The Psychology of Health, Immunity & Disease Conference
Two-Day Intensive Training Institute
Hilton Head, SC
December 9-10, 2003
The Journey to Wholeness:
A Practical Psychology for Living an Authentic Life
Kathleen Brehony, Ph.D.
Day One - Morning
Helping Patients Be All They Can Be
The teleological process of growth – From
Acorn to Oak
Jung’s Landscape of the Psyche and it’s
inherent optimism
How to bring the shadow to
consciousness
The “Alchemical Metaphor” for
psychological and spiritual growth and how
to apply this in clinical settings
What is “Wholeness”?
adj.
1. Containing all components; complete: a whole wardrobe for the tropics.
2. Not divided or disjoined; in one unit: a whole loaf.
3. Constituting the full amount, extent, or duration: The baby cried the whole trip home.
a. Not wounded, injured, or impaired; sound or unhurt: Many escaped the fire
frightened but whole.
b. Having been restored; healed: After the treatment he felt whole.
n.
1. A number, group, set, or thing lacking no part or element; a complete thing.
2. An entity or system made up of interrelated parts: The value of the whole was greater
than the sum of its parts.
[Middle English hool, sound, unharmed, See kailo- in Indo-
European Roots.]
The Path to Wholeness:
Life as a Teleological Process
Michelangelo:
It is already inside you.
A Major Reason for OPTIMISM!
Individuation – Carl Jung
Self-Actualization – Abraham Maslow
Self-Realization – Carl Rogers
The Good Red Road – Lakota
The Pollen Path – Navajo
Tao -- Taoism
“The common theme among these
diverse traditions is that life is a
journey, and the goal is the discovery
of one’s true nature, a transformation
of one’s view of the world, an enhanced
wisdom, and an authentic, loving
connection to all of life and to some
larger universal power.”
-- Awakening at Midlife (pg. 20)
Maslow’s Characteristics of Self-Actualization
Realistic orientation
Acceptance of self, others, and the natural world
Spontaneity
Task orientation, rather than self-preoccupation
Sense of privacy
Independence
Vivid appreciativeness
Spirituality that is not necessarily religious in a formal sense
Sense of identity with mankind
Feelings of intimacy with a few loved ones
Democratic values
Recognition of the difference between means and ends
Humor that is philosophical rather than hostile
Creativeness
Nonconformism
The Process of Individuation
From Latin “individuus” – “undivided,” “whole”
A process of psychological differentiation, having
for its goal the development of the individual
personality
Not to overcome one’s personal psychology and
become perfect, but to become familiar with it
Increasing awareness of one’s unique
psychological reality, including personal strengths
and limitations, and at the same time a deeper
appreciation of humanity in general
A spiraling, circumambulating process rather than
a linear path in the unfolding of the Self
When we are on the path, we are at the goal
Polishing Your Diamond
The “art of personality” fulfills the
purpose of life, and that we are all born
with such a personality -- “But even a
diamond must be cut. It has the light in
it, yet cutting is required: it cannot
show that glow and that brilliance
before it has been cut. The same thing
applies to personality.”
-- Sufi Master Hazrat Inayat Khan
Self Growth is not a passive process.
Jung’s Landscape
Psyche refers to the totality of all
psychological processes. It “embraces
all thought, feeling, and behavior, both
conscious and unconscious. It functions
as a guide which regulates and adapts
the individual to his social and physical
environment.”
“My psychology Yikes!
isn’t worth
anything if it can’t
be understood by
a Swiss farmer!”
The Self
The Center of the Psyche
The “Central Archetype”
Like the Sun in the Center of the Solar System
Archetype of order, organization, and unification
Unites the personality
Responsible for fulfilling the blueprint of life
At birth – all is the Self
Connecting bridge to “The Unity”
Goal is psychological wholeness and completeness
Transpersonal, transcends the ego
Archetypes
Primordial structural elements of the psyche
Functional units of the collective unconscious
(later called “The Objective Psyche”)
Archetype = “First,” “Original,” “Prototype”
Primordial Images
Blueprint for Life (like an innate releasing
mechanism in certain animals)
Universal
Unconscious
Collective unconscious is distinct from the Personal
Unconscious
Complexes
Emotionally charged group of ideas or images
Functional units of the personal unconscious
A group of associated “feeling-toned ideas” bound
together by a shared emotional charge
Unconscious, highly emotional, feel autonomous
Like split-off, partial, independent, and separate
personalities
Vital part of everyone’s psychological make-up
The less conscious, the greater its degree of
autonomy, and the more we will project it onto
others.
The Ego
The central complex in the field of
consciousness
Organizing function of the
conscious mind
Gives sense of identity, continuity and
personality – “I”
Composed of conscious perceptions, memories,
thoughts and feelings
The “gatekeeper to consciousness”
Actually a very small part of the overall psyche
The Persona
The part of ourselves we show to the
world. Personae from the Latin for
“Mask.” Helps us adapt to society –
to conform to the roles we play in our
relationships and culture. Social
masks allow conversation and
commerce to flow easily from one
person to another. Sometimes our
“New Year’s Resolution self.”
The Shadow
All that is set aside, repressed, or
unrecognized. Hidden part of
ourselves that has been repressed or
never recognized. All that is banished
from the persona. Unconscious and
unknown part of ourselves. All that
we think we are not. Our unlived life.
There is gold in the shadow. Accepting
the shadow means accepting our full
humanity.
Illuminating the Shadow
1. Make a list of all the adjectives that you (or
someone who knows you well) would use to
describe you. Take the opposite of that word
and write it down. That list comprises some
of what is in your shadow.
2. Look honestly at those you immediately
dislike or like. What is it about them that is
similar or different to how you see yourself?
3. Ask someone who knows you well one simple
question: “What is my greatest flaw?”
4. Look at the content of dreams and slips of the
tongue.
Anima/Animus:
The Internal Masculine and Feminine
Anima – The internal, unconscious
feminine aspect of a man
Animus – The internal, unconscious
masculine aspect of a woman
Jung speaks of the anima/animus as both
archetypes and complexes. They are:
1) unconscious
2) charged with emotion
3) relatively autonomous.
Relationship Between Anima/Animus
and the Ego
Yin Yang
Feminine Masculine
Negative Positive
Moon Sun
Darkness Light
Yielding Aggressive
Left side Right side
Warm Cold
Autumn Spring
Winter Summer
Unconscious Conscious
Emotion Reason
Right Brain Left Brain
Psychological Types
Basic Attitudes: Introverts(I) and Extraverts(E)
Decision-Making Style:Thinking(T) v. Feeling(F)
Take in Information: Intuition(N) v. Sensation(S)
Deal with the Outer World: Judging(J) v.
Perceiving(P)
Superior and Inferior Functions
Goal is wholeness and integration of the “inferior
function”
1. Energizing (direction of energy) 2. Attending (perception)
Extrovert (E) Introvert (I) Sensing (S) iNtuition (N)
•External •Internal •The 5 senses •6th Census
•Outside thrust •Inside pull •What is real •What could be
•Blurt it out •Keep it in •Practical •Theoretical
•Breadth •Depth •Present •Future
•People, things •Ideas, thoughts •Facts •Insights
•Interaction •Concentration •Using established skills •Learning new skills
•Action •Reflection •Utility •Novelty
•Do-Think-Do •Think-to-Go •Step-by-step •Leap about
3. Deciding (judgment) 4. Living (orientation to the outside world)
Thinking (T) Feeling (F) Judgment (J) Perceiving (P)
•Head •Heart •Planful •Spontaneous
•Logical system •Value system •Regulate •Flow
•Objective •Subjective •Control •Adapt
•Justice •Mercy •Settle •Tentative
•Critique •Compliment •Run one’s life •Let life happen
•Principles •Harmony •Set goals •Get data
•Reason •Empathy •Decisive •Open
•Firm but fair •Compassionate •Organized •Flexible
E Extraversion People who prefer Extraversion tend to focus on the
outer world of people and things
I Introversion People who prefer Introversion tend to focus on the
inner world of ideas and impressions.
