Kjell Standal, Bergen. Norway,
THE INTERACTION OF PSYCHE AND SOMA.
What we all seem to have as a basis can be called an organic, reductionist mindset. The dualistic glasses make it such that the body, as the expressive bearer of life and history, remains inaccessible to us, (Thornquist, 1992). By separating mind and body, both physically and mentally, we do not see the sick person’s own experience. At the very least, we see the person and their illness and existence as a whole (lledberg, 1992).
We experience the body at all times; and it continuously reacts. The body is used both to express and influence emotions. This implies that body language and verbal approaches must complement each other in new ways to understand the body’s language. It is important to gain an understanding of how the patient experiences his or her symptoms and illness. In what way is the body-language part of the existence disturbed and in what way are the relationships with the world disturbed? Mankind is not healthy because it has regained full use of “being in the world” (Boss, 1979 in Hedberg, 1992).
I would to ruminate a bit about this here.
DUALISM AND RECENT RESEARCH.
Within Western medical tradition, a dualistic conception of the mind/body relationship has been dominant. According to dualistic thinking, man consists of two essentially different substances: a mental, intangible and inner world and a physical, material and outer world. These two substances or forms of life, according to Cartesian dualism, are so fundamentally different in nature that they can only affect each other through causal relationships, which means that one affects the other. The body is given the status of a material external size, different from and separate from the person as the acting subject and the being.
Spiritual Sciences and religion have, for centuries, been preoccupied with the interior that is considered the actual human, while the objective field of medicine has seen the body as purely a physical phenomenon – belonging to the vast world. As such, the body can be examined and defined in quantitative and objective sizes, and only that which can be technically operationalised is reflected and methodically investigated. The body has been regarded as a machine that could be analysed from the parts it consisted of. Disease was caused by breakdowns in the machinery. The task of the doctor was to diagnose the malfunction (find the cause, etiology) and repair the machine. Dualism has led to a medical model that is hospital- and clinic-based, and which focus on increasingly sophisticated technology in the treatment of diseases (Bishop, 1994). The mutual dependence that exists within the body and between the body and the surrounding environment is often lost in such thinking. For bodily dysfunctions, we provide body-oriented measures — repairing — providing medication and physiotherapy. For mindful problems, we go to psychotherapy. Recent psychobiological research and clinical work in many areas give reason to doubt such a basic understanding of the interaction between the psychological and body language factors (Gjærum, 1994).
George Engel is one of the strongest critics of the biomedical model. He argues that the model rests on assumptions of a clear mind-body distinction and a reductionism that argues that complex phenomena such as disease can be reduced to physical phenomena alone. Treatment is about treating the physical aspects of the diseases, only secondary to the patient as a person (Engel, 1977, Bishop, 1994). The inclusion of psychosocial factors as important elements in the pathogenesis and course of a disease/disorder makes this model invalid as a standard for clinical practice. Engel rejects the biomedical model in favour of the more realistic and pragmatic biopsychosocial model (Engel, 1977, Green, 1985).
Reiser is another advocate of the biopsychosocial model. He emphasizes how what happens in the brain has far-reaching consequences for the entire organism. “The brain orchestrates, integrates and at points transduces across the biologic, psychologic, and the social realms”. Thus, this can lead to a disease state or maintenance of homeostasis (Reiser, 1975, Green, 1985).
Both Engel and Reiser emphasize the importance of understanding a person’s idiosyncratic perception of their illness. This is important because symbolic thinking can have an impact on the patient’s response to the illness/disorder. Both emphasize the meaning of the illness to the individual, which in turn has an impact on the individual’s ability to cope with the illness/disorder. Biological, emotional and social forces provide a subjective cognitive and affective understanding of the illness’ state, which will determine whether the individual will deal with health problems effectively or will have a pathological illness response (Green, 1985).
Fline Flornquist argues that the body, as a field of expression as we daily experience it, is set aside in professional contexts. “One must ask the question of whether health professionals operate with different types of rationality: ‘Is the body a person in life but a subject in professional contexts?’” (Thornquist, 1992).
The place of emotion in the life of consciousness has surprisingly been overshadowed by research. “Now science is finally able to speak with authority about these pressing and convoluted questions about the most irrational aspects of the psyche, and with a certain precision, map out the human heart” (Goleman, 1997).
Candance Pert (Moyers, 1994) believes that we are in the midst of a scientific revolution that is about incorporating the mind and emotions into science again. This will have enormous consequences for medical practice (Moyers, 1994).
PERSPECTIVE VIEWS ON THE BODY — A LOOK BACK
The ancient Greeks cultivated “a sound mind in a healthy body” and can, to some extent, be said to have had a holistic understanding of man. Greeks and Chinese saw illness as a natural phenomenon. The Greeks focussed on the natural causes of suffering, in which the body and mind influenced each other. Both Aristotle and Plato talked about how the psyche affected the body and vice versa (Kaplan, 1975, in “Health Psychology”, George Bishop). In the younger antiquity, a divide emerged. The body was perceived as impotent and bound by desires and needs. Thoughts, on the other hand, and the mind which conceived the thought, were conceived as man’s opportunity for freedom, which could transcend all material limitations.
Chinese understanding developed independently of Western influence. Body and mind were closely related to one another; a person’s physical health was influenced by behaviour and emotions. We find this in Chinese medicine even today.
