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by Dr. John C. Lowe
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The Emotional
Effects of
Noxious Myofascial Stimulation
Dr. John C. Lowe
Reprinted
from:
The American Chiropractor,
January, 1989, pp.22-24.
Dr. Scott Haldeman wrote in 1973 that
insomnia seems to be the only well-documented effect of noxious somatic
stimulation on emotional behavior.[1] [2] When such noxious stimulation
activates certain receptors in the myofascia tissues, however, I believe
that the emotional effects include far more than insomnia.
Scores of my patients come to me with
severely painful myofascial constrictions and trigger points. In pursuing
relief, many of them have done everything from drugging themselves silly
to permitting surgeons to slice open their flesh to explore for a cause of
their pain.[3] Their frantic and extreme behavior indicates that they are
strongly motivated, both by pain and unpleasant emotions. Also, many of
them volunteer (without prompting from me) that along with their pain they
have felt unpleasant emotions ranging from annoyance to virtual rage.
After I relieve these patients'
constrictions and trigger points, many of them comment (once more without
prompting) that not only have they slept better, but that they have become
less irritable, fearful, belligerent, apprehensive,
nervous, worrisome, or anxious.
These clinical observations are sufficient
reason to me to conclude that myofascial constrictions and trigger points,
sources of somatic stimulation, give rise to a variety of unpleasant
emotions. But for the skeptic—someone who has not treated patients for
noxious myofascial conditions—I present in this paper evidence of a more
objectively verifiable nature.
Neural Pathways
In a current paper[4], I describe the
neural pathways that transmit noxious nerve signals from the myofascia
into the brain. To summarize that description, signals are transmitted via
type C and type A delta sensory signals from the myofascia into the
reticular activating system of both the brainstem and thalamus. From there
signals are sent to all other parts of the brain, and the net effect is
that the individual undergoes a general physiological arousal. According
to Guyton [5], these nerve signals "have a very potent effect for
activating essentially the entire nervous system, that is, to arouse one
from sleep, to create a state of excitement, to create a sense of urgency,
and to promote defense and aversion reactions designed to rid the person .
. . of the painful stimulus."
Guyton continues, "Therefore, these
signals are designed almost entirely for the single purpose of calling
one's attention to injurious processes in the body. They create suffering
that is sometimes intolerable." A small isolated myofascial
irritation may give rise to great misery, for as Guyton further writes,
"Even weak pain signals can summate over a period of time by a
process of temporal summation to create an unbearable feeling even though
the same pain for short periods of time may be relatively mild."
Guyton's description of this pain and its
concurrent generalized arousal suggests that the afflicted person must
simultaneously experience unpleasant emotions. It seems tautological to
even affirm the connection since pain is by definition emotionally
unpleasant—except to human masochists and hungry lab rats conditioned to
electrically shock themselves to get food pellets.
Specific Emotions
One might suppose that general
physiological arousal from a specific somatic tissue irritation, for
instance constricted myofascia, would give rise to only one specific
emotion—perhaps anger, anxiety, or fear. But the source of the general
arousal may be irrelevant to the type of emotion produced.[6][7][8]
Studies have been performed in which a group of people were given electric
shock or chemical sympathetic stimulants to generally arouse them. They
then exhibited emotions as diverse as anger and euphoria. What determined
their emotional reaction was not the original arousing stimulus. It was,
instead, the suggestive influence of a particular emotional behavior
exhibited by others in the same situation at the same time. Bandura
reviewed the relevant studies and wrote, "Results of both
physiological and psychological studies support the conclusion that a
common diffuse state of physiological arousal mediates diverse forms of
emotional behavior and that different emotional states are identified and
discriminated primarily in terms of external stimuli rather than internal
somatic cues."[9]
Consider, for example, someone who is
generally aroused from a neural assault on his central nervous system by
noxious sensory signals from his myofascia. He might interpret his arousal
in various ways—worry, fear, anger,
apprehension, insomnia, and so on—depending on his current situation. He
might be a student assaulted by tight myofascial constrictions, who is
trying to sit still and study. He might translate his
arousal as restlessness and boredom with his current task. If he is again
disturbed while trying to sleep, he surmises that his insomnia must stem
from worry. In both situations, the emotion he has designated is a
function of his external predicament, though his arousal is myofascial in
origin.
Muscle Tension and Emotions
Edmund Jacobson did many studies that have
helped clarify the relationship between emotions and muscle
constrictions.[10][11] [12] [13] [14] [15] [16] [17] [18] He found in
clinical observations and physiological studies that
disturbed thoughts and emotions are accompanied by electrically measurable
heightened muscle tension. He also found that relaxing the tightened
muscles relieved the unpleasant thoughts and emotions, even though the
subjects had no knowledge of what the experimenters expected to occur. As
a result of his studies, Jacobson wrote: "There has been abundant
evidence in these as well as in many other of our clinical studies that
with the relaxation of such muscular acts, the entire process of thinking
practically ceases for brief intervals." He also wrote, "It is
true that maintaining general relaxation succeeds in markedly reducing,
perhaps to zero, disturbed mental states."[19]
Jacobson proved that general muscular
relaxation and emotional arousal are physiologically incompatible.[20]
[21] Joseph Wolpe, the father of behavior modification, reiterated this
conclusion and stated that it is the basis of his clinical procedure
called systematic desensitization.[22] The effectiveness of this procedure
has been experimentally demonstrated many times. Apparently
relaxation is not critical to its effectiveness, however, as Wolpe
originally thought.[23] Others researchers[25] and I[24] have demonstrated
that an excitatory response can also effectively countercondition anxiety.
