SPIRITUALITY

HEALTH & HEALING

IMPLICATIONS FOR

PROFESSIONAL PRACTICE

Jonathan Robison, PhD, MS

"DISEASES OF CIVILIZATION"

Related to stress, diet, drug abuse, sedentary living, pollution, etc

85% of U.S. health care costs

Conventional medicine less effective

CHRONIC CONDITIONS

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

HEALTH CARE IN CRISIS

SCIENTIFIC REVOLUTION

"MECHANISTIC" WORLD VIEW

Universe = a great machine

Nature = huge clock, dead & inert

No purpose, life or spirituality in matter

17th CENTURY SCIENCE

MECHANISTIC

REDUCTIONIST DUALISTIC

Whole = sum of it's parts

Analysis = to break down

Matter and spirit separate

MATTER & SPIRIT SEPARATE

MATERIAL UNIVERSE - objective, quantitative & measurable

IMMATERIAL UNIVERSE - subjective, qualitative & immeasurable

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 "

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 "

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 "

MEDIEVAL VALUE SYSTEM

"ORGANIC" WORLD VIEW

Universe = organic, living, spiritual Nature = material & spiritual Science = reason and faith Purpose = live in harmony with nature

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

PATRIARCHY

" Man is more courageous,

pugnacious, and energetic than

woman, and has more inventive

genius."

Charles Darwin

THE HUMAN "MACHINE"

Spirit Church

Body Medical Science

Mind Psychiatry

Human Beings = machine Disease = biological malfunction Doctor = repairman Physical determinants of disease Curing vs. Healing

THE BIOMEDICAL MODEL

CORONARY HEART DISEASE

CORONARY HEART DISEASE

POOLING PROJECT STUDY Combined first 6 big CHD studies

7300 men followed for 10 years

Smoking, Cholesterol, Blood Pressure

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

" ESSENTIAL "

HYPERTENSION

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.

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THE RESEARCH

BIOLOGY & BELIEF

The Mind / Body / Spirit Connection

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

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

THE PLACEBO EFFECT

ANGINA PECTORIS 5 treatments from 1930’s & 1940’s

initial studies 70-90% effective

later studies 30% "placebo” effective

Dr. Armand Trousseau

THE PLACEBO EFFECT

" you should treat as many patients

as possible with the new drugs while

they still have the power to heal "

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 thanthe specific treatments "

Turner, JAMA, 1994

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

THE “NOCEBO” EFFECT

“ The causation of sickness or death

by expectations of sickness or death

and by associated emotional states.”

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

PERCEIVED HEALTH

"For your age would you say, ingeneral, your health is excellent, good, fair, poor, or bad?"

3500 seniors Examined by physicians 7 year follow-up Control for risk factors/prior illness

...AND MORTALITY

RESULTS " Poor " health 3 times more likely to die

Better predictor than tests and exams

At least equal to traditional risk factors

OPTIMISTIC OUTLOOK

Success result of personal efforts

Failure result of others, bad luck

Crisis temporary challenge

Feelings of control over life

PESSIMISTIC OUTLOOK

Success due to others, luck

Failure due to personal faults

Crisis overwhelming obstacle

Feelings of lack of control over life

OPTIMISM AND HEALTH

Increased survival following heart attack

Increased survival with breast cancer

Less illness, fewer doctor visits

Stronger immune system

PSYCHONEUROIMMUNOLOGY

P N I

Psycho mind and emotions

Neuro brain & central nervous system

Immun defenses against disease

NEUROPEPTIDES

Dopamine Serotonin Endorphin Epinephrine Acetylcholine

Pert, Molecules of Emotion

“ The brain is like

a bag of hormones ”

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

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

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)

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

PSYCHOSOMATIC NETWORK Cholecystokinin (CCK)

Influences hunger and satiety

Increased levels lead to feelings of fullness

Receptors for CCK located in:braingall bladderimmune system

(Pert, Molecules of Emotion)

FUNCTION?

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)

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)

PNI RESEARCH

Multiple personalities

"Pessimism" in animals & humans

Stress and the common cold

Stress and wound healing

Mother Theresa

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

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

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

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

THE HARVARD STUDY OF ADULT DEVELOPMENT

Aging Well: Surprising Guideposts To A Happier Life by George E. Vaillant

WHAT PREDICTS POSITIVE AGING?

A good marriage at age 50

Low cholesterol at age 50

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

RELATIONSHIPS & CANCER

HEALING VS. CURING

Spiegel

" 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 "

RELATIONSHIPS & CANCER

5-year follow-up to disprove psychosocial interventions could prolong life

Women in support group lived twice as long

Only women in support group survived

Spiegel

CONNECTEDNESS

TOUCH

Rabbits Infants

THE POWER OF TOUCH

47% greater weight gain

more active, alert, mature

6 fewer days in hospital

$3,000 savings per infant

Field, Pediatrics, 1986

"HOLISTIC" HEALTH

“KAILO”

whole, uninjured & of good omen

HEALTH

Whole Holy

"BIOMEDICAL" FOCUS

RISK FACTORS FOR DISEASEblood pressurecholesterolHDL, LDLcholesterol ratioblood glucosetriglyceridessmoking, drinkingabdominal strength

cardiovascular fitnessupper body strengthflexibilityback careweightwaist / hip ratiobody fat %fat, Na, sugar, fiber

"HOLISTIC" FOCUS

SUPPORTIVE FACTORS FOR HEALTHpurpose in lifespiritual connectionssocial supportwork satisfactionemotional healthoptimism / hopefulnessperceived happinessperceived healthaltruism

intellectual stimulationrestful sleeptime alonepleasure and playfinancial resourceslaughter / humormovementnormal eatingcontact with nature

" It is more important to know what

sort of person has a disease than

what sort of disease a person has "

Hippocrates