S Sensing People who prefer Sensing tend to focus on the present and
on concrete information gained from their senses.
N iNtuition People who prefer Intuition tend to focus on the future,
with a view toward patterns and possibilities.
T Thinking People who prefer Thinking tend to base their decisions on
logic and on objective analysis of cause and effect.
F Feeling People who prefer Feeling tend to base their decisions
primarily on values and on subjective evaluation of person-centered
concerns.
J Judging People who prefer Judging tend to like a planned and
organized approach to life and prefer to have things settled.
P Perceiving People who prefer Perceiving tend to like a flexible and
spontaneous approach to life and prefer to keep their options open.
Regarding Typology: Jung's model is
concerned with the movement of energy and
the way in which one habitually or
preferentially orients oneself in the world.
Prayers Based on MBTI Types
ISTJ: Lord, help me to relax about insignificant details
beginning tomorrow at 11:41.23 a.m. EST.
ISTP: God, help me to consider people's feelings, even if most
of them ARE hypersensitive.
ESTP: God, help me to take responsibility for my own actions,
even though they're usually NOT my fault.
ESTJ: God, help me to not try to RUN everything. But, if You
need some help, just ask.
ISFJ: Lord, help me to be more laid back and help me to do it
EXACTLY right.
ISFP: Lord, help me to stand up for my rights (if you don't
mind my asking).
ESFP: God, help me to take things more seriously, especially
parties and dancing.
ESFJ: God, give me patience, and I mean right NOW.
Prayers Based on MBTI Types
INFJ: Lord, help me not be a perfectionist. (Did I spell that
correctly?)
INFP: God, help me to finish everything I sta
ENFP: God, help me to keep my mind on one th - Look a bird -
ing at a time.
ENFJ: God, help me to do only what I can and trust you for the
rest. Do you mind putting that in writing?
INTJ: Lord, keep me open to others' ideas, WRONG though
they may be.
INTP: Lord, help me be less independent, but let me do it my
way.
ENTP: Lord, help me follow established procedures today. On
second thought, I'll settle for a few minutes.
ENTJ: Lord, help me slow downandnotrushthroughwhatIdo.
What is unconscious
will be projected onto others
and into the world.
Wholeness requires
withholding projections and
bringing what is unconscious
into consciousness.
Holding the Tension of
the Opposites by
Integrating Dualities
The Transcendent Function:
The psychic function that arises from
the tension and conflict between
consciousness and the unconscious.
Thesis
Synthesis
Antithesis
Relative Proportions:
Conscious and Unconscious
What Does It Mean to be Conscious?
From the Latin conscius, meaning “knowing with
others, participating in knowledge, or aware of.”
Includes all the things we are aware of and know
An understanding of “knowing that we know”
Sometimes builds slowly and sometimes comes
like a blinding insight
Awakening
A dynamic process of growth, change, and
evolution
Consciousness best defined on a spectrum or
continuum rather than “all or none”
Consciousness is best thought of as manifesting
in steps, layers, dimensions, sheaths, levels or
grades -- holarchy
Vijnanas -- Buddhism
Layers of
consciousness --
Jung
Sefiroth
Kabbalah Spectrum of
Koshas - Vedanta Consciousness –
Western philosophers
(e.g., Ken Wilber)
The Johari Window
Known to Yourself Unknown to Yourself
Known to Others Open Self – Known to Blind Self – Unknown to
Yourself and Others Yourself but Known to
Others
Unknown to Others Private Self – Known to Unknown Self –
Yourself and Unknown to Unknown to Yourself and
Others Unknown to Others
A model for awareness in interpersonal relationships
Joseph Luft, Ph.D. & Harry Ingham, MD, 1955
The Alchemical Metaphor
“We are born to be
awake, not to be asleep!”
-- Paracelsus, 16th Century Swiss
Alchemist
The Power of Alchemy
“The truth of alchemy is discovered
when we accept it as metaphor –
an intricate allegory – for
consciousness and as a clearly
defined path for both spiritual and
psychological development in
which suffering and loss are seen
as initiating events.”
From: After the Darkest Hour
Stages in Alchemical Transformation
Nigredo: “The Blackening”
Albedo: “The Whitening”
Rubedo: “The Reddening”
The Vitality of Transformation
Like the Buddha WAKING UP
Realize the values of the first half of life
are not sufficient for the second half
Change in philosophy and worldview
Psychological and spiritual maturity
Coming to our senses
Live differently – with greater joy,
meaning, and passion
In the absence of some traumatic
event that initiates the beginning of
individuation in a younger person,
this process is a task reserved for
the second half of life.
At midlife, we know that the time
left for this momentous work is
running out.
Day One - Afternoon
The Midlife Passage
Crisis and opportunity
The unique developmental tasks of the midlife
transition
A differential diagnosis between midlife
symptoms and DSM-IV criteria
Why the pursuit of passion and meaning at
midlife is so important
How to release old patterns of behavior that no
longer serve
Six practical strategies for psychological and
spiritual growth at midlife
1. What is Midlife?
2. Why Midlife can be
dangerous and difficult?
3. How to use Midlife for Self-
Growth.
There are lots of us in Midlife…
81 Million Americans between the
ages of 35-55.
10,000 Americans turn 50 every day
(one every 10 seconds)
Midlife is a specific
developmental period of life.
How we get off track…
We are born whole but quickly
become shaped by family, religion,
culture, gender role, etc. etc. etc.
Midlife Gives Us Wake-Up Calls
Physical
Psychological
Emotional
Relational
Professional
Spiritual
Sometimes Midlife is a
Crisis…
“Danger” and “Opportunity”
Sometimes you just hear Peggy Lee
singing…
Is that all there is,
my friend? Is that
all there is?
Midlife Demands a Change in
Consciousness
Consciousness is Awareness and Self-
Major Illusion: Things Don’t Change
Most of us grow when life pushes us to do so
What the You know what I’m going
hell is he to do this weekend, honey?
talking I’m going to grow.
about??!!
Knowing an Underlying Secret
The Answer
An Underlying Secret of Mathematics
“The Rules of 9”
Rule #1:
When any number is multiplied by nine, if
the individual digits in the resulting product
are added together, they will ALWAYS total
nine as long as you keep summing the
digits produced at each step until you get
a one-digit number.
That Number will ALWAYS be 9.
The Underlying Secrets of Midlife
Realization: Life is half-over
We recognize our mortality in a new way.
Life as we have known it is now over.
A major change in consciousness.
Losses and change initiate a path to a new
sense of meaning and greater passion.
The ego has believed that everything revolves around it.
Wrong!
Ego
The Self
At Midlife, the Self is asking –
“When will you get around to me?”
In the first half of life, we devote our
psychological resources to
developing the persona.
The Shadow Knows…
Repressed Shadow Material Can
Explode Out Like a Dam Bursting
In our culture we tend to discount
the inner life but that doesn’t
make it any less real.
Unconscious versus Conscious Midlife Passages
We don’t like to think about or
talk about the losses
associated with Midlife
Poised for the Hero’s Journey
“We have only to follow the thread of the hero path, and where we
had thought to find an abomination, we shall find a god. And where
we had thought to slay another, we shall slay ourselves. Where we
thought to travel outward, we will come to the center of our own
existence. And where we had thought to be alone, we will be with
all the world.”
-- Joseph Campbell, The Power of Myth
Stages of the Hero’s Journey
The Call
The Separation
The Adventure
The Return (Hero is ALWAYS changed)
The Agony of the Chrysalis
Rowing & Flowing:
The Sailboat Metaphor
To be Conscious is to be AWAKE!
I’m
AWAKE!
