems are actually information transducers that amplify the minimal stress
signals of the mind-body.
The process of refram ing a n d rechanneling stress signals into appropriate
patterns of personal developm ent and m eaning resem bles the tradi-
The Psychobiology of Mind-Body Healing

192

bo x

16 T ransform ing a Problem into a C reative Function

1. A ccessing and am plifying a problem-encoded resource

A c c e s s th e c ir c u m s ta n c e s d u rin g w h ic h a c h ro n ic p ro b le
m b e c o m e s m a n ife s t.
G r a d u a l l y a m p l i f y y o u r s e n s i t i v i t y to m i l d e r i n s
t a n c e s o f th e
p r o b l e m b e f o r e it c a u s e s y o u r u s u a l d i s c o m f o r t .
W o n d e r h o w y o u r n e w s e n s itiv ity c a n b e co m e a re s o u rc e
fo r
p ro b le m -s o lv in g .
2 . T ransducing a problem into a creative function
U s e y o u r h e i g h t e n e d s e n s i t i v i t y a s a r a d a r to s c a n
th e m i n i m a l
c u e s in th e s i t u a t i o n s t h a t a r e e v o k i n g y o u r " p r o b l
e m . "
S e e , h e a r , f e e l , i n t u i t th e m e a n i n g s o f y o u r m i n d -
b o d y r e s p o n s e s . R e co rd , d ra w , a n d m e d ita te o n d re a m s
a n d fa n ta s ie s
a b o u t th e p r o b l e m .
R e co g n iz e w h a t p e rs o n a l d e v e lo p m e n ta l ch a n g e s a re n
e e d e d fo r
a w i s e r a d a p t a t i o n to li f e s t r e s s o r s .
3 . Ratifying yo ur new creative function
R e v ie w a n d c o n tra s t y o u r o ld , p a in fu l a n d m a la d a p tiv e
w a y o f
b e in g w ith y o u r n e w u n d e rs ta n d in g .
R e f r a m e y o u r p r e v i o u s lif e p r o b l e m s i n th e l i g h t o f
y o u r n e w
r e l a t i o n s h i p to th e w o r l d a n d s e l f - i d e n t i t y t h a t y
o u a r e a c t i v e l y
cre a tin g e a ch d a y .

tional approaches of m any forms of cultural and spiritual healing. In these

fram eworks, sickness is frequently conceptualized as a visitation from God
to guide us in our uncertain p ath th ro u g h the shadow s of life. H ow ever,
m any of these ancient healing practices eventually becom e lim ited and
dogm atic in their perspective, rath e r th a n continually experim ental and
innovative as life is itself. Let us h ope th at our psychobiological perspective
can integrate the best of the old an d new approaches to m ind-body
healing by using n a tu re 's ow n m essages as our constant inspiration and
guide.
6) The Sexual System and Neuropeptide Activity. In a recent assessm ent of
n eu ro p ep tid es and their receptors as a psychosom atic netw ork, Pert et
al. (1985) noted that hum an testes are " a s rich a source of m essenger RNA
Mind Modulation of the Neuropeptide System

293

for the opiate p e p tid e p ro o piom elanocortin as th e p itu ita ry g la n d ."

