Mindfulness and Sexual Dysfunction Amongst Women

Can Mindfulness Treat Sexual Dysfunction?

Sexual dysfunction among women is more pervasive than many realize. But research is revealing that non-judgmental, moment-to-moment awareness can help.

BY JILL SUTTIE | JANUARY 30, 2013

 

Sexual dysfunction is not a subject you hear women talk about, even with their best friends. Many women find it embarrassing or too personal to discuss, believing that sexual difficulties reflect badly on themselves or their sexual partners. Unable to share their concerns, they often end up feeling alone, helpless, and doomed.

But sexual dysfunction—characterized by low sexual arousal, vaginal atrophy or dryness, painful intercourse, or lack of orgasm—is more pervasive than many realize.

In a 2008 survey of over 32,000 women conducted by the Massachusetts General Hospital, 43 percent of the women surveyed across all age groups reported some kind of sexual problem in their life, the most common being low sexual desire. In fact, a full 39 percent of the women surveyed reported experiencing low desire, while 26 percent had low levels of arousal, and 21 percent had difficulties with orgasm.

While many physical ailments can affect sexual response, researchers have found that psychological factors often play a bigger role in creating sexual dysfunction, especially in cases of low libido. According to Lori Brotto, a professor of gynecology at the University of British Columbia, mood, interpersonal relationships, and general wellbeing are much more central to a woman’s lack of sexual desire than physiological factors.

Even when physiological factors do affect sexual functioning—like in menopause, where vaginal dryness can make intercourse uncomfortable without lubricants—the low self-esteem, poor body image, and relationship problems that often accompany these are what’s often most devastating to a women’s sexual self, she says.

But Brotto has been researching a new treatment for sexual dysfunction that may promise relief for millions of affected women…and men, too: mindfulness.

Brotto’s studies have shown that mindfulness—the ancient Buddhist practice of paying attention to one’s moment to moment experience without judgment—can help women with sexual dysfunction increase their sexual desire by helping them to become more attuned to their body’s sexual response and learn to accept their body’s physical limitations. And, not only that, mindfulness can help decrease stress and alleviate depression, helping women to feel better and enjoy sex more. 

Mapping women’s arousal

Researchers have known for decades that a women’s sexual response has both physical and psychological components. While women respond physically to sexual stimuli in much the same way as men—for example, lubrication in the genital area when viewing erotic films—they won’t always experience these body sensations as arousing.

According to Brotto, stress, mood, self-judgment, and other worries can prevent women from feeling sexually aroused, and women who suffer from physical ailments (like cancer) or emotional traumas (like child sexual abuse) are particularly prone to these.

Inspired by the work of Jon Kabat-Zinn—whose Mindfulness-Based Stress Reduction program had been used to decrease stress, pain, anxiety, and depression in patients suffering from illness, including cancer—Brotto wondered if mindfulness might hold the key to helping women with sexual dysfunction.

In a 2008 pilot study, Brotto provided three sessions of mindfulness-based cognitive behavioral therapy (MB-CBT) to cancer survivors with severe sexual desire and arousal problems. Mindfulness exercises included focusing on the breath, paying attention to body sensations, and watching thoughts come and go without judgment. These were coupled with sexual arousal exercises, general information on sexual functioning, and cognitive therapy to challenge negative thinking patterns. The women were asked to practice exercises mindfully for five to seven hours per week to increase their awareness of and acceptance of their own sexual feelings.

When compared to a group of women waiting for treatment, the women receiving the MB-CBT had significant increases in sexual desire and arousal, and less sexual distress, with these positive effects lasting six months post-treatment. In follow up interviews with the women, many expressed that they found the mindfulness exercises to be the most helpful part of their treatment.

“The women seemed to respond positively to the mindfulness,” she said. “They really started to incorporate it into their lives.”

In addition, the women in the study were tested in a laboratory setting before and after treatment to see how well they could tune into their own physiological sexual response. After being shown an erotic film, the women were measured on levels of vaginal swelling and then asked to describe any sexual sensations they noticed and to rate how sexually aroused they felt. Those who’d received the MB-CBT became significantly more aware of their physiological sexual response and experienced it as more arousing than women in the control condition.

