Spirituality and Healing in Medicine

1. Spirituality and Healing in Medicine Dr. Phil Shapiro

2. The Convergence of Spirituality, Healing, and Medicine • The convergence of spirituality, healing, and medicine offers exciting new possibilities. • The Seeker: a personal, private spiritual experience becomes medically relevant with the advent of mind-body medicine. • Mind-body medicine: • People with an active faith or belief system have better outcomes in medicine, surgery, mental health, and addiction.

3. Mind-body Medicine • The scientific connection between spirituality and healing has been made. • Spiritual belief systems have a role in healing body, mind, and soul. • When we activate or intensify our spiritual belief systems, healing power expands. • This gives health care professionals, patients, and everyone access to an expanded reservoir of healing power. • This is very good news. However, this is not easy to do in medical practice. • There are many barriers.

4. Problems Entering the Spiritual Domain • We don’t work with Spirit. • We are not comfortable talking about religion. • We have no language or map. • We ignore or refer to spiritual counselors. • Lack of training • Belief systems are personal, intimate, complex. • Many have a traumatic religious history. • Fierce feelings and defensiveness • Fear of unravel to the abyss (The Cheeseburger) • Enormous variation and level of commitment • There is no time—brief appointments, paper work… • How to enter without losing life, limb, or property.

5. Guidelines for Approaching Belief Systems • Access: we need models that give us safe, efficient, effective access to the territory of belief systems. • Map: how to get there • Language: how to talk to each other and our patients about religion and spirituality • Keys: to enter the territory of belief systems so we can get in and out safely and effectively. • An efficient delivery system: so we can help our patients learn how to do this work when we are already too busy

6. Guidelines for Approaching Belief Systems • Universal and inclusive • Look for universal of near-universal spiritual healing principles, methods, and qualities. • Design models that can work for as many as possible. • Include atheist, agnostic, religious, and spiritual persons.

7. Guidelines for Approaching Belief Systems • Individualize • Stay in religion of origin and expand practice or • Build your own program. • Root cause and solution • Look for root causes and solutions to our deepest suffering. • User-friendly • Yet remain user-friendly and non-invasive as possible.

8. Universal Spiritual Healing Models • To address these issues, I will present two models: • Brutal Reality and the Illusion of Safety, Security, and Immortality (1980) • Healing Power: Ten Steps to Pain Management and Spiritual Evolution (2005)

9. Integrative Medicine Where Spirituality fits in the spectrum of medical practice • Biological high-tech medicine has great power but alone can be reductionistic, often leading to symptom management without getting to the root causes of disease. • Integrative medicine includes biopsychosocial and spiritual aspects. • Look for the root causes of disease and healing here.

10. Integrative Medicine Four evidence based healing universes • Biological • Traditional medicine • CAM: Complimentary and alternative medicine • Psychological • Social • Spiritual • Mind-body medicine

11. Spirituality and HealingEvidence-based: the data • It is now scientifically validated that people with an active faith or belief system have better outcomes in medicine, surgery, mental health, and addiction. • Includes cancer, coronary artery disease, cerebrovascular disease, hypertension, asthma, COPD, infectious diseases, kidney disease, and more. • Lower medication rates • Lower length of stay • Higher quality of life • Much more

12. Spirituality and HealingEvidence-based: the data • Suggested reading: • Herbert Benson M.D.: Timeless Healing: the Power and Biology of Belief • Jeff Levin PhD: God, Faith, and Health • David Larson M.D. • Larry Dossey M.D. • Dale Mathews M.D. • Harold Koenig M.D.

13. Spirituality and HealingThe Mechanism • Community: support from like-minded people • Behavior: good habits such as no smoking, drinking, or drugs; healthy diet • Thought: the power of positive thought--faith, hope, belief, optimism, and much more • Feeling: the healing power of positive emotion such as peace, love, joy, compassion • Spiritual practice: expansion of the healing power from spiritual practices such as yoga, meditation, mindfulness, and prayer

14. Mind-body Medicine • Mind-body medicine teaches us how to apply the power of the mind to healing and pain management. • Most medical schools now address mind-body principles in their general curricula.

15. Mind-body Medicine Principles • There is no separation between mind and body. • The mind is connected to every cell in the body. • In some yet to be determined way, thoughts have leverage in the inner workings of our cells having to do with: • disease and healing • pain management

16. Mind-body Medicine Principles • We can harness the untapped power of the mind for: • expansion of healing power • pain control

17. Mind-body Medicine Principles • Pain Management • Often we cannot take disease away, but we can always help with pain management. • Pain is both physical and psychological. • All pain is experienced in the mind and can therefore be modulated by the mind. • We can control pain so pain does not control our lives.