In the Middle Ages, European medicine was dominated by religion. The Renaissance focussed on the natural causes of suffering. Both Descartes and Spinoza made a sharp distinction between the mind and the body. Descartes identified man’s “nature” as his ability to think. He had a mechanistic view of the body, in which all bodily functions are predictable. Descartes entered into an agreement with the Catholic Church. He was allowed to study science, entrusting his mind, feelings and consciousness to the church (Pert in Moyers, 1994). We also find radical dualism in today’s vocabulary, such as, “I need to charge the battery“ and “we are burnt out”.
With the Age of Enlightenment and Industrialisation, people were concerned about the body’s individual parts, and the power of the body was a tool for production work in industry. One became alienated in relation to one’s own body. The body became taboo because the bourgeoisie imposed social restrictions, rules of the body’s use and acceptable functions of the body on people. Michael Foucault has written extensively on the disciplining of the body and the individual, in which the human body becomes the object of social power relations (Foucault, 1991).
Norbert Elias’ (1897-1990) work “The Civilizing Process” of 1938 has become a sociological classic when it comes to the regulation of the body. Elijah shows how taming the body, and the effects of this, is a prerequisite in a society in which many people are referred to each other’s services. The body’s functions are subjected to increasingly stringent control. Elias claims that eventually there was an increased embarrassment threshold. The history of customs is also about how we learned to suppress our emotions.
Industrial society’s view of the body still characterises our culture. In addition, the body of post-modern society has become a “showcase” and subject to perfection. Jean Baudrillard says that modern society is characterised by the fact that people, through their fascination, are controlled by objects. Our spontaneity is hampered by a deliberately calculated use of effects. As passive recipients, we are bombarded with impressions. How does this affect our health? What happens to the sensuality of the body and the need for touch, movement, tension and relaxation? The body can be seen as “a lonely anarchist”. Idea historian, Trond Berg Eriksen, argues that “the body avenges itself when, in the process of civilisation, it is referred to as purely a tool of rational plans. When the mind cannot let go, negative emotions remain in the body. Many lifestyle disorders appear because we do not take the body’s signals seriously (Trond Berg Eriksen, 1993).
Within Western Platonism, the body has been subject to a special value hierarchy, in which the dirty, evil and shameful body has been pitted against the pure, good and free thought. The link between the body’s instrumental character and shameful embarrassment has prepared the body both as a productive force and a machine, and has forced desire and sensuality “behind” muscle armour and restrained breathing, in a “trapped” hidden and lower bodily heat (Berg Eriksen, 1989 in Engelsrud, 1990). Thus we can say that Western culture carries both thought forms and experiences that have tamed and removed the body’s sensuality, expressiveness and drive. Western body culture is left with an instrumental, stereotypical and external view of the body.
A dualistic body understanding can have multiple forms of expression: A mechanistic training culture, an instrumental body interpretation, a romanticising body cultivation, and a shame-domesticated body may be stereotyped variants of a dualistic body understanding (Engelsrud, 1990).
When the body is not supposed to be touched, the mind remains the subject of penance and healing. According to Michael Foucault, this is the origin of the present human mind with regards to psychology and psychotherapy.
If we look at psychology as a tradition of knowledge, we find that it is mainly characterised by two traditions. The experimental part is rather towards the reductionist perspective and has knowledge of biological conditions. The clinically directed part is rather towards a more dualistic view, in which the psychotherapy and focus on the psyche, are understood relatively independently of the bodily conditions.
In “The Structure of Scientific Revolutions” (1970), Thomas Kuhn points out that we have a hard time grasping a universe that is infinitely complicated and large, and that we are therefore trying to reduce it to propositions that we can cope with more easily. Thomas Kuhn therefore believes that scientific knowledge in a particular area is limited and structured by a framework, a paradigm. A scientific revolution involves the shift of one paradigm with another.
The paradigm shifts of this century have mirrored the psychological spirit of time. Positivist behaviourism considered mental processes as by-products. The cognitive revolution of the 60s brought the mind back to psychology. It then became legitimate to conduct research on mental processes, such as how the brain records and stores information. One was seduced by the computer to regard this as a model of how the brain works. But emotions were still a forbidden area. There was a lack of understanding that reason is guided by and can be overshadowed by emotions.
Psychology has now begun to recognise the crucial role of emotions in thinking (Goleman). Damasio is among the world’s leading neurologists. He believes that it is now clear that there is a scientific basis for the distinction between “mind” and “body”. Damasio believes that emotions are an expression of the state of our body, a link between the body and its regulation of survival on the one hand and consciousness on the other. Instead of viewing emotions as complicating factors for the intellectual brain, he views them as an integral part of the brain’s decision-making process. Damasio says that rational decisions are not a product of logic alone, but require the support of feelings and emotions. He shows that, on the contrary, the absence of emotions can break with rationality (Damasio, 1994).
WHAT CAN THE BODY CONTRIBUTE TO PSYCHOLOGICAL TREATMENT?
Historically, the body has been underestimated and forgotten. Our dualistic mindset tells us that “personality” is something other than the body (Berg Eriksen, T, 1989 in Fengelsrud, 1990). We fail to perceive the body as an expression of intention and meaning according to Thornquist (1992). She warns against recent medical “holism” as a disguised dualism.
Consequences of a practice based on a dualistic frame of understanding, is that one can build up under the patient’s object conditions – viewer conditions – to one’s own body. The body can be perceived as it is considered and treated: as something outside oneself, something to be dealt with – checked and fixed. Because we usually separate body and soul — physically and psychologically — in medicine, we do not see the sick person’s experience of him or herself and his or her illness and existence as a whole. The body is our phenomenological foundation, the prerequisite for our existence (Hedberg, 1992).