“We were pleasantly surprised [by these results],” says Brotto. “We expected some reduction in distress (as this is common no matter what treatment modality is given) but the significant increases in self reported desire and arousal were a nice bonus.”

To help make sure that mindfulness and not other factors were what caused this effect, Brotto conducted another study in which 22 women with a history of child sexual abuse and self-reported sexual dysfunction were assigned to either CBT or mindfulness group therapy. The women were then compared on many of the same sexual function measures as in the first experiment, as well as on agreement between their subjective arousal and their physiological response to explicit material.

Although both groups experienced reductions in sexual distress, only the mindfulness group also experienced greater agreement between subjective and physiological responses, suggesting that women using mindfulness techniques were better able to tune into their body’s response and experience it as pleasurable. For Brotto, these results were huge.

“In cases of sexual abuse there is often a disconnect between the mind and the body, because when you experience unwanted sexual acts, you learn to dissociate from what’s happening to you,” she says. “But mindfulness seemed to help the women to anchor their experience so that they could stay with pleasant sensations.”

Brotto thinks that mindfulness targets the negative self-talk that many women with sexual dysfunction experience. Too busy worrying about how their bodies look, evaluating their ability to sexually “perform,” or feeling too stressed, anxious, or depressed, can prevent women from really being engaged in sex, she says, while mindfulness appears to help people let go of these distractions.

“Mindfulness allows you to surf the difficult thoughts without being swept away by them,” she says.

Changing the experience of pain

From the time she was 19 years old, Meredith M. has suffered from provoked vestibulodynia (PVD), a condition in intercourse causes severe pain in the vaginal opening. PVD interfered with her relationships, her health, and her peace of mind, sometimes driving her to self-medicate with alcohol in order to deal with the pain.

“Nothing I did helped,” she said. “I just dealt with it for a long time.”

Meredith was one of 200 women who became part of Brotto’s most recent study focusing on how mindfulness might help women with PVD cope. At first, Meredith thought the idea of using mindfulness sounded like a “silly new age thing”—but she was desperate to try anything at that point in her life, she says.

In the treatment group, Meredith learned how to become more aware of sensations in her body and to develop curiosity about those sensations without recoiling from them. After weeks of practicing tuning into different sensations—her breath, sounds in the room, and feelings in her body—and cultivating an accepting attitude toward those sensations, Meredith was encouraged to practice these techniques while provoking a little cervical pain using a dilator.

Although it was difficult at first, Meredith found that she was able to tolerate the pain better using mindfulness. As she continued to practice over the months following treatment, she saw continued improvement in her condition, including more flexibility in her vaginal opening. She also has a much more positive outlook on life, in general, with less self-judgment and more acceptance of her negative feelings.

“Mindfulness was very helpful to me,” says Meredith. “I’ve improved a lot. I’m still in pain; but now I feel like it’s not the end of the world.”

Although mindfulness may seem an unusual treatment for PVD, pain researchers have known for years that one’s experience of pain can be exacerbated by stress and anxiety, often due to catastrophic thinking about the pain—for example, worrying that it will never go away or becoming hyper-vigilant around potentially painful situations. Indeed, functional resonance imaging of the brain has shown that emotional and cognitive centers in the brain light up when one is in pain, supporting the theory that feelings and thoughts play a key role amplifying or de-amplifying pain.

When Brotto measured the effects of the mindfulness treatment on the group of PVD sufferers like Meredith, she found that the women experienced decreased pain during intercourse, decreased hyper-vigilance and catastrophizing, decreased distress and anxiety, and increased mood, when compared to women waiting for treatment. Six months later, these symptoms appeared to improve even further.

Though Meredith is happy with her progress, she still finds it challenging to stay focused on the present and to not start wishing for her pain to dissipate completely.

“It can be hard to accept the point you’re at,” she says. “You have to remember to stay in the moment and remain curious.”

Brotto is careful with patients to not promise their pain will end; but she does promise that mindfulness can change one’s experience of the pain. Meredith recounts how, before she entered the group, she was getting intravenous vitamin infusions and experiencing tremendous pain from having a needle stuck in her arm. But after the mindfulness group, she had an experience where a technician had to prick her ten times to find a vein, and it hardly bothered her.

“The difference in my pain tolerance was amazing,” she says.

