Heike S. Buhl, M.D.

AUTONOMIC NERVOUS SYSTEM AND ENERGETIC MEDICINE

Bioenergetic and Psychosomatic Causes for Health and Illness

Translation by Christine Genrich

1. INTRODUCTION

This talk evolved from another one I held in January of 1991. Back then; I was wondering what special contribution towards body therapy I had to make, based on my daily work as a medical doctor with Reich's method. Case studies, emotional discharge techniques, theoretical concepts of the work - it all seemed right, just not my subject. Thus, I tried to recall how I had "come to Reich".

I was in the middle of medical school and for years had been learning all sorts of illnesses and symptoms by heart. But the question of how illness actually develops was never raised in my studies. We only dealt with the "damage" and how best to repair it - almost like with a broken car, which won't run any more because the individual parts were just not built very well. With many diseases, I came across remarks like "etiology unknown" or "auto immune disease". The big questions - what exactly is the meaning behind the term "auto immune disease", where does cancer originate, how does cardiovascular disease develop - remained unanswered. And at first glance, alternative medicine did not seem too convincing either - instead of pills they used the acupuncture needle, the homeopathic drugs or healing herbs, all too often administered within a doctor's general practice without sufficient knowledge of the system of thought behind it. Once again they were just puttering with the symptoms (with somewhat less dangerous means) instead of searching for the cause. Psychosomatic medicine became excluded as some sort of marginal science, and referred everything only to the psyche, without offering a holistic concept for body AND mind.

That I only found when studying Wilhelm Reich's writings. He spoke of unobstructed pulsation, the meaning of sexuality, functional identity of body and mind. I became "hooked on Reich"; on a concept which saw a person within his social context, and which offered a radical psycho-somatic model without reducing body to psyche or vice versa.

Therefore, I do not want to speak too much about body therapy itself, but rather about Reich's concept of health and illness, with health meaning not merely the absence of physical symptoms, but also mental well-being. I'd like to explain what orthodox medical concepts Reich's model is based on, and especially elaborate on the function of the autonomic nervous system. I will then elucidate Reich's understanding of health as unobstructed pulsation, as well as the term "biopathy". With regard to individual diseases, I will then describe impairments of the autonomic nervous system, and illustrate which techniques we use in body therapy to exert influence upon the autonomic nervous system, the morphological basis of pulsation, in order to stimulate and support the healthy functioning of the whole human organism.

2. AUTONOMIC NERVOUS SYSTEM

2.1. Definition of the Autonomic Nervous System (ANS)

In context with his works on sex-economy in 1934 through 1938, Wilhelm Reich researched the biological basis for sexuality and anxiety. Doing so, he recognized the ANS' central importance as an interface for bodily and emotional processes: on the one hand, it is closely connected to the functions of internal organs; on the other hand, it serves as a messenger for emotional perception via blood and plasma streams, and is linked to the cerebral areas which represent emotion through connections in the central nervous system. According to Reich, body therapy involves working with the somatic and the psychological systems simultaneously. The emotional energies are released from the character and muscular “armor“, as he called it.

Due to the ANS' great importance, I would like to elaborate a little further now upon what it actually is, how it works, and its relevance regarding health and disease.

The autonomic nervous system is part of the human central nervous system (CNS). The CNS is basically made up of three sections, the functions of which closely interact. One part manages voluntary movement, the muscle system's response to various stimuli from the environment; this part is called motor nervous system. Another part processes information from the sense-organs, such as eye, nose, or sense of touch, into conscious perception; it is called sensory nervous system.

The central nervous system's third section - the ANS - coordinates the internal organs' functions. It originates from the brainstem and the spinal cord and includes the nerves, which innervate the smooth muscles of the internal organs, heart and glands. The regulative cycles of the autonomic nervous system are tightly entwined with those of the other two sections, causing numerous interdependencies between the individual systems.

CNS

motor NS sensory NS autonomic NS

sympathetic parasympathetic

nerves nerves

fig. 1: structure of the nervous system

There are two substructures within the autonomic nervous system, the sympathetic and the parasympathetic, which originate from different areas in the brainstem and spinal cord, and also respond to different biochemical transmitter substances. They both regulate the internal organs by stimulating or inhibiting their activity in a co-ordinated fashion.

