SPIRITUALITY HEALTH & HEALING

1. SPIRITUALITY HEALTH & HEALING IMPLICATIONS FOR PROFESSIONAL PRACTICE Jonathan Robison, PhD, MS

2. "DISEASES OF CIVILIZATION" CHRONIC CONDITIONS • Related to stress, diet, drug abuse, • sedentary living, pollution, etc • 85% of U.S. health care costs • Conventional medicine less effective

3. HEALTH CARE IN CRISIS • 60% of doctor visits are for complaints with no physiological basis • 25% of office visits are for problems patients could treat themselves • 20% of 1992 health care costs ($134 billion) spent on unnecessary procedures & services

4. SCIENTIFIC REVOLUTION "MECHANISTIC" WORLD VIEW • Universe = a great machine • Nature = huge clock, dead & inert • No purpose, life or spirituality in matter

5. 17th CENTURY SCIENCE MECHANISTIC REDUCTIONIST DUALISTIC Whole = sum of it's parts Analysis = to break down Matter and spirit separate

6. MATTER & SPIRIT SEPARATE MATERIAL UNIVERSE - objective, quantitative & measurable IMMATERIAL UNIVERSE - subjective, qualitative & immeasurable

7. 17th CENTURY SCIENCE RENE DESCARTES " I do not recognize any difference between the machines made by craftsman and the various bodies that nature alone composes "

8. 17th CENTURY SCIENCE RENE DESCARTES “I consider the body as a machine ...my thought...compares a sick man and an ill-made clock with my idea of healthy man and a well-made clock "

9. 17th CENTURY SCIENCE RENE DESCARTES " There is nothing included in the concept of the body that belongs to the mind; and nothing in that of the mind that belongs to the body "

10. MEDIEVAL VALUE SYSTEM "ORGANIC" WORLD VIEW • Universe = organic, living, spiritual • Nature = material & spiritual • Science = reason and faith • Purpose = live in harmony with nature

11. 17th CENTURY SCIENCE PURPOSE: " To torture nature's secrets from her, so she can be forced out of her natural state and squeezed and molded" Sir Francis Bacon

12. PATRIARCHY " Man is more courageous, pugnacious, and energetic than woman, and has more inventive genius." Charles Darwin

13. THE HUMAN "MACHINE" • Spirit Church • Body Medical Science • Mind Psychiatry

14. THE BIOMEDICAL MODEL • Human Beings = machine • Disease = biological malfunction • Doctor = repairman • Physical determinants of disease • Curing vs. Healing

15. CORONARY HEART DISEASE

16. CORONARY HEART DISEASE POOLING PROJECT STUDY • Combined first 6 big CHD studies • 7300 men followed for 10 years • Smoking, Cholesterol, Blood Pressure

17. CORONARY HEART DISEASE POOLING PROJECT STUDY • 80% with 3 risk factors did not have MI • 90% with 2 risk factors did not have MI • Most MI's in people without risk factors

18. " ESSENTIAL " HYPERTENSION

19. ???????????????? Unlike machines, human beings have personalities, thoughts, feelings, and emotions, all of which appear to contribute significantly to our resistance to illness and our ability to heal ourselves.

20. THE RESEARCH BIOLOGY & BELIEF The Mind / Body / Spirit Connection

21. PLACEBO " treatment or aspect of a treatment that does not have a specific action on a patient's symptom or disease...an inactive substance...a procedure with no therapeutic value " Dorland's Medical Dictionary

22. THE PLACEBO EFFECT 25-35% of patients consistently experience satisfactory relief when placebos are used instead of regular medicines or procedures for a broad range of medical conditions

23. THE PLACEBO EFFECT ANGINA PECTORIS • 5 treatments from 1930’s & 1940’s • initial studies 70-90% effective • later studies 30% "placebo” effective

24. THE PLACEBO EFFECT " you should treat as many patients as possible with the new drugs while they still have the power to heal " Dr. Armand Trousseau

25. THE PLACEBO EFFECT: PAIN " the quality of the interaction between the patient and the physician can be extremely influential in patient outcomes, and, in some (perhaps many) cases, patient and provider expectations and interactions may be more important than the specific treatments " Turner, JAMA, 1994

26. THE PLACEBO EFFECT • Increase hair growth in balding men • Increase lung capacity in asthmatic kids • Pain relief equal to real surgery • Ipecac cures nausea and vomiting NY Times, Oct. 13, 1998 Wolf, J. Clin. Invest. 1950

27. THE “NOCEBO” EFFECT “ The causation of sickness or death by expectations of sickness or death and by associated emotional states.”