Results like Meredith’s have made Brotto shift from feeling optimistic about mindfulness as a treatment for sexual dysfunction to being sure that it’s helpful.

“I’m very convinced by the data and also with the clinical feedback I get from patients,” says Brotto. “If you’d asked me five years ago, I would have been much more tentative.”

Sexual healing

Brotto’s success has prompted others to look at how mindfulness may help with sexual dysfunction. Alex Iantaffi, at the Center for Sexual Health at the University of Minnesota, has been working as a sex therapist for years and has found that mindfulness helps his patients—both men and women—to communicate better with their partners around sex. He uses it in conjunction with other treatment tools to help people become more aware and accepting of their experience.

“It helps people to expand their tolerance of themselves and their partners, to look non-judgmentally at their condition, and to make better choices,” he says.

He and colleague Sara Mize recently did a pilot study to see how mindfulness approaches might augment group treatment for women patients with sexual dysfunction. They incorporated mindfulness techniques and exercises into their usual treatment protocol, and then studied its effects on the patients’ sexual functioning.

Measurements taken pre- and post-treatment showed that the group members had less self-judgment and better body awareness after the mindfulness treatment. In addition, Iantaffi found that in post-treatment focus groups the women were more willing to express themselves in ways that could benefit them—i.e. talking to their partners more openly, communicating with health practitioners more effectively, sharing challenges with group members, etc. 

“Without mindfulness, it can be hard to engage people in treatment,” says Iantaffi. “Mindfulness helps them to open up.”

For Nettonya R., another woman in Brotto’s PVD study, mindfulness helped her to become more aware of her body and to pay more attention to her pain threshold, learning how to honor it rather than just pushing through it as she sometimes did. She began to talk to her husband more openly about what was going on for her, making him an active participant in her treatment.

“It helped me to talk to him and it strengthened our relationship,” says Nettoyne. “In that regard, I’m very grateful.”

However, in spite of that, Nettonya was disappointed in Brotto’s mindfulness program, saying that it didn’t make much of an impact on her vaginal pain.

“We did a number of sessions of meditation and learned how to relax in the program, but that doesn’t help when you’re in the middle of a sexual encounter,” she says.

She regrets not getting a more “physical” intervention for her problem from the group and is currently seeking hormone treatment therapy that she hopes will be more effective for her condition.

Though Brotto is sympathetic to women like Nettonya who want a cream or a pill to take away their pain, she finds that many of her patients have already tried multiple treatments—including hormones—without getting significant relief.  Mindfulness may be the best course for these women, she says, because it can help uncouple the stress and the worry around the pain from the actual experience of the pain, giving at least some respite to the women.

Still, this can be hard for patients to accept.

“People don’t want to be told that their pain is made up in their head,” says Brotto. “The idea that your mind can impact your experience of pain is counter-intuitive.”

Brotto notes that, even though mindfulness seems to help, many people have trouble continuing with mindfulness after learning the techniques, deciding they just don’t have the time. In addition, patients can get confused about the purpose of mindfulness and become discouraged.

“Improvement in pain is not necessarily a primary goal of mindfulness; it is a secondary goal,” says Brotto. “We are encouraging non-judgmental experiencing of the pain. Continued practice, in our experience, then results in reduction of pain,” though there is no guarantee.

Nettonya admits that she has stopped practicing meditation, and it’s unknown how much that has affected treatment outcomes. But, she has found that the mindfulness training has helped her to become a calmer, more grounded person. She uses it on a daily basis to try to experience more pleasure in her life, she says, even in mundane activities like walking her dog, which now she finds she enjoys much more.

Brotto often hears similar stories from her patients about how mindfulness affects other aspects of their lives—not just their sexual health. She points to how ubiquitous mindfulness programs have become in schools and in hospitals around the country, many of which report positive impacts on emotional and social health of those who practice, and to the fact that mindfulness has been practiced for millennia in the Eastern world.

“It seems almost dangerous to say how much mindfulness seems to help,” she says. “Here in the Western world, though, we still need proof.”

 

Read To Empower Your Self - Dr Marilyn Allen PhD

Books, glorious books. Read something for at least an hour a day, preferably something positive to program and strengthen your mind.