Seeing Ourselves Differently
Schopenhauer -
Embroidery
What do we do with this new-found insight?
Stay just as we
are?
Move to Tahiti as Gaugin
did?
Um, are you
sure you
don’t want
to call your
wife and
kids?
The Journey is frightening and we
have a natural desire to get over it!
JUST DO IT!!!!!!!
Holding the Tension of the Opposites
Tools for the Journey
Dreamwork
Containers
Meditation, Prayer, Silence
Creative Expression
Physical Body
Stay in the Present
“Stay here, quivering with each
moment, like a drop of mercury.”
-- Rumi
On Tigers and Goats
Late Bloomers &
Don’t Die Guessing
Day Two - Morning
The Dark Night of the Soul
Why suffering offers both danger and opportunity
Real versus “Neurotic” suffering
12 strategies for letting go of unnecessary
suffering
Why we are destined to search for meaning
The power of optimism and internal locus of
control and their effects on resiliency
12 practical strategies for growth through hard
times
Better or Bitter?
The Phoenix
“What does not destroy
me,
makes me stronger.”
-- Friedrich Nietzsche
Expansion of Consciousness
The Expansion of Consciousness Leads
to:
The Search for Meaning
“Once an individual’s search for meaning is
successful, it not only renders him happy but also
gives him the capability to cope with suffering.”
-- Viktor Frankl, Man’s Search for Meaning
Real versus Neurotic
Suffering
“Real suffering burns clean; neurotic
suffering creates more and more soot.”
-- Marion Woodman (Author and Jungian Analyst)
Real Suffering Cannot be Avoided
“Real suffering is an authentic and realistic response to the
ragged wounds of living a human life. It’s also unavoidable and
an essential part of every human life. Illness, loss of loved
ones, disappointment, decline, death, limitations, and
imperfections startle and shake us. But they awaken us to find
meaning, dignity, and significance in our lives. They open the
heart to pure compassion and newfound creative energy. Real
suffering is useful. It propels us to new levels of consciousness
and self-knowledge. It is through suffering and pain that we
break down our habitual barriers between ourselves and others
and allow for the entrance of a transpersonal, transcendent
perspective: a full appreciation of our intimate and profound
spiritual connections.” -- From “After the Darkest Hour” pg.
21
Neurotic Suffering Can Be Avoided
Neurotic suffering offers no meaning. Jung called
it “an unconscious fraud,” declared it bogus and
with no moral merit. Neurotic suffering is a flight
from the wounds of life and an unconscious – and
unsuccessful – attempt to heal them. Neurotic
suffering is a refusal to discover the meaning in
our pain through a childish insistence that things
should be as we want them to be and not as they
are. It is expressed as self-pity and envy toward
people whose lives seem better or less difficult.
-- From “After the Darkest Hour” pg. 22
On the True Nature of Reality
Or
The Absolute Truth About Life
The Wheel of Life
The Consolation of Philosophy
(De consolatione philosophiae)
Anicius Manlius Severinus
Boethius (480-524 C.E.)
Everyone’s life is a drama
The Story of Kisagotami
“God sends rain on the righteous
and unrighteous alike.”
-- Matthew 5:45
Buddhism’s First Noble Truth
“Life is Suffering.”
Accurate Translation:
Life is dukkha.
Dissatisfaction,
discontent, dislocated
A Few True Things
• Change is the natural order of the
universe
• Change always incorporates loss
• We cannot control all the events of our
lives but we can control our responses
to them
• There are hidden gifts in suffering
We cannot determine the events of our life,
but we can determine our responses to
them.
Gifts Hidden in Suffering
Or
Turning Lead Into Gold
“God does not want us to be burdened because of
sorrows and tempests that happen in our lives, because
it has always been so before miracles happen.”
-- Julian of Norwich, 14th Century Mystic
“It is by going down into the abyss that we recover the
treasures of life.”
-- Joseph Campbell
How prepared are you for the
inevitabilities of a human life?
• Straw Houses
• Illusions
The Problem with Straw Houses
Overflowing Glass
Stress, suffering, pain,
hard times, challenges
How full is
your glass?
Principles of Deductive Logic
A specific conclusion will be
accepted based on one or
more premises. If the
premises are true, then the
conclusion must also be true.
Thus, if A (a general
statement) is true and B(a
specific statement) is true,
then C (the conclusion)must
also be true. Yada, yada,
yada.
Deductive Reasoning Syllogism
A. All normal dogs are born with one head and
four legs. (General Statement)
B. Dorothy is a normal dog. (Specific Statement)
C. Dorothy has one head and four legs.
(Conclusion)
Hey, that’s true!
Psst.
Here’s the
BIG
SECRET!
Negative Self-Image Leads to Suffering
Because…
The unconscious cannot
differentiate between false versus
true premises as it draws all of its
conclusions by way of deductive
logic syllogisms.
Premise A**: I am worthless, stupid,
and will never amount to anything.
(General)
Premise B: I failed my exam.
(Specific)
Conclusion C: I truly am worthless
and stupid. I’ll never amount to
anything.
**Premises based on one’s history, experience, belief system,
Ways You Can Tell You Are Adding to Your
Suffering Through Negative Self-Image
“That’s just the way I am.”
“I could never do that well.”
“People like me can’t ______ (be
successful, change, overcome obstacles,
learn to tap dance, fill in your own “can’t”).
Any number of Self-Fulfilling Prophecies.
Learned
Helplessness
Commonly-Held Illusions and Suffering
Life is fair.
I’m immune from Life’s realities.
I’m in total control. I create my life.
If something bad happens to me, I
must have done something to deserve
it.
Beyond Resiliency
“Resiliency” from the Latin resilire – “to spring back.”
Luck, Destiny & Free Will
Good Luck? Bad Luck? Who Knows?
“Do you have the patience to wait
till your mud settles and the water is
clear? Can you remain unmoving till
the right action arises by itself?”
-- Tao te Ching
The Three Fates
Lachesis – The Lot
Giver
Klotho – The Spinner
Atropos – The Inflexible
Locus of Control
(A Continuum)
Internal External
Locus of Control Locus of Control
Free Will Vs. Destiny
Rowing AND Flowing
The Middle Way
The Path With Heart
“Look at every path closely and deliberately.
Then ask yourself and yourself alone one
question…Does this path have a heart? If it
does, the path is good. If it doesn’t, it is of
no use.” -- Don Juan, Yaqui sorcerer
Ways We Add to Suffering
• Resistance to change
• Expectation that life is always fair
• The illusion of egoism
• Failure to take responsibility for responses
• Ruminative suffering
• Failure of compassion
• Unconscious approach to life
12 Strategies
For
Growing Through Suffering
#1 Discover a Larger Perspective
The Eagle Nebula – 7 Million Light Years Away
Some Ways of Discovering a Larger
Perspective
Explore religious & spiritual traditions
Read about your own tradition
Take classes in philosophy, metaphysics
or other disciplines
Investigate your family genealogy
Look to nature
Write down or sketch your thoughts and
reflections
#2 Turn Toward Compassion and
Help Others
Look at the things you say to yourself
when you’re in pain
Find a voice that expresses
compassion to others AND to yourself
Fuel your compassion with action –
Volunteer
#3 Recognize and Stop Self-Imposed
Suffering
Listen to the wake-up calls about the things you do in your
life
Look honestly at your feelings about yourself
Surround yourself with good company and lovingly avoid
negative people
Forgive yourself
Change your inner self-talk
Don’t set perfectionistic goals
Celebrate your strengths and achievements
Gravel in Your Knee Can Hurt for a Lifetime
Holding on to a Negative Self-
Image
Believing in Illusions
Avoiding fixing things that can and
will lead to suffering
#4 Practice Mindfulness
“Stay here, quivering with each
moment, like a drop of mercury.”
