Low-grade inflammation and the brain

What is inflammation?

We usually talk about “inflammation” in relation to infections and injuries. When the body is infected, the immune cells recognize the ‘non-self’ molecules and produce inflammatory factors, called “cytokines”, to coordinate the fight against the infection. Cytokines signal other immune cells and bring them to the site of infection. Inflammation is clinically assessed by measuring cytokine concentrations or other inflammatory markers in the blood and is used as a sign of infection.

What is low-grade inflammation?

It is a question that remains hard to answer. Low-grade inflammation is usually defined as “the chronic production, but a low-grade state, of inflammatory factors”. Conditions characterized by low-grade inflammation are for instance obesity (1), depression (2) or chronic pain (3). Low-grade inflammation does not come from an infection but several physiological mechanisms are involved. Concentrations of inflammatory factors in these conditions are overall slightly higher than in healthy populations, but still remain in the healthy ranges. It is therefore hard to determine whether a specific patient exhibits “low-grade inflammation” but it can be better defined at the level of a group of patients.

Inflammation and the brain

When we are sick, we often want to sleep, have reduced appetite, prefer to stay home alone, have difficulty concentrating and can be a bit moody. All these feelings and behaviors are induced by cytokines! Indeed, in addition to coordinating the fight against infection in the periphery of the body, cytokines also act in the brain and induce behavioral changes (4). All these behavioral changes are adaptive, with the purpose of limiting the spread of the infection and allowing the body to spare energy in order to fight the infection instead of, say, going out partying with friends.

However, the behavioral effects of cytokines are not always beneficial. When the cytokine signal is too strong or lasts a long time, such as in cancer patients during treatment with cytokines, these effects can become maladaptive and lead to more chronic and pathological behavioral alterations, such as depression (5). Inflammation is therefore one hypothesized contributor to depression (4). One critical difference between infection or cancer therapy and most cases of depression is, however, the level of production of inflammatory factors. Cytokine levels are high during immunotherapy, i.e., “inflammation”, while depression is characterized by a state of “low-grade inflammation”.

The proportion of subjects who suffer from depression is higher in conditions characterized by low-grade inflammation than in the general population. For instance, 20 to 30% of obese individuals suffer from depression while the prevalence in the general population is of 5-10% (6). While psychological factors are highly likely  to be involved, we and others investigate the possibility that low-grade inflammation contributes to this psychiatric vulnerability (7). We have notably shown that low-grade inflammation is associated with behavioral changes in obese individuals, such as fatigue (8) or altered cognitive functions (9). One interpretation of this relationship is that the production of inflammatory factors at a low-grade state may be sufficient to induce behavioral alterations and therefore could be one factor participating to the vulnerability to depression.

Low-grade inflammation and chronic pain

The association between low-grade inflammation and behavioral alterations has caused the team of the Behavioral Medicine Pain Treatment Service at the Karolinska University Hospital in Stockholm (Sweden) to wonder whether low-grade inflammation could modulate the efficacy of behavioral treatments for chronic pain. Cognitive and behavioral strategies are indeed the targets of behavioral treatments for chronic pain and low-grade inflammation could prevent the effects of such treatments.

In collaboration with this group, we showed that treatment outcomes were improved in patients with chronic pain and low levels of inflammatory factors while patients with “low-grade inflammation”, i.e., with higher levels of inflammatory markers but still in the healthy range, exhibited less improvement (10).

Although this study was only exploratory, the findings suggest that low-grade inflammation may promote a state of resistance to behavioral treatment for chronic pain and give a potential explanation regarding non-responder patients.

About Julie Lasselin

julie-lasselinDr Julie Lasselin is a “psychoneuroimmunologist”, conducting research assessing the relationships between the brain and the immune system. She got her Ph.D. in 2012 in NutriNeuro in Bordeaux, France. She then has been working as a post-doc at the Department of Clinical Neuroscience (Psychology Division), Karolinska Institute and at the Stress Research Institute, Stockholm University in Stockholm, Sweden. Julie is currently a post-doc in the Institute of Medical Psychology and Behavioral Immunobiology in Essen, Germany and is affiliated to the Karolinska Institute and Stockholm University. Her research focuses on the contribution of inflammation on the development of neuropsychiatric symptoms in vulnerable populations, such as patients suffering from obesity and type 2 diabetes. She carries out both clinical observational studies and experimental studies using the model of administration of lipopolysaccharide (a component of bacterial shell) in humans. She also assesses more specifically the role of inflammation in fatigue and motivational changes, two symptoms that are highly sensitive to inflammation and may explain the psychiatric vulnerability of obese patients.

References

  1. Wellen, K.E. and G.S. Hotamisligil, Obesity-induced inflammatory changes in adipose tissue. J Clin Invest, 2003. 112:1785-8.
  2. Dantzer, R., Depression and inflammation: an intricate relationship. Biol Psychiatry, 2012. 71: p. 4-5.
  3. Parkitny, L., et al., Inflammation in complex regional pain syndrome: a systematic review and meta-analysis. Neurology, 2013. 80:106-17.
  4. Dantzer, R., et al., From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci, 2008. 9:46-56.
  5. Capuron, L. and A.H. Miller, Immune system to brain signaling: neuropsychopharmacological implications. Pharmacol Ther, 2011. 130:226-38.
  6. Evans, D.L., et al., Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry, 2005. 58:175-89.
  7. Capuron, L., J. Lasselin, and N. Castanon, Role of Adiposity-Driven Inflammation in Depressive Morbidity. Neuropsychopharmacology, 2016 (in press).
  8. Lasselin, J., et al., Fatigue symptoms relate to systemic inflammation in patients with type 2 diabetes. Brain Behav Immun, 2012. 26:1211-9.
  9. Lasselin, J., et al., Low-grade inflammation is a major contributor of impaired attentional set shifting in obese subjects. Brain Behav Immun, 2016. 58:63-68.
  10. Lasselin, J., et al., Low-grade inflammation may moderate the effect of behavioral treatment for chronic pain in adults. J Behav Med, 2016. 39:916-24.

  Commissioning Editors:  Carolyn Berryman and Neil O’Connell

 

Comments

  1. Dear Julie
    Thank you for your reply (28 Nov2016). I went to respond but felt overwhelmed by the discussions which were raging. Julie, there are so many aspects which contribute to chronic pain that the possibility of chronic low-grade inflammation putting the body under continual stress makes sense. Where it comes from I’ll leave to the scientific laboratories but I do thank you for your explanations in your reply. As research on the impact of low-grade inflammation on cholesterol, heart disease and other medical conditions discovers the connection, on an individual level within a doctor’s office looking at inflammation markers in a person’s blood seems a good idea. Combined with other factors the person is presenting then treating the inflammation may be a way to go. I don’t know if there is a database to record positive and negative responses but this would give a more accurate picture than group studies where artificial on-going pain stimulus is used.
    Where mind/body techniques of various modalities work that is great. They can be used either on their own or to help enhance more mainstream treatments, and visa versa.
    Wording and phrasing within the medical and complementary health worlds can cause confusion and angst. This takes discussions off track with a lot of justifying happening. Please, whether for this discussion or others, ask for explanation rather than jumping to defend or accuse a set of words. You don’t have to agree to another’s modality but learning the benefits and limitations (even if a practice has a great record for treatment) will be helpful for everyone.

