Comment by tcj_phx | Hacker News Reader

Comment by tcj_phx | Hacker News Reader

Stress is a rather generic term. Emotional stress and biological stress are two ways of distinguishing different kinds of stress.

Biological stress is not getting enough nutrients, having to deal with bacterial exotoxin/endotoxin [1] (as pneumonia, a hostile microbiome, etc), lack of sunlight (UV light -> Vitamin D; red light refreshes Cytochrome C Oxidase, an enzyme in the mitochondria [0]), consuming artificial sugar and other fake foods, etc...

Emotional stress is related to how a person responds to situations -- to quote the article, "why crappy childhoods make for adult brains that don’t work well". Different people can respond to the same situation in completely different ways... Some people are able to use their "crappy childhood" as motivation to make something of themselves, while others are disabled by their own similar childhood.

The tragedy of our situation is how the medical profession considers Dr. McEwen's work as interesting but doesn't do anything with it.

[0] https://en.wikipedia.org/wiki/Cytochrome_c_oxidase --- this page doesn't talk about the use of certain wavelengths of red/infrared light to refresh the enzyme. search for 'red light therapy', then buy heat lamps if you're interested. My current setup cost around $20.

[1] https://en.wikipedia.org/wiki/Exotoxin

Emotional stress is biological stress unless you believe in an extreme form of cartesian dualism incompatible with modern understanding of physiology.

Sure, it's atoms all the way down; however, it is still important to make a distinction. Biological stress can be beneficial for our well being, while emotional stress (fight or flight response) has mostly deleterious effects.

You could have hormetic effects from psychological stressors as well.

They really are identical on a certain level.

I agree with you and I’d guess your parent commenter would too.

Yet, many people who consider themselves to be rational and scientifically-minded, and who reject dualism, scoff at the notion that physiological illness can be caused/exacerbated by emotional stress.

Try this out some time: suggest that an illness like chronic fatigue syndrome or general autoimmune illness is at least somewhat linked to emotional stress and/or trauma, and see what kinds of reactions you get (or go and look at the discussions about this topic in CFS communities).

Amazing how conversations swing from one side of extreme to another in just two comments.

What's next, are you going to suggest basilar skull fractures are somewhat linked to emotional stress?

The responses you'd get would likely be due to PTSD induced by interacting with the very rational and scientifically-minded profit-maximizing medical industry, and/or incompetent physicians unable to provide an effective relief for the underlying condition.

Try out this some time: try to reduce stigma around various disorders instead of suggesting running nonconsensual unethical experiments, bordering on sociopathy, on those suffering from difficult to treat disorders.

> What's next, are you going to suggest basilar skull fractures are somewhat linked to emotional stress?

If you want to discuss this topic in good faith you should edit your comment to remove this appeal to ridicule.

I don't know what you think I'm advocating that motivates the bilious accusations in the rest of your comment.

From what I can tell:

- We seem to agree that people suffering chronic, difficult-to-treat illnesses have it extremely tough, and it would be ideal if they didn't (I know this from personal experience)

- We also seem to agree that the profit motive creates perverse incentives in medical research and treatment.

Outside of that, your comment seems to be just another example of the very phenomenon I was pointing out.

To be clear: I've experienced difficult-to-treat illness that seems to be autoimmune-related for much of my life.

I'm now almost completely well, having undertaken a variety of treatments including deep emotional/trauma healing work over the past 8+ years.

There is no mainstream physician, of any supposed level of competence, who would have recommended the approach that has enabled me to achieve the level of health I've now reached.

There are notable exceptions – Gabor Maté and Bruce Lipton being the most prominent – yet neither are taken seriously by the scientific/medical mainstream, despite both having advanced mainstream medical credentials.

Glad to hear that your health is improving. I have my own set of experiences that lead me to support your argument, the medical community seems to suffer from a lot of defensive or downright elitist behaviour when it comes to a discussion of their field with anyone outside it. It seems like a very 'siloed' industry with little cross-communication at the front line of care. The emerging field of Psychoneuroendocrinology seems like an attempt to address that by 'dealing with the interrelated disciplines of psychology, neurobiology, endocrinology, immunology, neurology, and psychiatry, with an emphasis on multidisciplinary studies aiming at integrating these disciplines in terms of either basic research or clinical implications.' in their words; https://www.journals.elsevier.com/psychoneuroendocrinology