-- Rumi
Practice Mindfulness
Practice daily meditation
Read books about mindfulness
Tap into community support (e.g., yoga)
Find your unique path
Live in the present moment
Let yourself feel everything
#5 Grieve
“We’re healed from suffering only by
experiencing our grief to the full.”
-- Marcel Proust
Grieve
Recognize and acknowledge when you are
grieving
Let yourself feel the pain
Sometimes find diversions
Express your sorrow, Talk about it
Forgive yourself
Take care of your physical self
Be aware of “anniversary reactions”
Get help if you need it
Help others through their grief
#6 Build Good Containers
“No Soul is desolate so long as there is a human
being for whom it can feel trust and reverence.”
-- George Eliot
“We are here to awaken from the illusion of our
separateness.”
-- Thich Nhat Hanh
Containers
Shore up your connections in your
family by frequent contact
Create a family from friends
Build your containers BEFORE you
need them
Be a good container to others in your
life
#7 Count Your Blessings &
Discover the Power of
Optimism
“No pessimist ever discovered the secrets of
the stars, or sailed to an uncharted land, or
opened a new heaven to the human spirit.”
-- Helen Keller
Optimistic versus Pessimistic Cognitions During Hard Times
Optimistic Pessimistic
Temporary Permanent
Specific Pervasive
External Personal
Source: Martin Seligman, Learned Optimism
Blessings & Optimism
Always, and particularly during hard times,
look around at the blessings in your life
Calm your mind through meditation, yoga,
quiet time alone, and nature
Look at your own levels of optimism and
pessimism. How do you rate yourself?
Share the blessings you have with others
#8 Find Courageous Role Models &
The Hero Within
“Avoiding danger is no safer in the long
run than outright exposure. Life is either a
daring adventure or it is nothing.”
-- Helen Keller
Role Models & The Inner Hero
Sit quietly and reflect on your heroes
Study to learn more about them
Write a story – how would your hero
deal with your present challenge?
#9 Keep a Sense of Humor
“Humor is a prelude to faith and laughter is the
beginning of prayer.”
-- Reinhold Niebuhr
Humor
Don’t ever be afraid to step back
from your suffering and laugh
Share your laughter with others
#10 Express Your
Feelings
“There is no grief like the grief
which does not speak.”
-- Henry Wadsworth Longfellow
Express Yourself
Talk about your suffering with a friend of
therapist
Listen to others when they need an ear
Express your suffering through art or
ritual Process
and the
Story of the
Chinese Potter
#11 Silence, Prayer & Meditation
“There is nothing in all creation so
like God as stillness.”
-- Meister Eckhart
Silence, Prayer & Meditation
Set aside time each day to meditate or pray
Read, practice and learn about the many types of
meditation and prayer
Discover the joys of prayer and meditation with
others through a place of worship
Learn to love silence
Ask your friends and family to keep you in their
prayers
#12 Come to Your Life Like a Warrior
“The difference between an ordinary person and a
warrior, is that a warrior takes everything as a
challenge while an ordinary man takes everything
as either a blessing or a curse.”
-- Don Juan, Yaqui Sorcerer
The Search for Shambhala
The ABC’s of Living as a Warrior
A Awareness
B Bravery
C Compassion
D Discipline
Live Like a Warrior
Gently but honestly look at yourself and your
life in relations to the four warrior characteristics.
Where are you strong? Where do you need
work?
Work out a specific plan to keep yourself
physically, psychologically, and spiritually strong.
Every morning ask yourself one question:
“What do I need to do today to take greater
responsibility for my life and live with the
passionate vitality of a warrior?”
This being human is a guest
house…
“Open the door to your guest house.
Say “yes” to all of your life. Choose to
live joyfully even in your pain. Love
yourself and everyone else. Be
present always – alive to every
moment. Grieve when you should,
fight when you can, accept when you
must. But above all, say yes.”
-- From “After the Darkest Hour” pg. 262
Day Two - Afternoon
The Illusion of Separateness
and the Power of Connection
Resolving the dialectic between the ego and the
Self
What we know about belongingness and health
Why connection is and antidote to illness and a
precursor to vibrant health
Ten vigorous approaches to help patients enrich
their relationships
Become a Lake
“We are here to awaken from the illusion of our separateness.”
-- Thich Nhat Hanh, Vietnamese Buddhist Monk
The Landscape of Connection
The Biology of Belonging
The Psychology of Belonging
The Nature of Attachment
The Failure of Attachment
The Evidence for the Power of Connection
Social Capital and Where We Collectively Stand
The Usual Suspects
A New Paradigm/Honoring the Wake-Up Call
A Thousand Words for Snow
A Social Animal
“By our very natures, humans are prepared
to be social animals. We are biologically and
psychologically prepared for attachment and
bonding. Our need for connection is – from
birth and beyond – a fundamental survival
need.”
-- Living a Connected Life
Some Evidence for
Human Sociability
Infants cry at sound of another infant’s cry.
Menstrual synchronization.
Without touch and closeness, infants die.
Fine tuning of thousands of physiological events
– blood pressure, heart rate, body temperature,
sugar levels, hormones and salts are affected by
others and they, in turn by us.
Heart-to-Heart.
Attachment is Not Just In The Brain
“It is only with the heart that one can see rightly.
For that which is essential is invisible to the eye.”
-- Antoine de Saint-Exupéry “The Little Prince”
Attachments of the Heart
The heart forms in the developing fetus before the brain (within the
first 18 days post-conception) and a regular heartbeat can be measured
within days of that.
Heartbeat is “auto-rhythmic” self-initiated from within the heart itself.
Generates the strongest electromagnetic field produced by the body
(40-60% more amplitude than the brain).
Electricity generated by the heart can be measured in the brain waves
of another person when people are touching or near one another
(measured up to 12 feet).
Entrainment – heart cells from two different people will begin to beat
together even when in two separate petri dishes – synchronization.
Human Infants and Baby Sea Turtles
Compared to every other species,
human infants are born premature
and must continue to develop
outside the womb. We’re
biologically hardwired to ripen
through loving, secure experiences
with caregivers.
Psychology and Biology of Belongingness
Brain Development in Infants
75% of Brain develops after birth through experience
100 billion neurons and trillions of glial (“glue”) cells
Interconnections are most critical and forming
Changes 100,000 times more rapidly than an adult brain
Consumes far more calories than adult brain (65% v 15%)
Pre-wired and Pruning (“use it or lose it”)
Synaptic pathways
Renée Spitz Research – 1940’s
Infants taken from felon mothers and raised in “sterile
nurseries” where they were fed but not handled or cuddled:
Failed to thrive and were diminished in height and weight
for their age
Developed brains that were 20-30% smaller than normal
25% died within the first year. 37% died within the second
year
Ironically, 40% of the infants who contracted measles died
when the mortality rate outside the institution was only .5%
Scored 72 on the WISC (average intelligence is 90-105)
John Bowlby
“The Father of Attachment Theory”
Bowlby said human attachment
was much more like imprinting in
geese and less like the reward
and punishment schedules that
allowed behaviorists to make
rats run mazes or shape pigeons
to peck levers. Attachment is
innate and neurologically based -
Konrad Lorenz and baby geese An instinctive reciprocal
relationships with implications
for the survival of the species.
Harlow’s Monkeys – 1960s
Infant rhesus monkeys separated from
their mothers were apathetic, sometimes
hyperagitated, aggressive and given to
outbursts of violence. The were socially
inept, highly fearful, failed to interact
normally, showed inappropriate sexual
responses and often rocked like autistic
children. As adults – the females were
not able to care for their offspring,
would not breastfeed, and behaved
violently toward their babies.
