Social and Cultural Lives of Immune Systems

By James M. Wilce Jr | Go to book overview

Chapter 9

The enigma of hypertension and psychosomatic illness

Lessons for psychoneuroimmunology from beyond the conscious mind

Samuel J. Mann

Introduction

For several decades, a focus on perceived emotional distress has dominated psychosomatic research in the study of medical conditions such as hypertension. However, such studies have not clarified the link between emotions and hypertension. Clinical observations and reported studies suggest instead that this link can be found in emotions hidden from conscious awareness. These can be traced either to trauma-related emotions that have been repressed or dissociated, particularly events that occurred during childhood (Flinn, this volume), or to a lifelong coping style characterized by minimization of perceived emotional distress. The absence of emotional support, either at the time of trauma or during childhood years, contributes greatly to the need to defend against conscious awareness of such emotions, and ultimately to the physical manifestations that can result.

These findings suggest that greater emphasis on childhood history and coping style are needed in understanding the mind/body link in hypertension and in other unexplained medical conditions, for which a link to emotions is suspected but unproven.

While advances in genetics and molecular biology have enabled us to better understand the origin of many medical illnesses, the origin of many others, including many prevalent conditions such as those listed in Table 9.1, remains unknown. Science has discovered drugs that can treat the manifestations of many of these disorders, but cannot provide a cure.

Many of these disorders are believed to be related to emotions, but “mind-body” research has not clarified their origin. Most of this research has focused on the relationship between perceived emotional distress and physical illness. The role of emotions that are not consciously perceived, i.e. that are hidden from awareness, has received scant attention.

This report focuses on the role of such emotions in causing hypertension (sustained high blood pressure). Hypertension is the most important risk factor for stroke, and a leading risk factor for heart attacks. Its link to emotions, particularly perceived emotional distress, has been extensively

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