I totally agree. I was once in the camp that believed mental disorders/traumas could never manifest themselves in real, significant, physical ways. Currently, I work in juvenile dependency law (which I bring up often in comments... as it shapes my world view... a lot) where I represent our State Child Welfare Department when they intervene/work with families when parents are struggling to appropriately parent. We often work with children that have been sexually/physically/emotionally abused. These children will go in to foster care and their parents will engaged in services to address their lack of parenting skills. The parents will also, generally, have limited visitation with their children. Often, again, these children have severe issues: encopresis, extreme weight gain/loss, lack of social skills, lashing out at peers and adults for no reason, hyper-sexualized behaviors, etc... While in foster care, these behaviors often decrease significantly. Then, out of the blue, after one visit with a parent, the children see all of their issues re-arise and they completely decompensate for days or weeks or months. It is horrific to watch.

The point being, I imagine this same thing happens with adults. And I think we, as a society, do a horrible job realizing how deep trauma can run and how it can manifest itself. For children everyone accepts it as normal, but for adults the perspecitive seems to be exactly as you state it is. And this is just wrong.

If that makes sense.

It sure does make sense. Thanks for sharing your observations.

If you haven't already, I'd strongly recommend looking up Gabor Maté; he's written several books and has plenty of talks/interviews on YouTube, and at least a couple of threads here on HN I think.

He’s a Canada-based physician who has spent his career researching and writing/speaking about this whole topic.

The world needs to pay a lot more attention to people like him IMO.

Psychology/Social psychology exercises at school are the way to go.

More awareness = better outcomes.

How people handle Trump and his base is a good marker of the populations mental health/self-awareness levels.

> The point being, I imagine this same thing happens with adults. And I think we, as a society, do a horrible job realizing how deep trauma can run and how it can manifest itself.

Uncertainty is scary. That is why trauma victims are placed in boxes, but it is wrong to do.

We have celebrated people who persevere and overcome their circumstances and we must continue to do so. We must give the gift of believe and faith to people who exist through circumstances that are destructive to the development of faith, belief, and trust.

Any victim has the potential to do that if their environment is supportive to providing that. It always depends on surroundings and belief of everyone. Everyone matters.

This is a growing area of research now, on how trauma and emotional stress affect mental health. For anyone interested in this topic, The Body Keeps the Score by Bessel van der Kolk is a good resources. I also like the madinamerica website, which offers articles written by mental health practitioners who are critical of the chemical imbalance model of the brain (which was pushed by pharmaceutical companies https://www.newyorker.com/tech/annals-of-technology/the-psyc...).

Almost every disease can be linked to emotional stress or trauma. When people have a high ACES (Adverse Childhood Experiences Score) Score, their risk of almost every adult illness goes up a lot. That's because childhood trauma causes epigenetic changes that affect inflammation, immune function, etc.

A heart attack can be triggered by stress. But you don't go up to someone who's had a heart attack and say, "Just relax -- it's just stress." Stress may have been the spark but once the fire is lit it burns all on its own. Similarly with a lot of bodily ailments, once a system is compromised then "relaxing" might not be enough to fix it.

As someone with CFS, what we don't like is when people imply or just say that it's "not real," "not that bad," "all in our heads," etc. Often laypersons become armchair diagnosticians, tell you that you're 'stressed,' and then assume that knowledge will fix the problem. But, just like the patient who's had a heart attack, the problem is a lot bigger now, and the interventions required are a lot more difficult than "just relax."

A wide gulf exists between consciousness and neurons. There are many easy abstractions to make between the two and putting the stress from starvation and the stress from grieving a parent's death in the same bucket is pointlessly pedantic.

I agree with you, but there is an entire field ( psychology ) predicated on the mind and brain duality. So perhaps they might view some or all emotional stress as "mental/psychological" stress not entirely tied to biological stress.

> but there is an entire field ( psychology ) predicated on the mind and brain duality.

No, psychology isn't predicated on mind/body duality. Much of it is arguably compatible with mind/body duality simply because it doesn't address physical root causes but only higher-level phenomena, but going beyond that to say that it is predicated on mind/body duality is like saying that Computer Science, because it deals with abstract computation and mostly not the underlying physical mechanisms (left to the separate field of computer engineering) is predicated on computation/processor duality.

> No, psychology isn't predicated on mind/body duality.

Can you tell me how psychology exists without the mind?

> Much of it is arguably compatible with mind/body duality simply because it doesn't address physical root

So it is predicated on the mind/brain.

