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Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
Impact of religion and spirituality on health and psychology
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Impact of religion and spirituality on health and psychology

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These slides explore the importance of religion in individuals lives. While more the half of Americans identify religion or spirituality as vital to their lives therapists and doctors often do not …

These slides explore the importance of religion in individuals lives. While more the half of Americans identify religion or spirituality as vital to their lives therapists and doctors often do not include these beliefs in their treatment.

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  • The core concept identified was Self-Management Through a Relationship With God. Participants fell into one of three typologies: (a) Relationship and Responsibility: God Is in Background; (b) Relationship and Responsibility: God Is in Forefront: (c) Relationship and Relinquishing of Self-Management: God Is Healer.
  • NIA Fretzur – 7 exact domain copies, and forgiveness is its own domain.
  • Having a therapist who was not sensitive enough to know when and how much to address religion or spirituality in therapy. More then 94% of individuals in one study were found to be open to inquiry about faith and even welcome it. Only 15% of individuals had been asked. In a study 28% of folks felt that it was inaapropriate for the doctor to share their beliefs. 44% went as far as to think that it was appropriate for docotors to pray with paitients.
  • At the University of Chicago beginning in 1953, Eugene Gendlin did 15 years of research analyzing what made psychotherapy either successful or unsuccessful. The conclusion was that it is not the therapist's technique that determines the success of psychotherapy, but rather the way the patient himself behaves, and what the patient himself does inside himself during the therapy sessions.Gendlin found that, without exception, the successful patient intuitively focuses inside himself on a very subtle and vague internal bodily awareness — or "felt sense" — which contains information that, if attended to or focused on, holds the key to the resolution of the problems the patient is experiencing. [3] He found that successful clients intuitively focused on a very subtle and vague internal bodily awareness, which he termed a "felt sense"."Focusing" is a process and learnable skill, developed by Gendlin, which re-creates this successful-patient behavior, in a form that can be taught to other patients. Gendlin detailed the simple, learnable techniques is detailed in his book Focusing, written in conversational terms and meant for the layman, which describes the six steps of focusing and how to do them. Gendlin stated: "I did not invent Focusing. I simply made some steps which help people to find Focusing."
  • Since traditional psychiatry makes no distinction between psychotic reactions and mystical states, not only crises of spiritual opening, but also uncomplicated transpersonal experiences often receive a pathological label...[Emma Bragdon (1988)] states that: "Flexibility to adapt and accommodate to new areas of experience is part and parcel of the spiritual emergence process — in contrast to inflexibility, which characterises deeply entrenched psychosis.”Awareness of the intrapsychic nature of the process, satisfactory ability to distinguish between the inner and the outer, "owning" the process, ability to keep it internalized
  • RESULTS: The dominant and most consistent themes that emerged from these focus groups were1) spirituality as an important factor in general health, disease adjustment, and coping; 2) general life stress and multi-caregiving responsibilities interfering with daily disease management; and 3) the impact of diabetes manifested in feelings of dietary deprivation, physical and emotional "tiredness," "worry," and fear of diabetes complications. CONCLUSIONS: Our findings suggest that influences on diabetes self-management behaviors of African-American women may be best understood from a sociocultural and family context. Interventions to improve self-management for this population should recognize the influences of spirituality, general life stress, multi-caregiving responsibilities, and the psychological impact of diabetes. These findings suggest that family-centered and church-based approaches to diabetes care interventions are appropriate.
  • (1) change in functional status, (2) core beliefs, (3) medical/disease state information gathering and processing, (4) interpretation and understanding, (5) life scheme, (6) positive intentionality, (7) agency, and (8) subjective well-being.
  • Authors proposed reduced stress and "cognitive interpretation" as the mechanism of action in this studyIt is important to note that SOC accounted for 73% of the varience in this data.Spirituality and well-being: an exploratory study of the patient perspectiveSocial Science & Medicine, Volume 53, Issue 11, Pages 1503-1511Timothy P Daaleman, Ann Kuckelman Cobb, Bruce B Frey
  • Mindfulness Heals – Good outcomes studies. Interesting double blind study of health outcomes and mindfullness in practicioners. Practioners who meditated regularly had better outcomes despite theory.