The autonomic nervous system can virtually not be controlled consciously; hence the name. We cannot consciously manipulate our internal organs, such as altering the heart rate intentionally.

fig. 2: origins and distribution of peripheral autonomic nerves[1]

2.2. Function of the ANS

Most internal organs receive innervation from sympathetic as well as from parasympathetic nerves. Both portions of the ANS are active at the same time, but to a different extent. Their combined influence upon an organ is of opposing, but balancing antagonistic nature, meaning that the predominance of one system can inhibit a certain function, whereas that of the other system would stimulate the same function. Increased activity in one of the two autonomic systems inevitably causes an activity decrease in the other, but without ever completely disabling it. It is therefore impossible for an organ to be under maximal sympathetic and maximal parasympathetic influence at the same time, one can only dominate at the expense of the other. This is the equivalent of the interdependency of the organs' so-called Yin and Yang states in Chinese medicine.

Let us have a closer look at autonomic nervous activity with regard to the smooth muscles of some internal organs: sympathetic innervation of the heart, for instance, results in an increase in frequency, whereas predominantly parasympathetic stimulation decreases it. This example clearly shows that the heart cannot be equally stimulated by sympathetic and parasympathetic impulses, because that would mean it had to beat fast and slow at the same time. But the options are not just "heart racing" or "cardiac arrest" either. The frequency increases or decreases according to the prevalence of one or the other influence: the inputs of both systems are balanced with each other.

With the intestines, parasympathetic innervation causes the intestinal muscles to move more, sympathetic innervation slows down their activity. The bronchial muscles contract with parasympathetic stimulation and relax with sympathetic stimulation. In the eye, sympathetic activity results in the pupil's dilation by sending impulses to the respective intrinsic eye muscles, and parasympathetic innervation causes the pupil to constrict.

Thus the functional condition of an organ that is innervated both sympathetically and parasympathetically always depends on the balance of activity between both. The determining factor, however, is the predominance of the stimulating or the inhibiting aspect of the autonomic nervous system with regard to that particular organ.

	Sympath. Nerve	Parasymp. Nerve
Heart / smooth muscle	+	–
Blood Vessels Vasoconstricion Vasodilatation	+ -	Ø Ø
Intestines longitudinal Musculature Sphincters	– +	+ –
Urinary Bladder Detrusor vesicae Sphincter internus	– +	+ –
Bronchial Muscles	–	+
Internal Genitals	+/–	Ø
Eye M. radialis ( Dilatation of Pupil) (Constriction of Pupil) M. ciliaris (Lense) M. taris (Upper Lid)	+ –? – +	Ø + + Ø
Glands Sweat Glands Salivary Glands Lacrimary Glands Digestive Glands Bronchial Glands	+ + ? –? –?	Ø + + + +
Fat Cells	+	Ø

+ Activation; – Inhibition; Ø no effect

tab. 1: effects of sympathetic and parasympathetic activation[2]

2.3. Effect of the ANS on the Organism in General

So far, we have dealt with the ANS' effects on individual organs. But we can also characterize an entire organism in terms of sympathetic or parasympathetic disposition. Here, the organs are not examined individually, but in their entirety. Depending on the organism's needs, they are activated to achieve a certain task together; they all cooperate in order to fulfil that demand.

Exposed to outside stress, for instance, the body shifts into a "defense mode", maximally activating its sympathetic system. Respiration increases, the pupils become dilated, and in animals bristling of the hair on the nape of their necks can be observed as well. Blood pressure, circulation in the muscles, and heart rate increase, while intestinal circulation and motility as well as skin circulation are reduced. Everything is focused outwards here. Triggered by that outward stimulus, the whole organism shifts into a mode of gathering all energies inside in order to prepare for attack or flight (therefore also called "fight or flight reaction"). It contracts and is in an overall state of tension. W. Cannon calls this "emergency reaction". It can happen, for instance, when you are having an argument with your boss: in situations like that, your sympathetic system is maximally activated.

