IN THE WAKE of the Columbia tragedy, NASA and the public are keenly focused on getting astronauts into space and back home again as safely as possible. But scientists can’t ignore what happens to the astronauts on even the smoothest of space journeys—the extreme stress that space travel imposes upon the human body. During launch, the space shuttle accelerates by 33 miles per hour every second—25 times faster than an average race car. Gravity becomes magnified to three times the Earth’s pull, about the same degree of force that plasters riders to the wall inside those spinning carnival rides at the amusement parks. Meanwhile, within the body, the “fight or flight” response goes into hyperdrive. Blood weighs more under the drag of gravity, so the heart must pump faster to push blood to the brain. Blood pressure and heart rate skyrocket, making those on board miserably dizzy, nauseated, and prone to passing out. And after surviving the launch phase, astronauts face other major dangers: quick losses in bone density and muscle mass from long stays in outer space, and a potentially dangerous drop in blood pressure during the rapid return to Earth and its higher gravity. If humans are ever going to fully colonize the International Space Station or fly a mission to Mars, scientists must find a way to overcome these physiological changes. NASA researcher Patricia Cowings believes she has a solution. In fact, she would like to make life in space a routine reality. Cowings, a psychologist at NASA Ames Research Center in Northern California, has spent the last 30 years designing a technique to rid astronauts of their peskiest of problems—air sickness—as well as other long-term effects associated with extended stays in space. “Our primary mission is to enable a permanent human presence in space— - not just to visit but to stay and to function and to thrive,” Cowings says. Cowings hopes to prepare astronauts for these strange new environments by teaching them to control the physiological responses that lead to motion sickness and blood pressure problems. In these training sessions, astronauts wear a specially designed vest that measures physiological responses like heart rate and blood pressure. Cowings then uses a method called biofeedback to train people to control the autonomic nervous system—the part of the body in charge of the fight or flight response. The technique is a kind of physical workout, but instead of doing weight-lifting reps to strengthen muscles, she says, “we’re exercising the control over heart rate.” The treatment could have earthbound applications as well. Mae Jemison, a former astronaut, recently licensed the technology and plans to market it for common medical problems such as nausea and anxiety disorders. When the space shuttle program first began in the ‘70s, air sickness was a huge problem for astronauts. Approximately 50 percent of shuttle crews experience symptoms of motion sickness during space travel. Cowings first began working on a cure when she landed a job at the space agency’s Ames center as a postdoctoral researcher in 1973. Five years later, she joined the staff as director of its psychophysiology lab. By the mid-1980s, the agency began using the drug promethazine to control air sickness, but Cowings continued the line of work she had started. She collaborated with Russian scientists who were interested in finding an alternative to promethazine, which could cause fatigue. Cowings had always approached the problem with a philosophy very different from a pharmaceutical fix, partly because she had wanted to push the limits of human ability since childhood. As the only girl among brothers in her family, Cowings grew interested in human potential—the uniqueness inherent in each person and their individual promise. “With three brothers, I noticed at nine years old that white men get all the jobs, she says. “I figured, I’m not a man and I’m brown.” But her father, a grocery store clerk, told her she could transcend her gender and skin color. She recalls him saying, “You’re a human being—look at it from the point of what you can do.” He inspired her to study psychophysiology, the interaction between the mind and the body, which Cowings views as an exploration of human potential. For instance, she asks, “How can you make yourself do better? What keeps you from getting ahead? How do you fix it?” Cowings’ interest in psychology was partnered with a fascination with outer space. “I discovered science fiction in high school and emptied the library,” she says. Her role models were communications officer Uhura on TV’s Star Trek—and astronaut Jemison, who was the first African-American woman to fly a space mission Cowings went on to study psychology in graduate school at the University of California in Davis. She describes herself at that time as “a Star Trek woman and a paranoid black child,” referring to her love of space and the lingering fear of how difficult it would be to succeed in the white male world. Then in 1969, U.S. astronauts landed on the moon. Inspired by such a landmark achievement in human potential, Cowings decided to bring her fascination with space travel into her psychology studies. She talked her way into an aeronautics course in the school of engineering. “They probably only let me in because I read so much science fiction,” she says, laughing. The course objective was to propose a new tool for the space shuttle. Cowings wrote a paper exploring 12 ways that psychophysiology research could be applied in space flight. She got an A. That class would seal Cowings’ future at NASA. “We went on a class field trip to NASA Ames, and I’ve been here ever since,” she says. AS SHE TACKLED the challenge of air sickness, Cowings figured that since people adapt very differently to stressful situations, the best cure would be one that was tailored to the individual. To