Psychologists say that 86% of our self talk is negative and it goes undetected by the conscious mind. Listening to podcasts or audio books is an option, as well as watching positive programs. YouTube has such programs, Amazon sells audiobooks, Wordpress has blogs.

Minimise negativity in your life, for instance, watching programs or listening to people who trigger negative emotions in you. Be strong enough to live your truth, not be dragged into someone else’s toxic agenda which might drain you and make you lose your direction. Feed your mind and grow your emotions in a positive way. Never stop learning.

"Let your health be your wealth"! - Dr Marilyn Allen PhD

Lettuce

Know your lettuce - Iceberg or Romaine?

one cup of iceberg gives                                   one cup of romaine gives

- 8 calories                                                          - 8 calories

-.5g protein                                                         - .58g protein

-.7g fibre                                                             - 1g fibre 

- 10mg calcium                                                   - 16mg calcium

- 78mg potassium                                               - 116mg potassium

- 1.5mb vit c                                                         - 11.3mg vic c

- 16 mcg folate                                                     - 64mcg folate

- 13mcg vit k                                                         - 48.2mcg vit k

- 164mcg beta carotene                                      - 163 beta carotene                          

- 152 mcg  lutein/zeazanthin                               - 1087mcg lutein/zeazanthin

Source: USDA Nutrient Data Laboratory

Nourish Yourself From Within - Dr Marilyn Allen PhD

It is essential to nourish your self from within. All emotions have their place, some, a natural response to what is happening, some to protect us, some to make us contemplate, some to trigger our moral code. Elevating your self worth and a strong sense internal support system is key to self validation and thence nourishment. Work on your positive thinking, well being activities, good nutrition, generosity and kindness. Though it might take time, you will develop inner strength and need less external validation.

 

References

Lipton, B.H. 2016 The Biology of Belief: Unleashing The Power of Consciousness, Matter and Miracles. Hay House

Krunszyinski, J.,  2015 How We Start Healing The Hurt: Discover Self Love and Validation. Amazon Media

Miller, D., 2007 Managing Conflict and Getting Results Through Self Validation. Amazon

Photo Credit: Dr B. H. Lipton

Doshas - Dr Marilyn Allen PhD

Ayurveda philosophies believe we each contain varying traits of doshas/energies, generally one or two dominating, signifying who we are in our most balanced healthy state. When there is an imbalance in the harmony of mind and body, the doshas become aggravated.

 

These three correspond to our physical and personality traits in Ayurveda:

 

Earth - Kapha

Wind - Vata

Fire - Pitta

 

It is said that combination of these doshas determine the spiritual, physical and mental needs of the person. How does one identify body type?

 

Kapha - Larger built body. Very affectionate and compassionate, even tempered and sweet natured. Tends not to be keen on damp and cold. Methodical. Stable and easy to get on with. Oily skin.

Vita - Thin/Slight body frame. Sensitive. Dry skin. Ability to enthuse and motivate people. Tends to be vivacious, eager/quick to learn new things and does no like the cold e.g. food and climate.

Pitta - Medium built body. Kind. Extremely intelligent and tends to set and achieve goals. Hard working but can be irritable. Prefers the cold weather. Fair skin.

 

Signs of Vata Imbalance - the system becomes irregular and depleted, affecting organs and tissues.

 

- constipation

- anxiety

- craving warmth

- frequent infections

- dehydration

- disturbed sleep

- weight loss

 

Balancing Vata

 

- soupy grains like rice and wheat

- moderate dairy substitute

- boiled vegetables like broccoli, zucchini, leafy vegetables, cauliflower

- teas like camomile, fennel, ginger, liquorice, lemon

 

Signs of Pitt Imbalance - the person becomes irritable and aggressive, awakening the self critic and sometimes triggering perfectionist behaviour.

 

- over eating

- heartburn

- frequent infections

- violent/colourful dreams

- cravings for food

 

Balancing Pitta

 

- sweet fruits

- dairy substitute

- tea: red clover, liquorice, spearmint, fennel, camomile

- mild cooling spices like mint, coriander, tumeric, cloves

 

Signs for Kapha Imbalance - the person suffers from mental and physical stagnation and a feeling of lethargy.