In contrast to defense behavior, there is feeding behavior. After the ingestion of food - as we all know from experience with ample meals -, parasympathetic impulses prevail. Attention is withdrawn from the surroundings, we become sleepy, intestinal activity increases, and the abdomen with its digestive organs receives more blood. Circulation in the skeletal muscles decreases, as do blood pressure and heart rate, the pupils constrict. Here, the organism does not contract, but expands energetically outwards and is in a state of relaxation. On the other hand, attention is directed inwards.

Reich's definition of health is based on a creature's ability for rhythmical oscillation between those two modes, its contact with the environment and the focusing on the inner state of being. Reich calls this basic function "Pulsation of the Living". Thus, he does not define health as the absence of symptoms, disease or impairments, but rather as a function of the correlation between inner and outer world, an organism's ever-changing, pulsing confrontation with itself and its surrounding world.[3]

The oscillation between the two modes of the autonomic nervous system also exerts a crucial influence upon the body's hormonal and emotional wellbeing. Via constriction and dilation of blood vessels, sympathetic and parasympathetic activity has great influence on the movements of fluids and plasma within the body, which to Reich are the basis for emotional perception. The flow of liquids can either be from the center to the outside (expansion), or from the periphery towards the inside (contraction). The feeling of pleasure is functionally identical with unobstructed pulsation, the feeling of anxiety with impaired pulsation of the autonomic nervous system.

The ANS is also tightly interwoven with the "muscular armoring". Chronic muscular tension impedes the stream of body fluids, and impaired pulsation of the ANS manifests itself in chronically tense muscles.

The two constantly interacting systems of sympathetic and parasympathetic activity cannot be functionally separated; only their cooperation renders possible a harmonic functioning of the whole organism[4]. "The life process takes place in a constant alternation of expansion and contraction"[5], i.e. pulsation.

"If this biological state is disturbed in one or the other direction, that is, if either the function of expansion or that of contraction predominates, than a disturbance of the biological equilibrium in general is inevitable. Long continuation in a state of expansion is synonymous with general parasympathicotonia; conversely, long continuation in a state of anxious contraction is synonymous with sympatheticotonia."[6] W. Cannon calls the equilibrium between both conditions "homeostasis".

3. BIOPATHIES

In traditional medicine, we often regard illness as if the symptom develops out of the blue in an otherwise healthy body. The doctor becomes a bio-technician who repairs the damage. Reich's understanding is that illness develops when the whole organism's natural pulsation is disturbed. But, in our understanding, it is the whole person who is ill, not only one of his parts.

This does not imply orthodox medicine is worthless, but its value depends upon certain conditions. With many diseases, orthodox medicine today cannot offer a valid explanation as to why and where they originated. This is reflected in the fact that terms like "essential", "ideopathic", "endogenous", "genuine", or "etiologically unknown" are attributed to those diseases.

In Reich's understanding disease develops whenever the whole organism's natural pulsation is disturbed. Reich calls such a process affecting the autonomic vital structures a BIOPATHY. Thus, biopathy is a fundamental dysfunction of the autonomic nervous system. At first, it is a purely functional defect which concerns the entire body. Once in progress, however, it later on may manifest morphologically in various syndromes. Far advanced processes can cause "shrinking biopathy", and subsequently cancer.

"The biopathy can result in a carcinoma, but also in angina pectoris, asthma, cardiovascular hypertension, epilepsy, catatonia, paranoid schizophrenia, anxiety neurosis, multiple sclerosis, Huntington's disease, chronic alcoholism and so on."[7]

Accidents and typical infectious diseases are therefore not associated with a state of biopathy, since they are not based on irregularities in the autonomic vital structures, are limited and impair biological pulsation only secondarily. In the case of a disturbance of pulsation, the biopathy can "take the form of an emotional disorder of the psychological apparatus, i.e. neurosis or psychosis. But it can also directly affect the functioning of the organs and result in somatic illness."[8] The functional disturbance of pulsation precedes the organic manifestation here. Thus, strong abdominal cramps may exist without detectible organic cause at first, but over time lead to morphological changes in the organ. Only then "illness" in the traditional sense becomes detectable.

