Self Hypnosis

Inflammation: Pathway to Chronic Diseases

Inflammation is activation of the immune system in response to threat or injury to the body. Acute inflammation mobilizes the immune system to repair an injury or fight an infection. Once healing takes place the immune system goes back to baseline. Chronic inflammation, however, involves long term activation of the immune system caused by some ongoing stress to the body. More and more, researchers are beginning to show that chronic inflammation is the common pathway to many diseases. There are multiple causes of chronic inflammation. In this post I will write about the causes of chronic inflammation. I will also do a series of posts about the many diseases that chronic inflammation causes. These posts will be based on the structure of an excellent book: Inflamed – Deep Medicine and the Anatomy of Injustice. It is not easy to read because it is disturbing but I highly recommend it. I will also write about a test to measure chronic inflammation. I will write about things you can do to decrease chronic inflammation if you have it and how to prevent it if you don’t. There are many causes of chronic inflammation that have to do with the structure of our society. These are things an individual cannot control. These societal causes will take ongoing efforts by all of us to change some of the toxic structures of society.

The Process of Inflammation

The inflammatory process starts with damage or threat of damage to the body. That can be an infection, a wound, or perceived threat of such. The immune system mobilizes white blood cells called macrophages to the injured area or site of infection. The cells of the immune system also release a cascade of messenger molecules called cytokines that amplify inflammation. These include interleukin 1ß, interleukin- 6 and tumor necrosis factor -α. The liver also releases a protein called c-reactive protein. When the threat is neutralized the immune system helps the body start to heal by releasing anti-inflammatory cytokines including interleukin (IL)-1 receptor antagonist, IL-4, IL-10, IL-11, and IL-13.

In chronic inflammation the pro-inflammatory cytokines continue to predominate and the c-reactive protein continues to be elevated.

Causes of Chronic Inflammation

Causes an individual can do something about

  • Low levels of physical activity.
  • Having a BMI at or above 30 , especially when excess weight is deep within your belly (visceral fat). The best way to measure belly fat is to use a tape measure to measure your waist at the widest point. Increased belly fat is greater than 35 inches for women or greater than 40 inches for men
  • An imbalance of healthy and unhealthy bacteria in your intestine (dysbiosis). Dysbiosis can be caused by antibiotics and by eating foods low in soluble fiber.
  • Regularly eating foods that cause inflammation, especially highly processed foods, or foods high in sugar or salt
  • Inadequate sleep
  • Using tobacco products.
  • Regularly drinking too much alcohol
  • Periodontal disease (gum infection) and tooth decay
  • Perceived stress

Societal Causes

  • Experience of racism (structural or personal)
  • Poverty
  • Homelessness
  • Worry about debt
  • Work stress
  • Exposure to air pollution
  • Exposure to chemicals (pesticides and herbicides for farm workers, glyphosphate (RoundUp) for everyone, microplastics in our bloodstreams for everyone. Every day, we are surrounded by thousands of synthetic chemicals. They are in our food, clothes, tools, furniture, toys, cosmetics and medicines. We know the health effects of only a few of these).

Diseases caused by chronic inflammation

  • Cardiovascular Disease (coronary artery disease, heart attacks, congestive heart failure)
  • Strokes
  • Type 2 diabetes
  • Cancer (multiple types)
  • Inflammatory bowel disease (crohns disease, ulcerative colitis)
  • Rheumatoid Arthritis
  • Lupus and similar autoimmune diseases
  • Asthma
  • COPD
  • Pulmonary fibrosis
  • Depression

Tests to measure chronic inflammation

All of the inflammatory cytokines can be measured but those are expensive tests. A simple inexpensive test that measures inflammation, both acute and chronic is high sensitivity CRP. It will also be high with an acute infection or injury, but will return to normal after the infection or injury have resolved. If it remains elevated when you are not sick or injured it is a sign of chronic inflammation. It may be worth asking your doctor to order this test if you have any of the individual or societal risk factors for chronic inflammation. A normal hs-CRP is less than 0.55 mg/dl in men and less than 1.0 mg/dl in women. If your hs-CRP is high in the absence of acute infection or injury, that can serve as motivation to make lifestyle changes to decrease your chronic inflammation and put you in a population that has less risk of developing any of the diseases associated with chronic inflammation.

