The Myth of Normal 43

pathways and feedback loops linking the hypothalamus—the small, crucial area in the center of our brain whose role is to keep our body in a healthful, balanced state—with the pituitary gland at the top of our brain stem and the adrenal gland that sits atop our kidneys. Think of a busy transportation corridor connecting three major urban centers, replete with on-ramps, exits, and interchanges, and you start to get a picture. Although our species can survive in a broad range of external environments—far more than almost any other animal—our internal milieu must stay within a relatively narrow range of physiological states. Our temperature, blood acidity or pressure, and heart rate, along with many other bodily metrics, are all obliged by Nature, on pain of death, to stay within definite and nonnegotiable limits. The renowned American stress researcher Bruce McEwen[*] popularized the word “allostasis” to capture the body’s attempt to maintain inner equilibrium in the face of changing circumstances. The term is a combination of the Greek words allo, for “variable,” and stasis, for “standing” or “stoppage”; combined, we have something like “staying the same amid change.” We cannot do without it, and so our bodies will go to great lengths to maintain it—even to the point of long-term wear and tear if stresses do not abate. Such strain on our body’s regulatory mechanisms, which McEwen dubs “allostatic load,” leads to an excessive and prolonged release of the stress hormones adrenaline and cortisol, nervous tension, immune dysfunction, and, in many cases, exhaustion of the stress apparatus itself. We now know that the infrastructure of the HPA axis is set early in life, starting in utero and on through the young childhood years. Stress or abuse incurred during this delicate period can distort the stress-hormonal apparatus for a lifetime. Again and again, we see supposedly immaterial “nonthings” such as emotions having a material impact, decidedly and decisively. Reducing stress where possible, attending to emotions, overt or repressed, and taking care of our psychic well-being can have profound effects on physical health—this is intuitively obvious to many people. Yet for all their dazzling physiological and technical expertise, doctors by and large are not initiated by their training into the ancient wisdom and new science of the