The condition of impaired pulsation of the ANS is closely linked to impaired capability of sexual sensation. Obstacles in the process of bio-sexual stimulation cause disturbances in biological functioning. The organism's ability to energetically charge and discharge is a basic function of living, which can primarily be observed in sexuality and the opportunity of discharge through orgasm. The quality of sexual pleasure is functionally identical with full autonomic responsiveness. If that ability is restricted, for instance by repressive sexual education during childhood, it can lead to impaired pulsation through a diminished possibility of the organism to charge and discharge. In sexual context, this means less arousal and limited orgasm capability. With regard to the whole organism, it results in impaired pulsation as a foundation for a biopathy.

repressive sexual education/

impaired emotional expression

ß

chronic muscular tension

ß

disturbed charge/discharge function

ß

chronic build-up of energy

ß

impaired pulsation

ß

biopathy

fig. 3: causes for impaired pulsation

According to Reich, biopathy always starts with a chronic prevalence of contraction and inhibition of extension of the autonomic nervous system. In his clinical studies, he discovered that an organism's chronic persistence in a sympathically dominated mode, where per definition no more pulsation can take place, is perceived subjectively as unpleasant, as anxiety. This condition according to Reich equals a retreat from the world, as in fright. As described with "defense behavior" above, the skin grows pale and cold, the heart rate increases, as does blood pressure, the pupils dilate, the skeletal muscles are paralyzed or extremely tense.

Parasympathetic disposition, on the other hand, according to Reich emphasizes life's pleasant sides, the "flowing towards the world". With parasympathetic activity, the skin is warm and rosy, the heartbeat slow and strong, blood pressure reduced, the pupils small and the muscles relaxed, digestive activity stimulated, as described above with "feeding behavior".

In my opinion, this definition of biopathy, as first described by Reich in "The Bioelectrical Investigation of Sexuality and Anxiety", is insufficient. The parasympathetic state appears as "good", the sympathetic as "bad". Anybody who ever suffered an asthma attack or migraine, both characterized by extremely parasympatheticotonic predominance, will hardly agree: they would have experienced those conditions as unpleasant, as being trapped inside themselves and filled with anxiety, not at all a pleasurable flowing towards the world.

This apparent contradiction in Reich's findings can be dissolved by distinguishing the state of natural pulsation, with the organism fluctuating between parasympathetic/sympathetic activity according to time of day or outer necessities, from the state of being chronically stuck in either of the extremes. There are outer circumstances which make strong sympathetic activity by all means desirable: a cat catching mice, for instance, will surely have its attention focused on the outside, not at all relaxed, but not really unpleasantly contracted either. The same will be true of a racing driver during a race, or of a scientist doing exciting research. As soon as the external conditions change, the autonomic system will automatically shift into parasympathetic mode: the cat sleeps after its successful hunt, the racing driver and the scientist recover after having done their jobs and relax. We distinguish that kind of natural pulsation from chronic persistence in either mode.

A chronic sympathetictonus leads to the unpleasant subjective sensations as described by Reich: the body goes into some kind of inner "readiness for fight", triggered by external or also internal stress or anxiety. But since there is neither fight nor giving the all-clear, the organism is trapped in this state; pulsation as described above cannot take place any more.

The chronic persistence of parasympathetic activity, however, does not necessarily feel any better: the organism is in a state of extreme relaxation, resulting in heavy fatigue, floppiness, and lack of energy. Digestive activity is high, causing diarrhea or stomach cramps. The bronchial muscles become spastic, leading to the sensation of not getting enough air, which in the extreme can result in a fatal asthma attack. So here, instead of readiness for fight, we have resignation and regression, internal surrender.

Accordingly, pulsation can be stuck at any place. More important than in which phase (sympathetic or parasympathetic) the pulsation has stalled is the fact that it has.