Anti-inflammatory lifestyle

  • Exercise regularly. The CDC recommends 30 minutes of moderate exercise (walking briskly) for 30 minutes at least 5 days a week.
  • Eat mostly unprocessed or minimally processed foods and avoid sugary drinks or foods with added sugar or high fructose corn syrup. Also include foods with high soluble fiber such as beans, carrots, sweet potatoes, nuts, berries and most fruits (not fruit juice). Organic foods, while more expensive, have no residual pesticides or herbicides. If you eat meat buy grass fed beef, and pasture raised chicken and pork. Eat more plant-based foods than meat.
  • Avoid taking antibiotics as much as possible
  • Sleep. Average at least 8 hours a night
  • Floss your teeth daily, brush twice a day and see your dentist every 6 months
  • If you don’t smoke, don’t start and if you do smoke quit.
  • It is better not to drink alcohol at all, but if you do limit it to 1 drink a day or less.
  • Learn meditation or self hypnosis to manage stress. There are good books and videos, but an in person course is best if it is available.
  • Drink only filtered water and not bottled water in plastic bottles
  • Gas stoves cause significant indoor air pollution. If possible switch to an electric stove. Induction type burners actually heat more quickly than gas. If you have to use a gas stove, be sure to turn the ventilator fan on and open a window if possible.

Bottom Line

Chronic inflammation is the common pathway for many chronic diseases. There are many individual strategies that reduce or prevent chronic inflammation. Many of these strategies are not possible for people with socioeconomic problems. The stress black people experience from structural and individual racism, homelessness or inadequate housing, anxiety over debt, exposure to environmental synthetic chemicals, and exposure to air pollution are societal problems that we all have a responsibility to address.

My next post will deal with chronic inflammation and cardiovascular disease.

Chronic Stress Response: It Can Make You Sick or Kill You

All mammals, including humans have an innate response to perceived threat or stress. The more common name for it is the “flight or fight” response. Our remote ancestors faced many real threats. Let’s say for example one encountered a saber tooth tiger. As soon as he (or she) saw the tiger, several things happened. Epinephrine and norepinephrine were released, speeding up the heart rate in preparation for running away. A surge of cortisol was also released, which increased glucose in the bloodstream for fuel for muscles and the brain. Cortisol also increases mental alertness. Inflammatory molecules were released to promote wound healing should that be needed.

This kind of acute stress response is a good thing. People or animals with this kind of response were more likely to survive and reproduce. Once the acute threat was over, all the hormones and neurotransmitters quickly returned to their baseline levels.

In today’s world, threats from predators are not a problem for the vast majority of people. The threats we perceive are things like poor work conditions; experiencing discrimination, hate, or abuse; poverty; homelessness; divorce or other family discord; having little control over outcomes; feeling overwhelmed.

These are all things that produce the stress response, but unlike our remote ancestors, these threats are chronic. They are either lifelong or at least last a long time. Instead of returning to normal, the stress hormones and neurotransmitters stay elevated for long periods of time. A chronic stress response is definitely not a good thing!

Allostatic Load

The medical term for the acute stress response is called allostasis. Here is the definition of allostasis from Wikipedia: “Allostasis is the efficient regulation required to prepare the body to satisfy its needs before they arise by budgeting those needed resources such as oxygen, insulin etc., as opposed to homeostasis, in which the goal is a steady state.” Allostasis is an adaptive response to acute stress. Allostatic load on the other hand is the long-term result of failed allostasis, resulting in dysregulation (abnormal function) of multiple systems including the neuroendocrine, cardiovascular, immune, and metabolic systems.