 

- frequent candida

- craving warmth

- craving spicy foods

- water retention

- weight gain

- sluggish bowels

- procrastination

- need to sleep more

 

Balancing Kapha

 

- Ripe fruits except banana

- Grains: millet, rye, oats, barley, wheatbran, corn

- strong spices: paprika, salt, garlic, fennel, mustard, cinnamon, coriander, black pepper, cloves, basil, allspice, tumeric, ginger, cardamon, cumin.

- honey instead of sugar

- tea: fenugreek, peppermint, rasberry

 

Gupta, M. 2016. Handbook of Doshas. Amazon

Rao, K. 2014 Ayurveda Remedies by Dosha Types - a Guide to Homeopathic and Herbal Ayurveda Remedies. Create Space Independent Publishing

The New You... - Dr Marilyn Allen PhD

Unexpressed emotions will not go away. They are buried temporarily and will resurface in much complex ways later. Look after your body holistically. There is very little benefit in looking after your body but neglecting your mind. Look after your mind and your body will look after itself!

Consciousness - Marilyn Allen PhD

Consciousness includes human processes, and exists outside space and time. Many types of mind-to-mind or mind-to-object experiments have been rigorously and meticulously conducted for years with statistical significance though are often dismissed or ignored by mainstream science because of various concepts which are foreign to mainstream science’s view of objectivism e.g. non-locality actions and the possibility of mind-matter interactions. Ever heard of the Quantum Holographic model? We must try to evolve to the next level through change and adaptation. Nature evolves in one direction only. We must all remain open to new knowledge. Ignoring by lack of understanding or wilful neglect is no longer a choice.

“God sleeps in the minerals, awakens in plants, walks in animals and thinks in man”.

Photo Credit: ScienceDaily

References

Bricklin, J., Consciousness Already There To Be Uncovered: William James' Mystical Suggestion as Corroborated By Himself and His Contemporaries. Journal Of Consciousness Studies Vol. 17 pp 62-92 (31)

Hugenot, A. R. (2016) The New Science of Consciousness Survival and Metaparadigm shift to a Conscious Universe. Dog Ear Publishing

Lipton, B., (2015) The Biology of Relief, Hay House UK

Penrose, R., (1994) Shadows of Mind, Oxford University Press, Oxoford.

Mitchell, E., (2003) Quantum Holograph: A Basis for the Interface Between Mind and Matter, Bioelectromagnetic Medicine, Marcel Dekker, New York

Why Chia Seeds? - Marilyn Allen PhD

Chia Seeds (Salvia Hispanica), is considered a superfood. It is very versatile, moderately priced and easy to digest. It contains essential fatty acids (alpha linolenic, linoleic acid, vitamins A, B, D, E, strontium, mucin. It also contains such minerals as sulphur, thiamine, niacine, magnesium, manganese, and  iodine. It is high in anti oxidants. It provides fibre and protein. It is a good source of Omega oils.

Benefits of Eating Chia Seeds

- healthy skin

- reduces signs of ageing

- supports good cardiovascular health

- supports good digestive health

- improves bone and muscles formation

- helps manage some forms of diabetes

- helps manage dental health

- helps support breast care

- helps reduce inflammation

- helps with insomnia

- you pets can eat chia seeds too

- helps strengthen the immune system

- cleanses the colon

How do you eat chia seeds?

- sprinkle on soups

- sprinkle on smoothies 

- add to yoghurt

- soak and eat as dessert

 

Side Effects of Eating Chia Seeds

- if not soaked before consumption, you need to drink a lot of water as it absorbs water in your system.

- check with your Health Care Practitioner if you are able to eat chia seeds in your diet.

 

References

Illian, Travis G, Casey, Casey, Jason C; Bishop, Philip A Omega 3 Chia Seed Loading as a means of carbohydrate loading  Journal of Strength and Conditioning Jan 2011 - Vol 25 Issue 1 p 61-65 

 

Universal Life Force - Marilyn Allen PhD

We all have this energy, a life force, our soul. This is the essence of our being and consciousness and moves through us physically, emotionally, and spiritually.  This life force is called the Prana, Ki, Chi and so on. Our choices can have negative effects on this life force and affect us. For instance, our energy becomes unbalanced, stagnant or blocked. 

What Weakens The Life Force?