Attachment: An Exquisite Dance
Mother/Infant Proximity
& Breastfeeding
Balances levels of cortisol (a stress hormone) in
the infant and sends messages to the brain to make
connections
Flood of prolactin and oxytocin in mother
(“mothering hormones”)
Infant’s core body temperature coordinates with
that of her mother (called “thermoregulation”)
Interval of their heartbeats is the same
Fathering and Attachment
Not as clear as research with mothers – probably
because little research attention has been paid to
attachment and human fathers
New research is documenting dramatic endocrinological
changes for fathers in preparation for and after the birth of
offspring. Clear effects of paternity in several species of
mammals and rodents and most species of birds
Human fathers – reduction in salivary testosterone in
response to infant’s cries
Fathers’ levels of cortisol, prolactin and testosterone
changed dramatically during partner’s pregnancy
Infants Are Born Ready to Relate
Hearing is fully developed at birth –
the developing fetus has taken in 60%
of the sounds surrounding his/her mother
Even 2-day old infants show a decided preference for
human sounds and music over all other sounds
Preprogrammed to look for and see human faces – will
orient to a mask if it has two eyes, a smooth forehead, a
nose and moves. A mouth is not necessary! Between 3-6
months, infants smile – “innate releasing mechanism”
Can discriminate between miniscule changes in emotional
responsiveness of people around them
Erik Erikson’s 8 Stages
of Human PsychoSocial Development
1. Trust/Mistrust (Infancy – ages 1 or 2)
2. Autonomy/Shame (ages 2-4)
3. Initiative/Guilt (ages 4-6 – formal school)
4. Inferiority/Inferiority (“school age”)
5. Identity/Identity Diffusion (Adolescence)
6. Intimacy/Isolation (Young Adult)
7. Generativity/Self-Absorption (Adulthood)
8. Integrity/Despair (Maturity)
Mastering Trust/Distrust
When an infant learns to trust others, herself, and the
environment when her physical and emotional needs are
met and she is free from uncertainty, feels safe and
protected, develops secure attachments, and knows that
others will help and care for her. With this early
experience, the infant will grow into a person with
abilities to form and maintain relationships. She will
have positive expectations about others and a long-
standing belief in her own worthiness and the
expectation that the world can be a safe place.
Failing to Master Trust/Distrust
If the infant cannot (for any reason) master the
challenge of trust/mistrust, she will carry
remnants of this uncompleted task into the next
and subsequent stages of development and
mover through life with high levels of fear and
insecurity. As an adult, she will see the world as
an unfriendly, unpredictable, and chaotic place
and will be unlikely to develop deep and intimate
relationships with others.
Types of Attachment
1. Secure – Upset at mother’s departure and easily soothed
when she returned (about 70% of infants tested this way
in the “Strange situation”)
2. Insecure/Avoidant – May or may not be distressed at
mother’s departure but avoided or turned away from
mother on her return
3. Insecure/Ambivalent – Distressed at mother’s departure
but seeks both comfort and distance on mother’s return.
Crying and reaching to be held but attempting to get away
once picked up. Actively or passively showed hostility to
mother
Mary Ainsworth et al
Attachment: When Things Go Wrong
“Needy,” lonely, disaffected, pessimistic
High levels of psychological (e.g., low self-esteem,
depression, anxiety) and physical problems (e.g., failure to
thrive, infections, chronic illness)
Antisocial: sometimes aggressive or violent
Difficulties with trust, intimacy & affection
Attachment Disorders form a continuum bounded on one
end by “secure attachment” and the other by the most severe
Reactive Attachment Disorder (RAD) e.g., Romanian Orphans (1960s – 1990s)
Reactive Attachment Disorder
Sad Statistics
Attachment disorder is transmitted intergenerationally. Children lacking
secure attachments with caregivers commonly grow up to be parents who
are incapable of establishing this crucial foundation with their own
children. Instead of following the instinct to protect, nurture and love their
children, they abuse, neglect and abandon. The situation is out of control.
Consider the following:
The number of children seriously injured by maltreatment quadrupled
from 1986 (140,000) to 1993 (600,000).
Three million cases of maltreatment were investigated by Child
Protective Services in 1995. Over one million were confirmed as serious
abuse and/or neglect with risk for continued maltreatment. Surveys
indicated the actual number of cases are 10 to 16 times higher.
Child Protective Services are unable to handle the vast increases; only
28% of seriously maltreated children were evaluated in 1993 compared to
45% in 1986.
Source: www.attachmentdisorder.net
Symptoms of Reactive Attachment Disorder
1. Behavior: oppositional and defiant, impulsive, destructive, lie and steal, aggressive and
abusive, hyperactive, self-destructive, cruel to animals, irresponsible, fire setting.
2. Emotions: intense anger and temper, sad, depressed and hopeless, moody, fearful and
anxious (although often hidden), irritable, inappropriate emotional reactions.
3. Thoughts: negative beliefs about self, relationships, and life in general ("negative
working model"), lack of cause-and-effect thinking, attention and learning problems.
4. Relationships: lacks trust, controlling ("bossy"), manipulative, does not give or receive
genuine affection and love, indiscriminately affectionate with strangers, unstable peer
relationships, blames others for own mistakes or problems, victimizes others/victimized.
5. Physical: poor hygiene, tactilely defensive, enuresis and encopresis, accident prone,
high pain tolerance, genetic predispositions (e.g., depression, hyperactivity).
6. Moral/Spiritual: lack of faith, compassion, remorse, meaning and other prosocial values,
identification with evil and the dark side of life.
Source: www.attachmentdisorder.net
Our History MAY Become Our Future
Habits are formed through repetition
Psychological and neurological “ruts”
(Synaptic pathways)
Negative self-image, internal self-talk,
self-defeating beliefs
Lack of skills required for intimate connections
The Good News! People can change through insight and action!
Specialized Therapy is necessary for severe cases of attachment disorder.
Attachment:
When Things Go Right
“Secure adults find it relatively easy to get close to
others. They’re happy, socially competent people
with high levels of resiliency and persistence. They
don’t worry about being abandoned or having
someone close to them. They’re “emotionally
intelligent,” empathetic with others, solve many
problems on their own but aren’t reluctant to ask
others for help when they need it. They maintain
close, intimate connections with others.”
– Living a Connected Life
Maslow’s Hierarchy of Needs
Well, You Got To Have Friends
Loneliness breaks the spirit
-- Jewish Proverb
The Power of
Connection/Belongingness
“If you could do just one thing that would lengthen
your life, help you stay psychologically and
physically healthy, and support your healing when
you did become ill, you would maintain strong
connections to other people. The effects of
belongingness are so potent that if they could be
bottled, they would need FDA approval.”
-- Living A Connected Life
The Early Evidence
As early as 1897, French Sociologist
Emile Durkheim observed that one
could predict rates of suicide by looking
at the quality of social ties in an area.
In areas where there was strong “social
solidarity”, suicide rates were low.
Areas where social ties were weak had
much higher rates of suicide.
The Roseto Effect – 1950s
A small town in Pennsylvania – A close-knit community of
Italian immigrants who lived longer lives than people in
neighboring towns and were virtually free of heart disease.
Had they found the alchemical Elixir Vitae?
No! They had high levels of social cohesion, trust, and
mutual respect. They were connected.
From 1979 to 1994, eight large-scale
community-based studies confirmed
what those early researchers found
in Roseto.
Scientific Studies
Five decades of medical and epidemiological
research has shown the powerful and positive
effects of connections on:
Heart and cardiovascular disease
Stroke
Respiratory Diseases
Cancer
Allergies, Colds, and other Infectious Diseases
AIDS/HIV
Depression, Stress and other Psychological Problems
Positive Effects of Connections
In his book Love and Survival: The Scientific
Basis for the Healing Power of Intimacy,
physician Dean Ornish summarizes the power of
connections this way: “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.”
Interesting Gender Difference
When women are stressed – they move toward greater
connection with other (“Tend and Befriend” rather than
“Fight or Flight”).
Men under stress tend to “hole up.”
