Why do so many of us develop our diseases after periods of stress, for example? Why are we then unable to recover by addressing, removing or reducing the stress in our lives?
Why do some people with type 1 diabetes, or chronic fatigue, or other chronic illnesses have a sudden onset, such as after an infection or traumatic event, while others with the same illness have a slow onset with no observable cause (like me)?
For that matter, why is there such a variation in the first symptoms people have, even when they have the same disease?
Table of Contents
- 1 The Chronic Illness Model
- 2 How to Make Sense of Chronic Illness
- 3 Five Characteristics of Trauma Seen in Chronic Illness
- 4 Six Ways Early Life Influences Chronic Illness
- 5 Why Me? Why this Illness? Critical Periods
- 6 Mechanisms: Life Events Alter Genes
- 7 How Risk Develops From Early Life to Onset
- 8 How to Treat Chronic Illness
- 9 Different Illnesses, Same Cause?
- 10 Free Downloads For More Information
- 11 What You Can Do
- 12 Does This Make Sense of Your Illness?
- 13 Leave a Comment Below
Some of these variations are eloquently described in the onset stories on the blog Rheumatoid Arthritis Warrior (RAW).
This post introduces a chronic illness model I’ve developing over the past 15 years. It’s based on research I never learned about as an MD. The research addresses these questions.
Periods of stress occur before the onset of all kinds of different chronic illnesses, including my own. But I don’t think that a particular stressful event is the cause of most chronic illnesses. Rather, it’s more like the last straw in a series of events.
The Chronic Illness Model
I refer to the theories I’ve been developing through research and personal experience over the past decade plus as The Chronic Illness Model. Most of these paragraphs will eventually become one or more posts and ebooks with lots more detail.
Here I summarize research suggesting how experiences can induce a perception of threat – either through overtly traumatic events such as surviving war, natural disasters, and abuse OR in subtle and unrecognized ways that can begin before and during birth). These are important risk factors for chronic illness and are not psychological. The growing field of epigenetics is beginning to reveal one of the mechanisms for understanding how nongenetic factors affect risk for chronic diseases of all kinds.
Three examples of how healing subtle and overt trauma can decrease symptoms or even cure chronic illnesses (asthma, ME/CFS and autoimmune disease) offer insights as well.
My hope is that understanding trauma can help us recognize ways to prevent the onset of chronic illnesses in the long-term, slow down the progression and reduce symptoms in those of us who are already sick, and ultimately perhaps enable us to recover from our chronic diseases. I hope to introduce – and teach – this to doctors and other health care professionals one day.
So as not to overwhelm myself (and possibly you, too!), I will only list a few of the most readable references in this post.
For anyone who wants the whole shebang and the full description of the chronic illness model now, I have two published, academic-style, densely-written papers with tons of references. You can see or download the Journal Article (1)Mead, V.P., A New Model for Understanding the Role of Environmental Factors in the Origins of Chronic Illness: a case study of type 1 diabetes mellitus. Med Hypotheses, 2004. 63(6): p. 1035-46., where I explore how the model applies to type 1 diabetes, or the longer Book Chapter (2)Mead, V.P., Timing, Bonding, and Trauma: Applications from experience-dependent maturation and traumatic stress provide insights for understanding environmental origins of disease, in Advances in Psychology Research, A.M. Columbus, Editor. 2007, Nova Science Publishers. p. 1-80.. The chapter presents more details about type 1 diabetes and looks at the relevance of the model to two additional chronic illnesses: inflammatory bowel disease and asthma. I’ll list the references, including these two again with links for downloading, at the bottom of the post.
You can read my most recent perspectives and references on this chronic illness model in my free ebooks.
Patterns in The Chronic Illness Model
The answers to the questions we have about chronic illness lie in our nervous systems. Our nervous systems are much, much more adaptable to our unique, individual environments than we ever imagined. The term used to describe this quality is that they are plastic (3)Doidge, N. (2015). The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity Viking Adult.
Our brains and nervous systems are also much more sensitive, and dependent, on our environments than we have realized. Interactions between our bodies and our physical, emotional and psychological environments are what shape the patterns our nervous systems develop as we grow.