- Surrounded by negative situations

- Very little exercise

- Excessive consumption e.g. Bad eating habits, self medicating (recreational drugs/smoking/excessive drinking)

- Stress

- Little rest and restoration

- Little or no well being activities e.g. yoga, meditation, exercise

- Inability to regulate affect 

 

How Can We Restore Balance?

- Change of lifestyle gradually from negative to positive

- More well being activities e.g. yoga, meditation, exercise

- Chakra balancing (with Crystals or SCIO-Eductor)

- Aura balancing (with Crystals or SCIO-Eductor)

References

Goswami, A.,  (2011) Quantum Doctor: A Quantum Physicist Explains The Healing Power of Integral Medicine. Hampton Road

Anim-Addo-Allen, M., 2017 Chakra Medicine and Biofeedback Can Slow The Rapid Progression of Alzheimer's Disease. Thesis. 

Penrose, R., & s. Hameroff (2017) Consciousness and The Universe: Consciousness, Evolution, Brain and Mind. Science Publishers

 

Holistic Medicine - Marilyn Allen PhD

Holistic Medicine has been practised over centuries. Holistic Practitioners  integrate Conventional and Alternative Medicine, with a view to prevent illness and promote well being. The treatment focuses on the person as a whole -  psychologically, physically, emotionally, spiritually and  environmentally.  It is good practise to take into consideration, the emotional well being of the patient  at the time of consultation as it is equally important. The Practitioner is better informed about the patient. The patient is involved in the process which psychologically is healthier for patient as he or she feels empowered, thus  more engaging.

Working holistically should be encouraged as good practice across the board, both in conventional and alternative medicine. 

 

Potter P. J. , Frisch N., Holistic Assessment and Care: presence in the process. Nurs Cin North Am 2007 June 42(2): 213- 28 vi

 

Ventegodt s., Kandel I., & Merrick J., A short history of holistic medicine. Scientific World Journal 2007 Oct 57 1622- 30.

Thinking About Quantum Physics ... - Marilyn Allen PhD

Quantum Physics ... the science of what is not yet known to us - Marilyn Allen PhD

The very foundation of science is to keep the door open to doubt. Precisely because we keep questioning everything, especially our own premises, we are always ready to improve our knowledge. Therefore a good scientist is never 'certain'. Lack of certainty is precisely what makes conclusions reliable than the conclusions of those who are certain; because a good scientist will be ready to shift to a different point view if better elements of evidence, or novel arguments emerge. therefore certainty is not only something of no use, but is in fact damaging, if we value reliability. - Carlo Rovelli

IMG_7437.JPG

Early childhood adversities linked to health problems in tweens, teens.

 

Repost from eurekalert

Study is first to point to brain changes that underlie poor health in some children

 

Washington School of Medicine

 

Adverse experiences in childhood -- such as the death of a parent, growing up in poverty, physical or sexual abuse, or having a parent with a psychiatric illness -- have been associated with physical and mental health problems later in life. But new research at Washington University School of Medicine in St. Louis has shown that multiple adverse experiences in early childhood are linked to depression and physical health problems in kids as young as 9 to 15. Further, the researchers have identified a potential pathway in the brain to explain how such stressful experiences influence poor health in kids.

The researchers found that a key brain structure involved in regulating emotions and decision-making is smaller in kids who have lived through three or more adverse experiences before the age of 8, compared with kids whose lives were more stable. Young children who faced multiple adverse experiences also were 15 percent more likely to develop severe depression by their preteen and early teen years and 25 percent more likely to have physical health problems, such as asthma and gastrointestinal disorders. Due to the health problems, these kids were more likely to miss school.

The new findings are published Oct. 30 in the journal JAMA Pediatrics.

"We did not expect we would see health problems in children so young," said senior investigator and Washington University child psychiatrist Joan L. Luby, MD. "Our findings demonstrate how powerful the psychosocial environment can be. A child's brain doesn't develop based solely on its genetic infrastructure. It's influenced by the stresses of poverty, violence, the loss of a parent, and other adverse experiences, which together can have serious health consequences evident as early as the teen and preteen years."

The study involved 119 children, who were ages 3 to 6 when the project began. The researchers tracked adverse experiences in the kids' lives -- which also included experiences such as natural disasters, a parent's arrest, or a parent with a serious illness requiring hospitalization. The children in the study averaged more than five such experiences before the age of 8.

The researchers also performed multiple MRI brain scans of these children when they were ages 6 to 13. The first scans, performed when the children reached school age, showed that the inferior frontal gyrus was smaller in children who had more adverse experiences. The researchers also determined that the structure appears to be part of a pathway through which the stresses of adverse childhood experiences may influence mental and physical health.

"People exposed to adversity early in life experience changes in the volume of the inferior frontal gyrus that probably can make children more vulnerable to behavioral issues and bad decision-making," theorized Luby, director of Washington University's Early Emotional Development Program. "We suspect that such changes are associated with issues such as poor diet, risky and more dangerous behavior and generally not taking very good care of yourself, and overall, this contributes to poorer mental and physical health outcomes."

Previous research has connected adverse childhood experiences to problems such as cancer, heart disease and mental illness in older people, but no one had looked at whether those stressful experiences are linked to health problems in adolescents. And until now, researchers had not been able to explain how such experiences could contribute to poor health in these kids.

The researchers found that when kids had three or more adverse experiences, they also had smaller brain volumes that, in turn, were associated with lower scores on a scale that measures how well a child expresses emotions. Poor emotional expression has been associated with depression and worse social and emotional outcomes.

Such children also had more physical health problems. Parents reported that kids who had more adverse experiences were more likely to have significant health problems that appeared to affect school attendance.

In earlier research, Luby, who also is the Samuel and Mae S. Ludwig Professor of Psychiatry, found that kids can be resilient and, with nurturing parenting, may be able to overcome individual stressors such as poverty or the loss of a parent. This new research indicates that when kids accumulate multiple stressors, the experiences pile up and cause problems early in their lives, and family members and doctors need to be aware of the powerful influence of these psychosocial risks so that kids can get the help they need.

Luby added that the study could alter the way doctors and researchers think about the development of disease.

"We know toxins in the environment can contribute to disease, but this study suggests that kids can experience physical and mental health problems from exposure to psychosocial 'toxins,' too," she said.

Luby and her colleagues plan to continue tracking the health of these children as they grow into adulthood. Meanwhile, the researchers also are beginning a multidisciplinary study to follow pregnant women and their infants to see whether psychosocial stressors and adversity experienced during pregnancy and the first three years of a child's life also affect brain development and overall health.

 

Luby JL, Barch D, Whalen D, Tillman R, Belden A. Association between early life adversity and risk for poor emotional and physical health in adolescence: a putative mechanistic neurodevelopmental pathway. JAMA Pediatrics, Oct. 30, 2017. DOI:10.1001/jamapediatrics.2017.3009

This work was supported by the National Institute of Mental Health of the National Institutes of Health (NIH), grant numbers MH090786.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

 

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Scientist explores the mysteries of the gut - connection

By Karen Frances Eng

The brain in your head and the one in your gut are always exchanging info. But how do they do it? Neuroscientist Diego Bohórquez is trying to find out the answers.

If you were asked where the human body’s nervous system is located, you’d probably answer “the brain” or “the spinal cord.” But besides the central nervous system, which consists of those two organs, our bodies also contain the enteric nervous system, a two-layer lining with more than 100 million nerve cells that spans our guts from the esophagus to the rectum. The enteric nervous system has been called “the second brain,” and it’s in constant contact with the one in our skull. That’s why just thinking about food can lead your stomach to start secreting enzymes, or why giving a speech can lead to your feeling queasy.

Until recently, scientists thought the two systems communicated solely via hormones produced by enteroendocrine cells scattered throughout the gut’s lining. After sensing food or bacteria, the cells release molecular messengers that prompt the nervous system to modulate behavior. But it turns out the process may be much more direct. Intriguingly, Duke University gut-brain neuroscientist Diego Bohórquez, a TED Fellow, has found that some enteroendocrine cells also make physical contact with the enteric nervous system, forming synapses with nerves. This revelation opens the door to rethinking how we might affect these signals — and might someday change how we treat conditions as varied as obesity, anorexia, irritable bowel syndrome, autism and PTSD.