  2. Julie, I have worked with many bariatric patients and getting back to meaningful function is difficult even with gastric bypass surgery (lap bands or sleeves) however I have seen some people whose blood sugars stabilized, they no longer needed insulin and their mood elevated tremendously after surgery and as they returned to meaningful function their pain dissipated.

    From my limited understanding, 80 % of your serotonin production from the gut – role in mood – gut brain interaction – also big role in inflammation and depression. Several pathways through which inflammatory signals can be transmitted from the periphery to the brain – humoral pathway, neural pathway and cellular pathway. Julie, I would appreciate if you would provide clarity. I find it quite confusing. The role of BDNF? No simple answers / relations. However, I strongly believe in the role of voluntary aerobic exercise – ‘safe’ baseline – inflammation in one system affects other tissues & organs – this I see and therefore I think I know (karma runs over my dogma though).

    You referenced an excellent systematic review article on inflammation and CRPS. I think that this provided more questions than answers to me – help?

    Luke Reply:

    Do you mean our CRPS article. Shucks. Very kind. Thank you.

    Stu Reply:

    Luke, it seems that questions are what science is all about. What confused me was that the conclusions seemed to advocate for sympathectomy as an effective intervention. I realize that some people have been helped by this.
    However, I couldn’t determine why this was highlighted based on review.
    In terms of central control over autonomic nervous system, any thoughts?
    Any help?
    Pain is the conscious correlate of the implicit perception of threat to tissues in my mind but inflammation, from neurogenic to innate immune is different; perhaps the need for separation needs to be spelled out (for me).
    Silent nociceptors and their role need to be highlighted not just in periphery.
    There seems / seemed to be more of a direct relationship between inflammation and pain with patients with Rheumatoid Arthritis however with new biologics, don’t see the significant joint changes of past and pain is not as significant from my recall. However, pain is still present. Thoughts?
    GutMind (neurogastroenterology is relevant), HeartMind and BrainMind are all valid terms and I think need to be considered in this discussion.
    Just looking for further insight – not meaning to offend../

  3. John Quintner says:

    Tensions have not been lessened. EG continues to make sweeping statements which are unsupported by scientific evidence. But for those who might be interested, NLP has been the topic of a recent editorial: http://www.futuremedicine.com/doi/pdf/10.2217/pmt-2016-0028.

    Mark Quittner MrPhysio+ Reply:

    Thanks John and Heide,
    https://www.matthudson.com/about/
    Further reading.

  4. Dear all.
    Thank you for all your comments. Some of you have now strayed far beyond the subject of this blog post. For the sake of those readers interested in Julie’s post on inflammation and the brain can we ask everyone to stay on topic or feel free to take the the conversation offline.
    With thanks
    BiM

    EG Reply:

    Just a quick one if you don’t mind Heide. It might help lessen tensions:

    – 5 minutes, not 5 seconds.
    – Based loosely on NLP
    – Yes, the results are extraordinary
    – I suspect anyone can do this process and have similar success.
    – There are people around who can get deep pain relief in under 2 minutes using…. let’s call it ‘energy healing’ for want of a better word. I’ve mentioned this study before. http://www.charliegoldsmith.com/studies/
    Goldsmith is due to have his work investigated by an American documentary maker early next year.

  5. Julie, are you able to define terms more? Inflammation and edema? Different types of inflammation – not fully clear in my language. Microbiomes as sources of inflammation – North American diet? Interactions in ecosystem. People I see have kidney failure or systems in crisis who have challenges with healing and have pain. The language I use is important – can be inflammatory.

    I see micro-environments of inflammation (or at least that is how I perceive them to be) that I deem areas of neurogenic inflammation – demonstrate wind-up even though structures have healed. Container concept from M. Shacklock is helpful. I realize that there is hierarchy of control over autonomic system. Awareness helps settle the inflammation with some people. Breathe.

    Looking for insight – the more complex cases that I see, the less I see easy resolution as some have espoused but perhaps I need to see differently.
    Autonomy and meaning are 2 very important human needs – settling system.
    Feeling safe. Compassion as a starting point .Thanks for discussion. Thoughts?

  6. John Quintner says:

    Mark, I am proposing a proof of concept. But let us first await a detailed response from EG.

  7. John Quintner says:

    Addendum:

    I note that EG is making remarkable assertions. Using his approach to pain sufferers he claims to be able to reduce acute pain by 70% in fewer than 5 seconds and to reduce chronic pain by 50% in about 5 minutes.

    These are unprecedented findings and if they are replicable by other health professionals, EG’s approach should be made widely available.

    I suggest that EG provides a description of his approach in as much detail as possible and further that a physiotherapist or other health professional refers a patient to EG to have personal evidence that EG’s approach is more effective than current procedures.

    It should then be possible for a small group of therapists to use EG’s approach on a random selection of patients and have the results made public through BiM or elsewhere.

    By reporting his dealings with pain sufferers EG has indicated that he has discovered a procedure that produces outcomes appreciably more effective than any other known procedures or modalities of treatment.

    His claims should be seriously investigated.

    Mark Quittner MrPhysio+ Reply:

    Hello again John, Before I reconsider future contributions to sites such as BIM, your recent post re EG’s claims of success caught my eye, and I thought an observation may be relevant.

    I agree that claims for success rates of pain reduction treatment outcomes well above current known methods should be explored and validated.

    I am less sure that an ‘n’ of one patient referred by a health professional to EG would accomplish a definitive outcome.

    A double blinded set up would be more appropriate.

    The proposed follow-up idea for multiple therapists learning the technique has a little more credibility, but not much. Failures of clinicians to replicate what they are taught without bias introduction from the educator as well as the clinician, are well reported. Yet, that is the treatment world we work within.

    Patient claims of success for treatments provided are highly unreliable – witness the multi-billion dollar expanding non-science based health industry. The public voting with its feet, perhaps unwisely.

    Some governments are supporting this industry by deregulating many in the health field at the same time as strengthening regulatory agencies for the actual science provider therapists, but hamstringing research dollars. A bad mix.

    The public cannot be blamed for attending less than reputable ‘health’ providers and anyone trying to get out the message that caution should be utilized, is effectively drowned out.