Nevertheless, appropriate muscular relaxation effectively extinguishes
anxiety since mental distress and general relaxation cannot
physiologically coexist.
Conclusion
When mediated through type C and type A
delta sensory signals from the myofascia, unpleasant emotional effects of
harmful somatic stimulation extend beyond the phenomenon of insomnia.
Noxious sensory signals of myofascial origin induce a generalized
physiological arousal, accompanied by an assortment of unpleasant
emotions. How the individual labels or interprets the accompanying emotion
is determined more by external circumstances than by the internal source of the arousal. The emotional
effects of noxious myofascial stimulation, therefore, are as variable as
the plethora of human predicaments.
Acknowledgement: I want to thank Jackie
Yellin for her editorial assistance in preparing this article.
References
1.
Haldeman, S.: The Release from Abnormal Musculoskeletal Sensory Activity:
A Mechanism to Explain Chiropractic Results in Psychological Disorders. In
Mental Health and Chiropractic, Edited by Herman S. Schwartz. New
Hyde Park: Sessions Publishers, 1973, p.128.
2.
Birkmayer, W. and Pilleri, G.: The
Brainstem Reticular Formation and its Significance for Autonomic and
Affective Behavior. Montreal: Hoffman-LaRoche Ltd., 1966.
3. Lowe, J.C.: Spasm. Houston:
McDowell Publishing Co., 1983, p.77.
4. Lowe, J.C.: The myofascial genesis of
unpleasant thoughts and emotions: its neural basis. Digest of
Chiropractic Economics, 31(5):78-81,1989.
5. Guyton, A.C.: Textbook of Medical
Physiology, 6th edition. Philadelphia, W.B. Saunders Co.,
1981, p.614.
6. Ax, A.F.: The physiological
differentiation between fear and anger in humans. Psychosomatic
Medicine, 15:433-442, 1953.
7.
Schachter, J.: Pain, fear and anger in
hypertensives and normotensives: a psychophysiological study. Psychosomatic
Medicine, 19:17-29, 1957.
8.
Schachter, S. and Singer, J.E.:
Cognitive, social and physiological determinants of emotional states. Psychological
Review, 69:379-399, 1962.
9. Bandura, A.: Principles of Behavior
Modification. New York, Holt, Rinehart and Winston, Inc., 1969, p.488.
10. Jacobson, E.: Treatment of nervous
irritability and excitement. Illinois Medical Journal, March, 1921,
pp.243-247.
11. Jacobson, E.: Action currents from
muscular contractions during conscious processes. Science, 66:403,
1927.
12. Jacobson, E.: Electrical measurements
of neuromuscular states during mental activities: imagination of movement
involving skeletal muscle. American Journal of Physiology, January, 91:567-608, 1930.
13. Jacobson, E.: Evidence of contraction
of specific muscles during imagination. American Journal of Physiology,
95:703-712, 1930.
14. Jacobson, E.: Electrophysiology of
mental activities. American Journal of Physiology, 44:677-694,
1932.
15. Jacobson, E. The Physiological
Conception and Treatment of Certain Common "Psychoneuroses." American
Journal of Psychiatry. 98:219-226, 1941.
16. Jacobson, E.: Cultivated relaxation for
the elimination of "nervous breakdowns." Archives of Physical
Therapy, 24:133-143 & 176, 1943.
17. Jacobson, E.: Electrical measurements
of mental activities in man. Transactions of the New York Academy of
Science, June, 1946, pp.272-273.
18. Jacobson, E.: Neuromuscular controls in
man: methods of self-direction in health and disease. American Journal
of Psychology, 68, pp.549-561, 1955.
19. Jacobson, E.: You Must Relax: A
Practical Method for Reducing the Strains of Modern Living. New York,
McGraw-Hill Book Company, Inc., 1948, p.170.
20. Jacobson, ibid., 1948, p.85.
21. Jacobson, E.: Progressive Relaxation.
Chicago, University of Chicago Press, 1938, p.xv. & p.218.
22. Wolpe, J.: The Practice of Behavior
Therapy. New York, Pergamon Press, 1969, p.96.
23. Rachman, S.: The role of muscular
relaxation in desensitization therapy. Behavior Research and Therapy,
6:159-166, 1968.
24. Lowe, J.: Excitatory response to music
as a reciprocal inhibitor. Journal of Behavior Therapy and Experimental
Psychiatry, .4:297-299, 1973.
25. Salter, A.: Conditioned Reflex
Therapy. New York, Capricorn Books, 1949.
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