Instead of dividing into body and soul, or soma and psyche and seeing what falls in between as psychosomatic, one can ask the question of how the symptoms relate to this human being. How does the patient experience his or her symptoms and his or her illness? (Boss in Hedberg, 1992).
Only parts of the brain can speak to us through words. Both the body and the psyche have languages that cannot always be translated verbally. Freud pointed out the importance of the symptoms. He understood the communicative function of symptoms, and based on this understanding, he discovered the unconscious (Goldberg, 1991).
When man loses contact with emotions and body, he loses contact with himself. Alienation occurs. Physical and emotional openness is not present, thus limiting life (Engelsrud, 1985). Emotions are linked to contact with life-giving breath in the body. When the body stiffens like an object, musculature and breathing mutually bind and inhibit the body’s open attitude to the outside world. When the body is not perceived as “a real human”, emotions also become inaccessible and unknown. In such a situation, it is difficult to gain a consistent understanding of oneself as a sentient person.
Every single event in the mind’s universe — such as pain or a strong memory — triggers a new chemical pattern in the brain, not just in one place, but in a number of places. The body is changeable enough to reflect any mental event. Nothing can move without the entire entity moving. A body that can “think” is essentially different from what medical science today treats. It “knows” what happens to it, not just in the brain, but everywhere there are courier molecules, that is, in every cell (Chopra).
Freud believed that psychoanalysis would one day find its organic functions (Freud).
The psychoanalytic technique was, from the very beginning, a “vegetotherapy” insofar as Freud emphasised that treatment never has effect if one does not mobilise the bodily effects that have contributed to the provocative events or which have been slowed or disrupted by the conditions of life that have created the neurosis.
David Boadella (1987) believes that Wilhelm Reich provided the organic basis of his work through character analysis in what he called “vegetotherapy” — a therapy in which one works with the physiological roots of the neurosis (Boadella, 1987). Boadella claims that Reich created the first foundation for somatic psychology. He regards Reich as the “godfather” of all therapies that deal with the body’s emotional life. Reich was concerned with the biological basis of emotions. He believed the biological energy mastered the mental as well as the physical. There is a functional unit.
He broke with all common notions of the relationship between the psyche and the soma. Somatic diseases are not “consequences”, “causes”, accompanying phenomena of mental processes. They are these processes even in the physical realm. The assumption that these are two separate areas does not hold any weight. Psychopathological conditions and symptoms are caused by disturbances of the vegetative energy balance. “The exploration of the living has brought us beyond the limits of depth psychology and physiology into hitherto unexplored biological fields” (Reich, 1996). I will hereby show how recent research supports a more comprehensive understanding of the psyche/body, in which the biological basis has become more understandable to us.
Reich began to study and approach patients in the way Darwin recommended, i.e. first and foremost as organisms, in which their total behaviour was involved in their neurotic problems. If an animal is threatened by an event or object in its environment, a state of tension is created and it responds to the threat as an emergency. When the body is mobilised by the nervous system to cope with an emergency, there are usually two possible reactions, what we call “fight or flight”. In humans, we see that almost all ill-adjusted people live as if they were in a permanent state of emergency preparedness. Stress-states, and hyperactivity in the sympathetic nervous system that maintains it, have become chronic (cf. Ursin, tonic activation). Prolonged strain will make cells in the hippocampus sensitive to PTSD (low cortisol) damage. Both: Something has happened to the built-in, self-regulatory process. The usual built-in, self-regulating processes have ceased to function. Thus, external help (i.e. therapy or various stimuli) is required.
Wilhelm Reich was concerned with the physiological basis of psychological functioning.
Freud postulated a physiological foundation for in-depth psychology. Freud’s unconscious was deeply rooted in the biophysiological realm. Wilhelm Reich states that a human personality is the functional sum total of all its past experiences. He believes that the intensity of a mental imagination depends on the momentary bodily impulse it is associated with. The effects come from the operations, i.e. from the physical (Reich, 1996).
Boadella says that the body’s tension patterns can be considered a person’s “frozen history”. Recent research may confirm that the body “remembers”. As therapists, one must have respect for the “knowledge” that is embodied in the patient’s own body. The body is the carrier of a person’s history. Everything we are exposed to as human beings falls into the body, meaning everything we are exposed to falls into the body and is expressed physically. Every emotion has its physical expression because it involves movement and impulses. This can be expressed through bodily conditions such as muscle tension, posture, breathing and movement patterns. Influencing these bodily conditions can affect the person both emotionally and experientially.
We must understand both with emotions and the body. What the body wants to hide is often what it shows most clearly. The body carries with it what has happened to us, all the emotions we have experienced. When tension in the body is released, forces are released that allow the body to initiate a self-healing process. Something happens when what has happened to the organism comes into its consciousness, and consciousness comes into contact with the emotions. If the consciousness does not come into contact with the emotions, we will unconsciously follow the old ways of responding (Bøhler).
Trygve Braatøy emphasised the connection between mind and body and emphasized the central role of breathing in the balance between health and suffering. He believed that suppressed effects were bodily, falsely-cleansed, muscularly arrested phenomena. Braatøy says that the body hides experiences. Both the experiences and the bodily reactions may be inaccessible to the person himself (cf. recent research). Alienation from the body means that the body has the experience and the knowledge that the person him or herself is not aware of.
To get a complete understanding, it is necessary to study how emotions are manifested in the body. No disorder is only mental or physical. We need to look at the totality and the interaction of the psyche and soma. David Felten (Moyers, 1994) states that brain and mind are two expressions of the same thing. They are two parts of the same whole. In therapeutic treatment, we must look at the whole human being. Both physical and mental symptoms are the body’s signals.