At their core, sympathetic and parasympathetic activity are functionally identical: the foundation for both is autonomic excitability. Reich also refers to this towards the end of his book "Sexuality and Anxiety":

"The vegetative“ (autonomic) "nervous system has the ability to contract and expand. From the middle position of vegetative“ (autonomic) "equilibrium, it is able to move in the direction toward the world, (i.e., to stretch), or to retreat into itself, (i.e., to contract). It can also swing from one direction to the other or remain fixed in either of the extreme states. Putting it in somewhat simplified terms, the state of vegetative equilibrium“ (autonomic balance) "is one where neither expansion positions nor contraction positions have become established."[9]

There is another remarkable particularity about the ANS: not only can it fluctuate rhythmically between sympathetic and parasympathetic disposition, but the respective extremes can also blend into one another. An extreme and chronic sympatheticotonus can turn into an extreme and chronic parasympatheticotonus and vice versa. This is the reason why in situations of extreme sympathetic activity, like agitation before an exam, stress-induced diarrhea can occur (which actually indicates strong parasympathetic stimulation). Accordingly, one could say that permanent readiness for fight can turn into resignation, but also regression can turn into readiness for fight under increasing stress. This mechanism explains why an illness can be induced not only by persistence of one chronic state, but also by an irregular, uncoordinated "furious back and forth" between sympatheticotonic and parasympatheticotonic conditions.

In my opinion, a "healthy tension" is crucial for physical and psychological well-being. A state of balance is necessary within which the oscillation between the sympathetic and parasympathetic mode can go on unobstructedly from a centered position of the autonomic equilibrium. Unfortunately, due to stress and sex-economy-related reasons, we find rather a shifting from the neutral state towards the sympathetic, so that the relaxing function of parasympathetic energy cannot sufficiently come to fruition.

The American physician Robert A. Dew points out the fact that the biopathies can lead to non-locatable changes in the organism as a whole, such as hypertension, atherosclerosis or diabetes, but can also show up as clearly defined organic manifestations, such as gall stones or peptic ulcers. Dew developed a classification of biopathies in terms of increasing severity, based on the organism's decreasing autonomic responsiveness[10]:

health

ß

inflammatory diseases

ß

cardio-vascular diseases due to hypertension

ß

diabetes

ß

leukemia

ß

cancer

fig. 4: classification of biopathies

Following Reich, Dew views all diseases as primarily sympathetically induced (sympatheticotonia could almost be called a characteristic of our civilization). To Dew, parasympathetic symptoms are the autonomic system's struggle to free itself from stagnation. If energy cannot be freely discharged through pulsation, it can cause different kinds of "break-throughs" (phases of exacerbation of illness) in the organism. If even these break-throughs cannot happen any longer, the organism responds with resignation or shrinking. Considering this, the exacerbation of illnesses can represent a sub-optimal attempt of the body to maintain at least some kind of pulsation of the ANS. It is the best possible try under the present circumstances.

Later on, we will go into more detail regarding the impact of chronically impaired pulsation on individual organs. Here, I would just like to point out once more that disease is created the moment pulsation is impeded or interrupted.

4. INFLUENCING PULSATION

4.1. Technique

Over the years, lots of different schools with different priorities and techniques have developed from Reich's initial work. I will mention just a few techniques here, which are of relevance for my work.

The most basic technique in body therapy as developed by Reich is the stimulation of respiration. When breathing deeply and consciously, the body's energetic charge is enhanced, over-tensed muscles become more palpable and can thus be brought to awareness and worked upon. Depth of respiration also bears directly stimulating effects on the ANS' centers. Under stress, breathing is shallow and restrained, in relaxation deep and full.

In order to stimulate pulsation, we use immediate activation of the chronically contracted muscles. On the physical level, we act upon the autonomic oscillation through the activation of muscles. On the psychological level we analogically make withheld emotions conscious.

First, the patient must learn to feel his tension. Then it can be dissolved through various techniques. In order to achieve this, the muscular tension can be intentionally increased - for instance by exaggerating the respective facial expression, or by taking up stress positions developed by Alexander Lowen in Bioenergetics. By doing this, the sympathetic activity in that area is increased even more. The voluntary contraction of the muscles is to be maintained as long as possible, since the muscles' slackening results in a switch in autonomic activity. When the muscles in that area do relax, the blood runs warmly through them, and a sensation of relaxation sets in that can be accompanied by a feeling of inner flowing or unintentional muscle twitching.