18. Mind-body Medicine Principles • Pain Management • The fear factor: we are afraid of disease, disability, suffering, the unknown, and death. • This mental distress slows down healing and makes the pain worse. • When disease persists, we can teach people to slow down and relax so they can stay in charge and get their lives back.

19. Mind-body Medicine Principles • We think of high-tech medicine as real and mind-body principles as touchy-feely. This is reductionistic and wrong. • We are biopsychosocial and spiritual beings. A disturbance in any one of these leads to disturbances in the others. • Therefore, comprehensive treatment planning includes biopsychosocial and spiritual interventions. • There are many ways to do this. No one way works for all people

20. Activating Healing PowerIn Four Domains • There is an explosion of knowledge and models having to do with healing in each of the four domains: biopsychosocial and spiritual • However, there is no time to do it all: Managed care, fifteen minute appointments, paper work, and so on • How can we activate healing power in all four domains given the limitation of time and system problems? • Good news: it can be done through skills training and self-help

21. Self-help and Skills Training • Self-help: much of the healing in the psycho-social-spiritual domain is self-help • Skills training: classes, groups, books, manuals, internet, tapes, CD’s, DVD’s • We can teach people how to increase healing power while in the comfort of their own homes or during the day while performing their routine activities

22. Personal Spiritual history • Before discussing the models, a brief personal history • From personal to universal • To enter the spiritual domain, we need to learn how to move with facility from our personal religious or spiritual experience to the universal. • In that light, I will share with you a very brief history of my religious-spiritual journey as it relates to professional work. • As you listen, find yourself and your patients in these stories and models.

23. Personal Spiritual History • Seventh month of fetal life: an early introduction to brutal reality • Conservative Judaism • The dynamics of unraveling a belief system • The Cheeseburger • The Chess game: the King goes down • The Abyss: the unknown, the great mystery of life

24. Personal Spiritual History • Whether we stay in our religion of origin or not, belief systems remain monumentally important. • Belief systems give us: • The meaning and purpose of life • Story and metaphor • Cultivation of spiritual qualities • Inspiration • Protection and guidance • Truth • Healing • Community and service • Much more

25. Personal Spiritual History • The Seeker • Mining the great religious fields for pearls. • Studies in Christianity, Hinduism, Buddhism, Judaism, Native American Spirituality, others • Review the lives of saints, sages, teachers, masters. • Develop a spiritual practice: meditation, mindfulness, affirmations, prayer.

26. Brutal Reality and the Illusion of Safety, Security, and Immortality • Dual diagnosis process group at Harlem Hospital • The emergence of a model • Criteria • Brutal reality and higher states of consciousness • Connect the dots between pain and healing • Healing power: where is the leverage

27. Brutal Reality and the Illusion of Safety, Security, and Immortality • People • Activities • Belief System • Self-knowledge • Brutal Reality • The Illusion of Safety, Security, and Immortality

28. Belief Systems • Spiritual, religious, political, national, cultural, racial, familial, psychological, personal • Mechanism of perpetuation in health and disease • Thought repetition with denial and repression of conflicting data • The cheeseburger effect: a single countervailing thought or action has the potential to unravel an entire belief system, thrusting the individual into the unknown, the abyss. This is equivalent to psychological annihilation or death.

29. Belief Systems • Defense and resistance • The Living Room • Simple fixed belief systems • Eclectic synthetic belief systems • The abyss between simple fixed and eclectic synthetic systems • Intra-psychic battle for healing

30. A Universal Prescription For Any Pain, Problem, or Symptom • Tell your patients they can enhance healing when these four domains are active and positive: • People • Activities • Belief System • Self-knowledge • You can prescribe these with confidence: each is evidence-based.

31. A Quick Assessment for the Busy Practitioner A quick, efficient, and safe entry into the psychosocial and spiritual domain for the busy practitioner: • People: Who is in your life that you can really talk to? • Activities: What is your day like? • Belief system: Do you have a spiritual activity such as church, personal system, prayer, etc. • Self-knowledge: How do you handle emotions such as anger, depression, fear, and guilt?

32. Brutal Reality and the Illusion ofSafety, Security, and Immortality Exercise • Describe how the six components weave the fabric of your life. • Focus on how you use people, activities, belief system, and self-knowledge to shift from brutal reality to a feeling of safety. You might want to use the handout to help you diagram your story. • Describe how the six components drive the lives of patients, family, friends, strangers, and enemies.