Nature and Nurture
One example of interactions between environment and developing physiology happens at birth. Being born through the vaginal canal is actually designed to serve many purposes. It squeezes fluid from our lungs in preparation for the great shift that enables us to start breathing air for the first time. It inoculates us with healthy bacteria from our mothers, which populates our guts. After birth, the nervous system activity that was high during the birth process is designed to shift and settle when babies find their ways into the arms of their mothers and fathers. There is often a quiet period at this time, which allows for bonding, resting, and recovering. These are examples of life events that affect how our nervous systems learn to regulate. This is how we, as a part of Nature, are designed to grow and develop through interactions with Nurture.
How to Make Sense of Chronic Illness
Two areas that have given me the best insight into origins of chronic illness come from research in the fields of Trauma and Development.
Five Characteristics of Trauma Seen in Chronic Illness
Trauma is an experience that is perceived as life-threatening and inescapable and can lead to posttraumatic stress disorder (PTSD). Trauma can happen when we go to war, when we’re in a car accident, or during natural disasters. It can also be much more subtle. Trauma can occur in early relationships with parents that are emotionally unavailable (due to their own trauma), or with seemingly small accidents and more. Either way, trauma can leave tremendous, life-altering physical wounds.
We have, however, been greatly underestimating the impact of trauma – as a culture, as a population, in medicine – on the nervous system, on the psyche, on behavior, and on our emotions. What we’ve been learning from research is significant. Below are five of the main characteristics of trauma that I think are remarkably applicable as a different chronic illness model. Two books that provide good overviews of trauma are Peter Levine’s Waking the Tiger (4)Levine, P., Waking the Tiger. 1997, Berkeley: North Atlantic Books., and Robert Scaer’s The Trauma Spectrum (5)Scaer, R., The Trauma Spectrum: hidden wounds and human resiliency. 2005, New York: W.W. Norton.
1. Symptoms Usually Result From Prior Trauma (Rather than a Single Event)
Soldiers are at higher risk of developing posttraumatic stress disorder following a traumatic event when they have a history of prior, unresolved trauma, such as trauma from life before joining the military. This is part of the reason that not everyone who serves in a war (or is in an accident or goes through medical training), gets PTSD. Similarly, not everyone who experiences trauma, or the stress of divorce, job loss, or a severe infection develops a chronic illness. If you have a chronic illness and a history of trauma it does not mean it’s psychological. It’s because trauma has many different kinds of effects depending on when it happens. Risk for chronic illness appears to start in the womb.
2. Compounding: Effects of Trauma Add Up
The effect of multiple traumas over time is additive. In the trauma literature, this is referred to as “compounding.” Studies throughout the chronic illness literature find that there have been more stressful life events in those of us who develop a physical disease, compared to our peers who do not.
3. Latency Periods: Delay Between Trauma and Onset
There is generally a delay between a traumatic event and the onset of symptoms of PTSD. The time period can vary from weeks to months or longer, and is referred to as a “latency” period.
Most of us with chronic illness had intermittent symptoms, just like those of our diseases, months or years before the full onset.
Researchers looking at chronic illnesses have noted latency periods. In illnesses where antibodies have been identified, they are being found to precede the onset of symptoms. In lupus, it has been by as much as 7 years. In type 1 diabetes, antibodies are sometimes present at birth. Antibodies are also found years before onset of type 1 diabetes, rheumatoid arthritis and other chronic illnesses. Unidentified factors affecting risk for Alzheimer’s are believed to occur as much as 30 years prior to onset.
Stressors that cause exacerbations of PTSD are called triggers. The more intense the experience of trauma, the bigger the impact, and the more quickly the pattern gets stabilized. This can lead to an earlier onset of symptoms. Triggers are unique to the individual and to the way a traumatic event was perceived. What constitutes a trigger is therefore different for everyone.
This is similar to chronic illness, where the kinds of stressful events that precipitate the same chronic illness in different people varies. The trigger for one person may be an infection, while for another it is exposure to chemicals or toxins, or to trauma and other difficult life events, among others. I suspect that what these stressors have in common is the ability to stimulate existing patterns of nervous system responsivity and sensitivity to threat. What we see in the chronic illness model is that the trigger that affects risk varies for each a particular individual and is influenced by past experiences. The more frequent or intense the traumatic events in the past, the earlier the age of onset of chronic illnesses.
5. Buffers and Resources Decrease Risk From Trauma
Buffers are resources that support healthy patterns of nervous system functioning. They reduce risk of experiencing an event as traumatic, enable greater recovery when patterns arise, or may reduce risk of symptoms of PTSD altogether. Whether a nervous system pattern leads to PTSD depends on the timing and interaction between trauma and buffers.
