The Role of Autonomics in the Origin and Healing of Chronic Illness
In the spring of 2024, Bob Naviaux, who runs the mitochondrial cell laboratory at the University of California San Diego introduced me to Dr. Eric Gordon, a functional medicine doctor who specializes in treating complex chronic illness. Bob, who is one of the world’s leading practitioners of mitochondrial medicine made this introduction after a long conversation we had about the role of autonomic physiology in the origin and progression of chronic illness. Over the last several years, he had been writing about a phenomenon called the Cell Danger Response, a kind of localized cellular response in the body that in many ways mimics autonomic danger responses that happen systemically. In this response, cells at the site of an injury or wound begin dumping Adenosine Triphosphate (ATP) which is ordinarily used as their primary fuel, into the extra-cellular matrix, where it becomes toxic.
Mitochondria are our cellular engines. Once upon a time, these tiny organelles were other organisms entirely: several billion years ago early single-celled eukaryotic creatures developed a symbiotic relationship with them that has led to one of the most enduring marriages fundamental to the flourishing of life. The cells provided an ideal home for the mitochondria; in exchange the mitochondria power our cells. These tiny engines run on ATP, which is a primary energy currency for metabolic processes, powering the contraction of muscles, the propagation of nerve impulses, and various kinds of chemical synthesis.
The Cell Danger Response that Bob has noted and studied is perplexing, because when it happens cells take this precious fuel and start dumping it overboard. Intriguingly, outside of the context of the cell, this fuel is toxic, and one of the strange effects of this now extra-cellular ATP (e-ATP) is that it creates a sort of local rogue island around the site of injury that becomes unresponsive to signals of safety from the Central Nervous System: a very unusual effect.
When he told me this story for the first time, I imagined a motorboat and cans of gasoline. I know this is probably not a perfect analogy, but I remember filling boat motors as a kid, and that if you were not careful, sometimes an irridescent sheen of gas would dribble out of the motor and end up on the water. I always felt slightly sick when this happened. Inside the motor, the fuel would power the engine. Outside of the motor, this prismatic sheen of fuel would poison the water. When Bob explained the response to me, this is what I thought of. We are mostly water; more than 70%. Our body is in many ways an inward ocean, and I could see how this response would diffuse into a local area in the body, spreading away from the injured site.
I have spent the past 30 years studying the human nervous system, and the past fifteen focused exclusively on developing a new living model of autonomic physiology called Autonomics. As Bob described the Cell Danger Response, I felt the hair on my arms begin to stand up. It was as though he was describing a tiny fractal of processes of autonomic physiology I had been studying, writing about, and working with clinically for years. A fractal is a mathematical figure that is similar at varying levels of scale. Even if you’ve never heard this word, you know what a fractal is. Have you ever looked closely at the pattern of run-off from a puddle? And then have you ever been in an airplane and looked down at a river delta from altitude? They create the same patterns. Nature speaks in a pattern language, and the patterns hold true at different scales, from the minute to the immense. The branching of certain trees has the same structure as the branching of the vascular system in your body; the spiral of a chambered nautilus maps to the geometry of a sunflower which can also be found in the shape of the swirling arm of a galaxy. As Bob described the response I found myself once again in awe of the majesty and mystery of the human body as an expression of the design language of Nature.
The Autonomic Nervous System in the body works in ways similar to the Cell Danger Response. When we are in a salutogenic, or health-creating state, the Autonomic Nervous System orchestrates a profound harmonization of our three primary autonomic systems coordinated around the rhythmic pulse of safety, producing the deep neural foundations of wellbeing. But if the Autonomic Nervous System gets shifted into enduring danger or lifethreat responses, and is unable to shift out of them, there are clear and repeatable neurobiological sequelae of this shift that resemble the Cell Danger Response. Absent the coordinating pulse of safety, autonomic systems stop functioning, or go rogue. Digestion stops working properly, and food that before nourished us can become toxic, just like the ATP. As this process unfolds, the immune system gets involved, pathogens are no longer deflected, co-occuring infections flare, and on and on, creating and intensifying the conditions for complex chronic illness.
At the end of our call Bob said, I want to introduce you to a colleague of mine who is very gifted at treating complex chronic illness.
Amazing, I said. Does he live in the United States?
It’s a little town in Northern California, Bob said. I think it is called San Rafael.
That’s funny, I said. Because I live in San Rafael. And that was how I met Dr. Eric Gordon.
Eric and I zoomed shortly after Bob’s introduction, and met face-to-face for the first time on a spring afternoon in Nicasio, California, where I steward a forest. Meeting someone in a forest for the first time is ideal. There is no clock on the wall. No sound of horns and sirens in the background. No one telling you the conference room is no longer available.
