The Mind-Body-Interpersonal/Relational Connections in Sickness and in Health
How We Need to Account For Relationships Too
Western medical science is finally catching up with other traditions, wisdoms, and the knowledge embedded in so-called “alternative” approaches, which espouse the idea there really is no separation between brain, or mind, or consciousness, and body. For the very latest science of how profound and deep the mind-body connection really goes, especially when it comes to health and wellness, I highly recommend the Huberman Lab podcast.
Yet, there is still a glaring hole in the western medical paradigm, and in many alternative or complementary therapies too. When it comes to health, it is absolutely true that no person is an island: we cannot fully understand or solve someone’s issues outside of the context of their relationships. Indeed, in talking to hundreds of people with chronic conditions around the world about their lives prior, and leading up, to diagnosis, I’ve found there is invariably a toxic relationship lurking in the background.
On the other hand, folks with chronic illnesses, or suffering from trauma, can easily find themselves socially isolated, and this is known to greatly exacerbate such conditions. Indeed, a survey of thousands of people with Parkinson’s found that by far the biggest predictor of rapid decline is if you answer “yes” to the question “are you lonely?”.
In a previous article, we explored how just being in the presence of other people’s physiology can profoundly affected our own mind and body through entrainment,
but the effects on our physiology and psychology of other people when we actually interact or socially engage with them, is even more profound and deep.
We all intuitively know the truth of this: that how we feel in mind and body, our mood, our thoughts, our pains, and our outlook, are strongly impacted by who we are presently interacting with or who we are, or have been, in relationship with. The different feelings and sensations that we get from the interpersonal and relational interactions with the different people in our lives, are necessarily just reflections of the changes in our endocrine, nervous, and immune systems, which they produce.
Our social interactions can either be restorative and health giving, or immune suppressing and dysregulating, increasing our susceptibility to disease. So just like food and diet, our interpersonal interactions and relationships can be nourishing, junk, or toxic for our bodies and brains.
Neural and Physiological Effects of Social Interactions
The work of Dr Stephen Porges informs us that the principle pathways by which our bodies and brains heal, restore, detoxify and reduce inflammation, via the “Ventral Vagus Complex” of nerves, not only controls our heart and breathing rates, but also regulate the principle functions by which humans communicate, including facial expression and vocalization.
Thus the neural pathways that are responsible for anti-inflammation and healing are also profoundly involved in social engagement functions, and furthermore, the same pathways link our hearts to our faces, so that what we express and what we feel are bi-directionally coupled too.
Porges’ work further informs us that for those of us with nervous system dysregulation, and are hence prone to inflammation in our body and brain, also tend to find social interactions difficult and awkward. For example, we tend to have blank and hard to read faces, which Porges refers to as “flat affect” [such as the mask like face which often occurs in folks with Parkinson’s], and also tend to lack melodic or emotional content [prosody] in our voices. At the same time, we tend to be poor at reading others people’s faces and tuning in to human voices.
Conversely, social isolation or poor quality relationships lead to a lack of opportunity to exercise the Ventral Vagus Complex of nerves via healthy interpersonal interactions, leading to what is known as weak “Vagal Tone”, meaning we lose the ability to calm ourselves, deal with stress, or detoxify our brain and body.
The Heart of Trauma
A useful window into these concepts, and a framework to understand just how deep and important they are, is to consider the role of the interpersonal in trauma. Here, I will focus on the work of Bonnie Badenoch, via her beautiful and profoundly important book “The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships”.
Implicit Memory/Body Memories
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To be able to understand the importance of what Bonnie has to teach us, we first need to onboard a concept of how stressful events and episodes get written into our memories. This is via the concept of “implicit memories”, or “body memories”.
According to Bonnie, when we experience potentially traumatic events, much of the experience gets written into our bodies rather than our brains, awaiting to be processed and brought into conscious awareness once the danger has passed.
“This may leave people with implicit-only memories of highly stressful events, not only from early childhood but also from later traumatic experiences, which impairs the formation of a coherent autobiographical memory stream”.