    At the same time, those supporting the scientific method (a proven better mechanism for knowledge enhancement compared to anarchy and superstition) are set back by science industry scandals, re-assessments, and admissions of error receiving far more press than the equivalent non-scientific treatments and potions.

    Most of what I was taught at University has been totally debunked, but was gospel and accepted as validated at the time. That is progress, but a public not trained in the process can easily become doubtful and turn to those promoting quick fixes.

    Without the funding to investigate the multitude of claims made, the tide begins to turn against reason.

    At the same time, research into alternative health product claims can be minimal because the large pharmaceutical companies may not be able to patent and then make money from a ‘natural’ based product. Or that is the claim by the industry because research of a new medication from initial phase to product supply can take 10 years and Billions of dollars, and can fail at the very last stage. The alternative based products do not have to go through such rigid procedures nor spend the research dollars.

    Again, the public does not understand. Yet, products such as Curcumin, previously ignored by science but promoted by alternative practitioners is showing some promise for treatment of certain conditions. When alternative products are found to be helpful (unlike the homeopathic treatments), then the public are reinforced in their view there may be something in the claims across the board. Logical? No. Does it occur? Definitely.

    And John, I am happy for you to point out any errors I may make. I have reread my statement re chemistry and emotions. True, emotions are a description and not in physical form whereas the chemicals that may cause emotions are physical substances. Thank you for catching the error.

  8. To everyone, but more particularly to Alison and John:

    I think we are all accepting of the feedback loop principle in physiology.
    We are also likely to agree that everything that occurs within us (leaving religion to one side for a minute) is based on electro-chemical interactions.

    A little more contentious but strongly held views are those describing central mechanisms being dominant over peripheral, and this is countered by those believing the periphery feeds signals centrally and therefore peripheral input is more important.

    Psychology and psychiatric ideas have moved toward the idea of neuro-chemical learning and adaptation, replacing many of the early pioneering thoughts.

    Top down, bottom up thinking. Chemistry versus emotions.

    If anyone argues purely along the lines of one theory being correct, they are bound to be incorrect. The idea of a feedback loop describes the reality. Wherever the commentator is situated on the loop alters the perspective of the commentary. The overview requires perspective.

    Emotion influences the neurophysiology and the neurophysiology affects the emotion. The answers are not all in yet, therefore a debate can be held but cannot be won on the evidence. YET.

    That makes those in different camps claim victory and victory may lead to criticism of the perceived loser. Both sides are claiming victory on this site.
    My opinion is that the debate should continue and for that we need courageous researchers. Which is where this discussion began.

    Back to the egg and chicken analogy.
    Apply a bit of heat and imagination to both and a palatable meal may result.

    John Quintner Reply:

    Mark, I am not sure what point you are trying to make by addressing your comment to me (and to Julie). Unless I missed it, there has been no debate between us.

    But I have harshly criticised her unsubstantiated opinions by categorising them as psychobabble. By the same token, EG’s views can be similarly categorised.

    As for your formulation “Chemistry versus emotions,” might I suggest that you are making what is known as a category mistake?

    Where is the palatable meal?

    Mark Quittner MrPhysio+ Reply:

    Thanks John,
    I referred to Alison and you, not Julie.

    Yes, I may have made a category mistake by attempting to discuss issues colloquially, which may reinforce my point about language use across different fields of understanding. Errors occur when analogy is used because analogy as a communicative tool breaks down when applied to a very broad audience – especially one as diverse as a BIM discussion.

    I agree with you when you state that it is worth defending science against ignorance. I agree with Marcel’s quote stating that such education of the’ignorant’ to defend science requires far more effort than the original statement demonstrating the ignorant view.

    In my professional career, and in life in general, I have found worth in people’s questions, mainly because even an ignorant question can create a need for a correction or answer. Ignorant or ill-informed discussion also generates teaching or a rephrasing of the evidence in language suitable for different levels of understanding or education.

    Harshness or critical response can stifle educative outcomes – even if the initiating statement causes great frustration in the educator.

    The Irish comedian Dara O’ Briain is quoted as saying, “When alternative medicine works, it is called MEDICINE”. He is a champion of science, having a background in theoretical physics and mathematics at University level. He uses comedy to educate. There are various ways to impart the message.

    It all comes back to communication – and errors occur. Sorry.

    Tongue in cheek : perhaps one of the meals may be that which you make of those making statements you find to be unsubstantiated by the scientific method.

    In an obtuse way, I was referring to the heat of a discussion changing the debatable statements in a discussion for educative purposes in the way heat denatures the protein of raw foodstuffs such as egg and chicken into a different form and could be easier or safer to digest.

    Obviously, my verbiage became too tortured and also became denatured. Target missed.

    But I have learned from the experience.

    I am no Dara O’ Briain, nor should I enter Master Chef, and perhaps I should give up my physio career and discussion commentary as well.

  9. Yes Graham, the un(sub)conscious mind does guide in extraordinary ways – especially if the research demonstrating that the conscious mind is unaware that decisions are made milliseconds to minutes before we are even aware of the decision being taken.

    Possibly because the delay between thought generation and awareness may be so substantial, it becomes difficult to separate conscious analysis of pain or emotion from subconscious reactions. Subjective reporting of pain becomes over-ridden with conscious bias and descriptive language limitation.

    Why we think we or our patients react to a stimulus may well be totally incorrect. It does seem logical that our evolved systems are in place as protective mechanisms to avoid danger as well as assess when it is safe to interact for promulgation of the species or to maintain sustenance without being injured or killed in the process.

    In an evolutionary sense, it is also logical that various systems could have multiple functions and work synergistically with other systems – a multifunction printer on your desktop compared to four separate devices. Compromise has its advantages and disadvantages.

    Part of our defence mechanism is the immune system against disease and our damage repair system required following injury. Both have components requiring inflammatory responses in the short term. If the systems are overactive then we have auto-immune diseases with often nasty or fatal outcomes. Everything is on a sliding scale – acute to chronic. Homeostasis tries to maintain a comfortable range.

    But we know some people are ‘normal’ at the high or low levels of this range or even slightly outside it. The exceptions proving the rule.

    This discussion is about potential subclinical chronic inflammatory changes creating unwanted effects upon the organism. Broadening the discussion are ideas that emotion could influence the inflammatory pathways, or that the inflammatory pathways could influence emotions. Hard to say.

    If we are insulated from our subconscious already made decisions – and a philosopher has already written a discussion on whether this means free will cannot logically exist – David Eagleman’s quote mentioned by Graham is relevant.

    All this makes me very cautious when saying something is or is not possible.