As in PTSD, buffers also reduce risk for chronic illness. In some babies who are born with antibodies associated with type 1 diabetes, for example, these antibodies disappear and they do not get the disease. I suspect this is the result of factors such as buffers, and shows why so many people with traumatic life events, or who seem predisposed to risk from family histories or other factors, never develop a chronic illness.
Six Ways Early Life Influences Chronic Illness
As with trauma, we’ve also greatly underestimated the influence of relationships and how they contribute to the ways in which our nervous systems learn to perceive and respond to threat. The next 6 factors all play key roles in shaping our nervous systems. The book From Neurons to Neighborhoods (6)National Research Council and Institute of Medicine, From neurons to neighborhoods: the science of early childhood development. Committee on integrating the science of early childhood development, ed. J.P. Shonkoff and D.A. Phillips. 2000, Board on children, youth, and families, Commission on behavioral and social sciences and education. Washington, D.C.: National Academy Press, by the National Research Council, is an excellent resource. I will list several other books that I have greatly appreciated for informing me about specific fields of developmental research, in context, below.
Why Me? Why this Illness? Critical Periods
The reason we develop a chronic illness (rather than a mental illness or no illness) may be that we were exposed to adverse experiences during a critical period early in life. Such a period could have been when a particular organ system or function was developing, such as during the formation of the pancreas and blood sugar regulation in someone how develops diabetes, or when parts of our brains that deal with mental processing were growing for someone who is susceptible to autism or schizophrenia.
Exposure to toxins during pregnancy is known to affect organs developing at the time of exposure, leading to such problems as birth defects. This occurred with thalidomide, for example, which interrupted the growth of limbs and other organ systems when taken early in pregnancy, specifically between days 20 and 36.
The degree of organ system sensitivity depends on the speed at which an organ is growing and the stage of development it is in (early, late etc). This is known as a sensitive or critical period.
Birth is an example of a critical period because many significant changes are happening. They are also taking place in a very short period of time. The heart, digestive system and lungs, for example, undergo dramatic shifts in preparation for disconnection from the mother’s support system to independently being able to metabolize food and breathe air.
Studies find that there are critical periods in the development of risk for chronic illnesses. If a person isn’t exposed to risk factors for MS before the age of 15 or 16, for example, researchers suspect that they don’t develop the illness even if they might be at risk. An increasing number of researchers are also beginning to suspect that initiation of risk for chronic illness, such as type 1 diabetes, begins before birth.
2. Prenatal Stress
Prenatal stress can decrease organ size and size at birth while also increasing risk of being born prematurely, among other effects. These factors, in addition to stress and trauma at birth and in the first few weeks of life, also increase risk for chronic illness. I tell the story of how research changed my views about chronic illness in the Discovery Series, which introduces studies that lead to an understanding of how early life events affect risk for type 1 diabetes. There have been decades of research in this area, including in one field known as the Adult Origins of Health and Disease. An overview can be found in Life in the Womb (7)Nathanielsz, P., Life in the Womb: the origin of health and disease. 1999, Ithaca, NY: Promethean.
3. Events During Pregnancy, Birth and Infancy
The impulse parents have to hold their babies close to them after birth not only supports bonding it also helps to regulate a newborn’s immature physiology. Holding newborns skin to skin, referred to as kangaroo care in hospital settings, helps sick premature babies better regulate body temperature and heart rate and enables them to grow and recover more quickly. Separation of parents from their newborns, which remains common practice in hospital care, not only affects the parent-infant bond it also influences how a baby’s nervous system responds to stress. The duration of separation tends to be longer with difficult or complicated deliveries, including cesareans. My favorite book on bonding and the effects of early separation is Maternal-Infant Bonding (8)Klaus, M.H. and J.H. Kennell, Maternal-Infant Bonding. 1976, St. Louis: Mosby, which has an updated version I just learned about called Parent-Infant Bonding (9)Klaus, M.H. and J.H. Kennell, Parent/Infant Bonding. 2nd ed. 1982: Mosby. 326.
Many studies find that individuals who develop a chronic illness had more interventions, stressful events, and longer separations at birth. Part of the chronic illness model is about recognizing how subtle and even seemingly minor interventions can actually be experienced as life-threatening – and therefore potentially traumatizing – to babies. Some of my blog posts describe this area of research in more detail: Causes of Chronic Illness Part 1: Insights from Type 1 Diabetes, Part 2: Insights from Asthma, and Part 3: Early Life Events Alter Genes to Affect Risk for Chronic Illness. You can also learn more about Early Risk Factors for Rheumatoid Arthritis?
