Expanding on a previous post, which covered the psychosomatic factors in digestive disease, today we will cover an interesting topic; the personality traits, mental and emotional patterns in those with digestive disease.
If the psyche rules the digestive system, it only makes sense that specific, chronic and dominant personalities such as (neuroticism, introversion, openness to experience, agreeableness, etc.) along with mental constructs and chronic emotional patterns have a dominant role in the pathogenesis of digestive issues such as irritable bowel syndrome (IBS), inflamed bowel disease (IBD), chronic constipation, acid reflux, ulcerative colitis and any other variety of GI disorders.
It is well known that dominant personality traits and chronic emotional patterns strongly effect the autonomic nervous system, thereby effecting immune, inflammatory, endocrine functions and most importantly, digestive function. In fact, the digestive system is ruled by subbranches of the autonomic nervous system, named the sympathetic and parasympathetic nervous system.
This post will seek to explore the correlations between specific personalities, mental constructs and emotional expressions and their symptomatic burden on the disease physiopathology in digestive diseases.
This biopsychosocial model of illness includes the interaction between biological, psychological, environmental, and social factors in relation to physical disease. In other words, this is a holistic approach to the treatment and healing of digestive disorders and should take into account the heterogeneous nature of life and our health. Given the fact that we are more than just bodies, predominantly spiritual beings, with minds, occupying a complex, diverse and dynamic biological body, a successful treatment would include and be capable of differentiating between these worlds, but also understanding their interconnectedness.
Considering the noticeable, individual differences and uniqueness of each person, that includes their taste, view of life, personality traits and emotional patterns, it is only logical that true healing dwells far beyond medications, dietary interventions, and even lifestyle changes.
In this sense, and as I stress so strongly in my online course Perfect Digestion, the treatment of digestive disorders of all types should address not only the physiological factors but also include psychological treatments that address the personality traits and emotional features that are constitutive of, and integral to the triggering of digestive diseases. By addressing the psychological (mental, emotional and spiritual), we will leave the realm of physics into the world of metaphysics, and there have a greater chance of providing the optimal conditions necessary for an improved quality of life, in mind, body and spirit, that those suffering from digestive disease so often lack.
INTRODUCTION: MIND – BODY CONNECTION
The mind – body connection is not mysticism, but perhaps it is to the person who believes they are just their body, with disregard to their mind and soul. However, the simple fact of the matter is we have bodies. In fact, most of us innately know that we are not bodies, but they are something we have. We say “these are my hands, my hair, my eyes, etc.” indicating that they are possessions (havingness) not an identity (beingness). The fact is, we are spiritual beings that have a mind (a communication network) that animates our body.
For centuries mystics and eastern philosophies like Chinese Medicine and Ayurveda have attempted to help us understand these concepts. Finally, in the last two decades, the field of psychoneuroimmunology has witnessed the mechanisms through which stressful, thoughts and emotions alter white blood cell function. It has been discovered that pyschological stress diminishes white blood cell response to viral infected cells and to cancer cells. Moreover, vaccination is less effective in those who are stressed and wounds heal less readily in those who are stressed. Showing that psychological stress is senior to even the most advanced modern medicines.
Stress is also the major trigger behind most types of autoimmune disease, which involve particular subsets of white blood cells. Some studies have found that talk-therapy interventions was capable of altering immune system parameters and enhancing the body’s ability to combat disease, proving that our thoughts are senior to mechanics.
Taking a step further out, perhaps the best way to understand the mind – body connection is through the workings of the digestive system. The digestive system is operated by the CNS (central nervous system). When we are in a state of stress (physically or psychologically), the nervous system stimulates the endocrine glands to secrete stress hormones, which help the body regain homeostasis. While in this sympathetic state, the digestive system shuts off to preserve precious biological energy.
Specifically speaking, looking at the digestive disease known as irritable bowel syndrome (IBS), this a great example of the heterogeneous nature of disease. IBS is triggered by a number of complex stressors including dietary intolerance, low grade inflammation, altered gut immune activation, intestinal permeability, alteration of microbiota, abnormalities in the autonomic nervous system, as well as psychological stress.
The relationship between the central nervous system (CNS), autonomic nervous system (ANS), and enteric nervous system (ENS) is a bi-directional communication network between the neural and immunological networks in the gut. This is referred to as the brain-gut axis; a more refined relationship between mind and body. Since understanding the strong connection between the mind and gut, there has been dramatic improvements in the understanding of IBS pathogenesis and cure. We now know that when the mind is either hyperactive or the connection between mind and body is entirely abberated, then the neural, immune and endocrine pathways that are affected, resulting in the poor functioning of the gut. Predominant causes of a broken brain – gut axis involve of course environmental, chemical, biological and psychosocial stressors.