Proopiom elanocortin is th e celebrated " m o th e r m olecule" th a t generates
ACTH a n d e n d o rp h in , w hich, as w e h ave seen, are p e rh a p s th e m ost
ubiquitous m essengers of th e entire n eu ro p ep tid e system . A rich research
literature is d ev elo p in g a ro u n d th e m ind-body connections b etw ee n the
lim bic-hypothalam ic system , th e process of d ream ing, a n d sexual activation
(Rossi, 1972/1985). This literatu re em p h asizes th e A C T H -endorphin
p attern of n eu ro p ep tid e regulation. Indeed, the relationship b etw een sex,
stress, a n d aggression th a t h as b een em p h asized in th e psychoanalytic
literature m ay find its psychobiological basis in this A C T H -endorphin
system . S tew art h as to u ch ed u p o n recent th in k in g in this area as
follows
(1981, p. 774):
A lth o u g h th e re has b een considerable speculation ab o u t th e role
of this brain A C TH -End system , only no w is it possible to advance
a reaso n ed h y p o th esis as to w h at th a t role m ay be. W e p ro p o se th
at
this set of n eu ro n s is a m ajor regulator of central nerv o u s system
activity, principally th ro u g h its influence on th e m idbrain m o noam ine
system s. In certain circum stances it ap p ea rs th a t this sy stem can
cause the higher cortical centers to be tu rn ed off or else disconnected,
so that the organism functions u n d e r the control of the e v o lu tio n a ry
ancient m idbrain centers m ed iatin g prim arily instinctive behavior.
This " tu rn in g o ff" a p p ea rs to occur d u rin g acute stress, a n d th e
" d is c o n n e c tio n " d u rin g paradoxical sleep (PS).
S tew art co n tin u es (1981, p. 778):
M assive p erip h e ral A CTH release occurs in acute stress, a n d central ev en
ts can be p re su m e d to m irror this situation. A cute stress,
a n d particularly asphyxiation, w hich is co n sid ered to be a p o te n t
" h u m o r a l" stress, cause erection a n d orgasm , th e w ell-know n
"ag o n al o rg a sm ." Som e persons can evidently achieve orgasm only
u n d e r such stress, a fact w hich leads to accidental d eaths from choking a n d
p e rh a p s also to m uch of th e in terp erso n al violence of o u r
tim es. S tress-induced orgasm is depicted in such w orks of literature
as Sam uel Beckett's Waiting for Godot, John H ersh ey 's The War Lover,
a n d th e w orks of de Sade.
The diurnal rh y th m of ACTH release also contributes confirm atory
evidence to th e h y p o th esis. ACTH is secreted principally in b u rsts
d u rin g episo d es of paradoxical sleep (rapid ey e-m ovem ent sleep).
PS is characterized by sexual stim ulation. . . .
194

The Psychobiology of Mind-Body Healing

Since therapeutic hypnosis has been u sed to access an d m odulate this

same complex of stress, dreams, aggression, and sexual functioning (Araoz,
1982, 1985), one cannot help b u t w onder, once again, if n eu ro p ep tid es
are the com m on denom inator.
O ne of Erickson's m ost celebrated cases of psychosexual rehabilitation,
w hich took place w ith a patient w ho had organic spinal cord dam age, dealt
w ith this entire com plex of stress an d em otions and can serve as a clinical
illustration of w hat is possible in this area. A highly co n d en sed version
of this case is excerpted from Erickson an d Rossi (1979) as follows (pp.
428-439):
Som e years ago a young w om an in a w heelchair ap p ro ach ed the
senior a u th o r an d declared th at she w as profo u n d ly d istre ssed —in
fact, suicidally d ep ressed . H er reason w as th a t an accidental injury
in h er early tw enties had left her w ith a transverse myelitis: she w as
lacking in all sensations from the w aist dow n, an d she w as incontin en t of
bladder and bow el. H er p u rp o se in seeing the senior author
w as th a t she w an ted to secure a philo so p h y of life by w hich to live;
the incontinence of bladder an d bow el and confinem ent to a w heelchair w ere m
ore th an she felt she could en d u re. She had h eard the
senior au th o r lecture on h y pnosis an d h ad reached the conclusion
that p e rh ap s by hypnosis som e m iraculous change in her personal
attitudes could be affected. She explained further that as a small child
she had been extrem ely interested in cooking, baking, sew ing, playing w ith
dolls, an d fantasizing about the hom e, h u sb an d , an d child ren she w ould
have w h en she grew up. At the age of tw en ty she
had fallen in love an d m ade plans to m arry u p o n com pletion of college. She
had set to w ork filling a hope chest w ith hand-sew n linens
and designing her ow n w ed d in g dress. All she had ever w anted w as
a hu sb an d , a hom e, children, an d grandchildren. H er love for her
ow n gran d m o th ers w as a stro n g factor in h er life, an d she shared
m uch em otional identification w ith them .
The u n fo rtu n ate accident resulting in the transverse m yelitis p u t
an en d to all her dream s a n d expectations. A fter som e ten years of
storm y difficulties and com plications, she becam e able to use a
w heelchair an d to re tu rn to her university studies. Even w ith this
im provem ent in her situation she saw no future for herself in the
academ ic w orld, and becam e progressively d epressed w ith increasing suicidal
ideation. She h ad finally reached a point at w hich she
felt som e definite decision h a d to be m ade. Therefore she w ished
the au th o r to induce a " v e ry deep hypnotic trance and discuss
possibilities an d potentialities for m e. . . ."
Mind Modulation of the Neuropeptide System