    Another current discussion is examining the veracity of whether people with depression actually feel more pain than people without depression. This is so recent that I am having to rewrite part of my yet to be published book. The verdict is not yet in, however it does seem possible that meta-analysis is revealing a failure of data interpretation because the testing did not adequately discriminate between various types of stimuli. It may be that depressed people are in fact more likely to feel more of one specific type of pain stimulus but may also be less affected by other stimuli or are the same level as the general population.

    Also, antidepressant medication can alter pain perception, and such medication may have skewed test results.

    All in all, having a closed mind to change can be just as problematic as having such an open mind to possibility, that learned helplessness results. Both extremes can result in complete knowledge inertia.

    The brave push on regardless and weather criticism in the name of progress.

    We should be just as careful of ignorance, superstition, and bias as we are of the latest scientific claims. Especially if those claims have been extrapolated or misquoted. Something can be claimed as correct many times, but only has to be correctly proved incorrect, once. Science must be defended, yes. But science is the seeking of knowledge.

    We may seek, but there is an awful lot yet to find before we claim we are truly knowledgeable. What knowledge we have is based on comparison to that possessed by our forebears.

    Are we there yet? No, not by a long shot, but the journey is fascinating.

    Be humble.

  10. Julie states that in her exploratory study the behavioural therapy used so far did not help those with higher levels of chronic inflammation. So what is it that needs to be added or changed for this approach to be effective?

    If the increased cytokine/neuronal activity that was once helpful then becomes maladaptive as the reference suggests, what causes this? I suggest it is a persons’ own feeling of vulnerability which suppresses his individuality/ personality. This is too big a topic to discuss here.

    I would also like to say that for this discussion not to be an emotive issue is a form of denial and control. We are all emotional beings. It is appropriate to be passionate about what we believe to be constructive and beneficial to patients when other methods have failed the doctor and the patient When have you ever heard David Butler speak without passion ? The Brexit vote in the UK and the Trump vote in the US are further examples. People voted with their emotions and frustrations and hearts not with their minds, this energy is creative for change. It does not always feel safe, it can be felt as risky and unpredictable. Chaos initially occurs where previously there has been order, this is followed by an adjustment . (Higgs Bosun particle principle)

    To encourage this practical inquiry is a respectful part of any exchange and can be highly advantageous to all concerned, including in a therapeutic setting. This benefits both the practitioner and the patient.

    John Quintner Reply:

    “If the increased cytokine/neuronal activity that was once helpful then becomes maladaptive as the reference suggests, what causes this? I suggest it is a persons’ own feeling of vulnerability which suppresses his individuality/ personality.”

    More psychobabble?

  11. graham yates says:

    Great article Julie and who would have thought an article on psychoneuroimmunology would create such a response. You have obviously hit a nerve (or psychoimmune molecule!).
    I think it useful to go back to basics and think of us as Louis Gifford says as sophisticated amoebae carrying our genes forward and trying to stay alive long enough to do this. On a basic level we will either exhibit seeking behaviours or withdrawal behaviours depending on our response to environmental cues. Our immune systems would then logically work for us to stay away from perceived threat and to be pro social in times of perceived safety. The unconscious machine guides in ways that are extraordinary and leads to the view of David Eagleman who says the conscious mind is like a stowaway on a ship, who on safe docking, comes out and takes all the plaudits for the safe crossing

    Alison Reply:

    Precisely

    John Quintner Reply:

    “… who would have thought an article on psychoneuroimmunology would create such a response.”

    It was indeed unfortunate that the article elicited some responses that I can only categorise as psychobabble.

  12. Thanks Stu, Just to note. I am not an official moderator on this site. Thanks for the feedback, however. Most appreciated.

  13. Thanks Julie for the post – appreciated. I would like to learn more.
    Could you provide information on inflammasomes and role in inflammation?
    Could you also clarify the differences between innate immunity’s role and nociceptor’s role in inflammation? The definition of edema too…
    There is an excellent article from Chiu on neurogenic inflammation in Nature Neurosciences that was helpful for me – I profess to ignorance on details.
    To paraphrase,
    In terms of the chicken and the egg, during evolution, similar danger detection molecular pathways have developed for both innate immunity and nociception even though cells have different developmental lineages – integrated protective mechanisms both peripherally and centrally. Thanks John for the excellent reference. I am adding another. Layers and layers.
    Reference: Chiu I, von Hehn CA, Woolf CJ. Neurogenic Inflammation. Nature Neurosciences. 2012 July
    Perhaps with inflammation, modifying stuck thoughts or psychic distress via descending modulation may be the ‘main shut off valve’ for inflammation.
    Maybe. However, I have seen too many patients with lymphedema to say yes.
    Local environments to regions, it is a massive jigsaw puzzle – only see parts.
    Thanks Mark for moderation / mentworking.

  14. John Quintner says:

    In their opinion piece, Xanthos and Sandkuhler (2014) suggest the term neurogenic neuroinflammation for use specifically in relation to the topic under discussion:

    “In summary, the elaborated inflammatory response repertoire of CNS tissue may not only be used to deal with infectious, toxic or degenerative processes but also to cope with the demands of increased levels of neuronal activity and to enhance the computational power of neuronal networks in the CNS. However, neurogenic neuroinflammation may become maladaptive and aggravate clinical conditions such as pain, stress and epilepsy.”

    Reference: Xanthos DN, Sandkuhler J. Neurogenic neuroinflammation: inflammatory CNS reactions in response to neuronal activity. Nature Reviews Neuroscience 2014; 15: 43-53.

  15. John Quintner says:

    “Is it really worth taking the time and effort to challenge, correct and clarify articles that claim to be about science but in most cases seem to represent a political ideology?”

    In the context of this discussion, the answer must be YES.

    As Hippocrates once said: “Science is the father of knowledge, but opinion breeds ignorance.”

    Reference: The Canon [Law], IV. Translated by John Chadwick and William Neville Mann. The Medical Works of Hippocrates. Springfield: Charles C Thomas, 1950.

  16. We are all in a continually process of learning about ourselves and the world around us. We have come so far in understanding pain, but to alleviate the sensation of chronic pain and observe the changes at cellular level has so far posed a greater challenge. To find the answers we have investigated contributions from the physical , emotional and mental bodies . Many philosophers, scientist, health professionals and physicists believe that inclusion of the spiritual body/anima is also needed.

    A therapeutic process that helps to explain the perceived problem, affords illumination to it in an expansive way and finally renders a personal and collective wisdom , that is often beyond understanding, could fulfil this role.