  • Psychological theories include expectancy, in which NDEs are simply a product of the imagination; depersonalization, in which feelings of unreality protects one from the threat of death; and personality features, such as having an increased tendency for dissociation, a high capacity for absorption into the moment, and a proneness to fantasy. Physiological theories include altered arterial blood gases with hypoxia; neurochemical theories related to endorphins or endogenous ketamine-like neurotransmitters; intrusion of rapid eye-movement (REM) sleep; or neuroanatomical changes, including temporal lobe dysfunction or seizures. These have been predominantly speculative, with only minimal research support.“brain activity normally serves as a kind of filter, selecting material that is allowed to emerge into waking consciousness…the ‘relaxation’ of the filter under certain poorly understood circumstances may lead to drastic alterations of the normal mind-brain relationship and an associated enhancement of consciousness.”
  • FichteanDialectics (Hegelian Dialectics) is based upon four concepts:Everything is transient and finite, existing in the medium of time.Everything is composed of contradictions (opposing forces).Gradual changes lead to crises, turning points when one force overcomes its opponent force (quantitative change leads to qualitative change).Change is helical(spiral), not circular (negation of the negation).[The concept of dialectic existed in the philosophy of Heraclitus of Ephesus, who proposed that everything is in constant change, as a result of inner strife and opposition.[7][8][9] Hence, the history of the dialectical method is the history of philosophy
  • Transcript

    • 1. Religion Healthand Psychotherapy Meeting Clients On Their Terms Michael Changaris, Psy.D.
    • 2. Freud and ReligionReligion, Freud believed,was an expression ofunderlying psychologicalneuroses and distress.Freud believed that religion is a means of giving structureto social groups, wish fulfillment, an infantile delusion, andan attempt to control the outside world."Religion is an illusion and it derives its strength from thefact that it falls in with our instinctual desires." --SigmundFreud, New Introductory Lectures onPsychoanalysis,1933.
    • 3. The human psyche is religious by nature. Symptoms come from psycho-spiritual roots. Had semi-psychotic state after falling out with Freud. Jung viewed life as an ongoing transformation that is a process of ―individuation.‖ He argued that individuation was the ―mystical heart‖ of all religions. At once it is a meeting of the self and the ultimate.Carl Gustav Jung - 26 July 1875 – 6 June 1961 Jung played an indirect role “As far as we can discern, the sole in the founding of AA and purpose of human existence is to believed in a ―spiritual cure kindle a light in the darkness of mere for alcoholism.‖ being…”
    • 4. Matter of Facts…Two views of the world – ―Idealists and Materialists‖To idealists, spirit or mind is primary, and created mattersecondary.To materialists, matter is primary and mind or spirit issecondary, a product of matter acting upon matter.Logical positivism used formal logic to underpin anempiricist account of our knowledge of the world.We live in a ―De-enchanted‖ world.Mind – Brain – Self (universal mind)
    • 5. Importance of Religion in US
    • 6. Religious Importance in Americans of Non-European Descent African-Americans are among the most likely to report a formal religious affiliation, with fully 87% of African-Americans describing themselves as belonging to one religious group or another. African-Americans (79%) say religion is very important in their lives, compared with 56% among all U.S. adults. African-Americans (53%) report attending religious services at least once a week, more than three-in-four (76%) say they pray on at least a daily basis and nearly nine-in-ten (88%) indicate they are absolutely certain that God exists. Pew Research Centers Forum on Religion & Public
    • 7. Religious Importance in Americans of Non-European Descent Latino(a)s also report affiliating with a religion at a similarly high rate of 85%; among the public overall, 83% are affiliated with a religion. 94% of Filipino Americans Report being highly religious (not Pew Data) 87% of Korean Americans Report being highly religious (not Pew Data)
    • 8. Religious Importance in EldersDescriptive findings indicate that 96% of elders use prayerto cope with stress based on the Jalowiec Coping Scale.Women and African American Elders used prayer to copewith stress significantly more often than did men andeuroamericans.The most frequently reported alternative treatment modalityfor elders was prayer (84%).
    • 9. Discussion? What role does religion play in therapy?? Have you worked with clients when it was central to therapy?? How do you work with religious and spiritual experiences in therapy?? How have you seen religion help clients?? How have you seen religion hinder clients growth?
    • 10. William James was thePopularize of AmericanPsychology.His works form thefoundations of the field andare still often quoted.Co-author of James LangTheory of Emotions.Gave a series of lecturescompiled in the book, ―The Varieties of Religious Experience‖in University of Edinburgh inScotland between 1901 and1902.