195

H er req u est w as abided by and, probably because of h er d eep

m otivation, a very deep som nam bulistic trance state w as elicited. She
w as tested w ith great care for h er ability to m anifest the p h en o m en a
of d eep h y p n o sis. D epersonalization, dissociation, tim e distortion,
a n d h y p erm n e sia of the h a p p y p ast w ere eith er avoided or th e
suggestions w ere w o rd e d so carefully th a t th e re could n ot be even a
seem ing a tte m p t to ch ange h e r view s a n d attitu d es. . . .
O n e su g g estio n of a th e ra p eu tic character th a t d id com e to m ind
w as a w ell-know n song of th e old variety, w hich sh e w as asked to
hallucinate, visually a n d auditorily, w ith an o rch estra a n d singer.
The song w as th e on e about th e toebone bein g co n n ected w ith th e
footbone, th e footbone w ith th e heelbone, th e heelbone w ith the
anklebone, a n d so on. . . . [Erickson continues:]
" I noticed th a t y o u w ere left-thum bed, left-eyed, a n d left-eared
last w eek, a n d I m ad e u p m y m in d th a t you sh o u ld h av e free access
to w h a t y o u r conscious m in d know s ab o u t y o u r b o d y b u t does
not k n o w th a t it know s, a n d w h a t y o u r body kn o w s freely b u t th
at
n eith er y o u r conscious no r y o u r unconscious m in d open ly know s.
You might as well use well all knowledge that you have, body or mind
knowledge, and use all of it well. W hat does your body know a n d know
full well, w hich you k n o w a n d know full w ell consciously a n d
unconsciously? Just this little thing! You th in k th a t erectile tissue is in
th e genitals, just the genitals. But w h at does y o u r b o d y know ? Just
take y o u r finger a n d th u m b a n d sn ap y o u r soft n ip p le a n d w atch
it sta n d rig h t o u t in protest. It k now s th a t it has erectile tissue. You
h ave h a d th a t know led g e w ith o u t k n o w in g it for a long tim e. A nd
w h ere else do you have erectile tissue? In N ew York State you
ste p p e d o u t of doors in thirty degrees below zero an d felt y our nose
h a rd e n . N aturally! It has erectile tissue! W hy else w o u ld it h ard en ?
A nd w atch that hot baby slobbering for a kiss from the m an she loves
a n d see h er u p p e r lip get thick a n d w arm ? Erectile tissu e in the upp er
lip!. . . .
The external genitals are co nnected to th e internal genitals, a n d
th e internal genitals are connected to th e ovaries, a n d th e ovaries
are co n n ected w ith adrenals, a n d th e ad ren als are co nnected w ith
the chrom affin system , an d the chrom affin system is connected w ith
th e m am m aries, a n d th e m am m aries are conn ected w ith the parathyroids, a
n d th e th y ro id is connected w ith th e caratid body, an d
the carotid body is connected w ith the pituitary body, a n d the system
of all th e se en docrine glands is connected w ith all sexual feelings,
a n d all y o u r sexual feelings are connected w ith all y o u r o th e r
feelings, an d if you d o n 't believe it, let som e m an you like touch yo u r
196