    I include a reference on transformative learning that I find helpful .

    https://www.iup.edu/WorkArea/DownloadAsset.aspx?id=18335

    “Scientists are like those levers or knobs or those boulders helpfully screwed into a climbing wall. Like the wall is some cemented material made by mixing knowledge, which is a purely human construct, with reality, which we can only access through the filter of our minds. There’s an important pursuit of objectivity in science and nature and mathematics, but still the only way up the wall is through the individual people, and they come in specifics… So the climb is personal, a truly human endeavor, and the real expedition pixelates into individuals, not Platonic forms.” Jaana Levin, Black Hole Blues

  17. The Nature News article (linked above) is out of context here
    it should stay where it belongs, (not in this series of comments)
    My bad

    Mark Quittner MrPhysio+ Reply:

    Hi Marcel, Given some of the interchanges in this thread, I think your link was appropriate at the time and the moderators left it in.

    Thanks for your sensitivity.

    We can all move back to the actual topic – inflammation.

    Provided that
    everyone drops the emotive interchanges and sticks to the discussion rather than defending their own overview of the science, psuedo-science, and non- science debate.

  18. Thanks Marcel,
    Your post is definitely something we should all keep in mind. Unfortunately, no one thinks of themselves as a psuedoscientist and such articles are always thought to be commenting on others, but never ourselves.
    What fun it is as a site moderator/manager to watch the children play. Actually, it is quite informative, hence the reason I volunteer my time.

    If only all the bluster, heat, good intentions and energy in many discussions could be used productively.

    Everyone has a right to maintain a view on any topic and we can all learn if we maintain an open mind. There are some absolutes at either end of every argument – and we should all be aware of the huge amount of knowledge grey areas between the extremes.

    What is accepted today and yesterday is likely to be discarded as rubbish tomorrow only to turn up as worthwhile recycling in a different form later on.

    Most head butting in these discussions occurs because participants have very different mindsets coupled to words and phrases that have different meanings to different fields. And some of those fields are divided by a no-mans land due to completely different ways of seeing the world.

    Scientific method versus everything else, including but not limited to, religion, gut feeling and blind faith.

    Research findings, trials etc are forever being misquoted or extrapolated to the point of totally misrepresenting the research. I am guilty of commenting upon others views of a topic without reading all the original research. Despite my training, I am not educated enough to be able to understand all the concepts conveyed across so many fields of endeavour. I suspect I am not alone.

    Arguments then bog down with people quoting research they may not fully understand or have cherry picked because it does or does not support their or someone else’s viewpoint.

    In forums such as this, it is great to exchange ideas. There is a need to keep on topic (and my attempts at humor could be criticized for drifting) and guidance from those in the know can be valuable.

    Provided everyone remains civil , adopting a teaching role or a student role as appropriate, rather than a disruptor or point scorer, idea interchange will occur without people being scared to participate for fear of being flamed.

    We all need a safe place.

    Any contributors that are really clever already know their competence and do not need to show it off. The ignorant are always ignorant of their ignorance and should be forgiven their plight, but not forgiven if they do not wish to learn.

    There, I said it.

  19. This came out yesterday in: Nature News & comment

    “Take the time and effort to correct misinformation”

    Scientists should challenge online falsehoods and inaccuracies
    Phil Williamson. 06 December 2016
    Quote:”Most researchers who have tried to engage online with ill-informed journalists or pseudoscientists will be familiar with Brandolini’s law (also known as the Bullshit Asymmetry Principle): the amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it. Is it really worth taking the time and effort to challenge, correct and clarify articles that claim to be about science but in most cases seem to represent a political ideology?”
    http://www.nature.com/news/take-the-time-and-effort-to-correct-misinformation-1.21106

  20. John Quintner says:

    “Neurogenic inflammation is a different matter, but I believe that is caused directly by psychic stress. Psychic stress in the form of negative thinking or emotional suppression, can cause inflammation.”

    Is this yet another belief system based entirely upon conjecture?

    If it is not in this category, would you please provide some scientific evidence to support it.

    EG Reply:

    Conjecture is a very important way to proceed as a clinician when researchers are consistently using poor methodology and looking in all the wrong places. The amount of *usable* information that I get from pain researchers is so low, I am forced to do it myself. Patients have pain that they want fixed now, not in 50 years time.

    Sheldon Cohen, Denise Janicki-Deverts, William J. Doyle, Gregory E. Miller, Ellen Frank, Bruce S. Rabin, and Ronald B. Turner. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS, April 2, 2012 DOI: 10.1073/pnas.1118355109

    Get with the program.

    John Quintner Reply:

    I agree about the importance of conjecture to scientific advancement but having looked at the paper you referenced, I could not see how it would in anyway support the ones you trotted out.

    I would not have the temerity to equate exposure to “a major stressful life event” (which is the main thrust of the paper you cite) to your suggestions of “negative thinking” or “emotional suppression” as being associated with neurogenic inflammation.

    Whatever program you might recommend that I “get with” does not in any way appeal to me.

  21. Think about this:

    What comes first: “The egg of course. The chicken is only an egg’s way of making another egg.” (q=Quote from Richard Dawkins)

    Mark Quittner MrPhysio+ Reply:

    Thanks Marcel, Thankfully the thought has already been put in by Mr.Dawkins. He is much more succinct than me.

    There is a current theory where most major diseases are caused by the inflammatory effect caused by low-level bacterial infection. Sub-clinical.

    To mix definitions for further naughtiness – if bacteria could be to blame, then germs are responsible. An egg is a germ cell.

    As is a sperm – but male irritation of females is another debate altogether.
    Just joking, everyone.

  22. Thanks EG for following on with my tongue in cheek question about egg and chicken timing. We could come full circle and suppose that a chronic dilute but thoughtful solution of chicken soup could create psychic stress negatively impacting emotions, rather than a vigorous acute downing of raw eggs mixed with vegetable juicing before a stimulating run to cause initial inflammatory responses for an overall positive fitness outcome.

    So it may all be tied to dosage concentration and chronicity of application. The body accepts the egg as a bit of an insult but deals with it, but the low dose yet consistent application of chicken soup sneaks past the bodies protection.

    Or another view entirely, the good or bad outcome may not depend upon whether it is the chicken or the egg, but more where the chicken and egg present themselves. Both are good in the hen house (body) but not so good crossing the busy road (central nervous system). I think my flight of fancy with the original analogy should now have its wings clipped.

    Thanks for the observation about my rooms. I was proud to design and build this clinic – but I recently sold the property and someone else is now enjoying my efforts. As I have only just moved, my website pics are now out of date. Thanks for the reminder to update my site. My first book will be published soon, so that and moving has been taking up my time. Apologies to everyone for my silly indulgence here, just trying to lighten the tone of a very serious topic. I have experienced chronic pain, and coping mechanisms are as important as all the other technical aspects.

  23. As a moderator/manager on another professional site, I find the range of views and interactions expressed here, fascinating, as well as illuminating.