devise such a remedy, she would first need to know how a person responds to stress, and the most accurate way to measure that would be to mimic the stressful event as closely as possible. So Cowings headed to the lab, where space physiology researchers were devising ways to recreate the harsh stresses of space. One of the tests NASA uses to see how a person will respond to the conditions of outer space is called the “G-test”: A volunteer spends hours inside a small, spinning room designed to create conditions mimicking the Earth’s gravity and 1.5 times Earth’s gravity. The result is a sort of human centrifuge, like the contraption in the movie “The Right Stuff.” Four hardy volunteers braved the centrifuge—which was outfitted with a bed, a TV, computer, and food—for 22 hours, acting as guinea pigs for Cowings and other researchers who wanted to study how long periods of high gravity affect the body. Researchers knew from shorter spin tests that tolerance to high gravity varies: Some people pass out at 1.5Gs, while others could handle 4 or 5Gs. Under high-gravity conditions, blood is pushed out of the head, causing people to black out or faint. Cowings wanted to know what causes the varied tolerances, so during the marathon spin she measured skin temperature, blood flow, heart rate, and respiration rate. Subjects also took tests in typing and word comprehension to measure cognitive and motor function. Cowings further tortured these spinning souls by asking them to lie down, sit up, and stand up for a few seconds at a time to see how their bodies would react under high-gravity situations. When you stand up, gravity draws blood to the feet. The body compensates by increasing heart rate and blood pressure to pump more blood to the brain. Cowings found that the best “adaptors”—those who could withstand the highest gravitational forces—were physiologically flexible. The most adaptable person in the experiment had a heart rate that jumped from 60 to 120 beats per minute when he stood, allowing him to compensate for changes in the stresses of gravity—but also making him more susceptible to motion sickness. The results from the G-test confirmed what Cowings suspected: that a successful solution would be one that works for everyone, adaptors and non-adaptors alike. During development, Cowings tried all the tricks in her psychologist’s toolkit—yoga and transcendental meditation, hypnosis, and most promising of all, biofeedback. Biofeedback might sound complicated, but it’s a simple idea. People can elicit physiological responses in different ways, says David Shapiro, a psychologist at the University of California in Los Angeles who has been researching biofeedback for the last 40 years. Walking fast and thinking about emotional memories can each drive up heart rate and blood pressure, two involuntary reactions. Biofeedback uses monitors to show people exactly what their body is doing, so they can learn to control the otherwise automatic responses. Cowings combines biofeedback with a tension-reducing technique called autogenic therapy, which is similar to self-hypnosis. She uses visualization exercises to show the trainee how to focus their attention on different muscle groups and learn to control them. For example, she might ask the astronaut to focus on the fingertips of the right hand. “Think about your hand getting warmer, and it will increase blood flow,” she says. With only a few hours in the astronaut’s busy schedule available for biofeedback training, Cowings had to make her technique quick to learn. She streamlined the training to six half-hour sessions. “You only have 30 minutes, and you have to get the astronaut to forget about the arguments he had with his wife, or the fact that he’s launching on Tuesday,” Cowings says. So she figured out how to make those short spurts as productive as possible—she uses hypnosis throughout the sessions to focus the subject’s attention. When training, the astronaut wears a special close-fitting white vest made from a cotton polyester blend that Cowings and her team designed. It’s loaded with wires and sensors that monitor everything from heart rate to skin tension. The trainee sits in a modified dentist’s chair, facing a series of computers that will display the body’s every reaction. Cowings then gets to indulge her sadistic side by yelling at the astronauts to get their heart rates pounding. In the first few training sessions, she determines how a person responds to stress and figures out which of the feedback displays work best for them. “You’re like a director in a band,” she says. “There are 20 different displays happening and you have to direct the person which one to pay attention to.” The process is similar to learning to use a joystick in a video game, where players get feedback by watching their performance on the screen and then correct their movements to improve their score. In the next session, trainees are sent on yet another carnival-like ride, this time in a rotating chair built to induce motion sickness. Blindfolded and strapped into the chair, each astronaut is then spun around to see how well he or she has learned to control the changes in blood pressure and heart rate without looking at the biofeedback monitors. In the following sessions, trainees return to the biofeedback monitors and work on further honing their skills—to see how quickly they can, say, increase their heart rate, hold it steady, and bring it back down. The last stage of training is to introduce environmental distractions, and that means more shouting from Cowings. “It’s fine if you can control physiological responses in a dark quiet room, but what about in the real world?” she says. After training with Cowings for six to eight hours, 85 percent of people can reduce their motion sickness, she says. And while most people learn to control their physiological responses