Allostatic load is measured traditionally by 10 indicators of chronic stress. Primary indicators are the hormones and neurotransmitters released by stress. Secondary outcomes are measurements of the systemic effects of the primary indicators. All of these indicators are associated with the perception of stress. Below is a table showing the 10 indicators, how they are measured, and which body systems are affected. Here is a link to the full article from which this table comes: Allostatic Load: Importance, Markers, and Score Determination in Minority and Disparity Populations

CategoryMarkerFunctional purpose
Primary mediatorsDehydroepiandrosterone sulfate (DHEA), serumSecreted by the adrenal glands. When high with stress it tends to lower cortisol and be protective in the stress response.
Cortisol, urinaryIntegrated measure of 12-hour hypothalamic–pituitary–adrenal axis activity. Secreted by the adrenal glands. Has multiple effects in stress response.
Epinephrine, urinaryIntegrated indices of 12-hour sympathetic nervous system activity. Sympathetic nervous system activation increases heart rate and blood pressure.
Norepinephrine, urinary
Secondary outcomesSystolic blood pressureIndices of cardiovascular activity and major risk factor for vascular disease
Diastolic blood pressure
Waist–hip ratioIndex of long-term levels of metabolism and adipose (fat) tissue deposition. High value means fat around internal organs which increases inflammation and increases LDL (bad cholesterol) and triglycerides.
High-density lipoprotein cholesterolIndex of atherosclerotic risk protection. Low value increases risk of heart disease.
Total cholesterolIndex of long-term atherosclerotic risk
Hemoglobin A1CIntegrated measure of high blood sugar over 2–3 months

Each indicator that is a certain distance out of the normal range counts as one point. The score can range from zero to ten. The higher the score, the greater the risk of illness or death.

Other Indicators

Although the ten indicators were the ones described in the original papers about allostatic load, other indicators have been used as well.

  • Heart rate variability is the normal beat to beat variability in the heart rate. In a healthy heart there is slight variation in the timing of one heartbeat to the next. Chronic stress reduces or even eliminates this beat to beat variation.
  • High sensitivity C-reactive protein (CRP). This is a measure of systemic inflammation that can result from chronic stress.

How is the stress reaction triggered?

The stress reaction begins in the brain. Something in the environment is perceived in a part of the front of the brain called the prefrontal cortex. This is the executive decision maker in the brain. If the prefrontal cortex perceives something in the environment as a threat, then it sends messages to the limbic system (the part of the brain that is involved with emotions). It also sends messages to centers lower in the brain, especially the hypothalamus. The hypothalamus sends messages to the adrenal glands which secrete cortisone, norepinephrine and epinephrine. The hypothalamus secretes DHEA. Messages from the hypothalamus are also sent to the white blood cells which secrete inflammatory chemicals called cytokines. All of this prepares the body to deal with the perceived threat. Different people may perceive different things as a threat. It is the reaction to perceived threats that causes allostatic load. If another person experiences the same thing in the environment as not a threat, then there is no stress reaction.

Diseases associated with high allostatic load (high chronic stress)

A high allostatic load score is not disease in itself, but if chronic stress continues then disease in the cardiac, metabolic, neuroendocrine and immune system can occur. Here is a list of diseases associated with persistent high allostatic load.

  1. Heart disease, primarily progressive blockage of the coronary arteries. This can lead to angina and/or heart attack. Congestive heart failure and arrhythmia like atrial fibrillation can also occur
  2. Peripheral arterial disease. That is blockage in arteries in the legs and sometime fingers.
  3. High blood pressure
  4. Stroke
  5. Autoimmune diseases like rheumatoid arthritis or lupus
  6. Diabetes
  7. Fibromyalgia
  8. Chronic Fatigue Syndrome
  9. Dementia or decreased cognitive function
  10. Depression
  11. PTSD
  12. Cancer, particularly breast and ovarian cancer. The increase in cancer is probably related to decreased immune system function

Allostatic Load and Mortality

Many studies have shown that people with persistently hight allostatic load have about a 25% higher premature death rate than people with low allostatic load.