Within this biopsychosocial framework, digestive disease pathophysiology can be viewed as resulting from multiple interactions between biological mechanisms and psychosocial factors including most dominantly; environmental stressors, early life stress, social stress, and psychological stress, which disrupt the regulation and activity of the endocrine system, therefore contributing to the dtysfunctioning of the digestive system.
In conclusion, psychological stress is at much of a cause of the stress and disease as other stressors including chemical stress, biological stress, environmental stress, etc. All of these inhibit the functioning of the autonomic nervous system, immune system and digestive system via stress-hormone.
Next, we will discuss the roles of biological effects of personality and chronic negative emotions such as apathy, depression, anxiety, fear, grief, and anger.
PERSONALITY & HEALTH
The term personality refers to patterns and consistencies in behavior, taste and perceptions that form experience. These include pattern of thoughts, emotions, feelings, and perceptions.
Determining exactly how personality is developed might be a daunting task; given our immortal nature as spiritual beings, free will and unique view point of life, perspective is ultimately self-created and thereby difficult to say there is a general pattern for development. The most important thing to understand in regards to personality is that individual differences in personality are the result of life experiences and the self determination of how one decides to perceive those events.
However, amongst the infinite ways a person choses to perceive and thereby express themselves mentally and emotionally, there are some stylistic features of personalities. While ultimately different and unequal, every personality has its similarities as well. Similarities in personalities and character refers to those aspects of personality consistent. But keep in mind, the distinction between personality traits is not cut and dry, considering that each personality trait is self-determined, capable of change and takes on many volumes or degrees.
Refining the subject, the most important thing to understand about personality that it is produced by a person’s view or perception of the world. And perception creates thought, which create emotion. Therefore, a person’s chronic thought pattern will determine a person’s chronic emotional pattern. For example, in any culture, we will find common personality traits, beliefs and life views, all which produce a collective or common emotional tone to that group.
The old-fashioned assumption which has dominated earliest psychosomatic research was that specific personality profiles were associated with specific somatic illnesses; however, in order to understand this, we must understand something about what personality is.
There is actually a large of amount of research in the field of psychosomatic illness, which basically points out the relationships between personality traits and health. But what is personality?
Breaking down the word we have person-al-ity. The roots al and ity, and their reduced form alty, are word-forming elements. Examples include, reality, fidelity, and personality.
You could say that personality is the quality of a person, more so, it is a personal view point.
Taking it deeper, considering that you are a spirit (the awareness of awareness), what gives you “personality” is your ability to create thoughts and perceive. Why we all have unique personalities, is because we all are capable of a unique view point of space. So you could say, personality that describes your own personal reality, how you see things.
This is the fundamental hypothesis in psychosomatics, that your own personal view of life, how you perceive things, can result in different health outcomes.
According to research, there are three main mechanisms that have been identified in this realm:
- Pathogenesis, in which traits may result in various physiological reactions both to external and internal stimuli, leading to susceptibility to illness, health behaviors, and poor coping with sickness.
- Personality traits may also influence health via social cognitions and associative processes, whereby environments become associated with symptoms and illness behaviors, acting as triggers to illness presentation. In other words, how one perceives their environment may trigger the onset of symptoms.
- Consistent individual differences in stress reactivity and adaptability (how one responds to events based on perception) makes changes in the hypothalamic-pituitary-adrenal (HPA) axis, increasing cortisol levels, and in the ANS system, by altering cardiovascular activity.
To summarize, we often hear the term “stressed” used as if it is causative. However, stress is force, counter-force. In order for stress to exist, there must be opposition, that opposition mainly being a person. Life and existence themselves are not stressful, they just are. There can be unideal conditions, environments, etc that life poses; however, it is our own resistance and counter-force that creates the phenomenon we know as stress. Therefore, our personal viewpoint, taste, preference, etc is the prime dominator in what may be called personality-related stress generation, which contributes to the decline of physical health.
Moving forward let us have a look at some specific character patterns and their relation to digestive disease. According to research, these are some of the personality traits that have received attention in psychosomatic literature, they are:
Neuroticism: Neuroticism refers to a tendency toward negative emotions (anxiety, hostility, depression) with high reactivity to physiological changes, emotional instability, vulnerability to stress, and an inclination toward impulsive behaviors.
neuroticism has been also associated with reduced cellular immune activity, increased pro-inflammatory cytokine levels, and lower cortisol stress reactivity; a negative constellation of personality traits involving higher neuroticism, lower agreeableness and openness was associated with diminished stress reactions both of the cardiovascular system and the HPA axis. The association between neuroticism and blunted physiological stress responses has not been extensively replicated, since a number of studies reported no association between neuroticism and cortisol changes during exposure to stressors.
