Scientifically speaking, we must have faith and not give up.

Engel (1968) published an article on the giving up-given up complex. In this article he published the conclusions of a study in which he examined the life settings of patients who had fallen ill. Engel (1968) concluded that prior to the onset of illness the patients had displayed psychological disturbances such as a feeling of being unable to cope with life’s circumstances which resulted in biological changes that may have altered the patients’ ability to defend off pathogens resulting in the development of disease. Engel identified five contributing psychological characteristics which were a feeling hopeless or helpless, a decrease in positive self-image, loss of gratification with the roles they play in life with others, blending emotions from the past with the present and projecting them on the future, and focusing on and recalling prior memories of when they had wanted to give up. These symptoms became know as the giving-up-given-up complex. Engel further studied the psychological effects of extreme loss of control and found that individuals who experienced negative powerful events that resulted in a feeling of loss of control and he found a relationship between this experience and the sudden death of patients, usually from myocardial infarction or cerebrovascular stroke ( Lovallo, 2004).

It is not just the cerebrovasular system or the cardiac system that are affected by the effects of extreme loss of control. Animal studies and experiments were being conducted to determine linkage, such as Weiss adjusting the variable of water temperature on the stress levels experienced by rats and Seligman, Maier, and Solomon’s experiments on dogs by distributing shocks by varying their ability to control or manipulate how or if they received the shocks (Lovallo, 2004). In both groups the animals that did not have control experienced a reduction in the central nervous system norepinephrine levels. These findings led to the development of the motor activation deficit model of control by Weiss to explain how animal who experienced extreme loss of control and a reduction in the central nervous system norepinephrine levels also demonstrated lower response rates and decreased motor activity.

This may because the central nervous system uses the noradrenergic cell bodies in the locus ceruleus of the pons, which is located in the dorsal wall of the rostrol pons at the lateral floor of the fourth ventricle, and this area is a major source of storage of norepinephrine which influences the flight or fight response systems (Pinel, 2006). Upon receiving an alert from the amygdale the locus ceruleus increases the rate in which it fires signals and if this area is continuously exposed to excessive firing patterns the levels of noradrenergics depletes and causes a change in the performance of the amygdala, the hippocampus, and the prefrontal cortex ( Gorman, & Sullivan, 2000). Although this information is helpful in substantiating the relationship between feeling extreme loss of control over time and becoming lethargic which is consistent with symptoms of depression, it does not explain how other areas of the brain which manage serotonin areas, such as the raphe nuclei, remain unresponsive and unaffected by the changes in stress levels (Lovallo, 2004).

Engel, G. (1968). A life setting conducive to illness: The giving-up—given-up complex. Annals of Internal Medicine, 69(2).

Gorman, J. M. & Sullivan, G. (2000). Noradrenergic approaches to antidepressant therapy. Journal of Clinical Psychiatry, 61(1), 13-6

Pinel, John P. J. (2006). Biopsychology with “beyond the brain and behavior” (6th ed.). Boston: Allyn and Bacon.

Lovallo, W. (2004). Stress & Health: Biological and Psychological Interactions. Thousand Oaks, CA: Sage Publications

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