Disparities in Health Outcomes

The response to chronic stress (allostatic load) may explain some of the disparities we see in health outcomes. We know, for example that Adverse Childhood Events (ACE), which include things like abandonment and abuse, increase the risk of many chronic diseases in adulthood. Studies have shown that adults with a history of ACE have high allostatic load scores.

African Americans have higher incidence of many cancers, as well as poorer outcomes from those cancers. They also have worse outcomes from heart disease, high blood pressure and diabetes. While a good portion of these poorer outcomes are related to lack of access to health care, these disparities persist to some degree even in middle class and upper middle class African Americans. Almost all African Americans have experienced or still experience racism on a chronic basis. African Americans of all social classes have higher allostatic load scores than caucasians. Chronic stress and response to it may be the common denominator for these disparities as well as for health outcome disparities in other marginalized populations.

How to reduce allostatic load

There is typically a long time between the presence of indicators of allostatic load and illness and death caused by diseases associated with these indicators. That presents an opportunity to reduce allostatic load before the chronic stress response leads to illness and death. So how do we reduce allostatic load?

Some of the things that cause allostatic load can only be reduced by societal changes. Things like poverty, structural racism and homelessness cannot be decreased by individual effort. Even these causes, though, can respond to the mind body methods discussed below. On the other hand, if you don’t have enough to eat, have no home, or have a job that gives you no control of your life, it is not likely that you will have the energy or the will, or the financial means to do many of the mind body methods discussed below. We should not be distracted from working to decrease the inequities that are responsible for societal causes of chronic stress.

Mind-Body Medicine

Remember that an external threat is first received by the peripheral nervous system and transmitted to the pre-frontal cortex. In order to reduce allostatic load we can either reduce the threat perception in the prefrontal cortex (top down) or reduce the transmission of threat in the peripheral nerves (bottom up).

Top Down Treatments

Top down treatments start with intentional activity in the prefrontal cortex. The idea is to decrease activation of the limbic system and the hypothalamus. This can be accomplished by mindfulness meditation, hypnosis (including self hypnosis), mental imagery and progressive muscle relaxation. All of these techniques when done regularly have been found to decrease allostatic load indicators and to reduce the risk of stress related illnesses.

Bottom Up Treatments

Bottom up treatments decrease the threat transmission to the prefrontal cortex. They include yoga, Tai Chi, massage and biofeedback. These treatments have also been shown to decrease allostatic load and to reduce stress related illness.

Bottom up and top down are somewhat of an oversimplification. All of these treatments have some aspects of both top down and bottom up. Yoga, for example includes aspects of meditation. The same goes for Tai Chi. Biofeedback involves some attention from the prefrontal cortex. Massage also includes progressive muscle relaxation.

Bottom Line

The body’s reaction to a perceived threat includes a complex cascade of messages from the executive center in the prefrontal cortex to multiple body systems including the nervous system, the endocrine system, the cardiovascular system and the immune system. All of these things prepare the body to deal with the threat. As long as the threat is short term the stress response is very useful to the organism.

Perception of chronic stress leads to continuous secretion of all the stress hormones and inflammatory cytokines and this leads to dysfunction of multiple body systems and eventually to illness and death.

Mind body treatments, both top down and bottom up can reduce the allostatic load (chronic stress response) and reduce the risk of stress induced illness and death.

Many causes of chronic stress have to do with the structure of our society, such as poverty, homelessness and structural racism. Individual effort is not likely to ameliorate the effect of these causes of chronic stress. All of us should be working toward societal change to reduce chronic stress response in marginalized populations.

The Power of the Unconscious Mind: How to Access it for Healing and Improving Health

I’m going to spend some time in this post writing about the neuroanatomy and function of the conscious and unconscious mind. Hopefully I will be able to clear up some common misconceptions about both. I will then write about the amazing power of the unconscious to facilitate healing from both physical and psychological injuries as well as to decrease pain from dental and surgical procedures. Finally I will write about how to use self hypnosis techniques to access the power of the unconscious.