The Psychobiology of Mind-Body Healing

bare breasts an d you feel th e hot, em barrassed feeling in y our face

and your sexual feelings. Then you'll know that every w ord I've said
is true, an d if you d o n 't so believe, try it out, b ut the deep red flush
on your face right now says you know it's so.
"S o continue sleeping deeply, review carefully every w ord I have
said to you, try to d ispute it, to argue against it. Try your level best
to disagree, b u t the h a rd er you try the m ore you will realize that I
am right.
" N o w p u t a look of starry-eyed expectation on your face, clothe
yourself in an air of h a p p y confidence. Rom ance for you is ju st
aro u n d the corner [a crucial statem ent], I d o n 't know w hich corner
[a statem ent that leaves the question undecidable and hence requiring fu rth er
consideration], but it's just around the cornerl D o n 't ever
forget th e re 's a Rachel for every R euben an d a R euben for every
Rachel, and every Jean has h er Jock and every Jock has his Jean, and
around the corner is your "John Anderson, my Jo."
" O n e d o ubt you will have, b ut naturally you are w rong! Your
body know s, so does your conscious m ind, so does your unconscious m ind. O nly
you, th e person, d o n 't know .
"Is there anything m ore ecstatic th a n the m aiden's first sw eet kiss
of true love? C ould there be a better orgasm ? O r the first grasping
of the little lips of the baby on your nipple! O r the cupping of your
bare breasts by the h a n d of yo u r love? H ave you ever felt th e chills
ru n u p and dow n your spine w h en kissed on the back of your neck?
"M a n has bu t one place to have an orgasm —a w om an has m any.
"C o n tin u e your trance, evaluate these ideas, m ake no error about
their v alid ity ."
A Ten-Year Follow-up
W ithin tw o years she w as m arried. H er h u sb a n d w as a dedicated
research m an, and his field of interest w as the biology and chem istry
of the h u m a n colon. They have been m arried happily for over ten
years, and there are now four children, all by caesarian operations.
Ten years after the m arriage the au th o r h a p p e n e d to be lecturing
in the state of her residence. She n oted a new s story on the au th o r
an d called him on the telephone, asking him to lunch w ith her the
next day. Before m eeting her, three duplicate sets of questions w ere
typed out. The answ ers w ere filled in on one set, w hich was sealed in
an envelope. The other tw o sets w ere placed in separate envelopes.
Mind Modulation of the Neuropeptide System

197

The p u rp o se of the duplicate sets of questions w as to obtain an objective

report from h er regarding h er sexual experiences an d com pare th em w ith
w h a t Erickson th o u g h t th e y w ou ld be. H er resp o n ses indicated th a t
she
w as experiencing sexual orgasm s three or four tim es a w eek w ith her husband.
She had learned to shift her genital orgasmic response to her breasts,
neck, an d lips. Erickson quo ted her descriptions of her sexual experiences
as follow s (H aley, 1985, Vol. 1, p. 26):
I have excellent orgasm s. I have p le n ty of orgasm s in m y breast,
I have a sep arate one in each nipple. I get a very w arm , rosy feeling
of engorgem ent in m y thyroid, and m y lips swell u p quite a bit w hen
I have an orgasm , th e lobes of m y ears. I have th e m ost peculiar feel‫־‬
ing betw een my shoulder blades. I rock involuntarily, uncontrollably,
I get so excited.
Erickson liked to use this case as an illustration of the p sy choneurophys‫־‬
iological alterations th a t w ere possible w ith th e ra p eu tic h y p n o sis.
There
is m uch to suggest th at the n eu ro p ep tid e system is th e
psychoneurophysiological basis of this type of h y p n o th e ra p eu tic resp o n
se. This hypothesis
is b ased o n th e m ind-body com m unication system illustrated in Figure
7 a n d th e outlin e in Table 5, w hich b o th su g g est how n e u ro p e p tid e
m essenger m olecules, channeled th ro u g h the autonom ic, endocrine, and imm u n
e system s, could m ediate th e all-encom passing scope of E rickson's
seem ingly nonsensical hyp n o tic rh y m e about " th e footbone co nnected
to th e heel bone. . . . th e external genitals connected to th e . . . ovaries
. . . adrenals . . . chrom affin system . . . m am m aries . . . p arath y ro id s
. . . thyroid . . . cartoid body . . . pituitary body . . [and the] endocrine
glan d s connected w ith all sexual fe e lin g s." It will require th e ingenuity
of u n iq u e team s of psychobiological researchers an d h y p n o th e ra p ists
to
explore th e actual m ind-m olecule com m unication system s th a t m ediate
such healing resp o n ses.
The w ide distrib u tio n of th e n e u ro p e p tid e system , as w ell as its
seem ingly unlim ited ability for inform ation tran sd u ctio n b etw ee n all the
channels of m ind-body com m unication, can act as a springboard for a nu m b er
of new ap p ro ac h es to th erap eu tic h y p n o sis b ased on E rickson's w ork
described above. This is particularly th e case w h e n a life problem is acco m
panied by feelings of h o p elessn ess an d dep ressio n , as in th e case
above. I have previously described h o w d ep ressio n can be a signal of the
n eed to break o ut of an ou tm o d ed p attern of adaptation into the
actualization of a new identity th at is already developing spontaneously w ithin
the
198