    The thread has a great instructional dynamic fed by the diverse views expressed by various personalities with varying interests, experience, and educational/research backgrounds.

    The initial interchanges delineated various contributors viewpoints, biases, and understanding of Dr. Lasselins interactive research, then a defense of individual viewpoints and a progressive emotional warming began.

    I was very impressed with the way Dr. Lasselin recognized the emerging primate hierarchical dominance (and I found it amusing to read a reference to primate research later in the thread) and the way her gentle and considered non-emotional responses provided a positive refocus of the discussion, following which the contributors became more respectful of each other.

    This topic and the thread reminds me of a Lava lamp, with each contributor’s viewpoint being their own type of wax, circulating around the discussion vessel by convection currents created by the discussion but not really mixing with the other circulating wax. Sorry if the analogy is poor or too obtuse.

    Specific to the discussion points raised, I agree with Dr. Lasselin (hopefully I am not misunderstanding), that her research is preliminary and is looking to define causation and linkages rather than claiming a full explanation exists at this point.

    The history of scientific endeavour should be remembered. Great progress is often made in a research field after initial idea resistance, then stagnation occurs, only to progress when disparate scientific fields merge. For instance, Astronomy and Physics, Astronomy and Radio, the fields of nutrition and psychology etc etc.

    When various knowledge bases merge, there is a settling in phase and new excitement when limiting boundaries are stripped away.

    I am old enough to have seen many dogmas fall by the wayside in my field (physiotherapy). In fact, most of the special tests I needed to espouse to gain accreditation for my profession are now known to be useless and have no specificity for outcomes. I thought these tests were suspect when they were being taught and said so at the time – only to delay my graduation until I towed the line. The same continues to occur post graduation and nearly three decades later.

    But that is the scientific method when mixed with preconception, dogma and human interaction. There will never be a single answer to the question of pain causation and the human experience of pain, because there are too many interactive variables. Dr Lasselin is correct. It is important to continue research to try and find out as much as we can to piece together the mechanisms to help us understand. Doing so may fine tune future treatment protocols, improving outcomes. The answer to a question often raises many more questions. A good thing, I believe.

    Which comes first? The inflammatory egg or the psychological chicken?

    EG Reply:

    “Which comes first? The inflammatory egg or the psychological chicken?”

    Chicken.

    Normal inflammation need not cause any psychic stress, so long as we know it’s a normal part of healing. I think most patients understand intuitively that inflammatory symptoms are part of recovery after physical trauma, and that such symptoms fade on their own without any professional input. Neurogenic inflammation is a different matter, but I believe that is caused directly by psychic stress.

    Psychic stress in the form of negative thinking or emotional suppression, can cause inflammation. That’s partly the fault of a society which attempts to shame the expression of negative emotions. It’s also partly the fault of practitioners who don’t know how to facilitate the release of such energies from the system. It’s not hard.

    Nice looking rooms you have their Mark.

  24. Hi, thanks for the fascinating discussion. I like the quote by Melanie Noel (especially in December) ‘Just teaching people to think about pain differently can alter not only the level of pain they’re reporting but the brain itself.’
    Perhaps it is the things unsaid or inviting the person to write or respond.
    What I struggle with is understanding facilitated neurogenic inflammation.

    From a peripheral sense, awareness is a starting point (that it exists) and how to alter behaviours or patterns of movement (or even breathing) to alter it – or using diabetic friendly or lymphatic friendly compression garments to alter it (with friendly aerobic exercise and micro biome friendly diet including Omega 3s, pre-biotic fibre and resveratrol possibly – Lorimer likes to have conversations over small amounts of wine (or grapes might do)) however inflammation in the brain with no lymphatic system confuses me – I realize there are systems to move fluid around and store fluid in the brain. Helps.

    Helpful to feel safe in this and that inflammatory thoughts exist and priming behaviours, thoughts, cultures can influence our systems and thinking – Kathleen Voh’s research is very helpful when you think about it. Thanks for this post – very important work. Could you provide further insight re inflammation? Does neurogenic inflammation differ? Is it important?

  25. Yes EG when you stop thinking you realise. That is the difference.

  26. Dear Dr. Julie Lasselin,

    Have you considered the role of: social environment and social status, (“Position in the social hierarchy is closely related to health and risk of disease.” https://www.ncbi.nlm.nih.gov/books/NBK242456/) or perceived social status, (“Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679065/), (” Snyder-Mackler et al. (3) show that primate social subordination promotes a proinflammatory response. Do the trials, tribulations, and inflammatory states of rhesus monkeys apply to us?, http://science.sciencemag.org/content/354/6315/967) and the “cross talk” between genes and social environment, (“adverse social environments have been consistently linked to upregulation of genes involved in inflammation and adrenergic signaling. In addition, predicted binding sites for transcription factors involved in the stress response are often found upstream of social environment-associated genes. For example, binding sites for the glucocorticoid receptor, which mediates the cellular response to HPA axis signaling, are enriched near genes linked to differences in social status and social isolation.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809334/).

    Kind regards
    Marcel

    EG Reply:

    Very interesting the whole social status / self-image / isolation aspects. The brain has been designed to reward increased status with highly addictive chemicals. But such a system necessarily has far fewer winners than losers, otherwise it collapses. Even the winners have to remain ever-vigilant lest their spot be taken from them. Not much of a system Nature has designed there. The rat race.

    The only solution that I’ve ever seen postulated is a spiritual approach where a movement away from the self-image is achieved. Meditation creates this change on a structural and chemical level after many repeated attempts and a LOT of skill. So rather than obeying the thought “I’m not good enough” then seeking to fix that with objects/achievement/money/sex/power/status, the thought itself is let go. If it’s let go, the brain paradoxically releases a huge dose of dopamine, AND it’s possible that addiction is less likely when it happens this way.

    Unfortunately, 20 minutes of “watch your breath” won’t even get you close. http://www.greatwesternvehicle.org/thejhanas.pdf

    Alison Reply:

    Absolutely EG , when you are happy to be yourself without fear of social structure of any sort the perceived problems fall away. This will not happen by any understanding or meaning of pain but only by listening to and answering your own questions.

    “It’s the questions we can’t answer that teach us the most. They teach us how to think. If you give a man an answer, all he gains is a little fact. But give him a question and he’ll look for his own answers.”
    ― Patrick Rothfuss, The Wise Man’s Fear

    EG Reply:

    “They teach us how to think”

    Yeh, but there might be more value in knowing how to stop thinking! Or is that just me…

    I find it strange that people aren’t interested in knowing how to very rapidly make pain vanish using the mind. Maybe no one believes me. Maybe that’s it. I admit there are downside risks in working the way I do. Here’s some of them:

    – clients can become confused/frightened. For many, having pain disappear quickly and without any physical input is unsettling. Even when it’s explained it can remain a difficult issue.