THE NEED FOR A NEW MODEL
The idea of a mind released from the body seems to have shaped the way Western medicine approaches its studies and treatment of suffering. This applies to both studies and practice. Damasjo believes Descartes’ dualism (“Descartes’ Error”) obscures the roots of man’s mind in a biologically complex organism.
In recent years, we have seen the development of a highly specialised technological medical world that has a dehumanising impact on the individual. There is a contradiction between this level of sophisticated technology and the perception of the patient as a whole person. Treating a patient’s specific organic or mental pathology in isolation is not the same as treating the patient (Greenville, 1985).
Kjersti Monsen believes that medical science has helped to create unrealistic expectations by giving the impression that it is the job of experts and society to keep us healthy. These have contributed to a passivism, alienation and lack of experience in being responsible with regards to one’s own problems.
Both somatic treatment and psychiatry are characterised by a strong one-sidedness in their view of illnesses and their treatment. This lack of holistic thinking also reduces the effect of treatment. Many bodily and mental disorders are probably the same type of underlying problem. One can easily feel frustration because of the absence of contact, social isolation, lifestyle diseases and mental health problems that we struggle with in today’s welfare society. Because of our one-sided and strong nature, and scientifically embossed conception of the exterior and material reality as the only real thing, our culture misses a necessary accentuation of the individual and contact with the inner dimension of experience described by Merkegaard. According to Merkegaard, human liberation lies in man himself (Monsen, 1989).
An over-consumption of medicine is also part of the development we have had. It helps to hide psychological, social and financial problems behind medical diagnoses. The treatment focuses on the sub-aspects, the symptoms, rather than the open-ended underlying causes. Medication for human life problems is in itself a serious worrying problem (Monsen, 1989).
The World Health Organisation’s definition of health encompasses both physical, mental and social welfare (well-being?). The complexity of the disease images has forced a holistic approach. Today, one approaches the view of people that the ancient Greeks had. Our knowledge of the mind/body connection is on a much more solid scientific basis and we have paradoxically arrived at the holistic approach through the reductionism of natural science and via a hypothetical, deductive method. But one has also understood the limitations of the Natural Science paradigm (Monsen, 1989).
Antonio Damasio (1994) believes that there has been a remarkable neglect of the mind as one of the organism’s functions. He argues that Cartesian neglect has delayed the understanding of the mind in a biological sense for decades. A distorted view of the human organism has also had a negative impact for the effective diagnosis and treatment of human suffering. The idea of a soul liberation from the body seems to have discovered the way in which Western medicine approaches the study and treatment of disorders. (Damasio, 1994).
School medicine has been slow to understand the importance of how people feel about their medical condition. This is crucial for the outcome of the treatment. The fact that mental illness can cause illnesses in the body is now beginning to be accepted, but it took a long time for medical professionals to take this seriously (Damasio, 1994).
More than 50% of patients who visit general practitioners do not go to them due to clinically identifiable diseases, but due to emotional or personal reasons (Jennings, 1986 in Bishop, 1994). A person can have a disease without feeling it. High blood pressure is called “the silent killer” because it is difficult to detect (Galton, 1973 in Bishop, 1994). Cancer can develop within weeks, months and years without being detected (Renneker, 1988). Studies show that people who are prone to negative affect (negative affectivity, NA), are more sensitive to physical discomfort than people who are not prone to these negative states (Watson and Pennebaker, 1989, 1991 in Bishop, 1994).
It is emotionally induced changes that lead to illness. Henry (1989) observed that such deleterious effects are more pronounced when the person does not pay attention to the emotional “arousal” (Margolis, 1991).
Any illness, large or small, alters the individual’s homeostasis — his or her psychobiological balance (Green, 1985). The intensity of emotional response is usually proportional to the severity of the illness, but illness is a subjective experience and there are many exceptions to this rule.
Unfortunately, emotional responses to illness often go unnoticed and are often regarded as something abnormal that should be trivialised or ignored. People register the effects of the disease on the body, but are less willing to register the effects of the disease on the psyche. Central to all psychosomatic understanding is the emphasis on the suppression of emotions as a possible causative factor of physical illness.
Medical treatment must involve an understanding of what an illness means to a particular individual at a particular time in his or her life (Green, 1985). The current model in the healthcare system, the biomedical model, is not concerned with the psychosocial aspects of the illness/disorder. By excluding the emotional and social factors from the diagnosis and treatment process, the clinician completely ignores the connection between body and psyche and consequently harms the patient.
Every patient lives in a particular context that can be beneficial or destructive to their welfare (Green, 1985).
Optimal medical treatment requires a thorough understanding of each individual’s disease dynamics. Deutsch and Murphy (1955 in Green, 1985) believe that it is impossible to treat organic disease and emotional disorders individually. A combination of biological and psychological understanding is required because the emotions are both physical and mental (Monsen, 1989).
A new model is needed to understand and control disease and disorders. Thornquist believes that the alternative to the biomedical model must be to look at the body with new eyes, where one perceives the body as an expression of intention and meaning. “The gap between the professional conceptual world and the intuitive and often silent world of experience shows the need for clarification of dualism and its consequences.” (Thornquist, 1992). Is the body an honest mirror? An expression that can be found in this regard. Von Bertalanffy, Bishop 1968, 1994 offers an alternative to the biomedical model.
General system theory states that the body consists of a continuum of interrelated systems that interact with each other, arranged hierarchically. Self-regulation is an important aspect of this system approach. Systems are goal-oriented and strive to achieve balance in their functioning. Self-regulation occurs using feedback loops. Thus, the concept of “self-regulation” plays an important role in our understanding of health and illness.