    • 11. William JamesBut such individuals are ―geniuses‖ in the religious line; and likemany other geniuses who have brought forth fruits effectiveenough for commemoration in the pages of biography, suchreligious geniuses have often shown symptoms of nervousinstability.There are moments of sentimental and mystical experience . . .that carry an enormous sense of inner authority and illuminationwith them when they come.Religion can lead to profound psychological change grantingnew found passion for life, depth, love and security.Mystical experiences can create profound changes in briefmoments. They often feel as if the individual is connected to andexpressing a vast intelligence. They are impossible to put intowords but transformative to those who experience them.
    • 12. Aspects of ReligionMoral System: All religions have a system of moralbehaviors that help people live a ―good‖ life.Practices: These are the tools, rituals, spiritual technology,skills and habits that the religion offers to help developeither moral habits or spiritual experiences.Beliefs: These are the ideas, thoughts, stories,philosophies and teachings that create the ―rasa‖ of areligion. These include elaborate cosmologies,relationship to ―ultimate‖ and the role of women in liturgicallife.Experiential/Mystical: These are the direct contact with thesacred. These can include visions, speaking in tounges,divine union, enlightenment, peace that passesunderstanding.
    • 13. Spirituality DefinitionNIHR (National Institute of Health Care Research)Defines Spirituality As: The ―feelings, thoughts,experiences that arise in search for the sacred.‖ Search: ―Are the attempts at identifying, articulating, maintaining, transforming, understanding, knowing and embodying.‖ Sacred: Is the divine, higher power, or ultimate reality as understood by the person.
    • 14. Religion: Operationalized1. Religious/spiritual preference or affiliation. – Affiliation with specific spiritual or religious group.2. Religious/spiritual history. – History of participation, Religious trauma, upbringing, and transformative moments.3. Religious/spiritual participation. – Frequency and amount of engagement in spiritual or religious activities.4. Religious/spiritual ―private‖ practices. - Prayer, meditation, rituals, ceremonies, contemplation, dance, movement and work.5. Religious/spiritual support. – Social support, Spiritual Guidance, Material Support and Imaginable Support.
    • 15. Religion: Operationalized6. Religious coping. – Ways individuals participate to cope with life experiences.7. Religious/spiritual Beliefs and Values. - Morality and belief structures. How the beliefs are held (truth, metaphoric, aspiration etc.).8. Religious/spiritual Commitment. Level of importance of religion/spirituality and how much it motivates actions.9. Religious/spiritual Motivation for Regulating and Reconciling Relationships. – Forgiveness, atonement…10. Religious/spiritual experiences. – Personal experiences with the divine.
    • 16. A Qualitative Study of Religion in TherapyOutpatient psychotherapy clients report a desire to discussreligious or spiritual topics in their therapy, and many alsoindicate that religion and spirituality are of central importance totheir healing and growth.Clinicians‘ uncertainty may be related as well to the minimalcoursework, supervision, and training regarding the place ofreligion-spirituality in therapy.Furthermore, they may also feel that working with religious orspiritual issues in therapy is outside their area of expertise andmay thus refer clients presenting with such concerns to otherprofessionalsClients felt that spirituality was important to discuss in therapyand felt validated and acknowledged by therapists‘ explicit andimplicit religious or spiritual interventions.
    • 17. A Qualitative Study of Religion in TherapyTherapists focused on existential questions or anger at God.These discussions were facilitated by clients‘ perception oftherapists as open, accepting, and safe.Discussions typically became unhelpful when clients felt thattheir therapists were passing judgment or imposing theirown beliefs on them.As an example, one client reported that her therapisttold the client that she was „„too Catholic,‟‟ which madethe client feel bad.A third client ‗‗got real mad inside and left therapy‘‘ becauseshe did not know what the therapist meant by the commentthat the client was ‗‗too Catholic.‘
    • 18. Religious or Spiritual Based TherapiesSecular w/ Spiritual Roots Overtly SpiritualDBT – Dialectical TranspersonalBehavioral Therapy. Psychotherapy.MBSR – Mindfulness American Association ofbased stress reduction. Christian Counselors.Jungian analysis. Alcoholic Anonymous…ACT – Acceptance and (NA, OEA, Alonon,commitment therapy. CODA)Humanistic Therapies
    • 19. Carl Rodgers Transcendent HumanismAn increasingly existential lifestyle – livingeach moment fully –"To open ones spirit towhat is going on now, and discover in thatpresent process whatever structure itappears to have" (Rogers 1961)Increasing organismic trust – they trust theirown judgment and their ability to choosebehavior that is appropriate for eachmoment.Holistic approach to human existencethrough investigations of meaning, values,freedom, tragedy, personal responsibility,human potential, spirituality, and self-actualization.
