The role of Gut Instinct and the Gut Microbiome (GM) in Psychotherapy

Learning Objectives

  • Role of gut instinct in shaping behaviour
  • How this can be harnessed in psychotherapy
  • Models of top down and bottom up information processing in psychotherapy
  • Integration of this information at the levels of: gut ---- heart-----brain (quintessential model)
  • Discussion of recent advances in neuroscience of body-mind-brain interface

Role of Gut microbes

  • Optimal brain development and functioning
  • Commensal “Cum Mensa” i.e. sharing a table or eating together
  • 5HT or serotonin needs microbes to develop
  • Social behaviour depends on our bacteria
  • Rodents have no bacteria and are known to have ASD type traits

Brain-Gut-Microbiota axis (BGM)

  • Central Nervous system or CNS
  • Neuro endocrine and neuro immune systems
  • ANS sympathetic and parasympathetic arms
  • Enteric Nervous System or ENS
  • Gut microbiome
  • Brain influences gut and vice versa
  • Bacteria, archaea,, protozoa, fungi and viruses digest sugars, synthesise vitamins inhibit pathogens

Brain-Gut-Microbiota axis (BGM)

  • Paradigm shift in neuroscience
  • Dysbiosis in neonate and elderly profoundly effects their body and mind physiology
  • Vagus Nerve (wanderer) key mediator
  • Description of vagal paradox (Stephen Porges)
  • Mechanisms of activation include cytokines IL1 and IL6 which release cortisol via HPA axis
  • Confirms inextricable link between mind/body

Parasympathetic system

Parasympathetic system

Parasympathetic system

Gut microbes interact with brain

  • Vagus or tenth cranial nerve activates anti inflammatory response protects against sepsis
  • Immune system mediates bacterial CNS effects
  • Hypothalmic cytokine levels altered impacting on corticotrophic releasing hormone CRH
  • CRH peptide regulates hypothalmic-pituitary-adrenal axis which is altered in eating, depressive and anxiety disorders

Bacterial interaction with neurotransmitters

  • Tryptophan essential amino acid
  • Choline Short chain fatty acids and choline
  • GABA derives from Lactobacillus & Bifidobacterium
  • Noradrenaline derives from Escheria & Bacillus
  • 5HT or Serotonin comes from Candida & Streptococcus
  • Dopamine comes from Bacillus
  • Acetylcholine comes from Lactobacillus

Gut colonization with microbes

  • Bacteria 200 common 1000 less common species
  • Gut microbiome 100x > genes in human genome
  • Microbes in human intestine same weight as brain (1500g)
  • How microbes in gut influence health is now a pioneering area of medicine