Wednesday, December 8, 2010

Body odors: A psychosomatic method of discharging aggression?

An Indian man in his mid-fifties reported that when stressed he gets allergic reaction that manifests as excessive mucous secretions from his sinuses and tracheo-bronchial passage. His face turns red, he has to repeatedly blow his nose, he can hardly talk because the constant dabbing of nose and mouth with facial tissues interferes with it, and he is unable to focus or listen to others.

A little exploration revealed that the last such attack occurred when his boss was being mean to him. The boss had exaggerated the significance of the mistake he had made, and this had triggered a strong reaction in him to resign, or to tell the boss some home truths about him too. But he could do neither.

So his "allergic reaction" had set in. But to me it appeared like an extension of crying. Now that he was a grown up man, the secretory response had shifted from mucosa of the eye to those of surrounding regions. It was crying in displacement.  It was discharge of tension and rage, caused by the insult, through a secretory response.

But there was something else to this displaced crying. Along with the paranasal sinus discharge and post-nasal drip, when stressed he also emits a strong odor. Which also, he attributes to allergic reaction. But why should an allergic reaction give rise to foul smell?

Is it possible that his odor was a form of aggression designed to tell others to get lost when he could not do it by words or physical action?

He claimed that his foul smell has nothing to do with anger because he does not believe in getting angry. Responding with negative emotions never resolves a conflict per his philosophy.

Now this gentleman, a sterling fellow, who I know well, is very religious, devotee of a Hindu Goddess, whose bhajjans (hymns) he listens to as he drives his car, and he genuinely strives to be saintly. Every insult hurled at him is handled with turning the other cheek and equanimity.

He countered my theory of undischarged rage by claiming that the odor is due to secretion of nitric oxide. And there is nothing more to it.

But can we accept his explanation? Or is it just a rationalization to hide from himself that he does get angry? A rationalization so strong that he does not feel the affect of anger which seeks expression through halitosis aimed to tell others to get off from his space.

Over the years I have observed that anger/destructive urges often find expression through foul odors. When something disturbs one, there is an immediate motor response to destroy the source of the disturbance. However, this is not always possible. The source of disturbance is often stronger than one's self or out of one's reach. In such cases I have found the motor response may occur through involuntary muscles. I have found that if I am driving and someone cuts in front of me, or honks at me, or even if someone else makes a traffic violation which has nothing to do with me, I react with a tinge of fear and then immediately get unpleasant sensations in my chest, and sometimes, a few minutes later,  get a gut reaction. The gut reaction is sensing of slight tension or pressure in the abdomen, an awareness of increased motility in the intestines, and sometimes discharge of the tension through flatulence.

Is the mechanism of Irritable Bowel Syndrome and various other colitis similar to this pathophysiological process that I see in myself?

Many of my patients who show a tendency to act out their conflicts through their intestines have reported to me that when something disturbs them, or if they hear their parents fighting, or a sibling makes them angry, they get "the gut reaction" and have to run to the toilet. The greater the stress the more thunderous is the reaction of the bowel.

They also report that greater the stress more foul is the smell that accompanies the gas and feces. Now in the man whose breath becomes foul under stress, he insists that it is due to allergic reaction.

Now allergic reaction itself is a method to expel and destroy foreign objects. There appears to be a cascading relationship between rage, motor response [mediated by cholinergic neurotransmission], generation of nitric oxide, histamine over-activity, allergic reaction, GI tract excessive secretions and foul odor.

Are all these different methods of getting rid of something alien or unwanted?

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