    • 20. Focusing: Eugene GildenClearing a space: What I will ask you to do will be silent, just to yourself. Take a moment just torelax . . . All right – now, inside you, I would like you to pay attention inwardly, in your body,perhaps in your stomach or chest. Now see what comes there when you ask, "How is my lifegoing? What is the main thing for me right now?" Sense within your body. Let the answers comeslowly from this sensing.Felt Sense: From among what came, select one personal problem to focus on. DO NOT GOINSIDE IT. Stand back from it. Of course, there are many parts to that one thing you are thinkingabout – too many to think of each one alone. But you can feel all of these things together.Handle: What is the quality of this unclear felt sense? Let a word, a phrase, or an image come upfrom the felt sense itself. It might be a quality-word, like tight, sticky, scary, stuck, heavy, jumpy ora phrase, or an image. Stay with the quality of the felt sense till something fits it just right.Resonating: Go back and forth between the felt sense and the word (phrase, or image). Checkhow they resonate with each other. See if there is a little bodily signal that lets you know there isa fit.Asking: Now ask: what is it, about this whole problem, that makes this quality (which you havejust named or pictured)? Make sure the quality is sensed again, freshly, vividly (not justremembered from before). When it is here again, tap it, touch it, be with it, asking, "What makesthe whole problem so ______?" Or you ask, "What is in this sense?‖ Be with the felt sense tillsomething comes along with a shift, a slight "give" or release.Receiving: Receive whatever comes with a shift in a friendly way. Stay with it a while, even if it isonly a slight release. Whatever comes, this is only one shift; there will be others. http://www.youtube.com/watch?v=j7PEC5Mh5FY&feature=related
    • 21. Mystical ExperiencesChristian Mysticism: "devotion of ecstasy or rapture," apassive state, in which the consciousness of being in thebody disappears .Buddhist Mystical Description of Awakening: Body andmind drops away.Islamic Mystics (Sufism) Hafiz:“And the sun and all lightHave forever fused themselvesInto my heart and uponMy skin.”
    • 22. Abhidhamma The earliest Buddhist writings are preserved in the three- part Tipitaka (Pali; Skt. Tripitaka). The third part (or pitaka, literally "basket") is known as the Abhidhamma (Wikipedia) The Abidharma is a systematic tool and series of teachings designed to lead to liberation. Abhidharma method presents the Buddhas teachings in technical terms that are carefully defined to ensure analytical exactitude.Ronkin, Noa, "Abhidharma", The Stanford Encyclopedia of Philosophy (Fall 2010 Edition), Edward N. Zalta (ed.), URL = <http://plato.stanford.edu/archives/fall2010/entries/abhidharma/>.
    • 23. Stan Grof – Spiritual Emergency Spiritual Emergence Network - provides individuals that are experiencing difficulties with psychospiritual growth a therapist referral and support service that is staffed by trained graduate students. In a culture which has not understood issues surrounding spiritual development, the gift of being heard and understood by a knowledgeable and supportive listener can be life-altering.
    • 24. Spiritual EmergencyIt is possible to undergo a profound crisisinvolving non-ordinary experiences and toperceive it as pathological or psychiatric whenin fact it may be more accurately andbeneficially defined as a spiritual emergency.-- Stanislav GrofSt. John of the Cross, ―Dark night of the soul.‖―It is the journey of the soul from its bodily home to her unionwith God. It happens during the night, which represents thehardships and difficulties she meets in detachment from theworld and reaching the light of the union with the Creator.‖Zen - Makyo refers to the hallucinations and perceptualdistortions that can arise during the course of meditation andcan be mistaken by the practitioner as "seeing the true nature"or kensho.
    • 25. Kundilini Awakening.Tingling in the body and brain region,Heat or cold in the system,Fluttering or twitching of muscles,Spontaneous yoga asans or kundalini yogamovements,Sexual desire for partner,Experience of divine light within.Spontaneous bliss, intensely pleasurable,Tremendous vibratory energy.