4. Ancestors and Multigenerational Trauma
The degree of nurturing behavior a mother rat gives her offspring affects its genes during the first week of life through the process of epigenetics. Experiences in our ancestors’ lives, including trauma during the formation of the embryo in a pregnant woman’s baby, affects future generations. We can also be influenced by traumatic events experienced by our parents in multiple ways, including at the same age they experienced an event (10)see the book “The Ancestor Syndrome“.
Learn more about the role of multigenerational trauma in this 2013 article “Grandma’s Experiences Leave a Mark on Your Genes” in Discover magazine and 2014 article in New Republic about how kids are inheriting their parents’ trauma.” Nova also has a documentary about a discovery that the stress of famine in one European village affected risk for type 1 diabetes in the population’s grandchildren. Here’s a link to the first 10 minutes of the 5 part series on youtube. I’ve started writing about the role of transgenerational trauma in my own family tree, starting with a look at my paternal grandfather and events that may have influenced the development of his rheumatoid arthritis.
5. Trauma in Childhood
Trauma that is inflicted by other human beings, who are supposed to care for and protect us, is one of the most difficult and influential kinds of events we can experience. The effects are most severe with children, because they are the most vulnerable among us. The adverse childhood experiences (ACE) studies (11)The study included 17,000 participants who completed surveys about their childhoods. Their average age at the time of first participation was 57. Participants were followed prospectively for 15 years after completing the surveys. Over 60 papers have been published to date. The researchers Dr. Vincent J. Filetti and Dr. Robert Anda and colleagues have followed 10 areas of trauma in childhood that affect risk for health problems in adulthood and which you can identify to calculate your own “ACE score.” Here’s an undated executive summary of the ACE study and findings find that trauma in childhood is an important risk factor for chronic illness in adults. The higher the number and types of exposure, the greater the risk. This is an example of compounding of trauma occurring during critical periods of development. See more in a detailed post about ACEs, “Boyhood,” and Chronic Illness and how early life events can play a role in risk for rheumatoid arthritis.
6. Early Relationships
The kind of experiences children have with their parents or other adult caregivers is what I increasingly consider to be one of the single most underestimated and unrecognized sources of trauma that affects risk for chronic illness and other health issues in adulthood. It’s the risk factor those of us with an ACE score of Zero and who have no obvious histories of trauma are likely to have experienced even as we’ve learned to think is completely normal. It reflects the long-term impact of how an adult’s nervous system is an essential contributor to how a child’s nervous system develops and learns to respond to stress and trauma (12)chore, A. N. (2001). “The effects of secure attachment relationship on right brain development, affect regulation, and infant mental health.” Infant Ment Health J 22: 7-66. These effects are not limited to mental and psychological health and behavior.
A 36-year prospective study (13) Sroufe, L.A., et al., The Development of the Person: the Minnesota study of risk and adaptation from birth to adulthood. 2005, New York: Guilford Press, which is still ongoing, has found that the imperfections in early relationships can increase risk for physical health problems in adults (14)Puig, J., et al., Predicting Adult Physical Illness From Infant Attachment: A Prospective Longitudinal Study. Health Psychol, 2012. I’ve written a detailed post about this called “Chronic Illness and Invisible ACEs: When your ACE score is Zero.” The 2013 article in Discover magazine, mentioned above about multigenerational trauma, also touches on this topic.
Mechanisms: Life Events Alter Genes
The emerging field of epigenetics is providing a mechanism for understanding how life events such as trauma and events that occur in prenatal and early life serve as risk factors for chronic illness (15)Francis, R.C., Epigenetics: how environment shapes our genes [kindle edition]. 2012, W. W. Norton & Company: New York. p. 256. Epigenetic changes occur outside of our DNA and affect how genes behave (read more in an introductory post on epigenetics). Epigenetic factors shape the level of activity of genes, which in turn regulate how our nervous systems and other organ systems work and how we respond to experiences such as trauma and early relationships, diet and exercise and potential perceived threats such as infections and toxins.
Veterans with posttraumatic stress disorder have epigenetic changes not seen in veterans who don’t have PTSD. These epigenetic changes have been found to be reversible following trauma therapy (16)Yehuda, R., et al., Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD. Front Psychiatry, 2013. 4: p. 118.