Women respond to stress with a surge of brain chemicals
(such as oxytocin) that buffer the “fight or flight” response,
pushes them toward social contact, which releases more
oxytocin which calms them further. Estrogen (a female
hormone) has an enhancing effect on oxytocin whereas
testosterone (a male hormone) reduces it.
Klein, Laura & Taylor, Shelley (UCLA Stress Research Lab), 2002
“Social Capital”
Social capital is the “glue” that holds
societies together and refers to the
quality and depth of relationships
between people in a community.
The Collective Benefits of High Social Capital
Joining one group cuts your odds of dying over the next year in half.
Joining two groups cuts it in quarter.
Communities with higher levels of social capital produce children with
higher SAT scores and higher performance on a broad range of testing.
Communities with higher social capital have lower dropout rates, higher
retention, and less youth violence.
The more connected we are in our community, the less colds, heart
attacks, strokes, cancer, depression, and premature death we experience.
The higher the social capital, the less murders and violent crimes in our
neighborhood.
Blood donations are higher in communities with high social capital.
Road rage is reduced in communities with high social capital.
Measured happiness goes up when we are socially connected in mutually
respectful, trusting relationships based on exchange and reciprocity.
The Sorry State of Our Connections
Family dinners and family vacations or even just sitting and
talking with your family are down by one third in last 25 years.
Having friends over to the house is down by 45 percent over
the last 25 years.
Participation in clubs and civic organizations has been cut by
more than half over last 25 years.
Involvement in community life, such as public meetings is
down by 35 percent over last 25 years.
Church attendance is down by roughly one third since 1960s.
Philanthropy as fraction of income is down by nearly one
third since the 1960s.
How Connected Are You?
How many of your neighbors’ first names do you know?
How often do you attend parades or festivals?
Do you volunteer at your kids’ school? Or help out senior citizens?
Do you trust your local police?
Do you know who your U.S. senators are?
Do you attend religious services? Or go to the theater?
Do you sign petitions? Or attend neighborhood meetings?
Do you think the people running your community, care about you?
Can you make a difference?
How often do you visit with friends or family?
The Social Capital Community Benchmark Study – www.bettertogether.org
The Usual Suspects
for our Dwindling Social Capital
Mobility
Where You Live
Sprawl
Not Enough Time
Television
Technology
Breakdown of Traditional Families
Women in the Labor Force
Generational Effects
Mobility
U.S. Census Bureau reports that residential
mobility has been exceedlingly constant over
the past 50 years, but if anything, we’re
relocating LESS now than in the 1950s (when
social capital was high by every measure)
1950s = 20% of Americans moved each
year compared to 16% (1999). Dismissed
!
Adding to the stability of present-day
communities, home ownership in 1999 was at
a record-setting high (67%).
Where You Live
Residents of large metro areas compared
to small-town counterparts are less likely to
join groups, attend club or public meetings,
attend church, or visit with friends.
BUT – metro residents are only about
10% less trusting and join different kinds of Dismissed
groups – More nationality-based and !
political clubs while smaller cities have
more veterans’, fraternal, agricultural,
service, and church groups.
Sprawl
Suburban sprawl has created an
environment in which most Americans no
longer live where they work
The average commuter spends 72 minutes
every day behind the wheel and most
commute alone (2/3 of all car trips are made Get back in the
alone) lineup, son!
Commuting represents twice as much time
as the average parent spends with kids
Every ten minutes of additional commuting
time cuts all forms of social capital by 10%
Not Enough Time
Time-use studies show that leisure
time from 1965 to 1985 actually
increased by 5 hours per week
The average American schedule has
more than 40 hours a week that could Dismissed
be used to make deposits into our !
social capital account
Question of priorities, not of time
Television
Americans spend more hours alone in front of their TV sets
(3-4 hours per day) than in any other activity except work & sleep
TV watching accounts for more than ½ of all leisure time activity
Heavy television watchers are more likely to be pessimistic,
overestimate crime rates, and spend less time engaged with others
The only leisure time activity that is associated with decreased
(rather than increased) social capital Get back in
the lineup!
“The data suggest that most Americans would rather watch
Friends than have friends.” – Robert Putnam, Bowling Alone
Longer work hours are associated with more (not less) civic
engagement and connections (e.g., report 30% less TV)
Technology
Some studies suggest that people who
spend a great deal of time on the Internet are
less connected to other socially.
Other studies have shown that technology
has enormous power to create and maintain
relationships. The Jury is Out!
“The Digital Divide” is a serious social issue.
Conscious use of technology needs further
exploration.
Breakdown of Traditional Families
Strong families increase social capital – at the core of our
sense of connection, belongingness
Changes in basic structure of family: number of married
Americans has declined from 74% (1974) to 56% (1998); ½ of all
first marriages end in divorce
BUT, the sharpest jump in the divorce rate occurred in the
1970s – “long after the cohorts who show the sharpest declines in
connection and social trust had left home”
Traditional family structure only associated with churchgoing Dismissed
and youth-related activities. Single and divorced people are more !
likely to attend club meetings and hang out with friends. Married
folks more likely to have dinner parties
Divorce and changes in structure of families have only a
moderate effect on social capital
Women in the Labor Force
In the 1960s only 37% of women held jobs
outside the home, 60% of women now do (2003)
Men belong to more groups, but women spend
more time with the ones to which they belong
Women who work outside the home actually
Dismissed
spent more time with clubs and organizations !
than women who did not work outside the home
Working outside the home or not, women still
spend more time in informal socializing than men
Generational Effects
Throughout the life cycle, people born before
1932 experienced more civic involvement, trust
between people, feelings of belongingness, and
relationships to neighbors and groups Get back in
the lineup!
“The Greatest Generation” vote more often
(double the rate for other generations), trust
people more (60% compared to 25% for their
grandchildren) and are more engaged in civic
and neighborhood life – they’re more connected
Robert Putnam et al. Saguaro Seminar
John F. Kennedy School of Government, Harvard University
Analyzing the Guilty Suspects
Generational Effects 40-50%
TV 20-25%
TV Generation 10-15%
Sprawl 10%
Work/Time Pressures 10%
A Terrifying Prophecy
“Creating (or recreating) social capital is no
simple task. It would be eased by a palpable
national crisis, like war or depression or natural
disaster, but or better and for worse, America at
the dawn of the new century faces no such
galvanizing crisis.”
-- Robert Putnam (2000)
…until now
September 11, 2001
A Changed and Changing World – Post 9/11?
Americans dramatically shifted their stated
priorities after the terrorist attacks of
September 11, 2001. Multiple polls showed
we said we wanted closer connections, and
more time with our friends and family. But,
unfortunately, this shift in values didn’t last
very long. By the spring of 2002, the surveys
showed we were back to business as usual.
Honoring the Wake-Up Call
Crisis and Opportunity
Paradigm shift
Establishing Values & Priorities
Respecting the Yin
What is Old Can Become New
Indigenous Cultures are strong in places where ours is weak:
Native American Tribes
Hawaiian hanai and ho’oponopono and aloha
Canela people of Brazil
The Downside of “Belongingness”
Al-Qaeda, Nazisim, Aum Shinrikyo, Gangs
Everything of substance casts a shadow
Closed systems
No respect for individuality/diversity
Patriotism becomes jingoism
“Us” v. “Them”
Deference to authority and conformity
abounds
Fragments, polarizes & abuses
Collective and Individual Balance
Both ruthless collectivism and rugged individualism are
unbalanced and destructive to human life. Either one in its
extreme form fails to provide the kind of society that
allows human beings to flourish in their individual
achievements and freedoms while nestled in the loving
embrace of community, social responsibility, and safe
harbors.
Integration of Dualities
As in all dualities, the
wise strive to “hold the
tension of the opposites”
to integrate and balance
opposing forces as we
walk in both worlds.
