maps bulletin • volume xxi number 1 15

Psychosomatic Medicine, Psychoneuroimmunology and Psychedelics By Ana Maqueda

“The Ancients said that the animals are taught throughThe their complex organs; let relationships me add to this, so are men, but they have the advantage of teaching their organsbetween in return.” the Johann brain, Wolfgang the von Goethe neuroendocrine and immune most psychotherapists who follow systems, and emotions Nowadays, the cognitive-behavior paradigm treat the Nmind as something separated from the body. Inversely, most physicians treat the body as if it were detached from mind and emotions. Empirical evidence available nowadays However, the need to take down these barriers shows bi-directional communication between and to integrate body and mind therapies is the central nervous system, the immune becoming increasingly clear to both psycho- system and neuroendocrine mechanisms, therapists and physicians. via neurotransmitters (dopamine, serotonin, The first references to the mind-body con- adrenaline, noradrenaline) which can directly nection are found in Hippocrates and Galen, mediate the immune response, given that im- whose teachings about the imbalances in mune cells T and B lymphocytes have receptors emotions and passions, and their translations for hormones and neurotransmitters on the as physical illnesses, survived well into the surface of their membranes. Some neuropep- eighteenth century. Descartes’ mind-body du- tides secreted by neurons, which are involved alism marked the start of a breakdown of the in pain transmission, have also been identi- relationship between mind and body. fied as immunomodulators, and cytokines, a In the nineteenth century, physicians type of activating chemical signaling cells of believed that all diseases were the result of the immune system, also occur in the nervous some sort of anatomical abnormality. Freud system. Under disease conditions, when the developed psychoanalysis trying to explain the organism needs to recover homeostasis, the im- Ana Maqueda cause of illness which could not be traced to mune system can reset brain-integrated neu- [email protected] anatomical sources. roendocrine mechanisms to promote immune Ana Maqueda is a clinical psychologist In the early twentieth century, Walter processes at the expenses of other physiologic and writer in Madrid, Spain. Cannon and his homeostatic theory stimulated systems [1]. new interest in the relationship between af- Neurotransmitters are considered the most fect, physiology and health, fostering the emer- direct functional link between the central gence of two schools. One of these schools, nervous system and immune processes. El- called “psychosomatic medicine,” approached evated levels of catecholamines (epinephrine, discrete emotions from the psychoanalytic norepinephrine and dopamine) were associ- paradigm. Franz Alexander, in the 1920’s and ated with an increased incidence of infectious Freud developed 1930’s, was its main theoretician, who along diseases in the upper respiratory tract. Several with Helen Flanders Dunbar, sought to explain longitudinal, prospective studies showed that psychoanalysis trying many somatic diseases–such as asthma, psoria- rheumatoid arthritis, pain and depression tend sis, hypertension and gastric ulcers–as arising to be predictive of each other [2]. to explain the cause of from mental disorders. Currently, neuroscientists like Antonio The second school focuses on biological pro- Damasio associate basic emotions with distinct cesses–rather than on discrete emotions–and patterns of cardiorespiratory activity [3]. illness which could not is represented by Hans Selye, who introduced Eysenck and Grossarth-Maticek (1995) have the concept of stress as a general adaptation provided robust results from longitudinal stud- be traced to anatomical syndrome that organisms develop in order ies, showing that some patterns of personality to survive. He also noted the negative conse- are good predictors of certain diseases such as sources. quences of sustained stress: fatigue, exhaustion cardiopathies (behavior pattern type 2, where and depression of the organism. Selye discov- raw anger and hyper excitement) or cancer ered the mechanism by which normal psycho- (type 1, emotional repression and helpless- logical stressors and biogenic stressors increase ness). On the other hand, neuroscientist the action of the neuroendocrine hypotha- Richard Davidson also found that meditation lamic-pituitary-adrenal axis, increasing the (mindfulness) may change brain and immune levels of hormones such as glucocorticoids (like function in positive ways [4]. cortisol), which in turn lower the proliferation of immune cells. 16 maps bulletin • volume xxi number 1