The Conscious Mind

We intuitively feel that our conscious mind makes up the largest part of who we are. Through our 5 senses we feel that we observe the real world, that is, what we see, hear, touch, smell and taste is out there in the world just the way we perceive it. That is an illusion, however. We perceive what is important for our survival. We see only a small part of the electromagnetic spectrum. We cannot see ultraviolet, for example, but bees can. We hear sounds of only certain frequencies. Dogs can hear ultrasonic frequencies, and dogs’ sense of smell is thousands of times better than ours. We do not directly sense the world. Information from our sense organs is extensively processed in the brain. We sense only a representation of the outer and inner world that our brains create. Furthermore a vast amount of sensory information is coming from our environment, both internal and external, being processed by our sense organs, and we become conscious of only a tiny part of that input. Our conscious minds can process about 50 bits of information per second. If that sounds like a lot, remember that internet download speeds are measured in millions of bits per second. The parts of your brain and spinal cord that are below the level of consciousness process about 11 million bits of information per second!

Carl Jung once described the conscious mind as like a cork floating on the sea of the unconscious. Modern neuroscientists have shown that his analogy was very accurate.

An example may make this point better. As you are reading this blog, you are seeing the letters and words upright. What is actually happening is the light and dark pattern of this sentence is focused by the lenses of your eyes into upside down two dimensional images on your retinas. A great deal of processing goes on in your brain so that what you actually perceive is right side up, has color and is three dimensional. All of that processing is below the level of consciousness. Furthermore, the high resolution part of your retinas, called the fovea can see only a small area at a time. Your eyes are constantly scanning back and fourth and up and down seeing only a tiny bit at a time and yet you perceive your visual world as whole. Finally your ability to read sentences and extract meaning rather than seeing individual letters and/or words is a learned pattern that has become automatic. Most of the process of reading is therefore done below the level of consciousness.

The Unconscious Mind

As you can see from the section above, the vast majority of the processing our brains do is below the level of consciousness. The unconscious mind controls our heart rate, our blood pressure, our breathing, our bowel function and all the things that are are necessary for our survival that we don’t have to think about to make them happen. The unconscious also contains all of our of automatic skills, such as playing the piano, riding a bicycle, or playing tennis. It is the source of stored memories, fantasies and dreams. It takes over patterns that we have learned over time to simplify our lives. Many of these patterns are necessary and helpful, such as brushing our teeth. Some patterns are not so helpful, such as phobias, anxiety and fear, or unhealthful habits such as smoking, excessive drinking or compulsive drug use.

All of these things are patterns of connections in the brain. We used to think that brain connections once made could not be changed, but scientists have since found out that not only can brain connections be changed, but they are constantly changing. This is called neuroplasticity. It is normal to grow new brain cells and to change their connections.

Can we change unhealthy patterns in the unconscious mind?

The short answer is yes! While the unconscious mind is generally not accessible to the conscious mind (that’s why it’s called the unconscious, after all), there are ways to influence the unconscious mind and to change unhealthy connections.

Altered States

The state of mind that we are in most of the time is called the waking state. Our conscious mind is controlling our actions (well sort of). There are other states of mind, often referred to as altered states or trance states. These are familiar to all of us. A perfect example is watching a movie or a television show. We get so wrapped up in the story that we lose awareness of all of our other surroundings. Sometimes people talk to us while we are paying rapt attention and we don’t even hear them. Reading a really good book creates the same altered state. Have you ever been driving somewhere and suddenly found yourself having arrived at your destination, but you don’t remember any of the details of the trip? Another altered state of consciousness or trance. If the word trance bothers you, think about the word entranced. We all know what that means. These altered states or trances are no different.

It turns out that once we get the conscious mind out of the way (entranced) the unconscious mind becomes accessible to change. The spontaneous trance states like television watching or driving while in a trance don’t change any connections, but it is possible to intentionally go into a trance state and purposefully change connections in the unconscious mind.

Hypnosis

Many people find this word scary, but all it means is going into a trance state (which we do spontaneously all of the time) and changing some connections in the unconscious mind. That can happen accidentally and accidental changes are often not healthy ones.