Another possibility for stimulating pulsation is the immediate treatment of muscles and connective tissue by the therapist, as for instance in the Points and Positions Technique developed by Will Davis. Here, the dissolution of tension takes place by means of light pressure applied to the muscle insertions, tendons, fascia and the connective tissue, dissolving the status quo in favor of enhanced or deepened pulsation by influencing the connective tissue's substance ("Points technique“). Tension is also released by "going with the contraction of the muscle“, holding the muscle in order to soften it rather than stretching it ("Positioning“)[11].

Muscles may also be activated by means of movement. The shoulder muscles, for instance, can be well loosened by beating movements, the chin muscles by biting movements, the pelvic muscles by kicking. The patient can also be encouraged to "feel into the tension" himself, and find out what motor impulse is held back in there.

4.2. Expression and Emotion

The mere mechanical stimulation of muscular activity can only be successful in the long run if pulsation on the autonomic level is also maximally stimulated once more. This is related to increased blood flow on the one hand (increased circulation in muscle and skin) and to the dissolution of emotional blocks on the other hand.

Through their tension, muscles impair the flow of blood and body fluids. Upon dissolution of muscular armoring, one of the three biological basic excitations, as described by Reich, occur: anxiety, anger, or pleasure. Anxiety here arises from the withdrawal of energy into the body's interior, anger from the disturbance of the energy's pleasant streaming towards the outside, and pleasure from unobstructed flowing of the fluids with unobstructed pulsation. Therefore, by liberating the energy tied up in the muscles, cathartic experiences can occur with childhood memories and a renewed experiencing of early childhood emotions. During therapy, the unpleasant emotions will surface first, such as anxiety, anger and pain. But after living through these feelings, the capacity for pleasant sensations like joy, pleasure and surrender will improve.

5. EXAMPLES OF IMPAIRED PULSATION

I would now like to introduce five syndromes on behalf of many other somatic diseases. I will point out the respective underlying autonomic disorder that leads to that particular symptom. Following, I will explain the psychological characteristics displayed by patients suffering from that disorder, what kind of expressive movement can hide behind the symptom, and have a look at clues as offered by popular use of language. Finally, I will deal with therapy.

When the biopathy finds manifestation in localized organic disease, the question of the selection criteria that led to that specific symptom comes up. The reason for this is definitely a combination of various trigger factors. Genetic elements, intra-uterine development, the basic level of energetic charge, and character structure all figure into it. Character structure corresponds to a certain pattern of muscular armoring and emotional suppression.

The correlation between illness, autonomic disturbance, and a psychological component are known in orthodox medicine as well. There however, therapy usually means the prescription of medication which either only battles the symptom, or which influences the autonomic nervous system artificially and, unfortunately, only temporarily without restoring natural pulsation.

5.1. Hypertension

5.1.1. Causes

Hypertension is among the most frequent diseases in humans, and particularly widespread in industrialized countries. Its percentage growing with increasing age, it usually manifests at the age of 30 - 60 and accounts for 25% of all deaths after age 40. In the USA, hypertension and its consequences are the number one cause of death. A person's life expectancy clearly decreases with the rise of his average blood pressure.

Hypertension is defined by blood pressure rates above 165 mm hg syst. and 95 mm hg diast. (Measuring the arterial blood vessels' tension during the heart's contraction/relaxation). It usually does not cause any subjective complaints and is often detected only accidentally upon visiting the doctor's office. It is, however, considered the risk factor for cardiovascular disease, coronary heart disease, congestive heart failure, heart attack, stroke, cerebral haemorrhage, and atherosclerosis, and may result in blindness and kidney failure.

The increasing pressure is primarily caused by the blood vessels' higher resistance against which the heart must pump, or by an increase in blood volume.

We distinguish between primary or essential and secondary hypertension: the origin for secondary hypertension is some underlying organic disease - for instance of the kidneys. Primary hypertension, however, is defined by way of the exclusion of secondary hypertension, so there is no individual, so-called "positive" definition of it.