    – some clients have underlying issues which surface only when the presenting pain is removed. Sometimes these underlying issues are quite major (both physical and mental), and I’m still working on ways to handle this properly. Chronic pain patients often have a layering of different symptoms. Sometimes switching off one pain in one area will immediately activate another area of the body, for example.

    – I tend not to get the clients who want to use their therapist as a surrogate partner/parent. It’s a huge market [$$], but I find it terribly draining and boring, so I don’t offer it.

  27. Julie Lasselin says:

    Dear Suzanne,

    Thank you for your interest in the post! Your questions are very relevant and point out the difficulties of our field!

    As I mentioned in the post, “low-grade inflammation” is unfortunately, for now, only known at the level of a group of patients, and not at the individual level. The reason is that low-grade inflammation remains in the non-clinical range. At a group level, we can detect that a group of patients (e.g., obese patients or chronic pain patients) exhibit slight increase in inflammatory markers. But the differences are very small (e.g., concentrations of interleukin-6 would be around 1 pg/mL in the control group against 3-4 pg/mL in the patient group; while it is more than 500 pg/mL during an infection). A lot of studies still indicate that this slight elevation in inflammation would be enough to contribute to other changes, such as behavioral symptoms; but we need more studies in order to understand its real impact and most importantly which sub-population would be more vulnerable to the effect of low-grade inflammation. Indeed, while low-grade inflammation may exist in a group of patients, I do not think that inflammation triggers behavioral symptoms in all these patients; but more the combination between low-grade inflammation and other factors of vulnerability (which can be biological but also, of course, psychological).

    At a level of one patient, it is hard to estimate whether this patient exhibits “low-grade inflammation”, except maybe if we could follow this one on several years and measure the inflammatory changes. But more studies aiming at understanding and characterizing “low-grade inflammation” will help to later been able to detect “low-grade” inflammation at the individual level.

    Still, we know that we can modulate low-grade inflammation. For instance, a balanced consumption of omega3/6 improves low-grade inflammatory state and, over a long time period, may therefore reduce the risk for behavioral consequences of low-grade inflammation. Reducing stress, for instance using yoga therapy, has also been shown to improve low-grade inflammation.

    Respectfully,
    Julie

    Alison Reply:

    Thank you for your insights Julie. Chronic pain does not respond to anti inflammatories so the assumption that it is the cause of pain or behavioural symptoms is due to low grade inflammation is as you say erroneous. You use the word ‘vulnerability’ to me this is the key for our patients into finding their own pathway to health. Peter O’ Sullivan uses this successfully with chronic back pain, but it can be applied to any area of ill health.

    Luke Reply:

    It is worth noting that the lack of response could be explained by several variables that have not been explained. Inflammation as a mechanism is like saying that the car engine is not working – if it is a faulty sparkplug, using seafoam to clean carbon deposits won’t achieve anything. Unfortunately, for the time being, we use the term inflammation to describe several potential but as yet unknown specific mechanisms. If, for instance, there is cellular change in the CNS we would not expect oral antiinflammatories to do anything as they won’t penetrate the BBB. If it is systemic, then we may not be targeting the right cells (since we do not know what the actual change involves). Lots of research to be done before we throw out the fetus with the placenta.

  28. John Quintner says:

    Alison, the dynamics of the interaction between clinician and person-in-pain is an important and too often neglected issue that Milton Cohen and I dissect in a chapter of a soon-to-be-released book – Meanings of Pain.

    Here is a link that advertises its publication: https://www.facebook.com/search/top/?q=meanings%20of%20pain%20by%20simon%20van%20rysewyk

    PS we have no pecuniary interest in sales of the book

    Alison Reply:

    Thank you for the link Dr Quintner I will look into it. The interaction between clinician and person- in -pain is certainly the most important.

  29. Good article Dr Lasselin – the role that inflammation plays in various conditions is becoming more apparent. I’m wondering at what point inflammation becomes a trigger for other changes, (especially chronic pain) as mentioned in your article? Also when does inflammation becomes low grade chronic? How might chronic low-grade inflammation be effectively treated? Especially if this inflammation might be throughout the body – this would be important where there is no trauma or injury to a specific site?

  30. KW,

    Looks like the moderators don’t mind (thank you Kat), so I’ll proceed.

    The above instructions are designed to stop you making effort. As much as possible, will power and attachment to a positive outcome should be removed from your clinical demeanor because they stop the ‘flow of water seeking its own level’ [to continue the metaphor]. Just stop all the ‘doing’ and ‘trying’. If you do routinely ask 20 questions in a new patient interview, ask 3. If you routinely perform 6 physical assessments on a sore knee, just do 1 or 2. By doing a lot less and by noticing better outcomes, you train your mind to understand through experience, that less is more.

    When you first try this, it may provoke anxiety in you. You may think “but how can anything change if I don’t do all these questions and tests and talking and poking and cracking?!”. You have to risk that, control your emotions in whatever way works best for you, and just notice the outcomes. Even if all you notice is that the outcomes are no worse, you’ve made a small step in the right direction. By further letting go anxiety and doing even less, the outcomes will improve further.

    Another part of ‘doing less’ is letting go of the affected professional mannerisms. Practice talking to clients the way you’d talk to a close friend. And by this I don’t mean joking and fooling around, I mean just without the professional facade. Just being normal, in other words.

    So that’s the first part. There’s a second part which does actually involve a small amount of ‘doing’. Let me know if what I’m posting is of interest and we can do the rest via email.

    KW Reply:

    EG thank you!
    Here is my email: kpain9999@sc.rr.com

  31. My clients are not interested in what happens at a cellular level, they just want to be better, be without pain. However, if neuroscience can demonstrate the changes that these therapies bring about, that would be fabulous! I am all for it!

  32. Julie Lasselin says:

    Dear Dr Quintner,

    Thanks a lot for your support and interest in our study!!!

    I am not a specialist of pain, neither in psychoneuroimmunology of pain. Maybe Mike Kemani, the co-first author of this paper could help!

    But I think that Substance P is likely one of the mechanisms explaining the role of inflammation in pain (and even maybe resistance to pain treatments…), and inflammation one component of what you call “whole-organism stress response” in chronic widespread pain!

    Respectfully,
    Julie

  33. Julie Lasselin says:

    Dear EG and Alison,

    I don’t think we should oppose our views but instead putting them together. This is by staying stuck in our way of seeing how the systems work that we do not understand how they works. I do think that your healing processes are working, I just think that they are biological bases that explain why it works. This is the founding principles of psychoneuroimmunology. I totally respect your work, but as a scientist, I am just captivate by understanding HOW it works, and psychoneuroimmunology is an answer for me. As they are many other answers, I am sure. We are far from saying that the effects of the immune system is the only contributor, but just one.