Bonnie spends many chapters of her book delving very deep into the latest science of how memories get written into various parts of our body, from our skin, muscles, autonomic nervous system, eyes, ears, vocal cords, bellies, and heart, to our brainstem, and limbic system.
“Trauma is an embodied experience, touching all the neural pathways in our bodies: our muscles, the brains in our bellies and hearts, our autonomic nervous systems, our brainstems, our primary emotional-motivational systems, our limbic regions and neocortices, and reaching down to even finer systems at the level of our cells and genes.”
These implicit memories of stressful events are then sequestered until such time as the situation is safe enough for them to be processed, brought back to the surface and integrated into consciousness. This later integration is basically what the process of trauma healing is all about. As social animals, feeling “safe enough” to process the implicit memories usually involves us being in the presence of loving, caring and trusted others.
So if we are without nourishing relationships, or stuck in defensive states due to spending too much time in toxic interpersonal interactions, than we tend not to be able to process these implicit memories, as the time to integrate them never comes. In this way, they build up and up in our bodies until the point they manifest as symptoms, and we get a disease diagnosis.
“We are continually making implicit memories because they do not require conscious attention to be encoded. They stay with us as surges of feeling, behavioral impulses, bodily sensations, and perceptions that, when reawakened, color everything because implicit memories have the felt sense of happening now no matter how long ago they may have been encoded.”
"When our relational lives have been nourished with warmth and responsiveness, these implicit memories support the ongoing experience of resilience and meaning; when we have instead taken in coldness or chaos, we are haunted by the ongoing presence or potential arising of those experiences in our bodies as well".
Trauma as Interpersonal and Relational
So Bonnie’s key insight is that trauma is not just the event, but is also connected to the quality of our relationships at the time.
“In addition to being an embodied experience, trauma is also a relational experience in that the embedding of trauma may arise not primarily from the nature of events, but from who is with us before, during, and after the overwhelming happening (or non-happening in the case of neglect).”
"Lack of support in the midst of wounding seems central to the movement from potential trauma to embedded trauma… integration, safety, and the central importance of implicit memory repair within relationship… actually arise from a single river of what it is to be a human being—fragile, tender, easily frightened, body and mind inseparable, resilient, adaptive, and forever interdependent."
These concept lead to Bonnie’s fairly concrete definition of trauma:
“Any experience of fear and/or pain that doesn’t have the support it needs to be digested and integrated into the flow of our [changing] brains.”
This allows us to:
“… return to the question of when an experience becomes a trauma… is it the event itself that lodges the indigestible experience in our embodied brains, or our aloneness with it?"
"On the other side of this threshold, we don’t have the internal resources in the face of the current challenge, and without interpersonal accompaniment and support, the experience will go from potential trauma to embedded trauma."
"Who we perceive as being with us before, during, and after an event is central to our ability to integrate the trauma throughout our embodied and relational brains."
Another key insight from Bonnie’s work is that it is not just our connections with people who are co-present to the potentially traumatic event, but that also people, presences and relationships that we have internalized matter.
For example, a traumatic event is less likely to embedded if we got our needs met by our parents, and we were supported by their care in early life, whether or not they are present or even still alive, or if we know there is a loving spouse waiting for us at home, or we have a group of friends we can truly rely on.
By the same token, there is also wisdom in indigenous beliefs grounded in a sense that we are connected to ancestors who love us and watch over us, or having a totem or spirit animal as a protector.
"At any moment, on [this] side of the doorsill, our embodied brains have enough already-established integration and support from internalized others to meet these events and digest them without additional support. Our ability to do this is often developed within our earliest relationships, or if these didn’t support us in building this foundation for integration, later empathic relationships may have offered enough repair for this capacity to be strengthened."
This last quote is important: there are healthy relationships out there to be had which can not only heal us, but will evermore bolster our resilience.
To learn more about body memories, their role in chronic illness and trauma, and pragmatic ways to address them for symptom reduction, sign up to our short online course on the topic: