Voodoo Death and Homeostasis: Brain-Body Unity Addressed

September 30, 2011

September 30, 2011 (Boston, Massachusetts) — As a young physician specializing in neuroendocrinology, Dr Deepak Chopra (Chopra Center for Well Being, Carlsbad, CA) said, several observations helped steer him toward a career in "alternative" medicine: "That patients do not have predictable responses to the same treatment," and, he noted, "that giving patients information affected their biology."

In his prelude to presenting the fundamentals of a field in which he has become famous, for an audience last week at the Heart Failure Society of America (HFSA) 2011 Scientific Meeting, Chopra noted that when physicians give patients bad news about prognosis, they "can see the biological response immediately." Adrenalin, cortisol, and blood pressure rise, and the heart accelerates. And if they tell a different patient that "everything's okay," the biologic response is entirely different.

"It intrigued me that all you had to do was speak two sentences, with different meanings, then the tympanic membrane vibrated and sent an energy signal to the brain, and the brain somehow processed its meaning--which seemingly had nothing to do with the electrochemical signal."

For him, he said, there was a growing realization that in neuroendocrinology, "the molecules that we were looking at, the neuropeptides, were actually the molecules of emotion."

Separately addressing the meeting attendees, Dr Martin A Samuels (Brigham and Women's Hospital, Boston, MA), a neurologist renowned for studying the physiologic ties between the brain and other parts of the body, shed light on the pathophysiology of "voodoo death" [1].

The colorful term was coined, at least in this context, in the mid-20th century to describe a less macabre phenomenon known more often by context than organic evidence: sudden death caused by fright, "acute grief," or other emotional extremes.

Unified Processes

Dr Deepak Chopra

Chopra called for contemporary medicine to incorporate "a new paradigm" that looks at human physiology from a different perspective, that has at its core a basic principle with three parts.

"The body is not a structure, but a process," he said. Second, "the mind is also a process." Last, the two are actually different aspects of one overarching system. "Your body's eating, breathing, digestion, metabolism, sensory experience, inner processing of thoughts, emotions, memories, and dreams--they are all a single process," according to Chopra. "As reductionist scientists, we try to separate these processes, but they are actually one.

"We want to think of the human body, or any biologic organism, more like a verb than a noun."

One narrow example of the two processes as one: during a discussion between two individuals, some of their neural circuits would be "lively" and others would be turned off, depending on the character of what is said. "So just by this conversation," he said to his audience, "I'm influencing the neural circuits in your brain. . . . I'm also influencing the activity of your genes, because your genes are going on and off depending on which neural circuits are being activated."

Indeed, there's no mental event that doesn't have a "neural representation," and "no neural representation that doesn't have a biologic response," according to Chopra. "Your neuroendocrine axis is connected to your endocrine system and to the sympathetic and parasympathetic nerves going to the heart and other organs.

"In Eastern wisdom traditions, unlike Western scientific reductionism, we look at the body as an integrated, holistic process, where everything is inseparably connected to everything else," he said. That means treatments aren't generally aimed at one organ or physiologic system. "The healing modalities in most Eastern traditions aren't specific. They are geared to restoring that state of dynamic nonchange in the midst of change that we call homeostasis. And once you restore that, the healing response is evoked."

Meditation, Neuroplasticity, and Gene Activation

At his institute and in various meditation programs over the years, he said, "We've practiced mental techniques with many people and have just recently started to discover the neural correlates of what's happening in a person's internal life." When subjects reflect on feelings like "compassion, love, empathy, kindness, joy, and equanimity, [with imaging] you can see activity in the prefrontal cortex, very significant activity. And over the long term--six months--you can actually see enlargement of the prefrontal cortex." Emotional bonding behavior activates and enlarges the limbic system. And "disruptive emotions" activate the midbrain and amygdala.

If you're the kind of person who says you are running out of time, and your behavior reflects that you are running out of time, that speeds up your biological clock . . . and if you suddenly drop dead from a heart attack, then you have run out of time.

One of the great recent "breakthroughs" in the field, he added, is the realization that "genes, except for mutated genes, are not deterministic. You can turn them on and off." In other research on meditating subjects, "within four months of mindfulness meditation and other types of meditation, the level of telomerase--the enzyme that controls the length of your telomeres, which affect your biological clock--went up by 30%." (Telomeres protect chromosomes at cell division, but with each division shorten until they are no longer functional, impairing further division; the enzyme helps lengthen them.)

That such a thing can happen through mental activity, Chopra beamed, "is extraordinary."

Another breakthrough has been the appreciation that "our relationship with time, which is an abstract mental experience, actually affects our biology," he said, and that changing one's relationship with time can promote healing. "If you're the kind of person who says you are running out of time, and your behavior reflects that you are running out of time, that speeds up your biological clock--you have a higher heart rate, more adrenalin--and if you suddenly drop dead from a heart attack, then you have run out of time."

"Men May Be Brought to Death"

Dr Martin A Samuels

Samuel's presentation to the HFSA meeting attendees graphically illustrated Chopra's dictum regarding mental events, their neural presentation, and the biological response. He related the work of Dr Walter B Cannon, who in 1942 in the anthropology literature (updated and republished in a medical journal in 1957 [1]) presented his explanation for a phenomenon observed among "primitive people in widely scattered parts of the world." That is: "When subjected to spells or sorcery or the use of 'black magic,' men may be brought to death."

The article makes the case that such "voodoo death" "may be real and that it may be explained as due to shocking emotional stress--to obvious or repressed terror." The physiologic cause, it says, is "a lasting, intense action by the sympathicoadrenal system."

Cannon also referred to it as a "sympathetic storm," according to Samuels, who noted that it has been associated since with not only fright, but also personal danger and "acute grief" and can occur at less obvious times: after danger has ended, on an anniversary, at a reunion, or on the occasion of "supreme triumphs."

In the journals, he noted, sudden death rates have been shown to increase after natural disasters like earthquakes, after the September 11, 2001 terrorist attacks on the US, or even in relation to sports events. He pointed to a 2006 report in the New England Journal of Medicine documenting a significant jump in "cardiac emergencies" in Germany on days the country's team played in the World Cup, compared with World Cup days on which the team didn't play [2]. The prevalence of ST-elevation MI went up 2.5 times and of symptomatic arrhythmias three times.

Samuels then displayed a long list of newspaper headlines describing what seem entirely like cases of modern-day voodoo death, including:

  • Mother of soldier killed in Iraq collapses, dies.

  • Boy dies after being frightened by bear.

  • Man comes back to life, scares morgue worker to death.

  • Golfer dies after perfect hit; collapses after snagging first hole-in-one.

"The advantage of the 'sympathetic storm,' as Cannon called it, improves our chances of survival in the wild," said Samuels. But newspaper headlines show that the "fight-or-flight" response can go awry. In his 1942 publication, the scientist also noted a "slight but definite downside risk to the sympathetic storm," a risk to the heart. Since 1942, according to Samuels, "nothing conceptually has changed from Cannon's idea."

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