Balance
Yin Yang
Feminine Masculine
Passive Active
Dark Light
Eros Logos
Right Brain Left Brain
Moon Sun
“Shady Side of the Mountain” “Sunny Side of the Mountain”
Yielding Aggressive
Unconscious Conscious
Emotion Reason
Relatedness, Communalism Individualism, Separatism
Open Systems Closed Systems
A Thousand Words For Snow
Assumptions for the Model
1. Everyone needs a variety of people and relationships in their lives
2. Relationships are not static; they change, as do our lives and needs.
3. Think of the “rings” in the model as semi-permeable membranes
4. It is the inner circle of relationships – those with whom we are
connected by the heart – that constitute our “tribe” or true safety net.
These are the containers that serve as our containers for emotional and
spiritual growth
5. With the possible exception of our biological family, most relationships
do not begin within this inner circle
6. Don’t mistake the “map” for the “territory” – life is really more complex
than any model can describe
The World At Large
Global Planet
Non-local Consciousness, Subatomic Particles
and Random Event Generating Machines
The Power of Love
More opportunities for connection than you
may ever have realized
Mitakye Oyasin and Namaste
Not Quite Strangers
& Acquaintances
We may have hundreds of people in our network
of “not quite strangers” who are wrested from the
great web of being
Friendship develops when one person says to
another, “What! you, too? I thought I was the only
one!” (C.S. Lewis)
Moving Closer to the Center
Shared values more important than shared interests.
But shared interests are a good place to start
Move relationship out of its original context (e.g., ask a
co-worker to your daughter’s wedding)
Original context makes a difference (Chinese saying:
“We will often forget those we’ve laughed with. We will
never forget those we’ve cried with.”) A refiner’s fire
Unexplainable chemistry
Friends For A Season or Reason
May have a number of “casual”
friends but are tied together for a
season or reason
When season or reason changes,
friend may not be so close
Our expectations should be realistic
These friends may become attached-
at-the-heart with time and nurturance
Attached-At-The-Heart Friends
“My friends are my estate.” Emily Dickinson
“A Friend is a single soul dwelling in two bodies.” Aristotle
“One loyal friend is worth ten thousand relatives.”
Euripides
“Friends are the masterpiece of nature.” Emerson
“Friend, our relationship is this that wherever you put
your foot, you feel me in the firmness under you.” Rumi
“Friendship? Yes, please.” Charles Dickens
Our Safe Harbor
Plato – searching for our missing half
Fictive Kin and Aunt Franny
Last a lifetime, call at 3 AM, good times/bad times
Celtic Anam Cara (“Soul Friend”)
Ceremonies pledging unconditional loyalty:
•“Blood brother” (Native American)
• Hawaiian pili hoaloha
• German & Swiss Duzen (to address informally)
The State of YOUR Safe Harbor
A Map To Connection
Your Friendship Values
Know Thyself
Social Skills
Acceptance – Are you a friend?
Boundaries: Armor, Gelatin, and semi-permeable membranes
Communication Revolution
Good Times/Bad Times
That Time Thing
“We have all known the long loneliness and
we have learned that the only solution is love
and that love comes with community.”
-- Dorothy Day, humanitarian and founder
of the Catholic Worker Movement, 1933
Your Friendship Values
Values are the foundation upon which
everything else relies
Conscious understanding and living one’s values
Yogi Berra – “If you don’t know where you’re
going, you’ll end up somewhere else.”
Rocks in a Mason Jar
Know Thyself
You can’t have a better relationship with
anyone else than the one you have with yourself
What do you bring into your relationships?
How well do you know yourself?
The Persona and The Shadow
Emotional Intelligence (EQ)
“To know others is to be wise, to know oneself
is to be enlightened” – Tao Te Ching
Social Skills
“Great news! 1. Verbal Aspects
You can learn
social skills
just like I did!
Self-Disclosure
Let’s do
lunch!” Me, Me, Me – The Song of Narcissism
Listening Skills
2. Non-Verbal Aspects
3. Cognitive Aspects (self-defeating beliefs
and negative self-talk)
4. Emotional and Physiological Aspects
Acceptance: Are You A Friend?
Similarities and Differences
The Futility of Seeking Perfection
Unconditional Love and Acceptance
Giving AND Receiving
Boundaries:
Armor, Gelatin & Semi-permeable Membranes
The importance of Interpersonal Boundaries
Turning Toward, Turning Against, Turning With
Unable to risk v. Co-Dependency
When friends hurt/Toxic relationships
Schopenhauer’s Porcupines
Communication Revolution
1. Express Yourself
Self-Disclosure
Clarity
Assertiveness
2. Advice and Truth
3. The fine (and lost) Art of Listening
4. The gift of communication technology
at the top of Mount Haleakala
Good Times/Bad Times
“Be more prompt to go to a friend in adversity
than in prosperity,” Chilo (6th Century BCE – Greek)
Two Travelers and the Bear (Aesop)
Ch-Ch-Ch-Changes (“Friendshifts” – Jan Yager)
Shared Interests/Shared Values
History and Remembrance
That Time Thing
“If you want to make good use of your time, you’ve
got to know what’s important and then give it all
you’ve got,” -- Lee Iacocca
Identify your use of time
Analyze your present situation
Develop a plan – short and long-term goals
Implement your plan
Re-evaluate your use of time
Lessons From Toulouse
Be patient, persistent, never give up
Welcome the stranger
Finding Your Pack
“Wolves love to howl. When it is started, they
instantly seek contact with one another, troop
together, fur to fur. Some wolves will run from any
distance, panting and bright-eyed, to join in,
uttering, as they near, fervent little wows, jaws
wide, hardly able to wait to sing.”
– Lois Crisler, Arctic Wild
There is no house like the house of belonging.
David Whyte, poet
Day Two - Afternoon
Spirituality, Healing and Clinical Practice
The connection between spirituality and health –
what the research tells us
A paradigm shift integrating science and soul
Ethical considerations in spirituality and healing
Reframing illness as an opportunity for spiritual
growth
The metaphysics of health
How to forge healing alliances with patients
Toward a new psychology of clinical behavioral
medicine
Spirituality, Healing, and
Clinical Practice in 1910
“Nothing in life is more wonderful than faith -
- the one great moving force which we can
neither weigh in the balance nor test in the
crucible…mysterious, indefinable, known only
by its effects, faith pours out an unfailing
stream of energy while abating neither jot
nor tittle of its potency.”
Sir William Osler (1910). “The faith that heals,” British
Medical Journal, 1:1470-72.
Spirituality, Healing and Clinical Practice
Separation of Religion and Medicine
occurred between 1400 and 1800
Illness first addressed in religious/spiritual
terms
First documented surgical operation
First hospitals to care for sick in general pop
For 1400 years, church controlled medicine
Many early physicians were priests or monks
First nurses came from religious orders
Modern psychiatric care had origins in “moral”
treatment of the mentally ill
Spirituality and Health:
What People Believe
84% of Americans think that praying for the sick
improves their chances of recovery; 28% think
religion and medicine should be separate
70% of Americans say they pray often for the
health of a family member. Just 52% say they pray
for world peace and 27% say they pray for financial or
career success
72% of Americans say they would welcome a
conversation with their physician about faith
72% of Americans say they believe that praying to
God can cure someone – even if science says the
person doesn’t stand a chance
Source: Newsweek Poll, 2003
More Factoids
More than half of American Medical Schools now
offer courses in “spirituality and medicine” – up
from just three a decade ago
NIH will spend $3.5 million over the next several
years on mind/body medicine
Harvard Medical School held a conference on
spirituality and health, focusing on the healing
effects of forgiveness
More than ¾ of the more than 35,000 online
prayer circles are health related on Beliefnet.org –
a popular interfaith web site
The Empirical Data
Hypothesis Strength of Data
Church/service attendance promotes longer life Persuasive
Religion or spiritual protects against Moderate
cardiovascular disease
Being prayed for improves physical recovery Moderate
from acute illness
Religion/spirituality protects against cancer Inadequate
mortality
Religion/spirituality improves recovery from Very weak
acute illness
Religion/spirituality protects against disability Very weak
Religion/spirituality slows the progression of Very weak
cancer
Source: Powell. L.H. et. al. “Religion and Spirituality: Linkages to Physical Health”
American Psychologist, Vol. 58, No. 1, January 2003
Life Expectancy:
One of the clearest health benefits of religion:
churchgoers live longer than others
Attendance Death Age
No Church 75
Less than 80
weekly
Once per week 82
More than 83
weekly
Living Well:
Churchgoing promotes healthy habits:
Weekly attenders are more likely to make
positive changes
Life Change Likelihood
Less Depressed +131%
Quit Smoking +78%
More Exercise +54%
Stopped Drinking +39%
U.S. Life Expectancy at Age 20
by Religious Attendance
Study sample: reviewing findings from
three national surveys totaling more than
5,600 older Americans
Study results: Attending religious services
was linked with improved physical health or
personal well-being.
