Your self does not end where your flesh ends, but suffuses and blends with the world, including other beings.

The Body Has a Mind of Its Own Sandra Blakeslee and Matthew Blakeslee

When we try to pick out anything by itself, we find it hitched to everything else in the Universe.

John Muir My First Summer in the Sierra (1911)

No man is an island, entire of itself...

John Donne 1572-1631 Meditation XVII

It sure looks like an "it" doesn't it?

You know, a unit, a discrete thing in and of itself. A stand-alone object.

The human body, I mean.

After all, it looks just like an individual organism, bounded by skin. It's got a form that's easy to recognize and that form remains stable, with minor changes, for decades. There are inflows and outflows of solids, liquids and gasses, but otherwise, it's basically a system unto itself.

The singular appearance of the human body is confirmed–so it would seem– by our subjective life experience. Just as we look like individuals, we also feel like individuals. There is a "me" and there is a "you" and unless we are lovers in the throes of passion, we remain as singular, individual bodies for the better part of our lives. I am one and you are one and the environment is "out there."

Our perception of physical singularity also seems to be supported by the doctor's anatomy chart. The body is right there on the wall, laid out in crisp graphic detail. The skin has disappeared of course, but there can be no question: the body stands alone, stark on the white page, unconnected to any other force, form or process. Popular magazine covers give us the same impression except that now the skin is Photoshopped to sexually-idealized perfection. The human body appears alone and doubly naked –there's no background, no context and no life support.

health is extrasomatic

Our perception of the human body as a singular, isolated unit, strong as it may happen to be, is actually an illusion. While we can and do function as individuals, we are massively interconnected with the biological and social world around us. In fact, it is not really clear where the human body begins and ends.

This is one of the most revolutionary discoveries in the world of medicine and public health of the last few decades. Findings in the fields of molecular biology, epidemiology, public health, stress medicine and social neuroscience have revealed without question that our health is profoundly extrasomatic or "beyond the body."

This means that, for all practical purposes, the body is bigger than the body. There are myriad forces and processes beyond the reach of our fingertips, forces that profoundly affect the functioning of our organs and our tissue. Our bodies are shaped in large measure by things that happen remotely, both in space and time.

Mystics and shamans have suspected as much for thousands of years, but now we are beginning to see our extrasomatic relationships in more concrete, scientific terms. The skin is not a barrier to the world, merely a transitional membrane. Our bodies may appear to us as isolated, stand-alone organisms, but in fact, they are in constant relationship, communication and interchange with other people and processes, many of which affect our health in surprising and profound ways.

we are embedded

One of the most striking challenges to the isolationist view of the body is the discovery of vast populations of non-human organisms both in and around us. The percentages are truly mind-blowing. Latest estimates have it that only one in ten cells in and around the human body are actually human tissue cells. That's right. We are literally awash in other organisms, mostly bacteria. Those organisms are living, metabolizing, discharging wastes and dying in great numbers, every second of every day.

You can wash your skin all you like and detoxify your gut for months on end, but you can never change this fact of human existence. In fact, if you were to somehow kill all of the "not-I" organisms in and around your body, you would die in short order. Like it or not, you can never be a single organism. You are an ecosystem with legs.

We also see profound interconnection between human bodies, especially our immune systems. Remember the last time someone coughed in a crowded room or sneezed in an elevator? And how about the people who leave the bathroom without washing their hands? We know, almost without being told, that their germs are spreading and threatening our health.

But there's a wider meaning here. Humans are constantly exchanging microorganisms with one another and in this sense, our personal immune systems are actually parts of a much larger, networked meta-system. My health depends, not just on my behavior and my relationship to the microbial world, but on the efficiencies of other immune systems in my neighborhood, community and workplace. If my neighbor's immunity is compromised for some reason, the microbial challenge eventually gets shifted onto everyone else. Like it or not, we are all participating in the same struggle against the microbial world; immunity is a community enterprise.

Moving to a more macro level, we see a massive interconnection between individual human bodies and habitat. We are constantly engaged in a chemical and energy exchange with surrounding plants, animals, air and soil. Everything that we eat, drink and breathe is touched and transformed by other organisms around us. And yet, in an age of industrial agriculture, we forget this simple fact. When farms and factories are hundreds or thousands of miles away, we develop a delusion of individual autonomy and forget our connection to the rest of life.

In his book Does it Matter? Alan Watts reminded us that our life support comes from both within and without:

...civilized human beings are alarmingly ignorant of the fact that they are continuous with their natural surroundings. It is as necessary to have air, water, plants, insects, birds, fish and mammals as it is to have brains, hearts, lungs and stomachs. The former are our external organs in the same way the latter are our internal organs.

social and cultural contagion

Ecological interdependence is just the beginning. Social and cultural forces are enormously influential in shaping individual health. Meaning and emotion flow between people constantly, even when no words are exchanged. Odors of fear or pleasure waft through the air and inform us –unconsciously – of prevailing emotional states. Posture and proximity allow us to in effect touch one another's bodies without actually doing so. If I stand near you and move my body in a certain way, I can affect your hormone levels, your stress response and your cognition. Meaning flows in both directions, bodies in a constant conversation.