More than 80% of hypertension patients suffer from the essential variety. Here we distinguish between unstable hypertension with varying readings and fixed or permanent hypertension.

Since orthodox medicine does not know how hypertension actually comes about, there has been a lot of research about the causes. It is generally agreed that there is a complex process as the determinant for hypertension. Below, I will give a short synopsis of the pertinent results:

Genetic factors. Hypertension tends to run in families, but genetic factors are not solely responsible. In identical twins, for instance, hypertension in both occurs in only 50% of the cases.

Environment. Environmental factors do have an effect on hypertension, evident for example in the distribution among spouses. This is called "psychological transmission".

Diet. There is a definite correlation between hypertension and overweight. With overweight on the rise due to improving living conditions, the number of people suffering from hypertension has shown a steady increase in Germany following the hungry years of 1944/45. Sodium chloride as a diet related risk factor is of secondary importance.

Social. The percentage of hypertension patients among the population increases with increasing age. For a long time, higher blood pressure was regarded "normal" in old age. But investigation results suggest that it primarily depends on social factors. Hypertension is a kind of "adaptation disease", meaning that increasing blood pressure in old age only occurs if the external living conditions change and the aging person feels that he cannot live up to those changes, thus losing their "ecological niche".

Stress. In 80% of the healthy population, stress does not lead to lasting hypertension. In hypertension patients, however, stress causes an increase in blood pressure both higher and longer lasting than in healthy persons. Therefore, it is assumed that the causes above - as well as emotional factors, see below - form a basis for the occurrence of hypertension, which is then triggered by additional stress.

In animals, the epidemiological occurrence of hypertension does not exist, except in experiments involving immobilization stress, electric shocks, or in cats which had been exposed to the barking of dogs in a cage for months. Those animal experiments prove the stress hypothesis.

Another population showing a low susceptibility to hypertension are blacks in their native countries (low-stress lifestyle?), while blacks in the Northern USA display extremely high blood pressure readings (high stress environment?).

5.1.2. Pulsation of the ANS

We need to distinguish between chronic sympatheticotonia or biopathy as the precursor of a disease and the symptom's occurrence itself. Hypertension is a very good example of this. On the ANS' level, stress means sympathetic excitation, with the body preparing for fight or flight. Besides chronic muscular tension, the failure of the anticipated activity to occur also causes a chronic increase of the arteriolic vessels' resistance. In accordance with Reich, this amounts to a biopathy: we have a "preparedness" that, in connection with situative stress, can lead to the changes in blood pressure which are stronger than in healthy persons, as mentioned above. The biopathy as the basis for illness is also the reason for the wide variety of blood pressure fluctuations: chronic hypertension, unstable hypertension, or hypertensive crises.

Beneath the surface - the "muscular armoring" according to Reich -, hypertension patients are emotionally still very alive. At its core, the organism keeps producing energy, it does not shut down as in cancer. Again, the hypertensive crisis can be viewed as the organism's struggle to escape stagnation, a sort of discharge towards the inside instead of living emotions or sexuality in the outside world.

Besides neuronal factors, hormones like renine/angiotensine and aldosterone also play a role in the increase of blood pressure.

In orthodox medicine, hypertension is mainly treated with medication. Beta-blockers, centrally effective sympatheticolytic agents (blocking sympathetic activity), saluretics (decreasing blood volume and sodium load), and vasodilators (dilating the blood vessels) are employed. The patient's compliance with this pharmaceutical therapy is often unsatisfactory, since there are no subjective symptoms. Pharmaceutical therapy may be also difficult because of the pressure's variability. Ideally, the medication should take effect when the blood pressure rises, but not further decrease normal pressure.

Stress reduction, physical activity, special diet (especially in overweight patients) as well as abstinence from cigarettes, alcohol, coffee, and tea are prescribed besides medication. Relaxation techniques and psychotherapeutical approaches are on the rise. Newer studies, however, showed that relaxation techniques alone were insufficient for lowering blood pressure: after one year, a group of hypertensive patients who had been instructed in various relaxation techniques displayed no lower readings than a control group which had only been advised by a physician.[12]

5.1.3. Psychological Component