    • 26. Discussion? Are there ―healthy‖ non-ordinary mind states?? How can these states effect therapy?? How can you tell the difference between ―healthy‖ non-ordinary mind states and healthy?
    • 27. Herbert Benson, M.D.founder of the Mind/Body Medical Institute a Massachusetts General Hospital. Harvard Medical School graduate.
    • 28. Relaxation SkillTonglen – ―The tonglen practice is a method forconnecting with suffering —ours and that which is allaround us— everywhere we go. It is a method forovercoming fear of suffering and for dissolving thetightness of our heart.‖ – PemaChodronIt is also a great skill for building Distress Tolerance…Basics: Think of a minor slightly frustrating event.Notice how it makes your body and mind feel. Breathas you breath in breath in the frustration. As you breathout breath out compassion.
    • 29. Health Outcomes and ReligionAll cause mortality is reduced byspiritual and religious practice.Depression, anxiety, aggression areall reduced byspirituality/religiousness.Belief in angry or punishing God reduces positive healthoutcomes.Watching T.V. preachers has negative and not positivehealth impacts.
    • 30. Health Outcomes and ReligionTwo factors account for Positive Healthoutcomes and religion: ―Religious attendance (RA).‖ Religious copingRA also positively impacts all causemortality to the greatest degree.Religion has a correlation with better recovery from illness andtransplants.Religion is correlated with reduced mortality after heart surgery,mortality after heart cancer.Religious practices are correlated with reducing the impact ofpain.
    • 31. Health Outcomes and ReligionYoga mitigates depression,anxiety and PTSD.Yoga shows changes in stress responseand HRV.Yogic breathing is safe for those with COPDA non-placebo controlled study with mall N found ―short-term training in yoga is well tolerated and inducesfavorable respiratory changes in patients with COPD.‖Religiousness: No direct effect on observable symptomsin COPD but displayed increased quality of life, reduceddepression, anxiety and less reported subjectivesymptoms.
    • 32. Negative Health Effects of ReligionReligious medical neglect – Some individuals have gotten sick or died due to the religious beliefs that medical interventions are not helpful. Current birth control controversy. Women‘s sterilization in the early 1900‘sBenson Study: Prayer had negative impact on health.Some argue it was due to a nocebo effects.Destructive beliefs: A belief in an angry punishing Godleads to negative health impacts.
    • 33. Prayer and HealthDistant intercessory Prayer:Praying for the health ofanother. Most studies findno or mixed impact. Some findsignificant impact on health.Contemplative Prayer: Sitting in the presence of God. No directstudies found. One study found five types—supplication, devotion, intercession, gratefulness, and contemplative prayer—elicited varying degrees of improvements in heart rate variability and corresponding psychophysiological coherence. (DOI: 10.1111/j.1467- 9744.2009.01036.x)Prayer as coping Prayer - A two-group controlled clinical trial in ICU of Baqiatallah hospital in 2010. Those ―Studied with recorded prayer for 3 days used prayer attributed to Prophet Muhammad‖ Had a highly divergent course of illness for those who prayed and those who did not.