The Psychobiology of Mind-Body Healing

perso n on an unconscious level (Rossi, 1972/1985). I frequently describe

the process as "tran sfo rm in g a problem into a creative fu n c tio n ."
T he N europeptide S ystem as M ediator
of T herapeutic H ypnosis

The characteristics of m ind-body com m unication via the n eu ro p ep tid e

system , particularly in contrast to com m unication via central and peripheral
nervous system s, suggest that neuropeptides m ay be a significant factor
in the neuropsychophysiological basis of our state-dependent m em ory and
learning theory of therapeutic hypnosis. Since this is an entirely new idea
about h y p n o th e ra p eu tic healing th a t could no t have been conceived of
before the recent conceptualization of the n e u ro p ep tid e system , I will
sum m arize a few lines of evidence th a t now n eed fu rth er experim ental
validation to su p p o rt this view. T hese lines of evidence touch u p o n
factors, such as the distribution, timing, archaic quality, conscious-unconscious
relations, and flexibility, w hich the n e u ro p ep tid e system seem s to share
in
com m on w ith the p h e n o m en a of h y pnosis.
The w ide distribution of the neuropeptide m essenger molecules and their
receptors could account for the idiosyncratic p attern s of hypnotic experience
that follow the " m in d 's body im ag e" rath e r th a n the classical pathw ays
of the CNS.
Since the n eu ro p ep tid es are tran sm itted th ro u g h virtually all the body
fluids (blood, lym ph, cerebrospinal fluid, etc.), as well as betw een neurons, the
neuro p ep tid e system is not confined to the traditional neuronal
circuits of the central n ervous system . The puzzlem en t that h y p n o th e ra
pists have h ad for centuries over the fact th a t psychosom atic or hypnotically
induced anesthesias do n ot follow the classical CNS p ath w ay s
innervating specific derm atones (segm ental cutaneous areas) of the body,
for exam ple, could now be explained: P erhaps the n e u ro p ep tid e system
is m ediating hypnotic resp o n ses by the " m in d 's body im ag e" via the
lim bic-hypothalam ic system . In d eed , m any m ind-body effects th a t have
been disparagingly described as caused by m ere im agination and therefore
being " u n re a l" m ay now have a recognizable biological basis.
As can be seen in Table 5, virtually any cell or pattern of cells in the body
can receive inform ation from the n eu ro p ep tid e system if it has the
appropriate receptors. The colum ns of Table 5 fit the classical three-stage
paradigm of inform ation theory: sender-channel-receiver. A m ajor area of research
is needed to investigate how receptors operate as a highly variable
system th at can change its p atte rn s of resp o n se as a function of life
experience encoded as sta te-d ep en d en t m em ory, learning, sensation, per-
table

5 Inform ation tran sd u c tio n in m in d -b o d y com m unication. Som e of th e

m ajor m e ssen g er m olecules
of th e autonom ic, endocrine, im m u n e, a n d n e u ro p e p tid e system s are
listed in th e ch an n el colum n.
SENDER

VIA NEURON CHANNEL

NEUROTRANSM ITTERS
Amino Acids:

Aspartic
Glutamic, etc.

