Psychoneuroimmunology and Conditioning
of Immune Function
Lynda W. Freeman
The challenge for health care professionals and for those in the field of medicine is no longer the treatment of acute diseases or traumatic injuries. Medicine has excelled in the treatment of these conditions. Rather, the future challenges for health care professionals reside with the effective treatment of chronic diseases, many of which are autoimmune diseases, such as systemic lupus erythematosus and multiple sclerosis, or diseases where the immune system fails to perform its surveillance duties adequately, as occurs with cancer.
In the past 25 years, we have learned a great deal about how both physiologic and immunologic responses become conditioned in animals and in human beings. This information has great potential for the development of new and less invasive ways to treat some of our most debilitating diseases. It also has implications for how, in some cases, medical intervention should be provided today.
In this chapter, you will learn in specific detail how conditioning occurs. You will also learn how undesirable immunologic and physiologic responses become conditioned in the patients you treat. The health care environment, itself, may reinforce some of these undesirable responses. An example of this conditioning occurs in chemotherapy-induced anticipatory-nausea. You will learn how to limit some of this undesirable reinforcement. Finally, you will learn how psychoneuroimmunology, as on applied field, offers promise for the development of less debilitating forms of treatment for autoimmune and dysfunctional immune disorders.
Psychoneuroimmunology is literally in its infancy. However, it is important that the health professional knows about research in this area because methods developed in psychoneuroimmunology are likely to become a part of our future health care practices. The reader is cautioned: No other chapter in this text is as complex or will require as much concentration as this chapter. Simultaneously, no chapter provides information as likely to mold the future of complementary medicine.
Physiologic and immunologic responses can become conditioned by exposure to certain conditions, such as taste, touch, or heat; by certain chemicals, such as immunosuppressive drugs; and by events that are emotionally meaningful or traumatic. The pathways by which these events occur are most clearly defined by the emerging interdisciplinary field of psychoneuroimmunology, which describes the interactions among behavior, neural and endocrine function, and immune processes.
The clinical works of Ivan Pavlov, a Russian researcher, demonstrated the ability to condition a salivary response in dogs by pairing a neutral stimulus (a light) with the presentation of food. Later, the presentation of the light alone elicited salivation in dogs. Other Russian researchers believed that immune responses could be conditioned in the same manner as physiologic responses. Two Russian researchers, Metal'nikov and Chorine, succeeded in eliciting a change in cellular response in animals by pairing the scratching of a single area of the skin with the injection of antigenic material. After many pairings, the scratching of the skin alone elicited a conditioned cellular response. Similar studies were replicated by these two researchers and by other Russian scientists.
Years later, two important events heralded a renewed interest in the mind-body domain in the United States. Solomon and Moos published their theoretical integration of emotion, immunity, and disease, and Robert Ader published his serendipitous findings demonstrating classical conditioning of immune function. Solomon and Moos' theoretical assumption was that autoimmunity may be