So all hypnosis is really self hypnosis. Some people, called hypnotists, become very good at helping us enter trance states and facilitate positive changes in connections in the unconscious mind. Good hypnotists, however are few and far between. Most people who advertise themselves as hypnotists are not very good. A few people respond to them and they say the rest can’t be hypnotized. They blame their incompetence on the people they are trying to help!

You don’t have to find a skilled hypnotist in order to make positive changes in the connections of the unconscious mind. There are tried and true techniques that allow you to purposefully enter a trance state and make all sorts of positive changes in the unconscious. Furthermore you can activate pathways in the brain and spinal cord that release endorphins and norepinephrine that eliminate or markedly reduce pain. You can use these techniques at the dentist or for medical procedures that would normally cause pain.

Self Hypnosis

There are three things you need to do before each self hypnosis session.

  1. Decide how long your self hypnosis session will last. Twenty to thirty minutes is plenty.
  2. Decide what change you want to make. You can say it out loud or just think it. The change needs to be positive. The unconscious is very literal and it does not understand “not.” If you frame your change as “I’m not going to smoke anymore” The unconscious will take that as a command to keep smoking. A positive wording might be “I will just do things that improve my health.” Once you have framed a positive change, your unconscious mind will take over once you are in a trance. You don’t have to, nor should you repeat the instructions for change while you are in a trance.
  3. State out loud or in your mind how you want to feel after the session. It will either be “I will feel rested and refreshed” or “I will be tired and ready for sleep.” If you are doing your session just before bedtime you would say “I will be tired and ready for sleep.” Any other time of day you would likely want to feel rested and refreshed.

Induction of Trance

Going into a trance on purpose is called an induction. There are many ways of inducing trance, but I’m going to give you two very simple ones. You can try them both and see which one you like better. The first one was invented by Mike Mandel, a Canadian hypnotist. The second one has been around a long time and no one knows who invented it.

Incremental Eye Closure Induction

Find a quiet place where you are unlikely to be interrupted. Be sure to silence your phone. Sit in a comfortable chair and pick something to look at above your eye level. As you stare at whatever you have chosen, start paying attention to your breathing. With each out breath let your eyelids close a tiny bit. You will find yourself progressively relaxing, and by the time your eyelids close completely you will be in a trance. The trance will continue to deepen for a while with each out breath. You don’t need to do anything at this point except enjoy feeling relaxed and comfortable. Your unconscious mind will take care of the rest and you will find yourself returning to your waking state after the length of time you specified. You will feel great, rested and refreshed or tired and ready to go to sleep depending on which state you specified beforehand.

Instant Eye Closure Induction

Same instructions as above about a quiet place and a comfortable chair. As you inhale deeply, roll your eyes up as high as you can. As you exhale, close your eyelids with your eyes still rolled up, let your head drop forward and completely relax. You will instantly be in a trance. Your trance will deepen with each out breath. Once again, simply enjoy feeling so relaxed and let your thoughts go wherever they will. Your subconscious will bring you back to your waking state at whatever time you specified before the induction.

Practice

I would suggest that you do this self hypnosis exercise for at least 20 minutes a day (More is okay too). You will find with practice that it gets easier and quicker to induce a deep trance. Either eye closure method works as what’s called an anchor. As you practice you will find eventually that simply closing your eyes induces a trance. If you have to have any procedure that usually causes pain, you can give your unconscious mind instructions to feel relaxed and comfortable during the procedure and then put yourself in a trance during the procedure.

Bottom Line

Our conscious minds can only process 50 bits per second while our unconscious minds can process 11 million bits per second. The vast majority of mental processing takes place below the conscious level. Unhealthy connections in the unconscious mind take place by accident when we are in spontaneous trance states. It is possible to remove unhealthy connections and create new healthy connections by self hypnosis techniques. These technique can also diminish or eliminate pain from dental and/or medical procedures. Regular practice creates “anchors” that produce trance very quickly.