RECEIVER

REFERENCES

Receptors
On neurons to all target
organs in ANS, heart, GI
tract, lungs, pupils, etc.

Hypnotic Literature
Barber, 1984; Black, 1969;
Braun, 1983a, b; Crasilneck &
Hall, 1985; Dunbar, 1954;
Erickson, 1943a, b, 1977;
Hudgins, 1933; Lewis & Sarbin, 1943; Olness & Conroy,
1985; Sternbach, 1982

Receptors
Pituitary

Hypnotic Literature
Crasilneck & Hall, 1985; Delhounge & Hansen, 1927; Dunbar, 1954; Erickson, 1943a,
b,
c; Gorton, 1958; Kroger &
Fezler, 1976; Wolberg, 1947

Monoamines:

Acetylcholinie
Catecholamines
Dopamine
Norepinephrine
Serotonin
Neuropeptides

Endorphins
Somatostatin
Substance P, etc.
ENDOCRINE
Hypothalamus

VIA BLOOD CHANNEL

HORMONES
Thyrotropin-Releasing Hormone (TRH)
Gonadotropin-Releasing
Hormone (GnRH)
Somatostatin
Corticotropin-Releasing Factor (CRF)
Growth Hormone-Releasing
Hormone (GHRH)

(continued)

Mind Modulation of the Neuropeptide System

AUTONOMIC
Limbic-hypothalamic brain
stem system; spinal nerves

CHANNEL
TABLE 5

Co11ti11ued
SENDER

ENDOCRINE

Anterior Pituitary

Cl JANNEL
VIA BLOOD CHANNEL

Adrenocorticotropic Hor
mone (ACTH)
/)-Endorphin
Melanocyte-Stimu!ating
Hormone
Prolactin

Growth Hormone (GH)

Luteinizing Hormone (LH)

Posterior Pituitary

Vasopressin
Oxytocin

N
a
a

Neurophysins
Enteric-Gastrointestinal

Vasoactive Intestinal Polypeptide (VIP)

Cholecystokinin (CCK)
Enkephalins
Endorphins
Substance P
Neurotensin
Bombesin
Secretin
Glucagon
Insulin
Gastrin

RECEIVER
Receptors

REFERENC "ES
Psychobiological Literature

Glands in endocrine system:

Besedovsky et al., 1985; Bul

adrenals, pancreas, testes,

loch, 1985; Domangue et al.,

ovaries, thyroid, etc.

1985; Pert et al., 1985;

Rosenblatt, 1983; Stewart,

1981; Weiner, 1977
IMMUNE

Organs such as bone mar

row, lymph, thymus, spleen,
tonsils, etc.; lymphocytes,
B & T cells, macrophages,
natural killer cells, neutro
phils, etc.

VIA BLOOD AND

Receptors

Hypnotic Literature

LYMPH CHANNELS

On neurons in the hypothal

amus and other brain areas;
leukocytes in blood, spleen,
thymus, lymph, skin, GI tract;
blood vessels; endocrine
glands

Achterberg, 1985; Black, 1969;

Hall, 1982-83; Ikemi & Naka
gawa, 1962; Mason, 1963;
Schneider et al., 1983

ACTH, TSH
Endorphins
Thymosins
Lymphokines
Interleukins
Interferon
VIA NEURONE, BLOOD,

NEUROPEPTIDE

DNA-+ RNA-+ Peptide in

limbic-hypothalamic system;
GI tract and other nodal
centers

N
0
......