Such a biopsychosocial model also addresses external conditions such as a social and cultural context and has important implications for treatment and how to study health and suffering. A system approach makes it clear that a person’s health status is a product of many different factors: cellular, biochemical, cultural, etc. Similarly, changes in a person’s health status have far-reaching consequences both psychologically and socially (Bishop, 1994).
By emphasizing the body/mind connection, the biopsychosocial model indicates innumerable ways in which our physical well-being can be influenced by thought and behaviour. The biological condition of the body is important, but poor health involves much more than just biological aspects (Bishop, 1994).
RECENT RESEARCH, HOW DOES THAT INTERACTION ACKNOWLEDGE THE PSYCHE/SOMA?
Patricia Churchland says that what is exciting today is that the philosophical question that was raised by the Greeks is now within the reach of science. Science has begun to fall into philosophy. Techniques such as Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET), have opened windows into the human brain, allowing researchers to “see” what a thought “looks like”, so they can observe glowing fears from the amygdala or see how neurons speak their own language when an old memory is brought to life.
Recent psychobiological research is in many ways an acknowledgment of the body/soul interaction (Gjærum, 1993). We have gained a shift in perspective from metapsychology to molecular biology, where developments in cell and molecular biology have made it possible to explore inner mental processes by means of biological analysis. This gives us a new and exciting approach to studying the connections between biological and psychological phenomena, and can give us a greater understanding of the psyche/body connection. Over the past decades, there has been a series of fundamental breakthroughs in terms of the neurobiology of emotions, memory and learning.
Psychoneuroendocrinology is the doctrine of the biochemical interaction between body and psyche in our cells. Peter G. Fedor Freybergh, is a professor of psychoanalysis in Salzburg. The basic idea of Fedor Freybergh’s theories is that it is wrong to separate the hormonal and the emotional. He considers life as a continuous process in a psychosomatic entirety. All functions already exist from conception in parallel and equally in the form of hormones and neurotransmitters. Some of these are complicated polypeptides, which have the ability to absorb, mediate and store information. In this way, our body’s memory develops. If our body did not have this ability to store memory, we would not survive. In order to survive, we must be able to adapt to a new situation. In order to adapt, one must make experiences, and to make experiences, we must be able to remember. Memory is one of many functions that exist in the body from the first moment, believes Fedor Freybergh. This is memory on a non-conscious level (Freybergh in Bøhler, 1994). Man, in his genetic makeup, has a predisposition to learn. Learning gives us greater potential for flexibility and change than what we see in the animal world. All psychotherapy is based on this potential to adapt and to try to learn new and better ways of living (Findeisen in Fedor-Freybergh, 1988).
Feeling is one of the main purposes of life. The body experiences or feels. The mind evaluates, which means the mind tells me what I am experiencing. Emotions judge. If we like what we feel, everything is fine. If we do not like what we feel, we resist, deny, suppress, push away, oppose. Thus, we trigger a natural “Law of Opposition” (Turner in Fedor-Freybergh, 1988).
Theodore Melnechuk (1988 in Margolis, 1991) concludes that emotions alter the production of hormones, neurotransmitters and opioids and can affect different stages of the healing process.
Emotions depend on the function of neurons in the same way as conscious thinking (Fischbach, 1993). To gain complete understanding, it is necessary to study how emotions are manifested in the body. No disorder is only mental or physical. Everything is 100% mental and 100% physical (Bohler, 1994). The psyche and soma are one. “The body and the mind are but rhetorical entities and use such terms merely as a convenience for communication” (Margolis, 1991). Margolis believes that it is in the synapses that mental and physical processes stand “face to face” with one another to become one and the same body-based process (Margolis, 1991).
Steven Rose (1992) has been particularly focussed on memory. The understanding of neuronal plasticity and the biology of memory is relevant to the entire human life cycle, from the development of memory and learning ability in children to the crippling states of confusion and illness later in life. In a healthy person, memory and forgetfulness are biologically balanced activities. Rose believes that they now have the experimental models and the neurobiological tools needed to define the cellular processes with increasing certainty and precision.
When an animal learns, specific cells in its central nervous system change their properties. These changes can be measured morphologically, dynamically, biochemically and physiologically. These are different levels or languages that can be “set beside the others and none of them is more fundamental than others. We need all the dimensions to understand memory. He points out that memory and forgetting are not just a passive storage of data in the brain. It is an active process. (Rose, 1991).
Lionel Standing (1973) has shown that there is no upper limit on memory capacity (Rose, 1992). Nothing is forgotten. It is the way one asks that is crucial. What then happens to the memories that are not remembered? Rose believes that they do not have to be lost because one does not remember. One needs a “flash” to get them back. Just as remembering is hard work, the same goes for forgetting.
Unlike declarative memories, procedural memories do not seem to be forgotten in the same way, suggesting that they are learned and remembered by mechanisms that are very different from declarative. Rose believes that this may be because procedural memories, as opposed to declarative memories — i.e. riding and cycling — are not just limited to the brain, but involve the entire set of other bodybuilding memories, which are coded in i.e. muscles and tendons. Memory is not limited to a small number of neurons, but must be understood as a characteristic of the entire brain, with the entire organism. To understand memory, one must understand the entire system (Rose, 1992). Rose believes aids such as PET scanners over the next decade will be able to tell us something about how we remember as a physiological or biochemical process.