Alexithymia: Inability to identify, describe and discern between emotions and feelings, poor imaginative thought and introspection, and a fixed cognitive style that is predominantly externally focused. Generally suppressed and inhibited emotional expression.
Alexithymic trait resulted associated with increased mortality, worse physical health outcomes, increased risk taking, internet addiction, and negative health and sexual behaviors. High prevalence of alexithymia was found in major diseases, such as cancer, type 1 diabetes, and systemic lupus erythematous. Additionally, these personality types seem to confer a specific vulnerability to chronic stress, and it has been associated with increased pro-inflammatory cytokine levels, higher risk of morbidity, mortality, low subjective and physician-assessed health ratings, lesser health behaviors, and worse illness perceptions in cancer survivors.
Confront: Confront, literally means to face. So here we are talking about a person who can confront, face a wide range of realizes and experiences. They have tendencies toward imagination, fantasy, aesthetics, creativity, ideas and values, and are flexible in thought and views.
Agreeableness: Agreeableness you could say is more so the willingness to agree. This doesn’t mean to lack integrity but to willing see someone else point of view. You might use the word “understandable” instead. This trait involves a being understanding toward society, trust, straightforwardness, and not inhibiting or enforcing views, communications, realities.
Conscientiousness: By conscientiousness we mean competent, orderly, organized, self-discipline, and motivated.
A high degree of Confront, Openness and Conscientiousness, is associated with a slow disease progression; where, low conscientiousness was associated with higher cumulative illness burden in later life, and high conscientiousness was a reliable predictor of longevity.
Extraversion: Extraversion refers to the attitude to experience positive emotions, warmth, excitement seeking, and activity.
Extraversion was related to reduced cytokine levels, increased cortisol levels, and, along with Moving towards other personality constructs, it has been proposed that alexithymia could affect health through a number of pathways, directly influencing autonomic, immune and endocrine activities leading to tissue damage and to the increased vulnerability to illnesses, or indirectly, by somatosensory amplification that causes low tolerance to painful stimuli.
Overall, findings from health research highlight the potential role of personality, conceived as built up from broad and stable traits, as a unifying structure embracing heterogeneous psychosocial factors which tend to cluster together, and contribute to raise the risk for illness onset, course, and outcome.
PERSONALITY AND DIGESTIVE DISORDERS
There are many findings on the psychological and psychiatric comorbidity in IBS patients that indicate psychosocial symptoms may be specific and basic to the syndrome. In scientific literature, it is still questionable. However, keep in mind that Western science is mostly concerned with the physical (matter, energy, space and time) and thereby grants causation to the body, which it is not. The body is the effect, you, the spiritual being operating the body is at cause. Our view is obviously more of a metaphysical view then, where metaphysics (transcending physics), is senior to the physical.
However, even western science has found strong correlations between neuroticism and patients with IBS. In my personal experience with clients over the past 12 years, I have made similar observations, where patients with digestive stress of any type had chronic negative emotional patterns, suppressed emotion, or at the least, psychological stress of magnitude.
According to the research, neuroticism, which refers to a marked vulnerability to negative emotions, is one of the main features of patients with functional digestive disorders and IBS. Furthermore, a community study showed association between neuroticism and a past history of sexual, physical, and emotional/verbal abuse in IBS patients, suggesting that neuroticism could be a predisposition for early childhood abuse.
The link between neuroticism and abuse has been further supported by a more recent, longitudinal study by the same research group showing, abuse during childhood was significantly associated with elevated levels of neuroticism, which was strongly related with baseline prevalence of depression and anxiety, and with moderately elevated scores on interference with life and activities.
Based on their findings, they suggested a conceptual model for IBS characterized by a “vicious cycle” between mood disorders and bowel symptoms in adults, with initial input from early life factors.
CHRONIC EMOTIONS: POSITIVE AND NEGATIVE EMOTIONS
First off, not all emotions are bad, not even “negative” emotions. Emotions are adaptive mechanisms, they animate the body and make life interesting. When clear and rational, even negative, low tone emotions can be helpful. For example, grief is a natural response to loss, fear is a natural response to life threatening situations. It is when emotions become chronic, reactive that one experiences mis-emotion and negative consequences.
