Decoding the language of the heart: developing a physiology of inclusion.

Constructs such as homeostasis and fight/flight have supported a scientific approach to physiology that has yielded a vast database of obvious heuristic value. Yet in spite of its value, these constructs have tended to create a mind-set that unwittingly supports what this article has labeled a "physiology of exclusion." Reinforced by the philosophy of René Descartes, this perspective has led investigators to focus on isolated or separate animal organisms that are reflexively wired for self-preservation. It has created a mind-set in which both research investigators and the public at large tend to view the human body as either in a steady state of vigilance, maximally prepared for fight/flight, or in a state of quiescence. Assumptions of the solitary body, and solitary man wired to react for "self" preservation, has made it difficult to incorporate a growing body of evidence that indicates that social support and loving relationships are conducive to good health. It also has made it difficult for investigators to fully understand why human loneliness is a major cause of premature death. This article delineates these trends and offers a new construct, one that suggests that a "physiology of inclusion" be added to the prevailing view of a "physiology of exclusion." Recent cardiovascular research is cited to help underscore the potential heuristic value of this new physiological construct.