Can we draw conclusions about people from what we know about animals? Rose argues that at the cellular and biochemical level, neurons from the human brain are almost indistinguishable from other vertebrates; there is no unique human brain cell type or brain protein, and the physiological and organisational characteristics of non-human mammals and human brains appear to be very similar. Areas of the human brain that are known to be involved in memory formation are analogous to the same regions in non-human mammals, namely the hippocampus. (See what the basis was for the 2014 Medical Nobel Prize, and what this research was based on.)
All of the biochemical mechanisms known to occur in non-human animal brains also appear to operate in humans (Rose, 1992). While all living creatures have a past, only humans have a history. We are the only creatures with a verbal memory. Our memory power is overwhelmingly richer than other animals. While procedural memory is dominant in animals, it is declarative memory that shapes every thought and action with us.
Candace Pert, Ph.D. is the former head of the biochemistry department at the National Institute of Mental Health. She has discovered opiate receptors and many other peptide receptors in the brain and body. This has led to an understanding of the chemical substances that move between the mind and the body.
Candace Pert (1985) believes that the neuropeptides and their receptors are the key to understanding the connection between mind and body. According to Pert, one can thus speak of a unit, which she calls “body mind” (Pen, 1986).
Everything in the body is controlled by transmitter substances and many of them are peptides. A peptide consists of amino acids, which are the building block of proteins. In the 1980s, peptides began to be found in the immune system and everywhere else. The peptides convey communication between brain cells and the body. Pert believes that the biochemical correlations to feelings in these neuropeptides and their receptors have been found. She believes that we have the scientific evidence we need to put forward a hypothesis that these information molecules make up the biochemical component of the emotion (Moyers, 1994).
It turns out that unlike other transmitter substances, neuropeptides are quite viscous and are not chemically degraded or re-absorbed from the synapses of the producing nerve cell. This is especially true for those associated with the emotion centres in the brain (Zachariae, 1992). Several of the neuropeptides enter the bloodstream, affecting both brain and body. The hypothalamus and amygdala are especially dense with active peptide receptors. In other words, the neuropeptide receptors are found in abundant quantities in the regions of the brain that are considered key nodes in the production of emotions. Pert states that “emotions are expressed in the body and are part of the body” (Pen, 1987).
Candace Pert states that the messenger molecules move around the body and associate with special receptor molecules. The endorphins and other biochemical substances that resemble them are found not only in the brain, but in the immune system, the endocrine system and throughout the body. These molecules participate in a psychosomatic communication network. The neuropeptides are secreted by various emotional states. Activity fluctuates with our moods. They translate the emotions in the body into bodily actions. The neuropeptides control emotions through receptors in the brain that are associated with emotions. Pert says that the more we know about the neuropeptides, the harder it is to think of the mind and body in traditional trajectories. It is becoming more and more natural to talk about a single, integrated body/mind unit, she says (Moyers, 1994). For the first time in the history of science, the mind has been given a visible platform to stand on (Chopra).
It has now been shown with certainty that the same neurochemicals affect the entire “body mind”. Everything is connected at the neuropeptide level (Chopra). The cells of the immune system have receptors for the various neuropeptides. In addition, they create neuropeptides themselves. In other words, these immune cells create the same chemicals that control the emotional state of the brain (Rossi and Cheek). It is no longer appropriate to regard mental and somatic illness as being played out in separate areas with little or no mutual influence. The psyche and soma are included in a holistic psychological system of multi-level mutual communication.
The discovery of the neuropeptides was so important because it showed that the body is changeable enough to keep up with the mind. A thought and a body reaction are in fact linked. The phenomenal property of the neuropeptide is that it can react lightning fast to the commands of the mind. Science has shown that there are hundreds of neuropeptides. They are produced all over the body. “The material body is a river of atoms, the mind is a river of thought, and what holds them together is a river of intelligence (DNA) (Chopra). Edelmann says that all life’s experiences and impressions change the anatomy of the brain: “We recreate ourselves for every thought we think”. Our DNA remembers everything that has ever happened to humans. (Chopra). Pen talks about “body wisdom”. There is intelligence in every single body cell.
A cell is a memory that has built matter around itself and formed a certain pattern (Chopra). DNA is in almost as much pure knowledge as it is matter. Emotions are stored in the body. Many emotional messages do not need such awareness that they become conscious. Nevertheless, they control everything in the body. The receptors are dynamic. They are energy molecules that twist and vibrate. They change shape from one millisecond to the other, and they change what they are associated with. Every time they connect, every time they react to each other, chemical messages are exchanged. The body reacts differently depending on which cell receives which chemical.
The message literally does not have to go from the brain to the body. It can happen almost spontaneously. It is another form of energy that we have not yet understood, one that leaves the body when we die, says Pert (Pert in Moyers, 1994). She believes that there are many phenomena we cannot explain without taking energy into account. Everything we do is controlled by emotions (Moyers, 1994). Dean Ornish is a professor of Clinical Medicine. He believes that ultimately everything is some form of energy. Even matter as solid as stone is energy. Albert EIstein showed us that energy can go into matter and vice versa. When you focus energy, you gain power in a positive or negative direction (Ornish in Moyers, 1994).
Pert believes that emotions must play a key role and that the displacement of emotions leads to illness. The chemical substances that control our body and brain are the same substances found in emotions. We need to be more aware of the importance of emotion for health and to develop serious theories about the role of emotion and suppressed emotion for illness (Moyers, 1994). Pert believes that Western medicine has come to a point where we overlook what is clear today. She recommends simple therapies that set the emotions free and to concurrently perform studies to find what works best.