A chronic emotional tone is a habitual emotional response, it is not rational, but entirely reactive. Another term for this is an emotional patterns, which refers to the chromatic pattern of emotional reactivity, processing and regulation. More specifically, they involve automatic or reactive, “unconscious” emotions occurring during stimulating experiences.
There are two broad dimensions of emotional patterns; in the simplest terms, they are positive or negative emotions. Somewhere in the scale of emotions, the frequency of emotions becomes painful and unpleasant. Because all emotions can be helpful, rather than labeling them positive or negative, terms which have taken on an ideology, let us categorize emotions into the realms of pain and pleasure. Positive emotions are pleasurable and pleasant, where negative emotions are painful and unpleasant.
Something else to understand is that emotions do not have “opposites”. The word opposite means, to oppose. There are only a wide range of human emotions that word in a scale-like or gradient fashion. When a person experiences pleasurable emotions, they are in full communication and awareness with the environment.
The basic painful emotions are boredom, hostility, pain, anger, hate, resentment, covert hostility, fear, grief, victim, hopeless and apathy. These emotions are negative because they have a vey dense, low energetic frequency and result in a state of fatigue, bad feelings, limited awareness, poor biological energy and low tolerance to stress.
It has been postulated that negative emotions are worse than positive ones; however, negative emotions are adaptations, which served the purpose of aiding surviving in life-threatening situations. In the right circumstance, anger and fear, inspire the “fight or flight” response, the urges to attack, resist, defense or to escape, mobilizing optimal physiological support for the action called forth, and requiring substantial physical energy also through heightened cardiovascular reactivity that redistributes blood flow to relevant motor districts, and through specific neuroendocrine pathways that sustain the stress reactions. Whereas positive emotions evoke nonspecific action tendencies, with a no autonomic activity.
It is also suggested that negative emotions diminish an individuals’ thought-action repertoires, where many positive emotions broaden individuals’ behavioral repertoires. This is indeed true; due to the fact that during a fight-or-flight response, a persons reactive (automatic/subconscious) mind is in charge, and the analytical or “conscious” mind is not. In other words, positive emotions lead to cognitive flexibility by keeping the analytical mind alert and aware, thereby making better judgement possible.
This will conclude the basic concepts around emotions. Now let us explore the relationship between positive and negative emotions and health.
EMOTIONAL PATTERNS AND HEALTH
It would be foolish to say that the emotions do not effect health. Thoughts are energy and emotions are thought energy in motion. The reason it has been so difficult for scientists to understand hormones, is because they are the chemical expressions of our consciousness – they are the chemical symbols of our emotions. For example, the hormone cortisol is a hormone secreted when a person is in fear or angry. However, anyone who has experienced strong emotions knows that emotions cause a biological effect on the body.
According to TCM, there is strong evidence that specific emotions can damage different organ systems. In short, the liver is effected by chronic anger, the kidneys by chronic fear, the lungs/colon by chronic grief, the spleen/stomach by chronic anxiety and the heart by excessive worry.
Science today is still trying to make sense of these ancient claims; however, take the liver for example. The liver is referred to as the seat of the soul in TCM – it also happens to produces most of the hormones in the body, which give life to emotions. Without a central nervous system and hormones, we could not physically feel our emotions. So in the most basic sense, the chronic experience of these negative emotions can put a biological stress on the associated organs.
Additionally, it has been shown in longitudinal studies that one’s chronic emotion in childhood is usually maintained into adulthood; thus, emotional functioning in childhood may provide an early indicator of adult health risk. As we learned earlier, chronic stress in childhood is associated with a range of adult physical health outcomes such as number of physical illnesses, inflammatory diseases, digestive disorders, and obesity. Whereas, positive emotions are generally associated with good physical, mental health, and longevity.
In general, there is plenty of research that shows strong proof of the harmful impact of chronic negative emotions on overall health. Studies have showed a correlation between chronic negative emotions and cardiovascular reactivity, heart disease, cancer and chronic illnesses, such as arthritis and diabetes.
Furthermore, it has been observed that certain negative emotional states influence health-related behaviors, such as perceptions of risks, decisions to improve their diet/lifestyle, to seek help, aversion to exercise, higher frequency of stressful events, and anti-social behavior. On the other hand, people who experience emotional wellness are associated with healthy habits and lifestyles, leisure activity, stress-freeness, and good social relationships.
A more intriguing hypothesis suggests that emotions have the potential to directly influence health through psychobiological processes, resulting in changes in multiple systems including, cardiac functioning, blood pressure, inflammation and immune responses, and neuroendocrine pathways, thus leading to increased vulnerability to illness and weekend immunity. It is acknowledged that negative emotions confer increased risk for disorders with an inflammatory and immune etiology. Also, chronic depression, anxiety, and anger have been linked with higher levels of pro-inflammatory cytokines such as interleukin IL-6 and other inflammation mediators, including C-reactive protein, and cellular adhesion molecules.
