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Stress and Illness: A
[presented by Dr. Rae Baum, Ph.D.]
(Source: Alexander Lowen, M.D., Stress and Illness: A Bioenergetic
View. Copyright © 1980 Monograph, with permission of the author)
D. Preventing Illness -- Coping with Stress
We have said that stress results from a situation which makes a demand upon the organism for the expenditure of energy. If the organism has sufficient energy to meet the demand, there is no problem. Trouble arises when the demand is excessive. In that case the normal and healthy response is to withdraw from the situation. All animals follow this pattern of behavior which is directed by the pleasure/pain principle. We experience the process of living as pleasurable when we have sufficient energy to meet the demands of life. When the demand is excessive or we are deficient in energy, the stress becomes distress which is painful. The pleasure/pain principle says that all organisms seek pleasure and try to avoid pain.
Human beings are also governed by another principle called the reality principle. This says that a person will forego pleasure and tolerate pain if he believes that such behavior will lead to a greater pleasure or to the avoidance of a greater pain in the future. Because of this principle known as reality people do not always withdraw from distressing or painful situations. A young child faced with a hostile and punishing parent cannot physically withdraw from the situation. Being alone is more frightening than the pain he must endure. But his submission does not relieve the shock effect of the hostility or punishment.
There is an alternative to flight. If one has the energy and strength, one can fight the aggressor which, if successful, may prevent the pain and the distress. Fight or flight are the basic animal responses to distressing or painful situations. In both fight and flight the energy reserves of the organism are mobilized through the action of adrenaline to meet the emergency. Such emergencies in the animal world are generally of short duration -- an attack by a predator, for example. The prey escapes and the emergency ends.
Generally, there is no escape from parental hostility. The child is forced to submit to the demands of his parents. On a physical level he can neither flee nor fight but he can do one or both psychologically. He can withdraw psychologically from a situation by cutting his contact with reality. This is done by withdrawing energy from the periphery of the body. It is the schizoid or schizophrenic pattern and it is also the equivalent of shock. The schizophrenic individual is in a more or less permanent state of shock which numbs him to reality. So in that state the stress of life or of reality does not affect him and he will not develop a psychosomatic illness as described above. Autopsies of schizophrenics have shown that their heart and blood vessels are like those of young people. The price he pays for this protection from stress is the withdrawal from life. He exists in a state of limbo, neither dead nor fully alive. By withdrawing he limits his ability to take in energy, his breathing is very shallow. I mentioned earlier that the schizophrenic individual is not as susceptible to colds as others because he remains in a somewhat frozen condition. However, because of his poor respiration he is liable to pneumonia as he gets older. In the past before antibiotics this was often his fatal illness.
Psychologically one fights by tensing the body so that one can take the punishment without breaking down. On the surface the child seems to have submitted; internally, he stiffens to resist the parents' demands. This tensing and stiffening of the muscles may be localized or generalized but in both cases he says "I won't" in the language of the body. But by this manoeuver the conflict becomes internalized since by his overt submission the child's ego incorporates the parents' demands as valid goals. Thus one part of the ego, the superego or ego ideal, commands the fulfillment of these goals while another part, the suppressed resistance, fights against their attainment. The child also accepts the parents' rationalization and justification for their negative attitude -- namely, that if the child was as the parents wished, he would be loved. This is the typical pattern of the neurotic individual who accepts the reality as his parents proclaim it and strives to fulfill their demands. He will be as his parents demanded. But all he can really do is erect a facade of conformity since inwardly he is just the opposite.
The basic difference between the schizophrenic and the neurotic attitude is that whereas the former represents a withdrawal of energy from the surface and reality, the latter is based on an overinvestment in the surface appearance as the true reality. Thus, we saw that the person who suffers from ulcerative colitis, the oral character type, has created a facade which denies his needing, his dependency and his fear of falling. The person who develops arthritis, basically a rigid type, denies his negative aggressivity and presents a facade of care and solicitude for others. Recently I worked with a young woman who suffered from lupus erythematosus. This is an illness which may properly be described as self-destructive in that part of the body, the immune system, seems to react negatively to its own tissues. The symptoms in her case were weakness, pulmonary inflammation, a facial outbreak, and eye disorders. Her facade was that of being "daddy's good little girl." This role required an inhibition of her sexuality, a suppression of her romantic longing and a denial of her rage at her father and men. In return she expected love and protection from her father and other men with whom she became involved. She had never gotten this from her father nor from any man. She did get implied promises of love and protection that were never fulfilled. Yet she believed in them and invested her energy into the effort to make them into reality.