    I am sure that the key to improve health is if we are open to different views and integrating all of them.

    I am very happy that this blog post can put people from different “worlds” in discussing together, as it is so hard to do every day!

    Respectfully,

    Alison Reply:

    Hi Julie, thank you for your reply. Co -operation is the way forward, every form is just trying to explain the whole so thumbs up for PNI. How does it work ?
    The essence of it is that you are an empty vessel, reflecting back what the client needs.You allow them to be see, empowering them to feel their body again, truly inhabit it with out fear. As a physiotherapist, helping clients inhabit their bodies is what it is all about, it is just done in a different timeframe and space. This normalises the actual physical structure, ie they can lift their arm again or make a fist but it gives them an awareness at a deeper level of who they are. This will be seen cellularly ..PNI. Shifts in fMRI between the emotional centre NAc and mPFC as shown by Apkarian I suspect will also be evident.

    John Quintner Reply:

    Alison, you are sadly mistaken in your belief that you (or anyone else) can be an “empty vessel reflecting back what the client needs”. I cannot see how such a mindless person would ever be able to enter into a dialogical discourse with another human being, let alone with one in pain experiencing an existential crisis. Why do you rule out the possibility of a truly intersubjective engagement taking place within a mutually constructed “third space”?

    Alison Reply:

    Thank you for your response Dr Quintner.

    I realise that I do not quite understand what you are asking me. Though English is my first language the terminology you use is unfamiliar to me and then of course my interpretation of it.

    From investigating the word ‘intersubjectivity’ I understand it can refer to psychological energy moving between people helping them to give meaning or definition to a situation, either shared fully or partially. If this relationship arena is expansive and allows for free dialogue without perhaps the dogmatic wishes/theories of either taking over then change happens. ‘Mutual’ is the ideal goal as you indicated. The patient chooses their own parameters by which to manage their crisis for only they know the truth of themselves. The space does indeed allow for suggestions, choices made and integration .

    Someone who is telling a lie is also engaging in an intersubjective act. so to come to a place where there is only truth requires more profound acknowledgement. None of this of course is on a purely mind level. I would also like to suggest that psychological energy as mentioned above is not the totality either.

    Old foundations/beliefs/interpretations may or may not be easy to shift but once recognition of the truth is acknowledged, appreciated and accepted we become it. Our physical bodies correspondingly follow.

  34. Dr Quintner, The laws of statistics indicate by the mere fact that there are at least two of us talking about the new paradigm in health in this discussion it is no longer a personal view. Neuroscience is but one facet in exploring ways to improve health, psychoneuroimmunology says it. Health is not a purely scientific endeavour. The knowledge that we are all seeking can only be realised by teamwork. If this includes a dimension to you that seems farcical then so be it.

  35. John Quintner says:

    Julie, congratulations on your publications and on your dogged pursuit of this important clue to the pathophysiology of these enigmatic persistent pain states.

    Your work resonates with our hypothesis for chronic widespread pain (aka fibromyalgia) [Lyon et al. 2011].

    What are your thoughts on the possible role of Substance P in the process of neuroinflammation?

    Reference: Lyon P, Cohen ML, Quintner JL. An evolutionary stress-response hypothesis for chronic widespread pain (Fibromyalgia Syndrome). Pain Medicine 2011; 12: 1167-1178.

  36. Dr Quintner
    So what is the cause of neuroscience? How is it any different to that of EGs ? Is it not finding the therapy that will enable the patient to feel well and whole again with minimal intervention. Neuroscience is wonderful at seeing what is happening at cellular level but it does not offer what EG and I do. I suggest a before and after measurement of cellular activity following this intervention.

    John Quintner Reply:

    ” … pain is nothing more than a representation of the part, the non-self that we have chosen to disregard. It in fact is an open doorway into ourselves. Once we realise this, there is nothing for our immune systems not to recognise.”

    Alison, your personal views, as expressed above, do not strike me as epitomising the cause of scientific endeavour.

  37. Perhaps the person with the ‘stuck thought’ isn’t the patient at all?

  38. John Quintner says:

    “Most of the time, pain is nothing more than a stuck thought.”

    Could this strange assertion be heralding a new model of the brain/mind?

    One analogy that occurred to me is that of the old-style gramophone where a record is playing a familiar tune. The stainless steel needle encounters some resistance in its groove and the music keeps jumping back a few bars.

    In my opinion, EG’s farcical comments (and also those of Alison) do a disservice to the important work of Dr Lasselin et al., as well as to the cause of neuroscience.

  39. Totally agree Julie, pain is nothing more than a representation of the part, the non-self that we have chosen to disregard. It in fact is an open doorway into ourselves. Once we realise this, there is nothing for our immune systems not to recognise.

  40. Julie,

    Inflammation is just one of many somatic effects. Negative thought patterns (a focus on lack) are the cause. We don’t need to waste time on studying effects when the cause is so easily accessed and manipulated.

    Nowadays I am regularly achieving significant (70+%) pain relief for acute clients in under 5 minutes with no physical intervention. Chronic clients can sometimes take longer (up to 10 minutes for 50+% change). Most of this change lasts well into the next appointment. Regression used to be an issue, but that’s no longer the case. Clients are regularly left scratching their heads, as am I – the rapidity and degree of change is that big.

    Most of the time, pain is nothing more than a stuck thought. My only role as healer is to get out of the way. Very little knowledge is required. It’s more like a knack, and anyone can learn it.

    KW Reply:

    E.G.,
    I want to learn it. Can you give me some info that would get me started? TIA

    EG Reply:

    Start by understanding that healing is a spontaneous phenomenon. When you and the patient enter the room, healing will start to happen regardless of your intent, words or physical interventions. You’ve heard about water seeking its own level? – well healing is like that. You can’t *do* it no matter how hard you try. It just happens according to its own laws.

    The flow of water seeking its own level *can* be physically blocked. In the same way, spontaneous healing of pain can be blocked by our own doubts, fears and wilful attitude. This is the level you need to target. Forget about physical interventions, education and even hypnosis. When you’re with a patient ask yourself “How am I preventing what would happen spontaneously? How am I preventing complete healing of this pain?”. Don’t concern yourself with the patient; just find a way to get out of the way.

    If something near miraculous doesn’t happen within a few minutes, you didn’t fail to *do* it, you *prevented* it.

    Make sense?

    EG Reply:

    Apologies Lisa, for intruding on your thread.

    BiM, if you want to remove my post now that KW has read it, go ahead.

    Luke Reply:

    Sounds like an incredible cure that beats all known analgesics. I would suggest that you conduct a proper trial to test its effectiveness.