Long-standing studies of people who survived the famine of the Dutch Hunger Winter in World War II have found that starvation during prenatal life affects health in adulthood and that the timing of exposure influences the type of diseases that develop. The study has been ongoing for 70 years and has found that there are multigenerational effects, in that the children of individuals born during the famine have also had an increased risk for disease. When starvation occurs during a war the type of stress that is experienced is not only nutritional but also emotional and potentially physical.
The field of epigenetics is helping us understand how life events affect risk for chronic illness. It is also exploring ways to identify and diagnose chronic illnesses such as chronic fatigue syndrome (ME/CFS). Most importantly, I think, epigenetic research may help identify different approaches for treating chronic illness. If trauma and life events affect risk for chronic disease, for example, treating the effects of these experiences may play an important and as yet completely unexpected role in health.
What of the aspects I love about this chronic illness model and way of thinking is that it enables those of us with chronic illness to explore such therapies immediately and without having to wait for science to figure it out. Here’s an example of epigenetic discoveries that help explain why asthma cures happen in kids by healing the effects of trauma from very early in life.
How Risk Develops From Early Life to Onset
The following is a summary of the chronic illness model. For another, similar point of view, see the book by Gabor Mate, a former family physician. It’s called When the Body Says No (17)Mate, G., When the Body Says No: Understanding the stress-disease connection. 2003, Hoboken, NJ: Wiley & Sons as well as Dr. Robert Scaer’s book mentioned under the section on trauma (18)Scaer, R., The Trauma Spectrum: hidden wounds and human resiliency. 2005, New York: W.W. Norton.
Chronic illness arises when our nervous system gets interrupted and learns a reactive pattern from which it is unable to shift. A series of traumatic events, from accidents and abuse, to emotional unavailability and mis-attunement in parent-child relationships, are important initiators and contributors to the development of altered patterns of nervous system regulation. The initiation of patterns leading to chronic illness occurs during critical periods of development, and probably happens very early in life, most likely before birth. Patterns are shaped and influenced, at least in part, by parental emotional and physical environments.
Trauma and triggers, whether emotional, physical, or psychological, perpetuate and strengthen a pattern once it has begun, creating what is probably a conditioned response. After a pattern begins, it starts to affect our physiology. It causes occasional symptoms, such as anxiety and depression, fatigue and pain, a rash that is later recognized when lupus is diagnosed, or the formation of antibodies etc. These symptoms, and triggers, are unique to the person, their experiences to date, and to the pattern.
When there are sufficient buffers, including the treatment of trauma and repairs in the parent-child relationship, patterns may never arise, or may soften or even resolve. Patterns emerge and progress when traumatic events during critical periods outweigh buffers.
The final stressor that occurs before a chronic illness is a precipitator, not a cause. It unmasks an existing conditioned response pattern that has been developing, often over a long period of time. There may be years or decades between the initiation of the pattern, which likely began before birth or earlier, and the onset of chronic illness. This is known as a latency period.
Symptoms and exacerbations are affected by the same types of stressors and triggers that created, perpetuated, and intensified the pattern before the illness ever began. They are therefore unique to each person, rather than to the chronic disease.
Interactions between Mind, Body and Emotions
Chronic illnesses of all kinds, including chronic fatigue and other “psychosomatic illnesses” such as fibromyalgia, asthma, and irritable bowel syndrome, are not attempts to get attention or “play the victim.” Chronic illnesses are the result of an interplay between our brains and bodies, thoughts and emotions, and the environment. The patterns that lead to chronic illness occur outside of conscious awareness and are not created by will. Symptoms that cannot be measured or understood are not “all in your head.” Life experiences, including stress, trauma and family dynamics play an important role in the formation of unconscious patterns that can affect our risk for chronic illness. From the perspective of the chronic illness model, trauma leads the body and brain to baseline levels of increased sensitivity and responsivity to threat. This perception of threat – which is stimulated by unresolved trauma and can outlast traumatic events by decades – is what drives the changes in biochemistry and physiology that cause chronic illness.
The Small Stuff is Important
An emphasis I want to make in the chronic illness model is that we’ve been failing to understand, and therefore notice, the little traumas and life events that happen every day and in the most subtle of ways in people’s lives. These experiences are often considered normal. Or they are minimized. But they, too, affect and shape our nervous systems. Small events are cumulative and play a very important role in risk for chronic illness. Possibly as much or even more important than the large, overt events we commonly think of as trauma.