Hypnosis and Placebo

LYMPH CHANNEL

Receptors

Literature

PEPTIDES
Hypothalamic Releasing Hormones
e.g., Somatostatin (growth)
Nodal centers in limbic
hypothalamic, dorsal horn of
spine, periacque-duct grey,
testes, ovaries, gastrointesti
nal, immune and endocrine
systems

Achterberg, 1985; Barber &

Meyer, 1977; Domanque et al.,
1985; Goldstein & Hilgard,
1975; Hilgard, 1977; Hilgard &
Hilgard, 1975; Olness, Wain,
& Ng, 1980; Rosenblatt, 1983;
Spruiell et al., 1983

Pituitary Peptides

e.g., ACTH (stress)

13-endorphin (emotions)
Vasopressin (memory)
Gut-Brain Peptides
e.g., Substance P (pain)
Others
e.g., Bradykinin (shock)
Angiotensin II (blood pres
sure)
202

The Psychobiology of Mind-Body Healing

ception, m ood, and m ental activity (Bloom, Lazerson, & H ofstadter, 1985;
C ordes, 1985).
Time relationships are an o th er aspect of the hypnotic experience th at
m ay be elucidated by the different modus operandi of the CNS an d the
n eu ro p ep tid e system : The CN S resp o n d s very quickly, in fractions of a
second for m ost behaviors, w hile the n eu ro p ep tid e system usually takes
several m inutes or even hours for som e of its responses (Rosenblatt, 1983).
The sam e is true for the full experience of m ost hypnotic p h en o m en a.
Erickson (1952/1980) has described how sufficient tim e (usually 10 to 20
m inutes, but som etim es hours) is necessary to effect the "p sy ch o -n eu ro
physiological" changes characteristic of a genuine hypnotic response, versus the
sim ulation of hypnotic effects th a t can take place instantly w ith
the help of conscious role-playing.
M any experienced clinicians have com m ented on the regressive, archaic,
or atavistic quality of hypnotic responsiveness (Gill & B renm an, 1959;
M eares, 198283‫ ;־‬Shor, 1959). In tracing th e evolutionary origins of the
neuropeptide system, Roth and his colleagues (Roth et al., 1985) presented
evidence th at it is older th a n the central, autonom ic, an d endocrine systerns;
it is the m ethod of com m unication in one-cell organism s, plants,
and low er orders of animal life. Since nature tends to conserve her system s
(Bockman & Kirby, 1985), we can now u n d erstan d how the neuropeptides
form a d eeper an d m ore pervasive system of m ind-body inform ation
tran sd u ctio n th a n does the CNS.
T hus the slow er-acting b ut m ore pervasive, flexible, and unconscious
functioning of n eu ro p ep tid e activity of m ind-body com m unication m ore
adequately fits the facts of hypnotic experience th a n the faster-acting,
highly specific, an d consciously g en erated processes of the central and
peripheral nervous system s. If w e w ere to use a com puter analogy, w e
could say th at the peripheral nerves of the CN S are " h a rd w ire d " in a
preset, fixed p attern of stim ulus an d response, just as is the h ard w are of
a com puter. The n eu ro p ep tid e system , how ever, is like the " so ftw a re "
of a com puter th at contains the flexible, easily changed p attern s of inform
ation. The receptors an d highly individualized responses of the neuropep tid e
system are easily chan g ed as a function of life experience, m em ory, an d
learning.
N europeptides, then, are a previously unrecognized form of inform ation
transduction betw een m ind and body that m ay be the basis of m any
hypnotherapeutic, psychosocial, and placebo responses. From a broader perspective,
the neuro p ep tid e system also m ay be the psychobiological basis
of th e folk, sham anistic, and spiritual form s of healing (that share m any
of the characteristics of hypnotic healing) currently retu rn in g to vogue
u n d e r the b an n er of "holistic m e d icin e ."
Summary and Overview

