Jay Schulkin’s book, Rethinking Homeostasis: allostatic regulation in physiology and pathophysiology, is s a thorough discussion of the concept of allostasis. The concept of allostasis as described by Schulkin is a useful model that integrates often disparate scientific realms from the biochemical, the genetic, the molecular, the organismal, the psychological level, and places them in a social, environmental and evolutionary perspective. Schulkin’s book is extensively well researched, with a bibliography spanning over 100 pages. Schulkin suggests the following definitions:
Allostasis; ” The process by which and organism achieves internal viability through bodily change of state. Allostasis comprises both behavioral and physiological processes that maintain internal parameters within the limits essential for life.”
Allostatic state: ” Chronic over-activation of regulatory systems and the alterations of body set points.”
Allostatic overload: ” The expression of pathophysiology by the chronic over activation of regulating systems.”
Allostasis provides a vital new model for approaching health because it integrates different fields and levels of understanding into a coherent picture and provides a whole person (from his genetics to his environment) understanding of an individual that is completely absent from our current medical model. In essence the concept of allostasis provides the beginnings of a western scientific model comparable to the Chinese or Ayurvedic “energetic” models that integrates the artificially sundered concepts of body, mind and soul. It does so by showing how behavior, emotions, social status, life events, etc., can effect physiology and neural patterns and potentially lead to pathology at the clinical level. This is the place where the Chinese and Ayurvedic medicine believe illness begins; the “energetic” and “emotional” level. Chinese doctors traditionally looked not just at the individual but their place (whether harmonious or disharmonious) in their family and community. Schulkin addresses the importance of social setting and human communications and physical contact in health, as well as stressful or traumatic live events (allostatic state and overload) and discusses their physiological effects, and the circle of how the physiological then effects the emotional and behavioral level and ripples outwards to the social setting and environment. The physiological and behavioral patterns discussed by Schulkin regarding states of chronic fear or angst, anxiety, depression, the effects of allostatic overload in pregnancy and on the fetus, and in drug addiction are strongly reminiscent of the symptom patterns described in Chinese medicine where pathology at the gross, organ level (western pathological diagnosis) is less informative than the actual emotional and physical symptom pattern displayed by the individual which is the apparent information that provides the practitioner with the data needed to find the root imbalance. In Chinese medicine this is described using energetic terms. In Schulkin the imbalances are either deficient or excess secretions of hormones, neurotransmitters or neuropeptides which effect metabolism and cause a complex pattern of changes visible at the metabolic, physical and emotional and behavioral level, or, the creation of states of hyper or under reactivity(such as increased number of CRH receptors-could this correlate to ideas of so-called false-excess or apparent deficiency in TCM?). These patterns (physiological, emotional and behavioral) are self-reinforcing-the more they’re used the stronger they get. Even more interestingly they can be propagated through the generations; patterns of anxiety can be passed on by the mother to their offspring, and even at the social levels we can see different cultures contributing to such patterns by their moors, rules, behavioral issues, dietary habits and they’re methods of interacting with “strange” behaviors (psycho-active drugs both prescribed and self-administered, etc). This summons to mind the concept of Karma, sometimes described in Buddhism as the net sum of an individuals thought, words, and actions, and the use of meditation and “right thought, right speech and right action” to erase old patterns (“bad karma”) and create new patterns of good behavior and calmness and clarity, as well as Karma as inherited karma and family or cultural karma. Interestingly, Schulkin brings up that researchers on allostasis have suggested that people should do activities that promote calmness such as transcendental meditation and that physiological states of chronic anxiety or hypersensitivity (so prevalent in our current culture) can be corrected. He also states that “consistent and reliable positive human touch and contact can mediate long-term effects of trauma and perhaps influence pathways related to CRH activity.” Which is proof enough that we need more hugs and less drugs in our modern health care system. Hopefully one day the medical system of the USA will catch up with the concepts of traditional knowledge and the scientific knowledge that so beautifully explains it in the language of western science.