How to Treat Chronic Illness
Reducing stress can resolve some chronic illnesses for some people. Dean Ornish is a physician who believed that stress reduction and lifestyle changes could heal heart disease. He couldn’t get funding for his initial studies because no one believed it was possible to reverse heart disease, let alone treat it through such simple interventions as lifestyle changes. He proved them wrong in study after study after study. So, this is one approach that really works for some.
Leaving medicine, taking a year off and greatly reducing my stress did not improve my fatigue. In fact, my symptoms worsened. Our very definition of chronic illness is that it is unrelenting, and that there is no cure. But some people recover some of the time from chronic illnesses of all kinds. These “anecodotes” are overlooked and often denigrated by many of our current approaches to research, science and medicine, but they are worth their weight in gold. What did these people do to recover? Can any sense be made of their stories? What can we learn from them?
Tony Madrid, Ph.D. is a psychologist in California who stumbled upon an approach for treating asthma in kids by treating trauma. The youngest children in his studies recover fully. The older they get (after about 9 years of age), the less fully they recover, although his treatment approach can still be very helpful in reducing symptoms.
The most fascinating aspect of his research is that he doesn’t treat the kids. He treats their MOTHERS for unresolved trauma that made it difficult or impossible for them to bond with their babies (see his book The Mother and Child Reunion (19)Madrid, A., The Mother and Child Reunion: Repairing the broken bond. 3rd printing. 2010, Monte Rio: AsthmaBusters. Tony helps these moms resolve the traumatic experiences they had during pregnancies, labor and deliveries, and when their kids were young. Their babies’ and kids’ asthma often resolves over night. He’s been finding that when he helps mothers repair their trauma wounds, the innate, underlying impulse parents have to bond with their kids is restored. And that’s when the asthma resolves or improves.
I find his work to be a remarkable statement about the role of trauma and bonding in chronic illness. It supports another tenet of the chronic illness model, which is that having a chronic illness does not imply we have done something wrong. It’s about what has happened to us.
Here’s a more detailed blog post about what Tony and others have learned about perinatal events and risk for asthma that I’ve found applies to other chronic illnesses as well.
As I have developed the chronic illness model over the years I have experimented with and come to like a number of approaches for working with my own chronic illness and addressing the effects of trauma in my own life. They have turned out to be quite powerful and are helping me to gradually recover and improve. Here are 10 under-utilized tools for treating chronic illness that fit with the tenets of the chronic illness model. Here’s a post on what trauma therapy and recovery look like.
Different Illnesses, Same Cause?
From what I repeatedly in the development of the chronic illness model, there is no specific event or single risk factor that leads to each particular chronic illness. Instead, it is more about patterns. Patterns that are affected by both 1) the timing of trauma, which determines the organ system(s) affected, the type of pattern(s) that develop, and therefore specific type of illness(es) that we may each develop; and 2) the way events are experienced, which leads to either the continuation or resolution of a particular pattern.
The research I’ve been doing (20)Mead, V.P., A New Model for Understanding the Role of Environmental Factors in the Origins of Chronic Illness: a case study of type 1 diabetes mellitus. Med Hypotheses, 2004. 63(6): p. 1035-46; Mead, V.P., Timing, Bonding, and Trauma: Applications from experience-dependent maturation and traumatic stress provide insights for understanding environmental origins of disease, in Advances in Psychology Research, A.M. Columbus, Editor. 2007, Nova Science Publishers. p. 1-80 looks at studies others have done in multiple disciplines. These studies generally look at one disease, one type of mechanism, or one particular type of trauma. They are usually very distinct and separate. There are studies of all kinds that look at the influence of events in our ancestors’ lives, as well as in prenatal, birth and early life that find a relationship to later physical health. The chronic illness model integrates the research from these different fields of study to help make sense of chronic illness.
The chronic illness model also brings together links between life events and individual chronic illnesses. Most of these studies are done by different researchers, each looking for causes in different areas and time periods and diseases. The following slide shows some of the studies showing a role for trauma in risk for and development of multiple sclerosis (MS) using perspectives from this chronic illness model. Most of them find an increased risk for MS in the areas we’ve been looking at in this post.