    • 34. Theoretical Models of Mechanism of Health and Prayer Prayer may improve health because of the placebo effect Prayer may lead to increase health-related behaviors Prayer may help by distraction from illness or increasing positive emotions. Prayer may increase health act of supernatural being. Prayer may change energy systems: e.g. chi. Prayer may link the consciousness of two individuals an promote healing. Breslin, J. M., Lewis, A. C. (2008). Theoretical models of the nature of prayer and health: A review. Mental Health, Religion & Culture, Vol. 11, Iss. 1,
    • 35. Mechanisms of Positive Health Impacts of ReligionIncreased positive health behaviors. Some evidence suggests that―strict‖ conservative religions have healthier participants.Social Support – Social support has many positive impacts onhealth. It has biochemical effects on brain health, inflammation,stress levels and purely behaviorally other people to help solveproblems and material support. Religions often put a premium onsupport behaviors.Coherence Hypothesis: Religion offers meaning and purpose evenin suffering. As Victor Frankle said, “A (wo)man can survive any “what”
    • 36. Coherence HypothesisCoherence has been shown in many studies to be one of thekey principles underling the impact of religion on health. ―God would never give you more then you can handle.‖ ―This is the Buddha appearing before you finding ways to free you from your own attachments, the very attachments that has made you suffer again and again and again.‖ DBT – ―Any time you feel a difficult emotion or have a stressful event it is a good chance to practice a skill and learn to use the skill more effectively.‖
    • 37. Bruce McEwen Preeminent Stress Researcher andAuthor of ―The End of Stress as We Know It‖ Allostatic Load
    • 38. Adverse GAD PTSD Childhood Life Coping Events Stress Chronic Style Pain Depression PersonalityPoor SocialSleep Support Inflammatory Cortisol Oxytocin ANS Balance Response And HRV Heart Disease
    • 39. Suggested Biological Mechanisms of Health Promoting EffectsStefano, G. B., Fricchione, G. L., Slingsby, B. T., Benson, H. (2001)The placebo effect and relaxation responsneural processes and their coupling to constitutive nitric oxide. Brain Research Reviews
    • 40. Placebo and Nocebo Effect Mechanism Pain Management Placebos induced activations of the endogenous Opioid system in these brain structures: Anterior Cingulate Cortex (ACC), Orbitofrontal (OFC), InsularCortices Nucleus Accumbens (NA) (DA release accounts for 25% of var. in placebo effects). Amygdala (AMY) Periaqueductal GrayMatter (PAG). Dopaminergic activation was observed in the ventralbasal ganglia, including the nucleus accumbens. High placebo responses were associatedwith greater DA and Opioid activity in the nucleus accumbens. Nocebo responses were associated with a deactivation of DA andopioid release.Scott, D.J., Stohler, C.S., Egnatuk, C.M., Wang, H., Koeppe, R.A., Zubieta, J.K., (2008). Placebo and Nocebo Effects Are DefiOpposite Opioid and Dopaminergic Responses. Arch Gen Psychiatry;65(2):220-231.
    • 41. Placebo and Nocebo EffectMechanism Pain Management Tracey, I. (2010). Getting the pain you expect: mechanisms of placebo, nocebo and reappraisal effects in humans Nature Medicine 16, 1277–1283 (2010) doi:10.1038/nm.2229
    • 42. Positive Early Social ChildhoodInteractions Experiences Effective Oxytocin Oxytocin Emotional Release Release Regulation Sustained Reduction in Stress (CORT) LONG TERM HEALTH
    • 43. Telomeres – Health – Life StyleWomen with high stress had telomeres shorter (10 years ofaging). doi.org/10.1016/S1470-2045(08)70234-1Telomere shortening cor. w/genetic instability also cor. withshortened life span as well as a reduced wound healing.doi.org/10.1016/S1470-2045(08)70234-1Telomerase increased after 3 mo intensive life style changes.(doi.org/10.1016/S1470-2045(08)70234-1)―Telomerase activity was significantly greater in retreatparticipants than in controls at the end of the retreat(p < 0.05).‖ (doi.org/10.1016/j.psyneuen.2010.09.010)
    • 44. God Spot – Temporal Lobe Epilepsehttp://www.youtube.com/watch?v=qIiIsDIkDtg A link between febrile seizures (seizures coinciding with episodes of fever in young children) and subsequent temporal lobe epilepsy has been suggested, but the exact role remains unclear
    • 45. Spiritual Brain Meditators and Multiple individuals with extensive religious experience have drastic changes in the brain. One of the key factors is asymmetry in the thalamus. Meditators who practice, ―loving kindness‖ have hyperactivation in the LPFC. In a graded stepwise relationship hours of meditation relate to increased thickness in omPFC. 45 minuets of MBSR changed neural structures for ―promega‖ employees. Differences have been shown in shamanistic or devotional practices and meditative states. (changes in prefrontal lobes) In 4 out of 11 participants who had left fronto-temporal lobe inhibited by TMS stimulation there was a dramatic increase in artistic ability (Snyder, et. al., 2003. J Integr Neurosci).Andrew B. Newberg, A.B., Wintering, N., Waldman, M. R., Amen, D., Khalsa, D. S., Alavi, A. (2010).Cerebral blood flow differencesbetween long-term meditators and non-meditatorsConsciousness and Cognition, Volume 19, Issue 4, December 2010, Pages 899-
    • 46. The Brain on MeditationSome might wonder "What is aBuddhist monk doing taking sucha deep interest in science?Although Buddhist contemplativetradition and modern sciencehave evolved from differenthistorical, intellectual and culturalroots, I believe that at heart theyshare significant commonalities,especially in their basicphilosophical outlook andmethodology.Dalai Lama at the annual meeting of the Society forNeuroscience on November 12, 2005 in Washington DC
    • 47. God Helmet
    • 48. God on the Brain"God helmet". Michael Persinger (University of Ontario),Using a helmet that ―entrains‖ brain states triggeredreligious experiences.Andrew Newberg (University of Pennsylvania) observedBuddhists as they practice ―Śūnyatā, ‖(emptiness) or meditative nirvana. The parietal lobes as playing a key role during this transcendental state. This area leads to falling away of body and mind (may also be involved in dissociation) and if damaged the area can lead to the feeling of being ―disembodied.‖
    • 49. God on The BrainA study of 40 participants, including Christians, Muslims, Jewsand Buddhists, showed the same areas lit up when they wereasked to ponder religious and moral problems. Experiencing an intimate relationship with God and engaging in religious behavior was associated with increased volume of R middle temporal cortex, BA 21. Experiencing fear of God was associated with decreased volume of L presumes and L orbitofrontal cortex BA 11. A cluster of traits related with pragmatism and doubting Gods existence was associated with increased volume of the R presumes.