Emotions are not just experienced by individuals, but shared, unconsciously and unintentionally, across social groups. This is most powerful in real-time, face-to-face encounters as mirror neuron systems read the emotional content of other bodies. The simple act of watching another person move affects how we feel, what we think and how we behave. In this way, emotion ripples and cascades through social systems affecting the health of everyone in the process.

population level

The tight interconnection between human bodies becomes even more apparent when we look at health and disease across large populations. In his book, The Status Syndrome, epidemiologist Michael Marmot compiled thirty years of evidence demonstrating the crucial importance of social rank in health. His conclusion is that "Health follows a social gradient."

Marmot found that social inequalities are powerful determinants of health: "Wherever we are in the social hierarchy, our health is likely to be better than those below us and worse than those above us." This holds true, not just for one particular kind of illness, but for all forms of human affliction. "Being low in the hierarchy means a greater susceptibility to just about every disease that's going."

Marmot spent almost three decades studying the health of British civil servants, all classified according to their ranking in the occupational hierarchy. The findings showed a dramatic social gradient in mortality for most major causes of death: disease of the cardiovascular, renal, gastrointestinal, and respiratory systems, most cancers, accidental deaths and violent deaths. His conclusion was that "subtle differences in social ranking can lead to dramatic differences in health."

Michael Marmot's findings are supported by findings of The Equality Trust, a UK non-profit organization. Researchers compared the health of people in low and high equality societies, revealing a consistent pattern: people in high-equality societies tend to be healthier. According to their website:

There are now over 170 studies of income inequality in relation to various aspects of health. Life expectancy, infant mortality, low birth weight and self-rated health have repeatedly been shown to be worse in more unequal societies.

Research carried out since the early 1990s shows that many of the most pressing health and social problems are worse in more unequal societies. Societies with bigger income differences between rich and poor seem to suffer more of a very wide range of health and social dysfunctions. (See The Spirit Level: Why More Equal Societies Almost Always do Better by Richard Wilkinson and Kate Pickett.)

big health

We are now beginning to realize health is far more multi-dimensional than previously imagined. In fact, our bodies are part of an immensely complex, interconnected and chaotic system. This is not just poetic language–when an environmental butterfly flaps its wings on the other side of the planet, everyone's body is affected. Winds carry topsoil, dust, seeds and pathogens around the world. Pharmaceuticals pass through animal bodies and into the water supply where they are absorbed by other organisms. Fertilizers, pesticides and herbicides filter into rivers, lakes and aquifers. Plastic byproducts find their way into our bodies, disrupting vital endocrine systems. Ultimately, our embedded bodies experience the ripples of energy and substances that course through the living world.

it's all contagious

The discoveries of ecology and epidemiology are forcing us into drastic re-evaluations of some basic medical assumptions. For the last half century, we have divided human disease into two distinct categories: infectious and non-infectious. Infectious diseases are caused by pathogens such as bacteria and viruses. Non-infectious diseases are caused by "lifestyle factors." People eat too much, drink too much, smoke too much and sit on their butts too much.

But now it's starting to look like things are a lot more complicated. The problem is that the so-called "non-communicable" or "lifestyle" diseases may in fact be "spread" through social networks, influence and mimicked behavior. To say that heart disease, diabetes and obesity are matters of "lifestyle" misses the point because lifestyle itself is highly contagious. Lifestyle doesn't infect people the same way that smallpox does, but there is no longer any question of social and cultural contagion. An enormous percentage of our health and disease is "catching," one way or the other.

no health islands

Given what we now know about the tight interconnection of human health with the surrounding world, we are forced to ask some hard questions: Is it even possible to be healthy in the midst of a sick culture or biosphere? Does it make sense to focus on the health of individuals while simultaneously ignoring the biological and cultural context?

The short answer is completely unsatisfactory. Yes, it is possible, for a time, to isolate individual bodies and promote individual adaptations. This is precisely what we see in the world of elite health clubs and athletics. Wealthy individuals channel a massive stream of energy and resources to themselves and so, in the short term, manage to build up islands of health. But this apparent "health" is not particularly meaningful, enduring or interesting. Given enough resources, just about anyone can do it.

In fact, health islands are not a good model for our future. Yes, we can direct vast amounts of time, expertise and resources into building up the state of individual bodies, teams or athletic programs, but what exactly have we accomplished? Aside from pumping up the appearance, vitality and status of the "islanders," all we're really done is stretch the social health gradient, increasing the distance between the health rich and the health poor. Ultimately, the process becomes self-defeating as the islanders, fit and healthy as they might be, find themselves isolated in a world of declining health.

who's holistic?

Our understanding of human continuity gives new meaning to the practice of holistic health. In conventional circles, we reflexively label mind-body-spirit orientations as "holistic." But if we're only talking about my body, my mind and my spirit, what we're doing isn't even close to being holistic. In fact, just the contrary. With the mind-body-spirit orientation is focused on the individual, the best we can hope for is a temporary, unsustainable health island.

If we really want to be holistic, we have to include the rest of the biological and social world. In this respect, the conventional prescription for health must be expanded to include a third element:

diet + exercise + activism

In other words, watch what you eat, get off the couch and start being inconvenient. Eat real food, practice functional movement and stand up for environmental preservation, sustainable agriculture, peace and social justice. Take care of your internal organs, of course, but take care of your external organs too. It's all one body.

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