There is a tremendous amount of research supporting the chronic illness model for many different diseases. In addition to research in MS, I’ve been finding studies that support this model in asthma, type 1 diabetes, inflammatory bowel disease (such as Crohn’s and Ulcerative Colitis), chronic fatigue and fibromyalgia, lupus, multiple chemical sensitivities, Parkinson’s, and rheumatoid arthritis, as well as with autism and schizophrenia, among others. Studies in the Adult Origins of Health and Disease have also been finding relationships between prenatal stress and many diseases in adults ranging from the metabolic syndrome (high blood pressure, cholesterol, weight, and sugar; heart disease, type 2 diabetes, and stroke) to celiac disease, inflammatory bowel disease, and osteoporosis; to autism and asthma. I’ll be adding references, including many of those listed in these last slides, in future posts.
Free Downloads For More Information
View or download a PDF of this post
Download the slides in a larger format
Download a free copy of my publications about this model (a journal article and book chapter).
Feel free to reprint either of these documents for personal use (and not for commercial use or making any $$$). Kindly cite me and my blog “Chronic Illness Trauma Studies by Veronique Mead, MD, MA” as the source.
What You Can Do
Here are therapies for working with different kinds of trauma that can be applied for working with symptoms of chronic illness.
Does This Make Sense of Your Illness?
Leave a comment about the issues in this post. Which ones make the most sense of your life and chronic illness. Which ones seem less relevant to you?
Leave a Comment Below
References [ + ]
|1.||↑||Mead, V.P., A New Model for Understanding the Role of Environmental Factors in the Origins of Chronic Illness: a case study of type 1 diabetes mellitus. Med Hypotheses, 2004. 63(6): p. 1035-46.|
|2.||↑||Mead, V.P., Timing, Bonding, and Trauma: Applications from experience-dependent maturation and traumatic stress provide insights for understanding environmental origins of disease, in Advances in Psychology Research, A.M. Columbus, Editor. 2007, Nova Science Publishers. p. 1-80.|
|3.||↑||Doidge, N. (2015). The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity Viking Adult|
|4.||↑||Levine, P., Waking the Tiger. 1997, Berkeley: North Atlantic Books.|
|5, 18.||↑||Scaer, R., The Trauma Spectrum: hidden wounds and human resiliency. 2005, New York: W.W. Norton|
|6.||↑||National Research Council and Institute of Medicine, From neurons to neighborhoods: the science of early childhood development. Committee on integrating the science of early childhood development, ed. J.P. Shonkoff and D.A. Phillips. 2000, Board on children, youth, and families, Commission on behavioral and social sciences and education. Washington, D.C.: National Academy Press|
|7.||↑||Nathanielsz, P., Life in the Womb: the origin of health and disease. 1999, Ithaca, NY: Promethean|
|8.||↑||Klaus, M.H. and J.H. Kennell, Maternal-Infant Bonding. 1976, St. Louis: Mosby|
|9.||↑||Klaus, M.H. and J.H. Kennell, Parent/Infant Bonding. 2nd ed. 1982: Mosby. 326|
|10.||↑||see the book “The Ancestor Syndrome“|
|11.||↑||The study included 17,000 participants who completed surveys about their childhoods. Their average age at the time of first participation was 57. Participants were followed prospectively for 15 years after completing the surveys. Over 60 papers have been published to date. The researchers Dr. Vincent J. Filetti and Dr. Robert Anda and colleagues have followed 10 areas of trauma in childhood that affect risk for health problems in adulthood and which you can identify to calculate your own “ACE score.” Here’s an undated executive summary of the ACE study and findings|
|12.||↑||chore, A. N. (2001). “The effects of secure attachment relationship on right brain development, affect regulation, and infant mental health.” Infant Ment Health J 22: 7-66|
|13.||↑||Sroufe, L.A., et al., The Development of the Person: the Minnesota study of risk and adaptation from birth to adulthood. 2005, New York: Guilford Press|
|14.||↑||Puig, J., et al., Predicting Adult Physical Illness From Infant Attachment: A Prospective Longitudinal Study. Health Psychol, 2012|
|15.||↑||Francis, R.C., Epigenetics: how environment shapes our genes [kindle edition]. 2012, W. W. Norton & Company: New York. p. 256|
|16.||↑||Yehuda, R., et al., Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD. Front Psychiatry, 2013. 4: p. 118|
|17.||↑||Mate, G., When the Body Says No: Understanding the stress-disease connection. 2003, Hoboken, NJ: Wiley & Sons|
|19.||↑||Madrid, A., The Mother and Child Reunion: Repairing the broken bond. 3rd printing. 2010, Monte Rio: AsthmaBusters|
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