Mind body dualism and allostatic overload

René Descartes

the Mind-Body distinction - the natures of mind and body are completely different from one another and each could exist by itself

reconciliation of dual approach

bio-psycho-social model and psychosomatics

functional disorders

impairment in the normal function of a bodily system/organ, but no structural/anatomical abnormalities can be detected

+many psychiatric disorders were put in this category

comorbidity

presence of two or more medical conditions/diseases occurring simultaneously

• managing one condition may affect the treatment of the other

limitations of mind-body dualism

1. interaction problem - influence

2. neuroscientific findings - brain activity is connected to mental processes

3. consciousness (subjective experience of physical processes - how they arise)

4. simplistic division - oversimplification

5. evolutionary perspective (doesn’t fit)

6. cultural validity - it is not universal perspective

7. burden (for med and psych)

8. isolation of the mind in science

9. increased stigma

psychological pain vs physical pain

activation of the same cerebral areas

embodied

the mind and body are deeply interconnected

=

cognition is grounded in bodily experiences

embodied - philosophy and cognitive science

the mind emerges from sensory and motor experiences

• time

• shape

embodied - psychology

emotions are tied to physiological states

• stress → muscle tension

embodied - sociology and anthropology

how societal practices become inscribed in the body

• moving

• expressing yourself

• experiencing the world

self

• fundamental reference

• psychological baseline

for processing internal signals and external inputs

Diagnostic Criteria for Psychosomatic Research

Stress: allostatic overload

Personality: Type A, Alexithymia

Psychological Manifestations: Demoralization, Irritable mood, Secondary somatic symptoms

Illness behavior: Phobias, Persistent somatization, Conversion symptoms, Anniversary reaction, Illness denial

Allostatic overload

the body’s adaptive mechanisms known as allostasis, are overstressed or overburdened

allostatis

changes made in response to stress in order to maintain body’s stability (homeostasis)

key aspects of allostatic overload

1. chronic overactivation of stress response system

2. insufficient recovery or insufficient response (lack of adequate time ti recover/inefficient stress response)

symptoms of allostatic overload

physical: increased risk of cardiovascular diseases, metabolic disorders, weakened immune system, hormonal imbalances

mental: anxiety, depression, cognitive decline

behavior: fatigue, sleep disturbances, changes in appetite and social behavior

causes of allostatic overload

• chronic stress

• prolonged exposure to stressors

• lack of adequate support or coping mechanisms

allostatic overload - criterion A

identifiable source of distress, which exceeds the individual coping skills

allostatic overload - criterion B

one or more:

1. two of the following symptoms: difficulty falling asleep, restless sleep, early morning awakening, lack of energy, dizziness, generalized anxiety, irritability, sadness, demoralisation

2. impairment in social or occupational functioning

3. impairment in environmental mastery (overwhelmed by the demands of everyday life)

biological markers of allostatic overload

• cardiovascular activity - blood pressure

• waist to hip ratio (cardiovascular risk) - BMI

• cholesterol (atherosclerotic risk)

• coagulation indices

• cortisol

• epinephrine

• norepinephrine

• DHEA

• HbA1c