Spirituality and Its Relationship to Health & Longevity Richard H. Cox, MD, PhD, DMin, ABPP,DAAPM Affiliations & Disclosures Richard H. Cox, MD, PhD, DMin, DAAPM Adj. Professor, Dep't. Psychiatry, Neurology, Behavioral Science Duke University Medical School, Durham, Scholar, Georgetown Univ. Medical School, Center for Clinical BioEthics, Washington, DC Disclaimer: There are no commercial financial relationships. Learner Objectives Define spirituality as relates to health. List at least five ways spirituality directly effects health and illness Identify at least five ways that spiritual thinking/application might improve your practice Critique current mental/physical medical practice in the light of today s presentation
Defining Spirituality To believe in nothing is to believe in something thus producing the results of that belief R.Cox Spirituality = the emotive being connected to a higher power Religious = the observance/acts of a specific form of belief Separating the two is largely artificial: Religion from Latin re & ligare, (i.e., to tie-back) Ties back to both emotion and behavior, hence religio-spiritus Defining Health Holos Gr. word for whole, holy, holiness, health Holokleria Gr.word for completeness Health is more than: the absence of illness physical well-being emotional well-being Health is that state of homeostasis that requires a perfect balance of thought, physiology and spirit R.Cox Anomalies in Spirituality, Health, and Healing, in Spirituality & Psychological Health, 2005 Relevance of Spirituality to Health There is an emerging plethora of literature attesting to the effects of belief on both health and illness. (McCullough, 1999; Miller, 1999; Richards & Bergin, 2000, 2005; Sperry & Shafranske 2005; - Psychology of Religion & Spirituality, Vol. 1, #2.; McBride, Arthur,Brooks & Pilkington 1998 Family Medicine, Feb. 1998) The majority of patients profess a theistic faith system (78-92%) while only 23-30% of health providers claim such. (Gallop Poll, 2006) Requests for Chaplains at Brigham up 23% since 2004, at Mass. General up 30% since 2006. (Gallop Poll, 2006)
Relevance of Spirituality to Health Found to be beneficial in virtually all illness. (Journal of the American Medical Association, Vol. 299, # 20) Spirituality awareness now considered essential in Behavioral Science training. (Psychology of Religion and Spirituality Journal, Vol. 1, #2) Hippocrates and Galen both advised: Pray and see the physician! Distinguishing Between Pain and Suffering Some persons have pain and suffering Some persons have pain and little or no suffering Some persons have suffering and little or no pain Pain is a nociceptive physiological process Suffering is an emotional existential process They may and often become Siamese twins Pain produces suffering and suffering produces pain Spiritual Beliefs and Practices Directly Effect Health and Illness Well documented mind/body connection Limbic system translates visceral & external signals into behavior That which is believed is always true i.e. all behavior is purposeful Beliefs control biology conditioned response cultural/individual and societal determinants
Modern Technology Provides New Information f MRI specific locations of emotional activity (Logothetis, Max Planck Institute, Germany; University of Pennsylvania) Biological Cybernetics (Illinois, Florida, Emory, Universities) National Library of Medicine over 82,000 studies, more than 4,600 in 2009 The Genome Project DNA, RNA, genetic knowledge predictability of health/illness (cf.collins) Comparison of Erikson s Developmental Paradigm and Cox s Spiritual Development Paradigm Erikson s Stages Trust vs. mistrust Autonomy vs. shame and doubt Initiative vs. guilt Industry vs. inferiority Identity vs. role confusion Generativity vs. stagnation Ego integrity vs. despair Cox s Stages Belief Spiritual self-hold apart from universe Self-affirming faith Positive productive faith Established personal belief Interpersonally shared belief system Contributory belief system Confident internalized hope It is important to understand where both healer and patient are in their Spiritual Developmental Journey
Spirituality is a Process Spirituality is not a technique Spirituality is not a modality Spirituality is not a religion Spirituality is not what you do but who you are Spirituality is not something you have but what you are getting Spirituality is not gotten and lost, but challenged and refreshed Biology and Belief Not mind over matter, but mind and matter The moment we encounter God, or the idea of God, our brain changes Newberg, A. (2009) Anatomy validates ability to believe occipital parietal: identifies God as object parietal-frontal: relationship ability frontal: ability to integrate belief/relationship thalamus: establishes emotional meaning amygdala: grants authority status striatum: emotional safety in presence of God-thoughts (Newberg, A, 2009) Smart Cells Cells are living organisms: want to survive remember structure and function microscopic people gene changes are external or environmental epigenetic control possible (Lipton, B. 2005)
Thinking and Being Cartesian theory now proven wrong: Mind/body research Ancients were right: As we think, we are (Prov. 23:7 RSV Holy Bible) Psychosomatic/somatopsychic medicine Psychotherapy vs.psychopharmaceutical Lifestyle,mindfulness, happiness, positivity (Newberg, A. 2006; Mace, C.,2006; Dali Lama,1998) Benefits of Spiritual Thinking Promise of potential healing Promise of less pain Hope Resources Networking Motivation Shares credit/blame Tranquility from illness through hospice Patient-Healer Benefits From Spirituality HOPE the attitude of both patient and healer they feed on each other CONNECTIONS the team, chaplains, church/synagogue, the family of believers RESOURCES The Holy Books, Sacraments, Prayer, Anointing with Oil MOTIVATION the higher purpose of life PERSONAL GROWTH Forgiveness, transcendence, being more than patient and more than provider
Applications for the Healer and Spiritual Growth Steps to enhance the journey: Contemplation/prayer Self-assessment mentor may be helpful See healer as person not provider Practice transcending problems, burdens, and that for which there are no answers Acceptance of professional and personal limitations. Explore/risk/experiment with applications of the spiritual life with patients, i.e., pray, listen, comfort, read, support chaplain, minister, etc. Science without religion is lame. Religion without science is blind. Einstein (1941) References and Readings Anderson, U., Immunology of the Soul, Health Access Press, Sanford, FL.,2001 Corrigan, J. (Ed.), Religion and Emotion, Oxford, NY 2004D Cox, R.H., Issues of the Soul, InSync Press, Sanford, FL. 2001 Cox, R.H., The Sacrament of Psychology, InSync Press, Sanford, FL 2002 Cox, R.H., Cox, B., & Hoffman, L., Spirituality & Psychological Health, Colorado School of Professional Psychology Press, Colorado Springs, CO, 2005 Dossey, L., Healing Words, Harper, NY 1993 Durant, W., On the Meaning of Life, Promethean Press, Dallas 2005 Grof S. & Grof C., (Eds.), Spiritual Emergency, Tarcher, Los Angeles 1989 Hillman, J., The Soul s Code, Warner Books, NY 1996 Lipton, B., The Biology of Belief, Elite Books, Santa Rosa, CA 2005 Newberg, A., How God Changes Your Brain, Ballantine, NY 2009 Loewenthal, K., Religion, Culture & Mental Health, Cambridge, NY 2007 Nuland, S. The Wisdom of the Body, Knopf, NY 1997 Rahn, C., Science and the Religious Life, Yale Univ. Press, New Haven 1928 Sims, G. (Ed.), Treating Spiritual Disorders, Health Access Press, Sanford, FL 2001 Smith, H., Why Religion Matters, Harper, San Francisco, 2001 USA Today, Images, p. 7 D, Sept.10, 2008