As long as she could maintain the facade she was in the stage of resistance and free from any symptoms of disease. She was, however, under great stress because maintaining the facade imposed much self-denial, and demanded considerable energy. She was close to the stage of exhaustion. And then, she had a shock. She was betrayed by a man who was in the position of a father surrogate. Judging by her reaction it was a severe shock for one day later she was in the hospital with a high fever. Cortisone slowly brought her condition under control and her symptoms disappeared but further stress reactivated them.
In therapy with me she made some progress -- feeling stronger and better. As her therapist I became a father surrogate who was supposed to protect and love her. In return she would be my little girl. Being a therapist involves much more than being loving and protecting to patients: I had to take a hard look at the patient's neurotic attitude and confront her with it. When I did this my patient felt betrayed and her symptoms reappeared in milder form. It was another shock. When I was away for the summer, her anger at me brought a recrudescence of her eye symptoms. And yet only through such shocks and the return of the illness could she discern the pattern that made her liable to this disease.
The maintenance of a facade predisposes a person to somatic illness because it imposes a constant stress upon the body. One tries to be what one isn't which deforms the personality and the body. When the deformation (stress) persists long enough, the internal structure of the body breaks down. It is not the facade that breaks down but the tissues of the body. The facade is maintained even at the cost of structural integrity. In the case of schizophrenia, it is the surface of the personality that breaks down under overwhelming stress while the internal organs are protected. We can put it another way. In schizophrenia the breakdown is mental or psychic whereas in the neuroses it is physical or somatic. This is clearly seen in the case of cancer.
I have related cancer to despair. The cancer victim almost never acknowledges his despair. He maintains a facade of courage and hope almost to the very end. He dies on the inside while maintaining a facade of interest in life on the surface. The schizophrenic, on the other hand, is never far from his despair. He cannot handle it any better than the cancer patient but he does not attempt to overcome it. By his withdrawal, he dies on the outside while guarding a core of integrity on the inside.
I am not trying to say that mental illness is better or worse than somatic illness. Neither is health which is what we want. I have written extensively about the problems of mental illness elsewhere. Here, I would like to focus on the psychosomatic illnesses and the problem of undue stress. But we need to know the energy dynamics that underlie these illnesses if we wish to treat them or prevent them.
We all know that the life style of modern society creates enormous stress for its members. The demands upon them are great and, often, excessive. These demands are, broadly speaking, to produce, to achieve, and to accomplish. The goals are success, power and fame. The attainment of these goals requires that the person devote almost all his energy to this task. This is especially true since the culture is also very competitive. People who are committed to the goals of this culture have no place in their lives for feelings. The drive for success requires the development of a rigid personality structure based on the suppression of all feeling including sexuality. The person becomes a doer, an achiever, a performer. In most families the training for this life style starts early in the life of the child.
The suppression of feeling is done by muscular contraction which places the body in a state of tension. While the tension creates the drive, it also reduces the body's energy through its restriction of respiration. The result is that persons who drive themselves are heading for a breakdown. This analysis suggests only one way to avoid illness and that is by reversing the pattern of this culture. The drive or push to succeed must be reduced and the life of the body expressed through feeling must be increased. We must realize that the drive for success is an attempt to compensate for an inner sense of failure as a man or woman. It is an effort to convince our parents and the world that we are worth being loved despite the fact that we don't feel lovable. But no matter how much we try nor how successful we become we never arrive at feeling loving or lovable and we succumb to the despair we refuse to acknowledge.
The key to health is to live fully the life of the body. This means that feeling is more important than doing, that being free is more important than being rich, and that the present is always more important than the future. This is not to deny some validity to the reality principle. But in sacrificing the present for the future we must be sure that the promise of future gain is not an impossible dream, an illusion that can never be fulfilled. In terms of the body there is neither success nor failure. Life is to be lived and in the living of it one grows old and dies. But when the living is postponed until success is achieved, "He made it," the end is always tragic.
Living the life of the body means being in touch with one's feelings and being able to express them. This requires that the body be free as much as possible from the chronic muscular tensions that affect all of us. We have to sense what goes on in our bodies. We can only do that if we take time to work with our bodies so that we can feel our legs and the ground, be aware of how we hold ourselves, and how we breathe. For me this means a regular program of bioenergetic exercises the rest of my life. Such a program can greatly help in keeping my energy at an optimum level.
It is most important in dealing with situations that create undue stress to have the courage to withdraw physically. We are afraid to withdraw because it feels like
defeat. We hang in because not to do so is viewed as failure. We must use our wills to overcome our seeming
fears and weaknesses to prove our worth. We struggle against a fate that becomes
more inevitable the harder we try to avoid it. Really, we create the stressful
conditions that break us down in the
long run. To return to the beginning
of this article...
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