In view of the fact that a century of medical and drug warfare has not liberated us from disease, progressive practitioners have put a growing emphasis on wellness and prevention as a health strategy, recognizing that maintaining a state of physical, mental and emotional good health is the best way to avoid illness. At the same time, new discoveries in the science of psychoneuroimmunology (PNI) have provided evidence that a healthy mental state is a prime contributor of wellness, especially for the athlete. Many athletes today are surprised when they get sick. But athletes as well as the general population should be aware of the importance of the wholeness of the body when it comes to discussing health of the human organism.

Threads of Psychoneuroimmunology in Sport

What Western science is now confirming, that mind and body are not separate and that thought and emotion influence physical health, is ancient history in Asian health care systems. Our minds possess the power to heal pain and create joy, wrote Tulku Thondup Ruspoche, a Buddhist scholar, in his book The Healing Mind (Shambhalu, 1996).

While it is true that a number of diseases seemed to have been all but eliminated in the 1950s and 1960s, widespread overuse of insecticides, fertilizers, antibiotics, and other drugs has resulted in new, mutant strains of insects, viruses, bacteria, and fungi, and many diseases are making a comeback. Increased mobility of the populace now guarantees the rapid spread of new viruses, exposing people to exotic pathogens from which they had formerly been isolated. Despite the progress that has been made, the human immune system is still subjected to a wide variety of infectious diseases, and it is unlikely the situation will change any time soon (Campbell, 1996).

Over the past decade, a number of integrated preventive diet and exercise plans have been created to promote general physical well-being, and they have proven quite effective (Bucci, 1995; MacKinnon, 1994). At the same time, new discoveries in the science of psychoneurimmunology have provided conclusive evidence that healthy mental states are also prime contributors to wellness (Ader, Cohen, & Felten, 1995; Lowe, 1979).

How Immunity Works

To fully appreciate the evolutionary twists and turns taken by the immune system over hundreds of millions of years, it is necessary to understand how immune response works. The most basic requirement for any immune system is the ability to distinguish the cells, tissues, and organs that belong to the host body from the foreign nonself that might also be present. The immune system’s role then is to eliminate nonself invaders, which are often dangerous bacteria or viruses. In addition, the immune system recognizes and usually eliminates nonself as well as altered-self cells or tissues, those changed by injury or disease such as cancer or hemolytic anemia. Immunologists agree that the immune systems of mammals including humans have the most sophisticated mechanisms both for recognizing and eliminating invaders (Levy, 1990).

Consider what happens when a track athlete running at full speed happens to trip and fall, lacerating the hands and knees. Within minutes, immediately after blood stops flowing normally through the injured area, the immune system begins to eliminate undesirable microbes introduced at the wound. Already on the scene (or quick to arrive) are phagocytic white blood cells known as macrophages. These cells not only engulf and destroy any invading microbes but also release proteins that activate other parts of the immune system and alert other phagocytes that may be needed.

This fast cellular response is sometimes called natural or innate immunity, because the cells that execute it are already active in the body. Innate immunity usually suffices to destroy invading microbes. If it does not, humans as well as other vertebrates rely on another response: acquired immunity. The soldiers of acquired immunity are specialized white blood cells called lymphocytes that function together as an army. Moving through the blood and lymph glands, lymphocytes are normally inactive; they become active, and begin to multiply, if they encounter specific molecules called antigens that are associated with foreign organisms. While it is highly effective, acquired immunity takes days to mobilize, because the response is very complex. An invading microbe must come into contact with the correct T or B lymphocytes; macrophages must be activated for assistance; the activated lymphocytes must divide; all the involved white blood cells must synthesize and release proteins that amplify the response; and B cells must manufacture and release antibodies (Booth, 1990).

But acquired immunity also has a hallmark trait, immunologic memory, arising from DNA-based mechanisms that allow lymphocytes collectively to recognize a great diversity of antigens, even though a single lymphocyte recognizes only one type of antigen. The second time a lymphocyte cell encounters a particular invader, it uses a sort of blueprint, enabling the response to occur more quickly and powerfully than it did the first time (Moye et al., 1995). The track athlete who fell in time will forget the resulting lacerations, but his or her immune system will not.