What fueled Bohórquez’s interest in the gut-brain connection? Chickens.After he moved to the US from Ecuador, his first position was as a visiting research scholar at North Carolina State University, where he worked in a nutrition laboratory that focused on chickens. “In poultry production, the biggest challenge is to feed the hatchling chicks as soon as possible so the bird can achieve its maximum growth potential,” Bohórquez says. “My PhD advisor came up with the idea to feed the chicks in the egg before they hatch. This in-ovo feeding consisted of delivering enzymes into the amniotic fluid of the embryo right before it hatched.” Bohórquez was surprised at how this practice changed what the chicks did after they hatched. “The unfed chickens came out of the egg and slept for five or six hours. But the ones fed in ovo went straight to eat,” he says. “They were also more alert, spent time looking around, and pecked each other. I became intrigued about how ingested nutrients alter behavior.”

A friend’s gastric bypass surgery also fueled his curiosity. “A friend was struggling with obesity and, as a last resort, decided to have gastric bypass surgery. It worked. She lost a lot of weight, and it resolved her diabetes,” he recalls. “But most strikingly, her perception of taste changed. She used to be repulsed by the sight of runny egg yolks, but after the surgery, she craved them.” Such a change in taste has been well documented in some patients who’ve undergone bariatric surgery, but scientists aren’t sure how or why it happens, says Bohórquez. “It’s a new subject, but rewiring the gut appears to physically change how we perceive the taste of food in the brain.”

While scientists have known that nutrients are sensed in the gut by enteroendocrine cells, the exact way this happens was murky. They understood that when stimulated, enteroendocrine cells release hormones that either enter the bloodstream or activate nearby nerves to affect how we eat. “My focus has been to figure out how a sensory signal from a nutrient is transformed into an electrical signal that alters behavior,” Bohórquez says. He and his colleagues began taking a close look at enteroendocrine cells, using 3D electron microscopy. Imaging them in this way revealed a whole new structure that hadn’t been seen before. “It turns out enteroendocrine cells not only have microvilli, or tiny protrusions, exposed to the gut, but they also have a foot-like extension, which we called the neuropod,” says Bohórquez. “It became evident that enteroendocrine cells have similar physical attributes to neurons, so we wondered whether they might be wired to neurons, too.”

The secret to tracking synaptic connections: a special kind of rabies. The key to illuminating the process was inserting a tiny amount of modified fluorescent rabies virus into the colon of a mouse. “Rabies is a virus that infects neurons and spreads through synaptic connections, so when used in a modified form that only allows it to jump one neuron at a time, it’s useful for tracking neural circuits,” Bohórquez explains. Seven days after undergoing this procedure, the enteroendocrine cells of the mouse colon glowed green, offering evidence that the sensor cells were indeed behaving as neurons. Bohórquez then bred a mouse that would allow the tracking rabies to make a second jump. When he delivered the tracking rabies into the colon of this new mouse, the enteroendocrine cells and the nerves that they connected to lit up, demonstrating the existence of a physical synapse between the sensor cells and its nervous system — and a physical connection that hadn’t been seen before.

Charting the communication pathway between the gut and brain could someday lead us to new treatments for disorders and conditions. A number of diseases — autism, obesity, anorexia, irritable bowel syndrome, inflammatory bowel disease, PTSD and chronic stress — share a symptom known as altered visceral sensing, or a hyper- or hyposensitivity to gut stimuli. “For instance, clinical observations have suggested that some children with anorexia may be hyper-aware of the food they ingest from an early age,” says Bohórquez. “Under normal circumstances, this process happens without detailed spatial and temporal awareness, but those children can feel what’s going on in there, which triggers anxious feelings.” With this knowledge, scientists may better understand other disorders that have been thought to be solely psychological.

Can our enteroendocrine cells smell, taste and touch? They possess the same molecular receptors that enable mechanical, chemical and thermal sensing in your nose and mouth, says Bohórquez. “These mechanisms are just beginning to be studied, and it’s where research is headed.” And beyond the gut, he points out, the lining of our body’s organs — including our lungs, prostate and vagina — all possess sensor cells similar to enteroendocrine cells. “Future exploration will continue to uncover how the brain perceives signals from these organs and how they affect how we feel,” he says.

ABOUT THE AUTHOR

Karen Frances Eng is a contributing writer to TED.com, dedicated to covering the feats of the wondrous TED Fellows. Her launchpad is located in Cambridge, UK.

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