to some degree, some truly excel. It’s impossible to predict who will be the “autonomic athletes,” as Cowings calls them, but one in four people qualify, learning to completely suppress motion sickness in just six hours. The ability doesn’t correlate with age, athletic ability, or education, and like any physical conditioning, it improves with practice. “It’s a talent—like playing music,” she says. And although astronauts seem to be a little bit better than most people at almost everything, when it comes to autonomic training, they are the same as everyone else. “A high school kid could come in and perform better than an astronaut,” she says. Only one in 20 people are “autonomic duffers,” those who can’t control their responses. COWINGS’ TECHNIQUE is still experimental. Her research is promising, but more in-flight research is necessary to determine if her technique is practical, says Malcolm Cohen, a branch supervisor at NASA Ames who also studies adaptability to high gravity. Extensive testing of her system in space isn’t likely to happen soon; with limited flight time and small crews, getting clearance to conduct an experiment in space can take years. “When you do experiments in space, you get in line behind the rest of the world,” Cowings says with a sigh. NASA also needs to determine if the technique is something the astronauts want to learn. Cowings says she has encountered some resistance against using the vest from pilots and astronauts. “They think it’s silly, and they don’t want to have anything to do with psychologists,” Cowings says. But when she portrays the technique as just another type of physical training, like a bench press, they seem to be more accepting, she says. Interestingly, Russian cosmonauts are more open to the biofeedback technique, probably because they’re more familiar with behavioral conditioning, says Cowings, noting that Pavlov, the psychiatrist who made dogs salivate at the sound of a bell, was Russian. For Cowings, the roadblocks are frustrating. In a study published in the Journal of Clinical Pharmacology in 2000, she found that her training exercise was much more effective at controlling motion sickness than promethazine. NASA gives the same drug treatment to everyone, regardless of their size, she says. “That’s not the scientific method, that’s the shotgun approach.” Whereas the drug can cause drowsiness, the benefit of the biofeedback technique is there are no side effects and it can be tailored to meet a person’s needs, she added. “One guy says he’s fine but faints, and another guy who is a good adaptor throws up. You can’t tell who is going to be susceptible to different disorders,” Cowings says. “We’re just now getting to agree that not one treatment works for everyone.” Cowings sees a place for her biofeedback vest beyond the astronaut world, in helping ordinary people handle anxiety or nausea. “There are lots of situations where your heart rate goes up—[such as] before a test or a speech,” she says. We’ve only touched the tip of the iceberg in the number of medical applications,” Cowings says. Cowings is working with Jemison, whose Houston-based medical technology company, Biosentient, is developing a portable, commercial version of the monitoring vest and display system for mainstream medical use. Biosentient researchers have been taking advantage of advances in wireless communication and power efficiency “to make a truly portable garment,” says Jemison, who is a doctor and chemical engineer. “It’s something people can wear over the course of the day, under a suit.” They now have a prototype which different research groups will take for a test drive in the upcoming year. Scientists or doctors could use the future biofeedback outfit—consisting of both a shirt and shorts—to track the activities of a person’s autonomic nervous system for different purposes. For instance, psychologists could use it during therapy session to help patients learn to manage their anger. Or patients with fear of flying or other phobias could wear the garment in a plane or whatever environment triggers their fears. Jemison says the outfit could be useful even without the biofeedback training. Professional athletes could wear the garment and have their vital signs monitored by trainers, who could spot the early warning signs of, say, heat stroke, from overtraining in the summer. Once the monitoring system is available, Jemison’s next step will be to conduct clinical trials testing whether a reliable and easy-to-use biofeedback protocol could help treat ailments that are tied to the autonomic nervous system, such as motion sickness and some anxiety disorders. Whether or not the tool developed for astronauts will find a market on Earth is unclear. Biofeedback first became popular in the ‘60s and ‘70s, but later fell out of favor partly because of a lack of research proving its effectiveness. Compared with existing biofeedback systems, the new NASA technology offers the important advantage of portability, but it still might come up against the same roadblock that Cowings had with pilots—a prejudice against what is often viewed as a “touchy-feely” treatment. Although the technique is used in treating a variety of conditions, from anxiety disorders to tension headaches to temporomandibular joint disorder, biofeedback has never really moved into the medical mainstream, says UCLA’s Shapiro. “It can be useful in cardiac arrhythmias and hypertension, but it’s not part of standard medial practice.” As a result, clinical use is holding steady rather than expanding. For now, Cowings says her number-one clients are the astronauts. She’s trying to get one of her vests up to a cosmonaut aboard the space station, but can’t get through the NASA bureaucracy. “I just keep working away in the basement,” she says. “I’ll keep doing this until I die or we get to Mars, which ever comes first.”