You sit outside together, the light filters through the trees and slowly changes as the sun makes its way across the sky, the birds sing, nature does its thing and you get to know someone outside of the tight strictures of the daily calendar that tells us we have a meeting at the top of the hour. Eric and I proceeded to have a series of conversations, about wellbeing and illness, about the Autonomic Nervous System and the immune system, about the difference between indigenous cosmovisions and modern cosmovisions, and then he started referring patients to me.
I think he would probably agree that this was not a great experience for either of us. Initially, Eric didn’t know how to explain to his patients what I was doing, which created a situation where they would arrive and think we were having a long conversation when I was, in fact, taking precise histories and working with them autonomically. Sometimes a couple of hours into this, they would ask me when we were going to start, at which point they would be surprised to learn that they had already been paying my consultation rate for several hours. Not ideal. For me there was another problem, which is that Eric’s patients were all extremely sick autonomically. Because the way that I diagnose is largely felt, being around this level of autonomic dysregulation tended to make me feel sick for 24 hours after meeting with one of his patients. This had deleterious effects on my own sleep and general wellbeing. We did this for a few months before I stepped back. And when I stepped back I realized the thing that I didn’t really have to do autonomic diagnostics on Eric’s patients because all of them presented with a common autonomic baseline.
There were individual variations in how they were sick, by which I mean the specific diagnosis (e.g., ME/CFS, Long COVID, Mast Cell Activation Syndrome, etc.), and the types of co-infections that most of them had (e.g., mold, Lyme Disease, etc.). But what all of them had in common were Autonomic Nervous Systems that had been pushed into, and were resistant to shifting out of, various formulations of lifethreat response. Some of these patients had this response blended with fight, some with flight, and some with sociality creating ‘appease’ or ‘placating’ autonomic states, but the common denominator for all was this shutdown response.
The second thing that all of them had in common was that there was not an immediate response to autonomic intervention, even if the intervention was appropriate. As in the Cell Danger Response, people in conditions of complex chronic illness were actually not sensitive to signals of safety from the Central Nervous System. Which is to say that, as distinct from a broad swath of people dealing with other kinds of stress-related issues, helping the nervous system detect safety was not enough to shift their autonomic baselines in real-time. The feedback loops from chronic lifethreat had simply moved other physiological systems too far in the direction of dysregulation.
This was frustrating both to the patients, and to myself, because we are used to seeing fairly immediate responses to neurological intervention in our work. But an important common feature of complex chronic illness is that it typically develops over decades. No one who is severely chronically ill becomes so in a short period of time. Complex chronic illness develops slowly through feedback loops that shift autonomic and metabolic baselines over long stretches of time, until a person’s center of gravity shifts across a threshold into profound illness. And in our experience, their healing likewise takes significant time.
About a year after this initial foray into collaboration, Eric interviewed me for a series he was putting together on chronic illness. In preparing for our conversation he read my book Autonomic Compass: Finding Home in your Nervous System, and when he came into the conversation had developed a clearer understanding about the lens through which we view well- and ill-being.
After this conversation it occurred to me that it would be useful to his patients, and to others with complex chronic illness, if I were to write up a straightforward account of how we view complex chronic illness through the lens of the Autonomic Nervous System, and therefore how someone with complex chronic illness might begin to think about the origin, progression, and eventual healing of their illness from the standpoint of the Autonomic Nervous System.
My name is Gabriel. I am a connection phenomenologist, and neural cartographer, and the Developer of Autonomics, which up-ends several hundred years of classical neurology, and teaches people how to grasp and move the deepest and most powerful levers that govern your moment-to-moment experience of wellbeing. I am the Founder of Hearth Science, and I have taught autonomic physiology internationally for the past decade. I led a global autonomic physiology study group for wellness professionals with five thousand members, have trained about twenty thousand wellness practitioners around the world, and the books and software platform that I architected have helped people in fifty countries internationally.
I am deeply expert in this terrain, but it is also quite personal for me. I recovered from complex chronic illness in my twenties and thirties, but come from a family where several other members have not. Complex chronic illness is, to a degree that is not generally recognized, relational. And this is because the Autonomic Nervous System, which is the neural architecture of the mindbody connection, governs the energy-processing templates that shape the way that we relate to one another. What this means is that the roots of most complex chronic illness are laid down in early childhood, when we are learning non-verbally how to relate to those around us: our family, our siblings, the social systems in which we are enmeshed. This learning is not cognitive at all. It is, rather, deeply felt. Primal: animal if you will.
It is often here, in early childhood, that the templates for our defensive responses get organized: how we defend ourselves against threat. And so this is where we will begin the business of attempting to understand complex chronic illness through an autonomic lens.
Excerpted from The Role of Autonomics in the Origin and Healing of Chronic Illness.