h e s u r v e y of th e psychobiology of m in d-body h ealing p re s e n te d in

this book h as led to a series of ever surprising insights into the changing stru
ctu re of o u r u n d e rs ta n d in g of th e h u m a n condition. Let us sum m
arize som e of th ese insights.
1) Information theory is capable of unifying psychological, biological, an d
physical p h e n o m e n a into a single conceptual fram ew ork th a t can account
for m ind-body healing, personality developm ent, the evolution of h u m a n
consciousness, a n d a fascinating p a n o ram a of cultural practices.
2) Information transduction is e m e rg in g as th e key c o n c e p t in o u r
psychobiological th e o ry of m in d -b o d y com m unication a n d healing. The
basic law s of biology, psychology, an d cultural anthropology are all essentially
d escriptions of different levels of inform ation tran sd u ctio n .
3)
State-dependent memory, learning, and behavior form th e m ost general
class of psychobiological p h e n o m e n a th a t can be u se d to account for the
dynam ics of inform ation transduction in h u m a n s. Classical Pavlovian an d
S kinnerian conditioning, as w ell as th e p sychodynam ics of p sychoanalysis, can
be econom ically conceptualized as special cases of state-dependen t m em ory,
learning, a n d behavior.
4)
There is no m ysterious gap betw een m ind and body. S tate-dependent
m em ory, learning, an d behavior processes encoded in the limbic-hypothalamic and
closely related systems are th e m ajor inform ation tra n sd u c e rs th a t
bridge th e C artesian dichotom y b etw ee n m ind an d body.
5)
T raditional psychosomatic symptoms and, p erh a p s, m ost m ind-body
problem s are acquired by a process of experiential le arn in g —specifically,
the sta te -d e p e n d e n t learning of resp o n se p a tte rn s of S ely e 's G
eneral
A daptation Syndrom e. E nduring m ind-body problem s are m anifestations
of these state-bound p attern s of learning th at are encoded w ithin a
limbichypothalam ic system ‫ ״‬filter" w hich m odulates m ind-body com m unication.
6) This lim bic-hypothalam ic system filter coordinates all the m ajor ch an

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The Psychobiology of Mind-Body Healing

nels of m ind-body regulation via the autonom ic, endocrine, im m une, and
neuropeptide system s. Messenger molecules (neurotransm itters, horm ones,
im m unotransm itters, etc.) flow ing th ro u g h these channels are th e
structural informational m ediators of m ind-body com m unication an d
transformation.
7) O ngoing research is clarifying the precise p athw ays by w hich these
m essenger m olecules are m ediating the mind-gene connection th a t is the
ultim ate basis of m ost processes of m ind-body healing via therapeutic hypnosis,
the placebo response, an d the traditional practices of m ythopoetic
and holistic m edicine.
8) The new approaches to m ind-bodv healing and therapeutic hypnosis
m ay be conceptualized as processes of accessing and utilizing state-dependen t m
em ory, learning, and behavior system s th a t encode sym ptom s and
problem s and th e n reframing th em for m ore integrated levels of adaptation and
developm ent.
9) The ultradian healing response is a new ly developed approach to m indbody
healing that is easy to learn, as people are encouraged to becom e
m ore sensitive to their natural 90-m inute psychobiological rh y th m s.
10) The new concepts of therapeutic hypnosis em phasize natural psychobiological
processes of inform ation tran sd u ctio n and state-d ep en d en t
m em ory, learning, and behavior to access and facilitate the utilization of
p atien ts' ow n inner resources for problem -solving. This is in sh arp contrast
to previous m ethods of authoritarian suggestion, influence com m unication, covert
conditioning, an d program m ing in hypnosis.
The psychology of m ind-body com m unication and healing as presented
in this book th u s introduces a broadly based inform ation paradigm th at
is capable of integrating and expanding the scope of all previous views
of illness and therapy. M uch of this m aterial is still so new th at it could
only be outlined in a m an n er that m ay seem intuitive and visionary; it is,
how ever, scientifically w ell-docum ented. The art an d science of refram ing sym
ptom s into signals and problem s into creative functions are only
beginning. It will require the dedicated efforts of all of us to gradually sift
o u t w hat is of value in this w ork as a guide for future research, theory,
and clinical practice.