Other studies: 12 other studies published
since 1980 found persons in organized
religious activity had higher levels of life
satisfaction.
Levin JS, Chatters LM. “Religion, health, and psychological well-being in older
adults: findings from three national surveys.” Journal of Aging Health
1998;10(4):504-531.
Meditation, Prayer, Chanting
Changes brain activity
Improves immune response
Lowers heart rate and blood
pressure
Reduces the body’s stress response
The Evidence Mounts…
In a national trial of 750 patients
undergoing heart catheterization or
angioplasty, patients who were prayed for
and who also received a special program of
music, therapeutic touch, and guided
imagery had death rates 30% lower than
the group that received standard care or
the group who was only prayed for.
Source: Mitchell Krucoff, M.D. Duke University. Research
reported at the American College of Cardiology, October
2003.
…And Mounts
In a survey of 1,500 people, results
showed that people who forgive
easily tend to enjoy great
psychological well-being and have
less depression than those who hold
grudges.
Source: Neal Krause – University of Michigan School of Public
Health, 2003.
“There’s a physiology of forgiveness. When
you do not forgive, it will chew you up.”
Herbert Benson, M.D. Head of the Mind/Body Medical Institute,
Harvard University
Mind/Body Connection Well Documented:
Progress in psychoneuroimmunology
Stress and the immune system
Health behaviors and immune function
Stress and wound healing
Social support as a buffering factor
Cancer incidence and metastasis
Progress in cardiovascular physiology
Stress and cardiovascular function
Health behaviors and cardiovascular function
Meditating nuns have increased activity
(red) in regions used for concentration
Source: Andrew Newberg, M.D. Director of Clinical Nuclear Medicine,
Director of NeuroPET Research, and Assistant Professor in the Department
of Radiology at the Hospital of the University of Pennsylvania
Meditating nuns have decreased activity
(yellow) in areas promoting a sense of self
(e.g., ego)
Source: Andrew Newberg, M.D. Director of Clinical Nuclear Medicine,
Director of NeuroPET Research, and Assistant Professor in the Department
of Radiology at the Hospital of the University of Pennsylvania
Why Integrate Spirituality
Into Healing and Clinical Practice?
“For the more than 70 percent of the
population for whom religious commitment is
a central life factor, treatment approaches
devoid of spiritual sensitivity may provide an
alien values framework... a majority of the
population probably prefers an orientation...
that is sympathetic, or at least sensitive, to a
spiritual perspective. We need to better
perceive and respond to this public need.”
Bergin and Jensen, Psychotherapy 1990;27:3-7.
Spirit and Science
Is there a fundamental “disconnect”
between the nature of spirituality and the
methods of modern science?
There are problems with using scientific methodologies to
investigate essentially existential questions. For example:
How do you measure the power of prayer?
Can one person’s prayer be stronger – and more effective –
than another’s?
How do you separate the health benefits of going to
church/synagogue/mosque from the fact that people who attend
religious services tend to be less depressed and smoke less than
those who don’t?
Most research has been done using attendance at church as a
variable of interest. Measuring “spirituality” rather than church
attendance is a more complex research issue.
Are Spirituality and Science
Mutually Exclusive?
“Religion and science seem to be mutually
exclusive perspectives.”
Stark (1963). Journal for the Scientific Study of Religion, 3:3-20.
“Religion and science are mutually exclusive realms
of thought whose presentation in the same context
leads to misunderstanding of BOTH scientific theory
and religious belief.”
National Academy of Science (1984). “Science and creationism: A
view from the National Academy of Science.”
Ken Wilber’s Four Quadrant Model
Four Quadrants Simplified
Dangers in the Integration of
Spirituality and Health
1. We will impose our own spiritual
beliefs on patients/clients
2. Infer that people who are sick are
somehow spiritually inadequate
Negative Effects
Used to justify hatred, aggression, prejudice
Judgmental, alienating and exclusive
May be restricting and limiting, rather than
freeing
May induce excessive guilt (not enough “faith”)
(NOTE: Seriously ill patients who thought God was punishing or
abandoning them were up to 30% more likely to die over the next
two years (Source: Kenneth Pargament, Ph.D. Green State
University (Ohio) – study with 600 patients)
May encourage magical thinking, sacrifice of
intellect
May be used instead of medical care
• Failure to seek prenatal, obstetrical, and other medical care
• Failure to vaccinate children
• Stopping of medication to demonstrate faith
Illness does not result
from a lack of spirituality or faith
Suzuki Roshi (who brought Zen from Japan to
the U.S.) died from liver cancer
Saint Bernadette died at age 35 of
tuberculosis
Sri Ramana Maharishi – the most revered
saint in India – died of stomach cancer
Siddhartha (the Buddha) died from
food poisoning
… and even the Dalai Lama has to
wear glasses!
Physicians’ Top Five Barriers
to Addressing Patient Spiritual Needs
Lack of Time 71%
Lack of Training as to how 59%
to take a spiritual history
Uncertainty about how to 56%
identify patient’s with
spiritual needs
Concern about projecting 53%
own beliefs onto patients
Uncertainty about how to 49%
manage patient’s spiritual
needs
Ellis, M.R. et al. “Addressing spiritual concerns of patients’ family physicians
attitudes and practices.” Journal of Family Practice, 1999; 48 (2), 105-9.
Application of Spirituality to
HealthCare Practice
Take a religious/spiritual history
Identify religious/spiritual needs
Orchestrate resources to meet those needs
Keep patient-centered
Support religious beliefs patient finds helpful
Address religious/spiritual issues???
Pray with patients???
Prescribe religious practices to non-religious???
Network with local pastors/parish nurses
Source: Harold G. Koenig, Duke University Medical
Center. Address to Academy of Psychosomatic Medicine,
San Antonio, TX, November 2001
Respectful Questions
Is faith (religion, spirituality) important to
you in this illness?
Has faith (religion, spirituality) been
important to you at other times in your life?
Do have someone to talk to about
religious matters?
Would you like to explore religious matters
with someone?
Recommended by American College of Physicians-American Society of
Internal Medicine End-of-Life Care Consensus Panel. Lo, B., Quill, T., &
Tulsky, J. (1999). Discussing palliative care with patients. Annals of
Internal Medicine, 130, 744-749.
Summary of Research
on Spirituality and Health
Our current health care system has its origins
and roots in religious practice
Religiously involved people generally have
greater well-being and better mental health
Religiously involved people generally have
better physical health and live longer
Religiously involved people generally need
and use fewer health services
Sensitive application of these research
findings to clinical practice should be
considered
Source: Harold G. Koenig, Duke University Medical Center.
Address to Academy of Psychosomatic Medicine, San Antonio,
TX, November 2001
Thank You. Mitakuye Oyasin.
www.fullpotentialliving.com
252-473-4004
Good Friends: Kathleen & Dorothy