CHRONIC NEGATIVE EMOTIONS AND DIGESTIVE DISEASE
There is research that observes the negative emotional patterns in relation to the pathophysiological and symptoms of IBS – mostly, anger, anxiety, and depression. These emotions have been consistently associated to visceral and pain hypersensitivity. In the presence of negative emotions, visceral sensations tend to be more noticeable and painful. People with GI disorders and IBS have a higher tendency to scan the body for symptoms and pain.
Additionally, according to research on the brain-gut axis, children with IBS have more somatic complaints and complaints of anxiety, depression, social isolation, and impairment in school functioning. There is a significant correlation between emotional instability and visceral hypersensitivity; impulsiveness and impatience, all features associated with less effective ability to manage stressful life events.
In adults, depression and anxiety were positively related with abdominal pain and pain duration. Anxiety, depression, and the recall of painful memories were associated with a greater perception of visceral pain. Also, depression levels are higher in those patients who reported lowered rectal pain threshold. This validates the strong effect the mind can have on the body, whereby simply recalling a pastime painful experience can effect the body in present time.
Other studies provided evidence that chronic anger significantly increased colon motility in IBS patients, whereas anger suppression was associated with prolonged gastric emptying and delayed gut transit (constipation). So quite literally, holding onto anger resulted in holding onto shit.
Also, negative emotions are associated with low-grade inflammation and decreased immune activity. It has been found that patients with IBS and chronic depression and anxiety have elevated peripheral levels of the proinflammatory cytokines interleukine (IL)-1β and tumor necrosis factor α, and decreased levels of IL-10, an anti-inflammatory cytokines.
Finally, it has been discovered hat chronic negative emotional arousal can lead individuals to attribute IBS symptoms to the stressful situation, creating a restimulatory or triggering environments that may vey well tigger symptoms by autosuggestion, again demonstrating the power of the mind.
Given the interrelatedness of the brain and gut, on one hand, the biological stress of IBS symptoms can lead to anxiety but also, the decreased ability to cope with stress increases the physical symptoms. Again, because the body is the effect (not cause), ultimately, the body is responding to us and our thoughts and emotions, therefore, treatment of the physical symptoms alone would be incomplete.
Overall, the findings from studies on negative emotions and IBS presents us with important information. It is a fact that emotions affect the body, and have at least the potential to effect the health of the body. Given the fact that emotions occur frequently (50,000 – 70,000 thoughts per day with the likelihood to produce emotion), it would be more realistic to approach to the healing of IBS and digestive disorders by including the pathophysiology.
TREATMENT AT THE ROOT: FOCUS ON PERSONALITY AND EMOTIONAL PATTERNS
The biopsychosocial model applied to IBS acknowledges and highlights the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. From this viewpoint, and also considering the bidirectional communications within the brain-gut axis, a holistic approach that involved lifestyle changes, dietary interventions, psychological treatments, and educational and behavioral mastery would provide the optimal chance of addressing symptoms, unideal conditions, and improve the quality of life of those suffering from digestive disorders.
Psychological and psychosocial treatments that helped to clear painful trauma from their past, improve their understanding of how the mind and emotions work, and thereby improve their ability to direct them would be an effective treatment for repairing communication between body and mind. In fact, in my personal experience and from study, psychological interventions are significantly effective in the first assessment and make for the best long-term solution, given the dynamic, changing nature of life.
Various models of psychotherapy would include; cognitive therapy, gut-directed hypnotherapy, mindlessness (getting out of ones head and being more aware), body awareness, mind awareness (observing ones owns thoughts), honest communication, intentional relaxation, chilling the fuck out, are effective and proven to helpful to gastrointestinal symptoms and quality of life in those with GI disorders.
As reviewed in the previous sections, personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality and emotional features that are constitutive of and integral to IBS.
In addition to my own observation and 12 years of working with clients, there is actually a large amount of modern day research which has provided evidence that personality traits and emotional patterns influence health, disease, and quality of life through a range of biological and behavioral pathways, including physiological reactions to stimuli, reactivity to stressors, health behaviors, and coping with illness. This evidence also extends to the functioning of the digestive system. In fact, it is most obvious in the digestive system, which is known to be inhibited by psychological stress.
If you enjoyed this information and are interested in learning more, along with practical tips to improve your digestive function and heal once and for all, be sure to enroll in my online video course Perfect Digestion.