33. Mind-body MedicineHerbert Benson M.D. • Conference in Chicago on spirituality and healing in medicine • Day one: science • Day two: religion • Day three: applications

34. Mind-body MedicineHerbert Benson M.D. • Day one: scientific proof of the healing power of faith and belief • Research data: people with an active faith or belief system have better outcomes in medicine, surgery, mental health, and addiction.

35. Mind-body MedicineHerbert Benson M.D. • Day two: religion • Rabbi, priest, Hispanic Pentecostal, Florence Nightingale mystic, Tibetan Buddhist PHD—former secretary of the Dalai Lama, Islamic professor and teacher • Each discussed healing principles, methods, and qualities within their tradition.

36. Mind-body MedicineHerbert Benson M.D. • Day three: application • Extract the healing principles, methods, and qualities from the great faith traditions, organize them into cognitive-behavioral or mind-body medicine practices. • Practice these ourselves and teach them to our patients.

37. Cascadia: Spirituality and Healing Group • Clinic survey • Create a group and manual using the criteria described earlier. • Two groups: • One is now consumer run • The other is ongoing at the Northwest Institute for Healing Power • The Ten Step Model

38. Healing Power: Ten Steps to Pain Management and Spiritual Evolution Steps 1-5: The evolution of suffering • The Core Drive • Duality and Brutal Reality • The Compromise • Bad Habits • Tools Become Barriers

39. Ten Steps Steps 6-10: Spirituality and healing • The Seeker • Soul and Spirit • The School of Life • Spiritual Practice • Spiritual Experience

40. Step 1: The Core Drive • We want: • Unlimited peace, love, joy, and safety • No suffering • Immortality: more time • This is our motivation whether robbing a bank or serving the poor.

41. Step 2: Duality and Brutal Reality • Life on the physical plane is dual and brutal. • Duality • The ups and downs of life • Pleasure and pain, good and evil, health and disease, success and failure, wealth and poverty, gain and loss, praise and blame, joy and sadness, love and hate, war and peace, and so on • Brutal Reality • Death, pain and suffering, and the unknown • The down side of duality

42. Step 3: The Compromise • There is a collision between the core drive and duality. • We can’t get everything we want on the physical plane. • We compromise by creating the illusion of safety through relationship and activities. • In the compromise, we may feel comfortable and safe.

43. Step 3: The Compromise • However, suffering is unavoidable. • Often we do not accept the inevitable suffering of life. • Instead, we make a desperate attempt to eliminate all of our suffering through faulty mechanisms such as the cultivation of bad habits.

44. Step 4: Habits • We seek eternal love and safety in a world where impermanence and limitation are the rule. • In a mighty but misguided effort to eliminate suffering, we develop bad habits. • Bad habits have a profound effect on our health and our response to health care interventions.

45. Alcohol Drugs Food Sex Power Shopping Gambling Money Materialism Computers/Internet TV Work Codependency Hyperactivity Violence Crime Step 4: Habits

46. Step 5: Tools Become Barriers • We use six tools to achieve the core drive. • While these tools are useful in helping us find some measure of peace, love, safety, and pain relief, they become problems themselves and add to our suffering.

47. Step 5: Tools Become Barriers The six tools are: • Mind • Emotion • Desire • Body • Activity • Ego

48. Step 5: Tools Become BarriersIn Alignment The six tools in alignment: • Mind: when positive, calm, and focused, it is brilliant at solving problems and shaping meaning. • Emotion: a source of self-knowledge • Desire: health, prosperity, and love • Body: engage life, the doer of all of our activities, carrier of higher states of consciousness; the source of our potential liberation and enlightenment • Activity: work, recreation, culture, hobbies • Ego: establish our place in the world of work and relationships

49. Step 5: Tools Become BarriersOut of Alignment The six tools out of alignment: • Mind: restless, relentless, a life of its own • Emotion: high emotional reactivity • Desire: excessive material desire resulting in attachments and bad habits • Body: heavy, tired, hurts, disability, death • Activity: hyperactivity • Ego: separation, selfishness, territorial, self-important

50. Step 5: Tools Become Barriers The six tools out of alignment: • The universal patient: does anyone not have this? • Fixation: pin us to the mat of the status quo • Root cause: the root cause of much of our suffering • Add ons: some people refer to these as add ons. • the suffering that we add to the inevitable suffering of life.