The need for the multidisciplinarity of the human being science

PTSD using MDMA was carried out in Madrid, Spain by clinical psychologist José Carlos Bouso [9], which established the psy- The empirical evidence in the field of psychoneuroimmunol- chological and physiological safety of this chemical. Although ogy (Ader, R., 1981) has shown that immune activity, as well further research is necessary, some studies are starting to reveal as some psychological parameters, can be modified by classi- the hormonal effects of this substance [10]. cal conditioning processes. This young discipline is providing Also in Spain, Dr. Jordi Riba conducted the first controlled scientific facts of the interrelations between emotions, stress, pharmacological study of ayahuasca in humans [11]; in recent anxiety, depression, chronic pain and the immune system. Pro- research, Dr. Riba and his team found, using the neuroimaging inflammatory cytokines play a key role in cardiovascular dis- technique SPECT (single photon emission ease, arthritis, Type II diabetes, osteoporosis, ...ayahuasca computed tomography), that ayahuasca Alzheimer’s disease, periodontal disease administration led to increased blood perfu- and some cancers [5]. Negative emotions administration led to sion in brain areas implicated in somatic like depression and anxiety enhance the awareness, subjective feeling states, and production of pro-inflammatory cytokines, increased blood emotional arousal [12]. The implications leukocytosis and increased natural killer cell of this research, and prospective ones, are cytotoxicity, as do psychological stressors perfusion in brain areas promising for depression and anxiety disor- [6]. Some of the current scientific research ders, and behind the intrincated pharmacol- in cancer shows that the boost of the im- implicated in ogy of ayahuasca may lead to breakthrough mune cells neutrophils could be a promising solutions for neurodegenerative disorders treatment against solid tumors [7]. somatic awareness, like Parkinson, and the future development All of the above shows that new para- of new antibiotic agents. digms of a multidisciplinary, holistic, non- In the seventies, Dr. Khorramzadeh dual and integrative science of the human subjective feeling states, administered ketamine to 100 psychiat- being are emerging, which conceive the ric patients with various psychosomatic human being as a delicate, intricate and and emotional arousal... diseases, like tension headaches, depression, interconnected universe and away from old anxiety, phobias, obsessive-compulsive neu- dualistic conceptions. Let’s see how psyche- rosis, hypochondriasis and ulcerative colitis. delics could be invaluable tools to foster this Dr. Khorramzadeh reported that 91 of his evolution. patients were doing well after six months, and 88 of the subjects remained well after “We are not primarily biological, with mind one year [13]. emerging as a kind of iridescence, a kind of epiphenomenon at the Some publications in the 1970’s detailed healing properties higher levels of organization of biology. We are hyperspatial objects of of LSD in disorders such as allergies, ulcerative colitis, rheu- some sort that cast a shadow into matter. The shadow in matter is our matoid arthritis and other inflammation of the joints. LSD and physical organism.” - Terence McKenna drugs related to it could have potent anti-inflammatory effects, Having noted only minimally the bidirectional and complex and could play an important role in the immune system, since it relations and interactions between body, mind and emotions, affects hormones. Charles Nichols, associate professor of phar- and how hormones, neurotransmitters, leukocytes and neurons macology at the LSU Health Sciences Center in New Orleans, share a common language, we can see the multiple potentials of has began to investigate them using tissue cells and cultured psychedelics -both in psychotherapy (powerful emotional in- animal cells. sights, treatment of traumas and psychological conflicts, coping It is interesting to note that many of the drugs currently with stress, positive experiences and expressing emotions) and used to treat various disorders keep a close molecular relation- medicine (immunoregulatory-antidepressants drugs, addictions, ship with some psychedelics: Sumatriptan, the currently most pain and anxiety), all of which are complex universes whose effective drug to treat migraines, is chemically very similar to mysteries are yet to be unveiled. DMT, and Methysergide, also prescribed for migraines, is based As Michael Kometer and Dr Franz Vollenweider recently on the LSD molecule. published [8], the downregulation of prefrontal 5-HT2A sero- Cannabinoids, among other properties, act on the immune tonin receptors (that are targets for hallucinogenic compounds) system by decreasing inflammation when brain damage occurs. might underlie some of the therapeutic effects of hallucino- Since neuro-inflammation and neuroimmune activation have gens in the treatment of depression, chronic pain and anxiety. been shown to play a role in the etiology of a variety of neu- (Anxiety and depression are interrelated with stress, which also rodegenerative disorders such as Alzheimer’s disease (autopsy affects the serotonin system.) reveals less expression of CB1 receptors in the hippocampus and MDMA’s ability to facilitate better emotional management, frontal cortex), the implications for further neuroprotection ap- and retrieval of traumatic memories without fear, could be a plications of cannabinoids are promising. powerful catalyst of healing for disorders such as post trau- The advance of psychedelic science is still slow, and encum- matic stress disorder (PTSD). As mentioned above, hormones bered by lingering bans and legal hurdles to research, but it chronically disturbed by stress may contribute to brain changes, seems increasingly unstoppable. • immune deficits, depression, emotional and behavior symptoms and somatic disorders. The first authorized clinical research on References for this article are on page 69.