    • 50. Experiencing an intimate relationship with God (PC1) positively correlated with cortical Experiencing fear of Gods anger volume at the R middle negatively correlated with cortical temporal gyrus (MTG), BA 21, volume at the L precuneus, Non-religious pragmatism BA 7 and the extending to the temporal pole. L orbitofrontal cortex, BA 11. inverse of PC3) (the positively correlated with cortical volume at the R precuneus, BA 7 and the R calcarine gyrus, BA 17.Kapogiannis D, Barbey AK, Su M, Krueger F, Grafman J (2009)Neuroanatomical Variability of Religiosity. PLoS ONE 4(9): e7180.doi:10.1371/journal.pone.0007180
    • 51. Die Before you die… Ironic, but one of the most intimate acts of our body is death. So beautiful appeared my death – knowing Who then i would kiss, i died a thousand times before i died. ―Die before you die,‖ said the Prophet Muhammad. Have wings that feared ever touched the Sun? i was born when all I once feared - i could love.Rabia Basri, the highly acclaimed woman sufi saint of 8th century (717 - 801)
    • 52. To Die Before You Die18% of individuals who with Cardiac Arrest experienced NDE.Most NDE‘s are filled with joy but some are deeply hellish (about15%).Most individuals attempt to make sense of the process. There isoften a increased religiosity in the after math of both types.Other common response are ―reductionism‖ where the personattributes the experience to a brain state. Still others are asking―why did this happen to me?‖ This is associated with blankstates in the NDE.Clinician explanation fall into three categories: Psychological,Physiological, and Transcendental. Griffith, L.J., (2009). Near-Death Experiences and Psychotherapy. Psychiatry
    • 53. Near Death Experiences (NDE)TRANSCENDENTAL ELEMENTS: Another worldEncountered beings, Mystical being, Point of no returnPARANORMAL ELEMENTS: Out of physical bodySenses more vivid than usual, Extra sensory perception(ESP), Visions of the future.AFFECTIVE ELEMENTS: Feeling of peace, Surroundedwith light, Feeling joy, Feeling cosmic unity/onenessCOGNITIVE ELEMENTS: Altered sense of timeAccelerated thought processes, Life review and Suddenunderstanding Adapted from Zingrone NL, Alvarado CS. Pleasurable Western adult near-death experiences: features, circumstances, and incidence. In Holden JM, Greyson B, James D, eds. The Handbook of Near-Death Experiences. Santa Barbara, CA: Praeger Publishers; 2009:20.