Mind and the Immune System

The mind’s impact on the immune system may not be as obvious as that of tranquillity and rest (sleep), but it is equally important. In recent studies (Bauer, 1994; Everson et al., 1996) cancer- and virus-fighting killer cells were taken from groups of depressed and non-depressed subjects. When the killer cells were placed in contact with cancer cells, those from the non-depressed subjects surrounded and destroyed the cancer cells, while those from the depressed subjects did nothing. Immune functions, one concludes, can be turned on and off by the emotions of the patient (Bauer, 1994). In a study by Medalie and Goldbourt (1976), a spouse’s love and support comprise an important balancing factor apparently reducing risk of angina pectoris, even in the presence of risk factors. The implications of such findings for pathophysiology and prevention of angina are stressed. A study by Everson (1996) found that bereaved spouses had 10 times less T cell (immune helper cell) function than did non-bereaved individuals. Another study by Ballieux (1994) found that natural killer cell activity was significantly decreased in “stressed-out” college students. Studies like these were featured in Bill Moyers’s recent investigative report, The Healing Mind (1994).

A number of hormones and neurotransmitters have been identified belonging to the process of immune system modulation, but each one of these is, to a significant extent, subservient to the emotions and beliefs of the mind (Harrington, 1995). Will the immune system respond in a diminished way if an athlete’s perception of his or her ability to react in a situation is threatened? The brain and the immune system continuously signal each other, often along the same pathways, which may explain how state of mind influences health (Mariano & Workman, 1991).


According to a study published in 1998 in the Journal of the American Medical Association (Eisenberg et al.), Americans made more visits to complementary and alternative practitioners than to conventional physicians that year. The trend appears to be persisting. Americans are ready for the theories and explanations of psychoneuroimmunology.

In the new millenium, scientists, teachers, coaches, and sports medicine specialists must catch up with consumer needs and demands. Athletes throughout the world should not continue to suffer because of a fundamental lack of reliable, readily available information on the subject of psychoneuroimmunology. There is a need to broaden the data in this important area, so everyone can learn which treatments are useful, which are not, and why. Consumer choice has made it clear in the last decade: Psychoneuroimmunology is here to stay. Now it is our responsibility to ensure that every athlete has access to the latest information on this promising new methodology.


Ader, R., Cohen, N., & Felten, D. (1995, January 14). Psychoneuroimmunology: Interactions between the nervous system and the immune system. The Lancet, 345, 99-100

Baker, B. (1997, July/August). The mind-body connection. AARP Bulletin, 38, 7-8

Ballieux, R. E. (1994). The mind and the immune system. Theoretical Medicine, 15, 387-395

Bauer, S. M. (1994). Psychoneuroimmunology and cancer: An integrated review. Journal of Advanced Nursing, 19, 1114-1120

Bergsma, J. (1994). Illness, the mind, and the body: Cancer and Immunology: An introduction. Theoretical Medicine, 15, 337-347

Booth, R. J. (1990, July). The psychoneuroimmune network: Expanding our understanding of immunity and disease. New Zealand Medical Journal, 314-316

Bucci, L. (1995). Pain Free. Ft. Worth, TX: The Summit Group.

Campbell, D. (1996, October). Energy, mood, stress and the healthy immune system. Total Health,18(5), 24-26

Eisenberg, D. M., Kessler, R. C., Foster, C., Norlock, F. E., Calkins, D. R., & Delbanco, T. L. (1993). Unconventional medicine in the United States. New England Journal of Medicine, 246.

Everson, S. A., Goldberg, D. E., Kaplan, G. A., Cohen, R. D., Pukkala, E., Tuomilehto, J., & Salonen, J. T. (1996). Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosomatic Medicine, 58, 113-121

Harrington, A. (1995, September/October). Probing the secrets of placebos. Alternative and Complementary Therapies, 299-304.

LaPerriere, A., Ironson, G., Antoni, M. H., Schneiderman, N., Klimas, N., & Fletcher, M.A. (1994). Exercise and psychoneuroimmunology. Medicine and Science in Sports and Exercise, 26(2), 182-190


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