> because it deals with abstract computation and mostly not the underlying physical mechanisms (left to the separate field of computer engineering) is predicated on computation/processor duality

Your analogy seems off and you assertion contradicts itself. Computer science is a math. It lives in the world of "forms". Computer science exists without the processor. It existed before the processor. Lambda calculus and the turing machine existed before the processor. Just like arithmetic existed before calculators. Are you saying the mind exists without the brain? The mind existed before the brain? So aren't we back to square one - the mind/brain duality?

If psychology isn't predicated on mind/brain duality, what is it predicated on?

> Can you tell me how psychology exists without the mind?

It doesn't (well, except maybe behavioral psychology, which arguably could) exist without the mind.

It just doesn't care one way or another about whether the mind is a direct product of the physical body or not. “Mind/body” duality isn't just “the mind exist”, but “the mind is at least in part not a property of the body”.

> If psychology isn't predicated on mind/brain duality, what is it predicated on?

Depends what particular branch. Behavioral psychology is predicated on humans existing and having behavior, most of the rest of psychology is predicated on humans existing and having cognition, whether or not that cognition is a property of the physical body.

> It doesn't (well, except maybe behavioral psychology, which arguably could) exist without the mind.

Okay. So psychology requires the mind. Good. Does psychology deny the brain exists? If not, you have the mind-brain duality.

> Mind/body” duality isn't just “the mind exist”

Yes. I suspect that's why the part about the brain and duality is in "mind/brain duality".

I'm glad we are agreed. Otherwise, if there was no mind-body duality, we wouldn't have psychology but only neuroscience. Maybe one day, hopefully.

Does neuroscience rely on neuron/collection-of-atoms duality?

IIUC, classically "mind-body dualism" involves an assertion that the mind cannot be explained physiologically. Psychology only asserts that the mind can be reasoned about directly. The usefulness of psychology depends on that reasoning being sufficiently accurate and sufficiently easier than reasoning neurologically for some problems.

> Does neuroscience rely on neuron/collection-of-atoms duality?

No because such duality doesn't exist. It's a relationship of composition rather than duality. It's empirically shown that neurons and atoms exist and neurons are composed of atoms. Last I checked, there isn't any empirical evidence for "the mind" just like there isn't any empirical evidence for "the soul". And nobody is asserting that the mind is composed of brains.

> IIUC, classically "mind-body dualism" involves an assertion that the mind cannot be explained physiologically.

No. Classically, the mind-body dualism is the idea that the mind and body are distinct separate entities and that the mind does the "thinking" and the body cannot "think". Has nothing to do one explaining the other.

> Psychology only asserts that the mind can be reasoned about directly.

Not directly, indirectly.

> The usefulness of psychology depends on that reasoning being sufficiently accurate and sufficiently easier than reasoning neurologically for some problems.

Or... there is no such thing as a mind-body duality and it's all just body and psychology is pseudoscience. Mind-body dualism is just a rehash of the soul-body dualism. People used to believe that the soul controlled the body and that's why the body could move. People used to believe that the sickenness of the soul translated to sickenness of the body. Hence why people used to believe diseased people were cursed by god for their sins. We don't subscribe to that belief anymore after advances in physiology. As we learned more about the body, the soul slowly faded away. Makes one wonder what advances in neuroscience may do to the mind.

You're being sloppy enough that this is frustrating and also uninteresting, so I am not going to continue.

> Okay. So psychology requires the mind. Good. Does psychology deny the brain exists? If not, you have the mind-brain duality.

No, mind-brain duality isn't “mind and brain both exist” but “mind exists independently of brain”. (It's usually referred to as mind/body duality rather than mind/brain duality now because no one actually thinks the physical basis of the mind is purely brain, and the essence of the purported duality isn't the mind having a physical locus other than the brain but it having some not-physically-determined aspect.)

Psychology is no more predicated on mind-brain duality than computer science is predicated on hardware-algorithm duality. It's a level of analysis issue. There's plenty of psychology close to the neuron, and there's plenty of psychology where invoking neural substrates is unnecessary or even impossible.

> There's plenty of psychology close to the neuron

Brain.

> and there's plenty of psychology where invoking neural substrates is unnecessary or even impossible.

Mind.

I already discussed the flawed algorithm/hardware analogy in another comment.

It's so strange that the two commenters claim psychology isn't predicated on mind-brain duality and yet in their same comment show that psychology requires mind-brain duality.

If psychology isn't predicated on mind-brain duality, it wouldn't exist any longer. We'd just have neuroscience.