Kandel has been particularly concerned with learning and memory. He believes that many mental disorders may be due to changes in synapse functions as a result of learning. In these disorders (flexible anxiety disorder), psychotherapy will work by producing long-term functional or structural changes in the brain, i.e. by altering synaptic strength and by producing changes in gene expression (Kandel, 1983). As a result, it can now be said that therapy is effective to the extent that it produces such changes. Thus, Kandel believes that traumatic experiences modify brain function. A therapeutic process must therefore similarly aim to modify.
Others have been concerned about how information is encoded at deeper psychobiological levels by the release of hormones and messenger molecules that are released by emotional and physical stress. This information is what we can call “state dependent”. That is, it is associated with a specific psychophysiological state of stress.
A lot of research and clinical studies support the hypothesis that many forms of memory and learning can now be considered either open or hidden state-dependent (Rossi & Cheek, 1988). Information substances (IS) can be important modulators at the molecular level in terms of fundamental mechanisms of memory, learning and behaviour (Martinez et al, 1981 in Rossi and Cheek, 1988). Most information substances trigger the second-messenger system (see LTP) in the cells, which must be the molecular basis for memory, learning and behaviour (Goelet & Kandel, 1986; Castellucci et al, 1986 in Rossi and Cheek, 1988). Kandel (1983) has suggested how these molecular genetic mechanisms can explain many phenomena of acute anxiety and neurosis.
Potentially, there are thousands of information substances interacting with hundreds of different receptors in the brain. This implies that state-specific neuronal networks are continuously changing dynamic structures. They serve as a psychophysiological basis for the mind, emotions and behaviour. The somatotopic maps of the mind/brain that can be modified by life experiences provide particularly vivid, experimental evidence for the psychobiological dynamics of the neural network (Kandel & Schwartz, 1985 in Rossi & Cheek, 1988).
Joose (1986) is concerned with the difference between the non-classical transmitters and neuropeptides. He thinks they have different functions. An important difference is that the peptides are encoded directly from the genes, while the classical transmitters are produced by more or less complex enzymatic procedures. This makes peptides more suitable for animal adaptation to the environment. The difference between classical neurotransmission and neuromodulation has important implications for understanding the psychobiological basis of mind-body therapy (Rossi and Cheek, 1988).
The neuromodulators trigger persistent metabolic responses in the target cells. These persistent metabolic responses are responsible for the “state” of the organism (i.e. state of homeostasis, non-arousal, inhibition, pain, hunger, thirst, sexuality, memory, learning, emotions, stress and all kinds of motivation. (Joose, 1986 in Rossi and Cheek , 1988).
The most striking example of state-specific memory, learning and behaviour, is post-traumatic stress disorder.
State-specific memory and learning can help us understand phenomena such as reversible amnesia typical of post-traumatic stress syndrome and psychosomatic problems. These are encoded in a state-specific manner using stress-related information substances (such as ACTH, beta-endorphins and adrenaline). According to psychophysiological theory, any preparedness or emotional activation simultaneously involves more or less distinct reactions of the body. When experiencing stress, a certain reaction always occurs in parallel in all organ systems. There is a general adaptation syndrome (General Adaptation Syndrome, Selye, 1956).
One now has clear evidence of the importance adrenaline plays in neurobiology when it comes to state-specific learning and memory (Gold et al.; Lynch et al., 1984 in Rossi and Cheek, 1988).
Recent research shows that beta-endorphins (Izquierdo et al. 1984) and ACTH (Izquierdo & Diaz, 198; Richardson, Riccio & Steele, 1986) released by stress encode state-dependent memory. Richter and Crabbe (1979) have looked at a number of experimental studies indicating that many hormones and their corresponding peptides (ACTH-like peptides, vasopressin-like peptides and Oxytocin) are involved in memory and modulation in the same way. All these peptides belong to the class of neuromodulators responsible for modulating the state of the organism.
In neuroses, there is usually an amnesia for the source of the psychological problem that created the conflict and which later led to these symptoms. A trauma is encoded under circumstances with stress-releasing adrenaline from the autonomic nervous system and related responses from the endocrine and neuropeptide systems.
Recent research based on molecular biology will try to explain this amnesia in that childhood is encoded in a special state of consciousness. This condition is constituted by a particular composition of neuropeptides. To access the conflict, one must change the biological substrate, that is, with the help of emotions, one must reactivate the specific state that encoded the trauma. An accident will, for example, cause a particular composition of information substances or peptides to suddenly be released by the limbic-hypothalamic-pituitary system and encode all external and internal sensory expressions from the accident in a particular condition or condition in consciousness.
A traumatic amnesia can be explained by the body/mind state having returned to normal. But the traumatic memories are there and they are active and can be expressed in the person’s dreams or in psychosomatic problems (Rossi and Cheek, 1988). The body remembers. The purpose of i.e. vegetotherapy is to bring back the traumatic childhood memories to consciousness. Emotionally important stimuli can initiate memory processes that can overcome state-dependent obstacles.
When the patient is recovering from the acute stress or trauma, the “state-dependent” memory is not available for the normal memory processes, because they are encoded in another state of the brain/body. This is what we call “state-dependent learning, memory and behaviour (SDLMB)”. SDMLB is a species-common form of learning that takes place in all organisms that have a cerebral cortex and a limbic-hypothalamic system.
This perspective argues that it is the information substances (hormones and messenger molecules that act as parasynaptic modulators), which are responsible for encoding classical and operant conditioning and which provide the flexibility characteristic of human condition-dependent memory and learning (Rossi and Cheek, 1988). Rossi believes that state-specific memory, learning, and behaviours encoded in the limbic-hypothalamic and closely related systems are the main information intermediaries between mind and body (Rossi, 1986d, in Rossi and Cheek, 1988).