    • 54. Reactions to NDEPERCEPTION OF SELF: Loss of fear of death, Strengthened belief in lifeafter death, Feeling specially favored by God, New sense of purpose ormission, Heightened self esteemRELATIONSHIP TO OTHERS: Increased compassion and love for others,Lessened concern for material gain, recognition, or status, Greater desireto serve others, Increased ability to express feelings.ATTITUDE TOWARD LIFE: Greater appreciation of and zest for life,Increased focus on the present, Deeper religious faith or heightenedspirituality, Search for knowledge, Greater appreciation for nature.PARANORMAL PHENOMENON: Out-of-body experiences, Apparitions,Extrasensory perception, Precognition, Healing, Spiritual, mystical, ortranscendent experiences.ALTERATIONS IN PERCEPTION/CONSCIOUSNESS: Heightenedsensation, Physiological alterations, Unusual movements, sensations,Unusual stimulation of special senses, Mental changes, Increased energy,decreased need for sleep. Adapted from Zingrone NL, Alvarado CS. Pleasurable Western adult near-death experiences: features, circumstances, and incidence. In Holden JM, Greyson B, James D, eds. The Handbook of Near-Death Experiences. Santa Barbara, CA: Praeger Publishers; 2009:20.
    • 55. Guidelines for NDE1. Avoid the assumption that a client‘s NDEs are symptomatic of pathology, but recognize that individuals with mental illness may also experience NDEs.2. Respect the profound nature of these experiences as well as the individuality of each experiencer.3. Provide a safe, nonjudgmental environment in which patients can freely discuss their experiences and the emotions surrounding their NDEs.4. Avoid projecting your own value system. Remember most of these individuals have recently nearly died and encourage them to also express the emotions related to the precipitating events.5. Normalize the experience for patients without taking away the uniqueness of the NDE.6. Assist patients with integrating the NDE into their daily lives to maintain best possible functioning.7. Refer patients to local NDE-focused groups, such as IANDS groups Adapted from Zingrone NL, Alvarado CS. Pleasurable Western adult near-death experiences: features, circumstances, and incidence. In Holden JM, Greyson B, James D, eds. The Handbook of Near-Death Experiences. Santa Barbara, CA: Praeger Publishers; 2009:20.
    • 56. DBT – OverviewDialectics – Being able to move between opposites and throughholding the tension between opposites ―finding a middle path.‖ Good and Bad – Human with positive and negitive traits Short-term and long-term goods – Will spend time on the phone after HW is completed. Humor and Irreverence – Humor requires having a meta- perspective.Behavioral Chain Analysis – Links that lead to behaviors Triggering events, Vulnerability Factors, Behaviors and Consequences. Identify each link in the chain like a detective. Links can be thoughts, feelings, sensations, external reactions.Excellent Video http://www.youtube.com/watch?v=OlYk2nWECpk
    • 57. DBT – OverviewThree aspects of DBT Treatment. Individual therapy: Lots of focus on Behavioral Chain Analysis and stopping ―therapy interrupting behaviors.‖ Skills Group Training: rotating 12 week groups. 24 hr skills coach.Four Stages of Treatment Stage 1 – Significant life chaos and emotional dysregulation. Stage 2 – Chaos reduced emotional distress is still significant. Stage 3 – Emotional regulation is with in normal range (aka ―ordinary neurotic‖ like all of us). Stage 4 – Steady, stable equanimity and enlightenment.
    • 58. DBT – OverviewFour Skill Domains Mindfulness Skills How Skills - Non-Judgmentally, One Mindfully, Effectively. What Skills - Observe, Describe, Participate. Emotional Regulation Skills – These are the tools an individual uses to learn to regulate emotions. Interpersonal Effectiveness Skills – Help people learn to be effective in relationships (Assertiveness, Keeping Good Relationships, Negotiation) Distress Tolerance Skills – Help an individual survive difficult emotions, thoughts, and events.
    • 59. DBT – Spiritual RootsWise Mind – The combination of emotional mind andrational mind. Many of the tools in DBT help and individual move from emotional mind to wise-mind…
    • 60. DBT SkillsMindfulness Skills – Observe and Describe Observing is seeing a thing as it self. Artists when they view an object see the lines, the color and blank spaces. Observe skill is the ability to see an object just as it is with out mental commentary. Describe skill is the ability to describe clearly and cleaning with out adding to the top of it. Most of the time emotions happen in an action packet. See – Feel – Judge the Feelings – Respond. This is a tool see our world and reactions simply as they are.Emotional Regulation - Opposite Action All emotions have urges. A times these urges are helpful and times not. Learning this skill helps us have choice with emotional reactions and not act on the destructive urges associated with emotions.Distress Tolerance - Wise Mind Accepts (see hand out)http://www.dbtselfhelp.com/html/wave_of_emotions.htmlInterpersonal Effectiveness – GIVE (see hand out)
    • 61. Questions

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