Do we have some form of map between emotions and soma ? I read a few things about hormone cascade and neurological noise when traumatized. But that's not very precise.

>Emotional stress is biological stress unless you believe in an extreme form of cartesian dualism incompatible with modern understanding of physiology.

Not necessarily.

You can believe in the "modern understanding of physiology" and still think that "Emotional stress" is a "thinking" process that does not affect biological physiology.

It's not necessary that every emotion or brain process manifests in any other way aside from brain synapses firing and so on (e.g. that it affects the bodily operations in some other way).

So, it's not an either-or, but 3 options:

1) cartesian dualism (emotion and biology are two different spheres, soul independent of the body etc)

2) emotional stress triggers biological stress

3) emotional stress remains a brain process and doesn't trigger biological stress

And the case is probably sometimes (2) and sometimes (3).

When you workout, your stress level increase. And your body somehow deteriorate, but with some rest adapt as the result of the training. And you improve.

Then you can have other stresses coming from life events, work, kids, travel, partner,... issues.

If you monitor your stress with Heart Rate Variability, you can see them all having a bad effect.

It could be interesting to check if the red light could help recover faster.

The "positive" kind has another name, eustress, for better distinction: https://en.wikipedia.org/wiki/Eustress

It can be dangerous to look at it this way, just like looking at environmental / physical aspects of someone and his mental state, both affect each other. And it is the same with "emotional stress" and biological stress" one can cause another and vise versa.

What gives you the impression medical profession doesn't do anything with it?

Sapolsky (h-index 109) was McEwen's student, probably one of his most prominent students, and has continued to work on stress, as did his other students.

Sapolsky alone made enormous contributions to our understanding and treatment of stress and stress-related disorders.

How often do you hear of a case where a doctor, upon establishing that a patient has a debilitating illness that doesn’t respond to conventional medical treatment, recommend that they undertake deep emotional development or trauma healing work?

I can tell you from personal experience, it doesn’t happen. Patients are left to figure this out for themselves, and usually don’t as the idea is considered so wacky.

Are you suggesting physicians are uncomfortable treating somatization disorders or something?

Your comment makes a lot of assumptions: 1) physician is qualified and competent. 2) diagnosis is correct. 3) treatment is optimal.

Those are all big assumptions. Misdiagnosis and inappropriate treatment are very, very common. "Placebo" prescriptions are common. Something like 25% of presentations at primary care are for medically unexplained symptoms.

However, any half-decent physician will attempt to address obvious psychopathology, if present. I don't believe it is commonly being ignored.

I don't know your case specifics, but in presence of objective abnormalities - there is obviously going to be hesitation to diagnose somatoform.

> I don't know your case specifics, but in presence of objective abnormalities - there is obviously going to be hesitation to diagnose somatoform.

From the HN Guidelines:

> Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith.

> Patients are left to figure this out for themselves, and usually don’t as the idea is considered so wacky.

In my case it's not just the idea per se, it's also how people tend to talk about it. When I look for stuff about "trauma healing", I mostly get three things:

1) Seriously questionable marketing copy (e.g. [1]).

2) (Discussion of) narratives of childhood abuse, almost always with at least one identified individual abuser, and usually recognizing their experiences as abuse only in retrospect.

3) Recommendations for $IMPORTANT_BOOK about $THEORY by $VISIONARY_INVENTOR_OF_THE_THEORY (which invariably leads back to #1; see also Scott Alexander's "all therapy books" review [2])

So I'm not surprised that this isn't clearly established as a treatment modality among medical professionals. There seems to be a good chance that something real is there, but I don't see anything convincing in terms of a validated theory or proven method of treatment. I honestly get the impression of something vaguely cult-like about some of the exchanges on social media around this (idiosyncratic uses of jargon, revelation of hidden truths as a major theme, claims of suppression by the mainstream/establishment), which I think has put me off trying to learn more about it because the whole thing starts to seem a little shady (cf. chiropractic, homeopathy, faith healing, etc.). Do you have any recommendations for someone who's had this kind of experience with the idea?

[1] The Foundation For Human Enrichment, d.b.a. Somatic Experiencing® Trauma Institute, is a 501(c)(3) nonprofit dedicated to resolving trauma worldwide by providing state-of-the-art professional training and public education in Somatic Experiencing® (SE™)

[2] https://slatestarcodex.com/2019/11/20/book-review-all-therap...

At what page red light therapy ?

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