In-depth psychology and psychoanalysis can now be understood as extended clinical examinations in which state-specific memories remain active at unconscious levels and provide the origin of complexes that are a source of psychological and psychosomatic problems (Rossi & Cheek, 1988).
Biological scientists have focused on the importance of the state-specific nature of the normal regulation of physiology. They believe that behavioural state is fundamental to understanding homeostatic integration in all systems on a broad evolutionary level (Hobson et al., 1986 in Rossi and Cheek, 1988).
Damasio says that emotions are a key element of learning and memory. This has an important adaptive function. The amygdala is the brain structure in which memory associated with fear is stored. Mistakes are accompanied by negative emotions that make one choose differently next time.
There are many clinical strategies designed to break state-dependent effects. Vegetotherapy is an example of this. Reus believes that such a state-dependent perspective may have practical clinical consequences as well as theoretical implications. Once the unconscious conflict has been accessed, the recalled material can be re-coded in a therapeutically controlled state (Reus et al., 1978). It seems to be important to use therapeutic techniques that touch emotions. “Cues” techniques can help guide the patient in the right direction. Selye (1976) believed that just as a shock can cause psychosomatic problems, a new shock or raised awareness can sometimes cure it.
The processes initiated by therapeutic intervention can thus be explained by the fact that the state of mind changes. New studies will give us a greater understanding of this context. This will hopefully enable us to develop techniques that are best suited to provide good therapeutic effect.
For Freud, dreams were the royal path to the unconscious. During sleep, the conscious is put out of action. Perhaps one can now say that this royal path goes via state-dependent learning and memory. Just as the dream puts us in a state where the unconscious becomes more easily accessible, state-dependent learning and memory can give us access to the unconscious in an awake state.
Damasio believes that emotions are necessary to make rational decisions. They lead us in the right direction, where we can make use of logic. The emotional learning that we have been subjected to throughout life sends signals that simplify decisions right from the beginning and eliminates others. Emotions thus have a bearing on the rational. They make it possible or impossible to think.
In a way, we have two brains, two forms of consciousness — and two different forms of intelligence: the rational and the emotional. The intellect does not function optimally without emotional intelligence. When these partners work well together, emotional intelligence as well as intellectual abilities increase. We thus do not want to get rid of emotions and put reason in their place, as Frasmus suggested, but instead find a balance. The new paradigm strongly advocates that we must coordinate the head and brain (Daniel Goleman, 1997).
Psychophysiology emphasises the mind-body interaction. Kenneth Hugdahl (1995) states that the challenge for psychophysiology today is to understand the interaction between cognitive and emotional processes, i.e. how emotions modulate cognitive processes and vice versa. Modern techniques such as MRI have broken down the old barriers between different biological sub-disciplines that are interested in mind-body problems (Hugdahl, 1995).
Neurophysiologist Joseph LeDoux of the Center for Neural Science at New York University, belongs to a new generation of neurophysiologists who, using new methods and technologies, try to map the working brain. He was the first to discover the crucial role of the amygdala in the part of the brain to which emotions are linked. Through his research into the circulatory systems of the brain’s centre of emotion, he has arrived at results that reject notions of the limbic system and instead places the amygdala in the centre and other limbic structures in completely different roles. LeDoux’s research explains how the amygdala can take control of what we do, even though the thinking brain, the neocortex, has not yet made a decision. The amygdala acts as a repository for the emotional memory and thus for the meaning itself.
By recording incoming signals from the senses, the amygdala scans all experiences for problems. This gives the amygdala a powerful position in the conscious world as something in the direction of a psychological security centre, an alarm system. The amygdala’s pervasive set of neuronal connections, in an emotional emergency, allows one to conquer and control much of the rest of the brain, including the rational brain (Goleman, 1997).
Through his animal research, LeDoux turned to the knowledge of which paths emotions follow. LeDoux believes that some emotional reactions and memories can be formed without any conscious, cognitive involvement. The amygdala can house memories and response repertoire, which we perform without understanding why we do it. The amygdala acts as a repository for emotional impressions and memories that have never known full consciousness (Goleman, 1997).
LeDoux’s work is one of the most significant discoveries of emotions within the last 10 years. The research includes a survey of nerve pathways for emotions that go beyond the cortex. The sensory organs send signals to the thalamus and then to the sensory processing areas of the neocortex. But LeDoux discovered that beyond the large collections of neurons that go to the cortex, there is a smaller bundle of neurons that leads directly from the thalamus to the amygdala. This allows the amygdala to receive direct “input” from the senses and begin a response before being fully recorded by the neocortex. With the help of the nerve pathways, the amygdala is able to respond before the neocortex. This cycle provides much of the explanation on how emotions can have such strength that they take power away from rational thinking. The research reveals how the brain’s construction gives the amygdala a privileged position as an emotional guard post capable of “hijacking” the brain.
Other research has shown that the first few milliseconds of observing something will not only unconsciously understand what it is, but also determine whether we like it or not. The “cognitive unconscious” presents our awareness of both the identity of what we see and the meaning of it. Thus, our emotions have their own form of consciousness (John A. Bargh, 1994 in Goleman). — Subliminal perception
This has been useful for our survival in an evolutionary context. An understanding of these two systems can help us better understand conscious and unconscious processes in a therapeutic context.
A lot of research remains, but it is also exceptionally exciting. No one would have thought that we should have two researchers who won an impressive prize for their research on sense of direction.
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