Feature Article


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How Autonomics and Chronic Illness Interact

Gabriel Kram

I have spent the past 30 years studying the human nervous system, and the past 15 focused exclusively on developing a new living model of autonomic physiology called Autonomics. Classical neurology divides your nervous system into a Central Nervous System, and a Peripheral Nervous System. The Central Nervous System contains your brain and spinal cord. The Peripheral system is everything branching off of that, and contains two distinct nervous systems. One of them is the Somatic Nervous System, which controls voluntary muscle. The other peripheral nervous system is the Autonomic Nervous System (ANS) – the focus of my research.

The Autonomic Nervous System governs the master levers that are responsible for calibrating all of your internal organs and sensory systems in responding to both internal and external environments. In this manner, it controls your breathing, your heartrate, and your digestion. It regulates your body temperature, and how your immune system works, and aspects of memory function. It governs the constriction and dilation of your blood vessels, and the amount of oxygen flowing to muscles. It dictates how your eyes and ears and other senses take in information. It moderates the tuning of your vocal cords that shape the sound of your voice. It does all of this dynamically, updating with each breath you take. It does this without you having to think about it at all. It does this to regulate the internal milieu (homeostasis), and it does this to calibrate energy flows through the body depending on whether you feel safe, in danger, or under life threat.

An autonomic state is an energy-processing template. Have you ever been to a recording studio? The sound engineer in the studio’s mixing booth listens to the band playing, and adjusts all of the subtle frequencies to obtain the most perfect expression of sound. They turn the bass up, and the treble down, and they fiddle with the mid-ranges. This is what your Autonomic Nervous System is doing in every moment. It is finding the most perfect nervous system expression to respond to your body’s assessment of what is happening. The Autonomic Nervous System is like the mixing booth of the mindbody connection. It is the sound engineer running your experience of your life, changing the volume knobs on your body and mind. The ANS, like a sophisticated stereo, comes with presets. These shape the energy and information flowing through our lives. In the same way that you can have a preset that gives you the feeling of an arena in a rock concert, and a different one that feels like an intimate jazz club, your autonomic presets shape your experience precisely. In this manner, the sound engineer doesn’t have to totally improvise each time something new happens. They can simply find the preset closest to meeting the needs of the situation you encounter. From there they can make micro-adjustments, but the general template for responding is in place very quickly. It feels important to note that this autonomic sound engineer is not your ordinary sense of self. It is something deeper, more primal, more survival-aware.

The reason life is so successful is because biology is incredibly good at conserving energy. Our bodies are amazing at tuning our systems very precisely to respond to our survival needs. Most of the time, hopefully, we can run autonomic presets that require relatively little metabolic energy. Most of the time, hopefully, our lives can be somewhat relaxed. However, if the Autonomic Nervous System determines that we are in danger, or under threat, it will very quickly and severely change the ways that energy and information flow through our mindbody systems. It is capable of accomplishing this transformation of how the bodymind works nearly instantaneously. If you’ve ever been startled by something, or jumped out of the way of something before you even knew what you were responding to, you have some sense of how quickly the ANS can respond. It can send the heartrate skyrocketing, dilate the pupils, and surge adrenaline through our systems in a split-second if necessary.

When we find ourselves in overwhelming circumstances, the energy-processing templates that the ANS cues up for us profoundly change the way that we experience our bodies, emotions, thoughts, sense of self, perceptions of the world around us, and how we behave. These changes can happen so fast, and can be so extreme, that even the person to whom they are happening can have no idea what is going on. Something crucial to understand: having our survival responses enduringly activated is fundamentally incompatible with well-being. If we spend more of our moments in survival states, we will inevitably become sick. It is simply too metabolically costly. The Autonomic Nervous System cannot chronically reside in detections of danger and life threat without you becoming ill.

In The Role of Autonomics in the Origin and Healing of Chronic Illness, I explore the genesis of complex chronic illness in early patterns of relating that put the nervous system into chronic lifethreat responses. The common autonomic antecedent to complex chronic illness is enduring and non-resolving lifethreat responses. In a life threat response, our three primary autonomic systems de-coordinate in a patterned manner. Absent oxytocin, and the coordinating impulse of safety, the body can move into fight-or-flight responses (danger responses) or more more deeply into shutdown responses. These responses have a different neurological, and neurochemical signature that our ordinary stress responses. The neurobiological sequelae of these responses down-regulate digestion, and if they do not resolve for long duration lead to gut permeability that leads to immune and inflammatory responses that create fertile ground for complex chronic illness to take root.

In our clinical work, we see a clear relationship between early relationships that put the physiology into lifethreat responses, and the development of complex chronic illness. When we are in a salutogenic, or health-creating state, the Autonomic Nervous System harmonises our three primary autonomic systems around the rhythmic pulse of safety, producing the deep physiological foundations of wellbeing, using energy very efficiently.

While The Role of Autonomics in the Origin and Healing of Chronic Illness looks at this pathogenic side of autonomic dysfunction and chronic illness, my new book, GROUND: How Modernity Disconnected from the Earth, Why it Matters, & How to Fix It, explores the way that the autonomic grounding system can become the seat of embodied intuition, and the location of our deepest connection to the Earth. We systematically fail to realise that the same neurological system, in conditions of life threat versus conditions of safety, either provides the primary neurological strata for complex chronic illness, or the primary neurological strata for embodied intuition, and a deep connection with the Earth. Learning about your own autonomic nervous system puts you directly into conversation with a set of uniquely powerful levers governing your moment-to-moment experience of wellbeing.

About the Author

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Gabriel Kram is Founder of Hearth Science, Inc., and Developer of Autonomics. In 2024 the translation research team he leads codified a new foundation model of autonomic physiology. Gabriel is the principal architect of the Autonomic Compass software, founder of the Autonomics Clinic, and the author of a dozen books about wellbeing, including Ground, The Role of Autonomics in the Origin and Healing of Chronic Illness, Finding Home in Your Nervous System, and The Neurobiology of Connection. All of his books are available at https://restorativepractices.com and ship to Australia. You can read a number of white papers about his work here: https://www.researchgate.net/profile/Gabriel-Kram/research