28. THE “NOCEBO” EFFECT • cardiac death in women fearful of MI • Increase airway resistance in asthmatics • Real rashes caused by fake poison ivy • Hair loss caused by fake cancer drug NY Times, Oct. 13, 1998 Hahn, Prev Med, 1997

29. PERCEIVED HEALTH "For your age would you say, in general, your health is excellent, good, fair, poor, or bad?" • 3500 seniors • Examined by physicians • 7 year follow-up • Control for risk factors/prior illness

30. ...AND MORTALITY RESULTS • " Poor " health 3 times more likely to die • Better predictor than tests and exams • At least equal to traditional risk factors

31. OPTIMISTIC OUTLOOK • Success result of personal efforts • Failure result of others, bad luck • Crisis temporary challenge • Feelings of control over life

32. PESSIMISTIC OUTLOOK • Success due to others, luck • Failure due to personal faults • Crisis overwhelming obstacle • Feelings of lack of control over life

33. OPTIMISM AND HEALTH • Increased survival following heart attack • Increased survival with breast cancer • Less illness, fewer doctor visits • Stronger immune system

34. PSYCHONEUROIMMUNOLOGY P N I Psycho mind and emotions Neuro brain & central nervous system Immun defenses against disease

35. NEUROPEPTIDES • Dopamine • Serotonin • Endorphin • Epinephrine • Acetylcholine “ The brain is like a bag of hormones ” Pert, Molecules of Emotion

36. RECEPTORS • Single molecule • Floating on cell or attached to membrane • Vibrating and changing shape • 70 different types of receptors per cell • Cell can have millions of receptors • Sensing molecules - scanners

37. THE CHEMICAL BRAIN “ The life of a cell…is determined by which receptors are on its surface, and whether those receptors are occupied…these minute physiological phenomenon on the cellular level can translate to large changes in behavior, physical activity, even mood.” Pert, Molecules of Emotion

38. THE CHEMICAL BRAIN “ Every change in the physiological state is accompanied by an appropriate change in the mental emotional state, conscious or unconscious, and conversely, every change in the mental emotional state…is accompanied by an appropriate change in the physiological state.” (Dr. Elmer Green Biofeedback, p.137)

39. EMOTIONS • Basic Experiences • anger, fear, sadness, joy, contentment, courage • Basic Sensations • pain and pleasure • Drive States • hunger and thirst • Subjective Experiences • awe, bliss, spiritual inspiration

40. PSYCHOSOMATIC NETWORK • Cholecystokinin(CCK) Influences hunger and satiety Increased levels lead to feelings of fullness Receptors for CCK located in: • brain • gall bladder • immune system FUNCTION? (Pert, Molecules of Emotion)

41. THE MIND “ Flow of information as it moves among the cells, organs and systems of the body …intelligence in the form of information running all the systems and creating behavior” (Pert, Molecules of Emotion)

42. THE “BODYMIND” “ The immune system, like the central nervous system, has memory and the capacity to learn. Thus…intelligence is located not only in the brain but in cells that are distributed throughout the body, and the traditional separation of mental processes, including emotions, from the body is no longer valid.” (Pert, Molecules of Emotion)

43. PNI RESEARCH • Multiple personalities • "Pessimism" in animals & humans • Stress and the common cold • Stress and wound healing • Mother Theresa

44. PNI RESEARCH • Multiple personalities • "Pessimism" in animals & humans • Stress and the common cold • Stress and wound healing • Mother Theresa • Relaxation, social support

45. CONNECTEDNESS SOCIAL RELATIONSHIPS • People with the fewest social ties have • 2-3 times higher mortality rates • independent of risk factors, SES, life • satisfaction, etc. • Rosetto Effect

46. LOVE & INTIMACY " I am not aware of any other factor in medicine - not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery - that has a greater impact on our quality of life, incidence of illness, and premature death from all causes." Dean Ornish

47. THE HARVARD STUDY OF ADULT DEVELOPMENT • 824 men and women • Followed for more than 60 years • Variety of backgrounds • Regular physical & psychosocial evaluation Aging Well: Surprising Guideposts To A Happier Life by George E. Vaillant

48. THE HARVARD STUDY OF ADULT DEVELOPMENT WHAT PREDICTS POSITIVE AGING? A good marriage at age 50 Low cholesterol at age 50 Aging Well: Surprising Guideposts To A Happier Life by George E. Vaillant

49. RELATIONSHIPS & CANCER • 86 metastatic breast cancer patients • Weekly 90-minute support group - 1 year • 1/2 pain and suffering, decreased anxiety • depression, fatigue, confusion, etc. Spiegel

50. RELATIONSHIPS & CANCER HEALING VS. CURING " even a confrontation with death in the form of a terminal illness could be a period of growth and life enhancement rather than emotional decline " Spiegel